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Zhang X, Zhang Y, Xiu M, Zhang Y, Zhu B, Ou Y, Wang S, Zheng C. Independent risk evaluation associated with short-term black carbon exposure on mortality in two megacities of Yangtze River Delta, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163273. [PMID: 37028672 DOI: 10.1016/j.scitotenv.2023.163273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/19/2023] [Accepted: 03/31/2023] [Indexed: 05/27/2023]
Abstract
The adverse health effects of PM2.5 have been well demonstrated by many studies. However, as a component of PM2.5, evidence on the mortality risk of black carbon (BC) is still limited. In this study, based on the data of daily mean PM2.5 concentration, BC concentration, meteorological factors, total non-accidental (all-cause) and cardiovascular mortality in Shanghai and Nanjing during 2015-2016, a semi-parameter generalized additive model (GAM) in the time series and the constituent residual approach were employed to explore the exposure-response relationship between BC and human mortality in these two megacities of Yangtze River Delta, China. The main objective was to separate the health effects of BC from total PM2.5, and compare the difference of mortality ER related to BC original concentration and adjusted concentration after controlling PM2.5. Results showed that there were all significantly associated with daily mortality for PM2.5 and BC. The percentage excess risk (ER) increases in all-cause and cardiovascular categories were 1.68 % (95 % s 1.28, 2.08) and 2.16 % (95 % CI: 1.54, 2.79) with 1 μg/m3 increment in original BC concentration in Shanghai. And the ER in Nanjing was smaller than that in Shanghai. After eliminating PM2.5 confounding effects by a constituent residual approach, the BC residual concentration still had a strong significant ER. The ER for BC residual in Shanghai got an obvious increase, and ER of the cardiovascular mortality for all, females and males increased by 0.55 %, 1.46 % and 0.62 %, respectively, while the ER in Nanjing decreased slightly. It also revealed that females were more sensitive to the health risk associated with short-term BC exposure than males. Our findings provide additional important evidence and ER for mortality related to independent BC exposure. Therefore, BC emission reduction should be paid more attention in air pollution control strategies to reduce BC-related health burdens.
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Affiliation(s)
- Xiaoling Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China; Chengdu Plain Urban Meteorology and Environment Sichuan Provincial Field Scientific Observation and Research Station, Chengdu 610225, China.
| | - Yuanrui Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China
| | - Meng Xiu
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China; Chengdu Plain Urban Meteorology and Environment Sichuan Provincial Field Scientific Observation and Research Station, Chengdu 610225, China
| | - Ying Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China
| | - Bin Zhu
- Key Laboratory of Meteorological Disaster (KLME), Ministry of Education, Collaborative Innovation Centre on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD), Nanjing University of Information Science & Technology, Nanjing, China
| | - Yihan Ou
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China
| | - Shigong Wang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China
| | - Canjun Zheng
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing 102206, China
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Zhang D, Chen W, Cheng C, Huang H, Li X, Qin P, Chen C, Luo X, Zhang M, Li J, Sun X, Liu Y, Hu D. Air pollution exposure and heart failure: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 872:162191. [PMID: 36781139 DOI: 10.1016/j.scitotenv.2023.162191] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
While the literature strongly supports a positive association between particulate matter with diameter ≤ 2.5 μm (PM2.5) exposure and heart failure (HF), there is uncertainty regarding the other pollutants and the dose and duration of exposure that triggers an adverse response. To comprehensively assess and quantify the association of air pollution exposure with HF incidence and mortality, we performed separate meta-analyses according to pollutant types [PM2.5, PM10, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and exposure duration (short- and long-term). We systematically searched PubMed, EMBASE, and Web of Science for relevant articles with publication dates up to July 12, 2022, identifying 35 eligible studies. Random-effects models were used to summarize the pooled odds ratios (ORs) and 95 % confidence intervals (95 % CIs). For long-term exposure, the growing risk of HF was significantly associated with each 10 μg/m3 increase in PM2.5 (OR = 1.196, 95 % CI: 1.079-1.326; I2 = 76.8 %), PM10 (1.190, 1.045-1.356; I2 = 76.2 %), and NO2 (1.072, 1.028-1.118; I2 = 78.3 %). For short-term exposure, PM2.5, PM10, NO2, and O3 (per 10 μg/m3 increment) increased the risk of HF, with estimated ORs of 1.019 (1.008-1.030; I2 = 39.9 %), 1.012 (1.007-1.017; I2 = 28.3 %), 1.016 (1.005-1.026; I2 = 53.7 %), and 1.006 (1.002-1.010; I2 = 0.0 %), respectively. No significant effects of SO2 and CO exposure on the risk of HF were observed. In summary, our study powerfully highlights the deleterious impact of PM2.5, PM10, and NO2 exposure (either short- or long-term) on HF risk. Serious efforts should be made to improve air quality through legislation and interdisciplinary cooperation.
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Affiliation(s)
- Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Weiling Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Cheng Cheng
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xi Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Pei Qin
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Chuanqi Chen
- Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xinping Luo
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Xizhuo Sun
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
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3
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Clerbaux LA, Albertini MC, Amigó N, Beronius A, Bezemer GFG, Coecke S, Daskalopoulos EP, del Giudice G, Greco D, Grenga L, Mantovani A, Muñoz A, Omeragic E, Parissis N, Petrillo M, Saarimäki LA, Soares H, Sullivan K, Landesmann B. Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework. J Clin Med 2022; 11:4464. [PMID: 35956081 PMCID: PMC9369763 DOI: 10.3390/jcm11154464] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/10/2022] Open
Abstract
Addressing factors modulating COVID-19 is crucial since abundant clinical evidence shows that outcomes are markedly heterogeneous between patients. This requires identifying the factors and understanding how they mechanistically influence COVID-19. Here, we describe how eleven selected factors (age, sex, genetic factors, lipid disorders, heart failure, gut dysbiosis, diet, vitamin D deficiency, air pollution and exposure to chemicals) influence COVID-19 by applying the Adverse Outcome Pathway (AOP), which is well-established in regulatory toxicology. This framework aims to model the sequence of events leading to an adverse health outcome. Several linear AOPs depicting pathways from the binding of the virus to ACE2 up to clinical outcomes observed in COVID-19 have been developed and integrated into a network offering a unique overview of the mechanisms underlying the disease. As SARS-CoV-2 infectibility and ACE2 activity are the major starting points and inflammatory response is central in the development of COVID-19, we evaluated how those eleven intrinsic and extrinsic factors modulate those processes impacting clinical outcomes. Applying this AOP-aligned approach enables the identification of current knowledge gaps orientating for further research and allows to propose biomarkers to identify of high-risk patients. This approach also facilitates expertise synergy from different disciplines to address public health issues.
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Affiliation(s)
- Laure-Alix Clerbaux
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | | | - Núria Amigó
- Biosfer Teslab SL., 43204 Reus, Spain;
- Department of Basic Medical Sciences, Universitat Rovira i Virgili (URV), 23204 Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Anna Beronius
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Gillina F. G. Bezemer
- Impact Station, 1223 JR Hilversum, The Netherlands;
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Sandra Coecke
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Evangelos P. Daskalopoulos
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Giusy del Giudice
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Dario Greco
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Lucia Grenga
- Département Médicaments et Technologies pour la Santé (DMTS), Université Paris-Saclay, CEA, INRAE, SPI, F-30200 Bagnols-sur-Ceze, France;
| | - Alberto Mantovani
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Amalia Muñoz
- European Commission, Joint Research Centre (JRC), 2440 Geel, Belgium;
| | - Elma Omeragic
- Faculty of Pharmacy, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Nikolaos Parissis
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Mauro Petrillo
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Laura A. Saarimäki
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Helena Soares
- Laboratory of Immunobiology and Pathogenesis, Chronic Diseases Research Centre, Faculdade de Ciências Médicas Medical School, University of Lisbon, 1649-004 Lisbon, Portugal;
| | - Kristie Sullivan
- Physicians Committee for Responsible Medicine, Washington, DC 20016, USA;
| | - Brigitte Landesmann
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
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Song X, Hu Y, Ma Y, Jiang L, Wang X, Shi A, Zhao J, Liu Y, Liu Y, Tang J, Li X, Zhang X, Guo Y, Wang S. Is short-term and long-term exposure to black carbon associated with cardiovascular and respiratory diseases? A systematic review and meta-analysis based on evidence reliability. BMJ Open 2022; 12:e049516. [PMID: 35504636 PMCID: PMC9066484 DOI: 10.1136/bmjopen-2021-049516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Adverse health effects of fine particles (particulate matter2.5) have been well documented by a series of studies. However, evidences on the impacts of black carbon (BC) or elemental carbon (EC) on health are limited. The objectives were (1) to explored the effects of BC and EC on cardiovascular and respiratory morbidity and mortality, and (2) to verified the reliability of the meta-analysis by drawing p value plots. DESIGN The systematic review and meta-analysis using adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and p value plots approach. DATA SOURCES PubMed, Embase and Web of Science were searched from inception to 19 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Time series, case cross-over and cohort studies that evaluated the associations between BC/EC on cardiovascular or respiratory morbidity or mortality were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcomes were analysed via a random effects model and reported as relative risk (RR) with 95% CI. The certainty of evidences was assessed by adapted GRADE. The reliabilities of meta-analyses were analysed by p value plots. RESULTS Seventy studies met our inclusion criteria. (1) Short-term exposure to BC/EC was associated with 1.6% (95% CI 0.4% to 2.8%) increase in cardiovascular diseases per 1 µg/m3 in the elderly; (2) Long-term exposure to BC/EC was associated with 6.8% (95% CI 0.4% to 13.5%) increase in cardiovascular diseases and (3) The p value plot indicated that the association between BC/EC and respiratory diseases was consistent with randomness. CONCLUSIONS Both short-term and long-term exposures to BC/EC were related with cardiovascular diseases. However, the impact of BC/EC on respiratory diseases did not present consistent evidence and further investigations are required. PROSPERO REGISTRATION NUMBER CRD42020186244.
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Affiliation(s)
- Xuping Song
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yue Hu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yan Ma
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Liangzhen Jiang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xinyi Wang
- Second Clinical College, Lanzhou University, Lanzhou, Gansu, China
| | - Anchen Shi
- Department of General Surgery, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Junxian Zhao
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yunxu Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yafei Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Tang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiayang Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoling Zhang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
| | - Yong Guo
- Department of Civil Affairs in Guizhou Province, Guizhou Province People's Government, Guiyang, Guizhou, China
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
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Kaufman JD, Elkind MSV, Bhatnagar A, Koehler K, Balmes JR, Sidney S, Burroughs Peña MS, Dockery DW, Hou L, Brook RD, Laden F, Rajagopalan S, Bishop Kendrick K, Turner JR. Guidance to Reduce the Cardiovascular Burden of Ambient Air Pollutants: A Policy Statement From the American Heart Association. Circulation 2020; 142:e432-e447. [PMID: 33147996 DOI: 10.1161/cir.0000000000000930] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In 2010, the American Heart Association published a statement concluding that the existing scientific evidence was consistent with a causal relationship between exposure to fine particulate matter and cardiovascular morbidity and mortality, and that fine particulate matter exposure is a modifiable cardiovascular risk factor. Since the publication of that statement, evidence linking air pollution exposure to cardiovascular health has continued to accumulate and the biological processes underlying these effects have become better understood. This increasingly persuasive evidence necessitates policies to reduce harmful exposures and the need to act even as the scientific evidence base continues to evolve. Policy options to mitigate the adverse health impacts of air pollutants must include the reduction of emissions through action on air quality, vehicle emissions, and renewable portfolio standards, taking into account racial, ethnic, and economic inequality in air pollutant exposure. Policy interventions to improve air quality can also be in alignment with policies that benefit community and transportation infrastructure, sustainable food systems, reduction in climate forcing agents, and reduction in wildfires. The health care sector has a leadership role in adopting policies to contribute to improved environmental air quality as well. There is also potentially significant private sector leadership and industry innovation occurring in the absence of and in addition to public policy action, demonstrating the important role of public-private partnerships. In addition to supporting education and research in this area, the American Heart Association has an important leadership role to encourage and support public policies, private sector innovation, and public-private partnerships to reduce the adverse impact of air pollution on current and future cardiovascular health in the United States.
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6
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Parvez F, Wagstrom K. A hybrid modeling framework to estimate pollutant concentrations and exposures in near road environments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:144-153. [PMID: 30711580 DOI: 10.1016/j.scitotenv.2019.01.218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/03/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Traffic related air pollution is one of the major local sources of pollution challenging most urban populations. Current air quality modeling approaches can estimate the concentrations of air pollutants on either regional or local scales but cannot effectively estimate concentrations from the combination of regional and local sources at both local and regional scales simultaneously. This study describes a hybrid modeling framework, HYCAMR, combining a regional model, CAMx, and a local-scale dispersion model, R-LINE, to estimate concentrations of both primary and secondary species at high temporal (hourly) and spatial (40 m) resolution. HYCAMR utilizes all the chemical and physical processes available in CAMx and the Particulate Matter Source Apportionment Technology (PSAT) tool to estimate concentrations from both onroad and nonroad emission sources. HYCAMR employs R-LINE, to estimate the normalized dispersion of pollutant mass from onroad emission sources, from primary and secondary roads, at high resolution. Applying R-LINE for one day per month using average daily meteorology yields seasonally-resolved spatial dispersion profiles at low computational cost. Combining the R-LINE spatial dispersion profile with CAMx concentration estimates yields an estimate of the combined concentrations for a range of pollutants at high spatial and temporal resolution. In three major cities in Connecticut, HYCAMR shows strong temporal and seasonal variability in NOx, PM2.5, and elemental carbon (EC) concentrations. This study evaluates HYCAMR year 2011 estimates of NO2 and PM2.5 against two sources: satellite-based estimates at coarse resolution and regression model estimates at census block group resolution. In this evaluation, HYCAMR demonstrates improved agreement with the land-use regression modeling and mixed agreement with satellite-based estimates when compared to the regional CAMx estimates.
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Affiliation(s)
- Fatema Parvez
- Department of Chemical and Biomolecular Engineering, University of Connecticut 191 Auditorium Road, Unit 3222. Storrs, CT 06269-3222, United States of America.
| | - Kristina Wagstrom
- Department of Chemical and Biomolecular Engineering, University of Connecticut 191 Auditorium Road, Unit 3222. Storrs, CT 06269-3222, United States of America.
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7
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Krall JR, Chang HH, Waller LA, Mulholland JA, Winquist A, Talbott EO, Rager JR, Tolbert PE, Sarnat SE. A multicity study of air pollution and cardiorespiratory emergency department visits: Comparing approaches for combining estimates across cities. ENVIRONMENT INTERNATIONAL 2018; 120:312-320. [PMID: 30107292 PMCID: PMC6218942 DOI: 10.1016/j.envint.2018.07.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/09/2018] [Accepted: 07/24/2018] [Indexed: 05/25/2023]
Abstract
Determining how associations between ambient air pollution and health vary by specific outcome is important for developing public health interventions. We estimated associations between twelve ambient air pollutants of both primary (e.g. nitrogen oxides) and secondary (e.g. ozone and sulfate) origin and cardiorespiratory emergency department (ED) visits for 8 specific outcomes in five U.S. cities including Atlanta, GA; Birmingham, AL; Dallas, TX; Pittsburgh, PA; St. Louis, MO. For each city, we fitted overdispersed Poisson time-series models to estimate associations between each pollutant and specific outcome. To estimate multicity and posterior city-specific associations, we developed a Bayesian multicity multi-outcome (MCM) model that pools information across cities using data from all specific outcomes. We fitted single pollutant models as well as models with multipollutant components using a two-stage chemical mixtures approach. Posterior city-specific associations from the MCM models were somewhat attenuated, with smaller standard errors, compared to associations from time-series regression models. We found positive associations of both primary and secondary pollutants with respiratory disease ED visits. There was some indication that primary pollutants, particularly nitrogen oxides, were also associated with cardiovascular disease ED visits. Bayesian models can help to synthesize findings across multiple outcomes and cities by providing posterior city-specific associations building on variation and similarities across the multiple sources of available information.
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Affiliation(s)
- Jenna R Krall
- Department of Global and Community Health, George Mason University, 4400 University Drive, MS 5B7, Fairfax, VA 22030, United States.
| | - Howard H Chang
- Department of Biostatistics & Bioinformatics, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, United States.
| | - Lance A Waller
- Department of Biostatistics & Bioinformatics, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, United States.
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Drive NW, Atlanta, GA 30332, United States.
| | - Andrea Winquist
- Department of Epidemiology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, United States.
| | - Evelyn O Talbott
- Department of Epidemiology, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States.
| | - Judith R Rager
- Department of Epidemiology, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States.
| | - Paige E Tolbert
- Department of Environmental Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, United States.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, United States.
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8
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Bates JT, Weber RJ, Abrams J, Verma V, Fang T, Ivey C, Liu C, Klein M, Strickland MJ, Sarnat SE, Chang HH, Mulholland JA, Tolbert PE, Russell AG. Source Impacts on and Cardiorespiratory Effects of Reactive Oxygen Species Generated by Water-Soluble PM2.5 Across the Eastern United States. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-57645-9_79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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9
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Zhao L, Liang HR, Chen FY, Chen Z, Guan WJ, Li JH. Association between air pollution and cardiovascular mortality in China: a systematic review and meta-analysis. Oncotarget 2017; 8:66438-66448. [PMID: 29029525 PMCID: PMC5630425 DOI: 10.18632/oncotarget.20090] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/26/2017] [Indexed: 12/23/2022] Open
Abstract
Air pollutant levels in many Chinese cities remained significantly higher than the upper limits stated in World Health Organization guidelines. In light of limited evidence in China, we conducted a meta-analysis summarizing the association between acute exposure of air pollution and cardiovascular mortality. We searched PubMed, and CNKI databases etc. for literature published in English or Chinese up to January 2017. Outcomes were pooled and compared using random-effects model. Excess risks (ERs) per 10 μg/m3 increase in PM2.5, PM10, NO2, SO2 and O3 were evaluated. Subgroup analysis was conducted according to lag patterns (lags 0, 1, 2, 0–1, 0–2 days), gender (male vs. female), temperature (cool vs. warm) and age (< 65 vs. ≥ 65). Study bias was detected using Begg’s and Egger’s test. Of 299 articles identified, 30 met inclusion criteria. Each 10 μg/m3 increase in the concentration was associated with a higher incidence of cardiovascular mortality for PM2.5 (0.68%, 95% CI: 0.39–0.97%), PM10 (0.39%, 95% CI: 0.26–0.53%), NO2 (1.12%, 95% CI: 0.76–1.48%), SO2 (0.75%, 95% CI: 0.42–1.09%), and O3 (0.62%, 95% CI: 0.33–0.92%), respectively. Air pollution conferred greater adverse impacts on cardiovascular mortality for longer duration of exposures. Strongest associations were seen for lag 0–1 day of exposure among all pollutants. Female, lower temperature, and age > 65 years were associated with greater risks of cardiovascular mortality for all pollutants. Higher concentrations of air pollutants correlated with a greater short-term increase in cardiovascular mortality. Further high-quality studies in China are urgently warranted to determine the susceptible population, which would offer reference for policy-making to minimize adverse health effects.
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Affiliation(s)
- Lei Zhao
- Key Laboratory of Protein Modification and Degradation, School of Basic Medical Sciences, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, 511436, China.,The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China
| | - Heng-Rui Liang
- Nan Shan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Feng-Ying Chen
- Key Laboratory of Protein Modification and Degradation, School of Basic Medical Sciences, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, 511436, China
| | - Zi Chen
- Huashan Hospital, Fudan University, Shanghai, 200040, China.,QuintilesIMS Asia Medical Oncology, Shanghai, 200032, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Jian-Hua Li
- Key Laboratory of Protein Modification and Degradation, School of Basic Medical Sciences, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, 511436, China
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Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. Associations between Source-Specific Fine Particulate Matter and Emergency Department Visits for Respiratory Disease in Four U.S. Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:97-103. [PMID: 27315241 PMCID: PMC5226704 DOI: 10.1289/ehp271] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 03/02/2016] [Accepted: 05/25/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Short-term exposure to ambient fine particulate matter (PM2.5) concentrations has been associated with increased mortality and morbidity. Determining which sources of PM2.5 are most toxic can help guide targeted reduction of PM2.5. However, conducting multicity epidemiologic studies of sources is difficult because source-specific PM2.5 is not directly measured, and source chemical compositions can vary between cities. OBJECTIVES We determined how the chemical composition of primary ambient PM2.5 sources varies across cities. We estimated associations between source-specific PM2.5 and respiratory disease emergency department (ED) visits and examined between-city heterogeneity in estimated associations. METHODS We used source apportionment to estimate daily concentrations of primary source-specific PM2.5 for four U.S. cities. For sources with similar chemical compositions between cities, we applied Poisson time-series regression models to estimate associations between source-specific PM2.5 and respiratory disease ED visits. RESULTS We found that PM2.5 from biomass burning, diesel vehicle, gasoline vehicle, and dust sources was similar in chemical composition between cities, but PM2.5 from coal combustion and metal sources varied across cities. We found some evidence of positive associations of respiratory disease ED visits with biomass burning PM2.5; associations with diesel and gasoline PM2.5 were frequently imprecise or consistent with the null. We found little evidence of associations with dust PM2.5. CONCLUSIONS We introduced an approach for comparing the chemical compositions of PM2.5 sources across cities and conducted one of the first multicity studies of source-specific PM2.5 and ED visits. Across four U.S. cities, among the primary PM2.5 sources assessed, biomass burning PM2.5 was most strongly associated with respiratory health. Citation: Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. 2017. Associations between source-specific fine particulate matter and emergency department visits for respiratory disease in four U.S. cities. Environ Health Perspect 125:97-103; http://dx.doi.org/10.1289/EHP271.
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Affiliation(s)
- Jenna R. Krall
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - James A. Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Armistead G. Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Sivaraman Balachandran
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
- Department of Biomedical, Chemical & Environmental Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrea Winquist
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Paige E. Tolbert
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
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11
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Krall JR, Chang HH, Sarnat SE, Peng RD, Waller LA. Current Methods and Challenges for Epidemiological Studies of the Associations Between Chemical Constituents of Particulate Matter and Health. Curr Environ Health Rep 2016; 2:388-98. [PMID: 26386975 DOI: 10.1007/s40572-015-0071-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epidemiological studies have been critical for estimating associations between exposure to ambient particulate matter (PM) air pollution and adverse health outcomes. Because total PM mass is a temporally and spatially varying mixture of constituents with different physical and chemical properties, recent epidemiological studies have focused on PM constituents. Most studies have estimated associations between PM constituents and health using the same statistical methods as in studies of PM mass. However, these approaches may not be sufficient to address challenges specific to studies of PM constituents, namely assigning exposure, disentangling health effects, and handling measurement error. We reviewed large, population-based epidemiological studies of PM constituents and health and describe the statistical methods typically applied to address these challenges. Development of statistical methods that simultaneously address multiple challenges, for example, both disentangling health effects and handling measurement error, could improve estimation of associations between PM constituents and adverse health outcomes.
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Affiliation(s)
- Jenna R Krall
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Roger D Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
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12
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Characterizing the spatial distribution of multiple pollutants and populations at risk in Atlanta, Georgia. Spat Spatiotemporal Epidemiol 2016; 18:13-23. [PMID: 27494956 DOI: 10.1016/j.sste.2016.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/16/2016] [Accepted: 02/23/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Exposure metrics that identify spatial contrasts in multipollutant air quality are needed to better understand multipollutant geographies and health effects from air pollution. Our aim is to improve understanding of: (1) long-term spatial distributions of multiple pollutants; and (2) demographic characteristics of populations residing within areas of differing air quality. METHODS We obtained average concentrations for ten air pollutants (p=10) across a 12 km grid (n=253) covering Atlanta, Georgia for 2002-2008. We apply a self-organizing map (SOM) to our data to derive multipollutant patterns observed across our grid and classify locations under their most similar pattern (i.e, multipollutant spatial type (MST)). Finally, we geographically map classifications to delineate regions of similar multipollutant characteristics and characterize associated demographics. RESULTS We found six MSTs well describe our data, with profiles highlighting a range of combinations, from locations experiencing generally clean air to locations experiencing conditions that were relatively dirty. Mapping MSTs highlighted that downtown areas were dominated by primary pollution and that suburban areas experienced relatively higher levels of secondary pollution. Demographics show the largest proportion of the overall population resided in downtown locations experiencing higher levels of primary pollution. Moreover, higher proportions of nonwhites and children in poverty reside in these areas when compared to suburban populations that resided in areas exhibiting relatively lower pollution. CONCLUSION Our approach reveals the nature and spatial distribution of differential pollutant combinations across urban environments and provides helpful insights for identifying spatial exposure and demographic contrasts for future health studies.
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Alhanti BA, Chang HH, Winquist A, Mulholland JA, Darrow LA, Sarnat SE. Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:180-8. [PMID: 26350981 DOI: 10.1038/jes.2015.57] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/16/2015] [Indexed: 05/22/2023]
Abstract
Previous studies have found strong associations between asthma morbidity and major ambient air pollutants. Relatively little research has been conducted to assess whether age is a factor conferring susceptibility to air pollution-related asthma morbidity. We investigated the short-term relationships between asthma emergency department (ED) visits and ambient ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and fine particulate matter (PM2.5) in Atlanta (1993-2009), Dallas (2006-2009), and St. Louis (2001-2007). City-specific daily time-series analyses were conducted to estimate associations by age group (0-4, 5-18, 19-39, 40-64, and 65+ years). Sub-analyses were performed stratified by race and sex. City-specific rate ratios (RRs) were combined by inverse-variance weighting to provide an overall association for each strata. The overall RRs differed across age groups, with associations for all pollutants consistently strongest for children aged 5-18 years. The patterns of association across age groups remained generally consistent when models were stratified by sex and race, although the strong observed associations among 5-18 year olds appeared to be partially driven by non-white and male patients. Our findings suggest that age is a susceptibility factor for asthma exacerbations in response to air pollution, with school-age children having the highest susceptibility.
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Affiliation(s)
- Brooke A Alhanti
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Lyndsey A Darrow
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Bates JT, Weber RJ, Abrams J, Verma V, Fang T, Klein M, Strickland MJ, Sarnat SE, Chang HH, Mulholland JA, Tolbert PE, Russell AG. Reactive Oxygen Species Generation Linked to Sources of Atmospheric Particulate Matter and Cardiorespiratory Effects. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2015; 49:13605-12. [PMID: 26457347 DOI: 10.1021/acs.est.5b02967] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Exposure to atmospheric fine particulate matter (PM2.5) is associated with cardiorespiratory morbidity and mortality, but the mechanisms are not well understood. We assess the hypothesis that PM2.5 induces oxidative stress in the body via catalytic generation of reactive oxygen species (ROS). A dithiothreitol (DTT) assay was used to measure the ROS-generation potential of water-soluble PM2.5. Source apportionment on ambient (Atlanta, GA) PM2.5 was performed using the chemical mass balance method with ensemble-averaged source impact profiles. Linear regression analysis was used to relate PM2.5 emission sources to ROS-generation potential and to estimate historical levels of DTT activity for use in an epidemiologic analysis for the period of 1998-2009. Light-duty gasoline vehicles (LDGV) exhibited the highest intrinsic DTT activity, followed by biomass burning (BURN) and heavy-duty diesel vehicles (HDDV) (0.11 ± 0.02, 0.069 ± 0.02, and 0.052 ± 0.01 nmol min(-1) μg(-1)source, respectively). BURN contributed the largest fraction to total DTT activity over the study period, followed by LDGV and HDDV (45, 20, and 14%, respectively). DTT activity was more strongly associated with emergency department visits for asthma/wheezing and congestive heart failure than PM2.5. This work provides further epidemiologic evidence of a biologically plausible mechanism, that of oxidative stress, for associations of adverse health outcomes with PM2.5 mass and supports continued assessment of the utility of the DTT activity assay as a measure of ROS-generating potential of particles.
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Affiliation(s)
| | | | | | - Vishal Verma
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign , Champaign, Illinois 61801, United States
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