Effect modification by maximum temperature of the association between PM2.5 and short-term cardiorespiratory mortality and emergency room visits in Lima, Peru, 2010-2016

Ambient temperature and the risk of childhood epilepsy hospitalizations: Potentially neglected risk of temperature extremes and modifying effects of air pollution

PURPOSE

Extreme temperatures and air pollution are increasingly important risk factors for human health in the background of climate change, with limited evidence available for neurological disorders. This study intended to investigate the short-term effects of extreme temperatures on childhood epilepsy and explore the potential modifying effect of air pollution.

METHODS

Daily childhood epilepsy hospitalization, meteorological and air pollution data were collected from 10 cities in Anhui Province of China during 2016-2018. We firstly employed a space-time-stratified case-crossover design and conditional logistic regression model to fit the short-term relationship between temperature and epilepsy. Then, we conducted stratified analyses by the level of air pollution and individual characteristics.

RESULTS

Both extreme heat and extreme cold increased the risk of hospitalization for childhood epilepsy. The effect of extreme heat [97.5th vs. minimum hospitalization temperature (MHT)] on hospitalization was acute and emerged at lag0 [OR: 1.229 (95 %CI: 1.035 to 1.459)], while the effect of extreme cold (2.5th vs. MHT) was delayed and appeared at lag5 [OR: 1.098 (95 %CI: 1.043 to 1.156)]. We also found children aged 6-18 years were more susceptible to extreme cold than children aged 0-5 years. Besides, extreme heat and cold effects differed by the level of air pollutants.

CONCLUSION

This study suggests that extreme temperatures might be the novel but currently neglected risk factor for childhood epilepsy, and air pollution could further amplify the adverse effect of temperature.

An exploratory analysis of PM 2.5 /PM 10 ratio during spring 2016-2018 in Metropolitan Lima

Aerosols (PM2.5 and PM10 ) represent one of the most critical pollutants due to their negative effects on human health. This research analyzed the relationship of PM and its PM2.5 /PM10 ratios with climatic variables in the austral spring (2016-2018) in Metropolitan Lima. Overall, there was an average PM2.5 /PM10 ratio of 0.33 with fluctuations from 0.30 to 0.35. However, there have also been high point values that reached ratios greater than one. This situation indicates a moderate condition of contamination by particulate matter with a predominance of coarse aerosols in spring, with an increasing trend over the years. The locations Ate and Villa Maria del Triunfo, especially Ate, presented poor quality conditions. Thursdays showed outstanding pollution peaks by PM10 , and a decrease is visible on Sundays. On the other hand, the PM2.5 showed a similar pattern every day, including Sundays. The maximum peaks occurred in the morning and night hours. The increase in anthropogenic emissions associated with the formation of secondary aerosols has been evident, being the case of the location Campo de Marte, the one that had a significant increase in ratios PM2.5 /PM10 , which confirms a greater intensity of secondary formations of carbonaceous particles from industrial oil sources, vehicle exhaust, as well as aerosols from metal smelting and biomass burning. There were negative correlations of the ratios with PM10 , temperature, wind speed, and direction, and positive correlations with PM2.5 and relative humidity. Contour lines were successfully developed that demonstrated the interaction of climate with PM2.5 /PM10 ratios. This will deepen the exploration of emission sources and modeling, which allows for optimizing air quality indices to control emissions and adequately manage air quality in Metropolitan Lima.

Geospatial analysis of short-term exposure to air pollution and risk of cardiovascular diseases and mortality-A systematic review

The cardiovascular risk associated with short-term ambient air pollution exposure is well-documented. However, recent advancements in geospatial techniques have provided new insights into this risk. This systematic review focuses on short-term exposure studies that applied advanced geospatial pollution modelling to estimate cardiovascular disease (CVD) risk and accounted for additional unconventional neighbourhood-level confounders to analyse their modifier effect on the risk. Four databases were investigated to select publications between 2018 and 2023 that met the inclusion criteria of studying the effect of particulate matter (PM2.5 and PM10), SO2, NOx, CO, and O3 on CVD mortality or morbidity, utilizing pollution modelling techniques, and considering spatial and temporal confounders. Out of 3277 publications, 285 were identified for full-text review, of which 34 satisfied the inclusion criteria for qualitative analysis, and 12 of them were chosen for additional quantitative analysis. Quality assessment revealed that 28 out of 34 included articles scored 4 or above, indicating high quality. In 30 studies, advanced pollution modelling techniques were used, while in 4 only simpler methods were applied. The most pertinent confounders identified were socio-demographic variables (e.g., socio-economic status, population percentage by race or ethnicity) and neighbourhood-level built environment variables (e.g., urban/rural area, percentage of green space, proximity to healthcare), which exhibited varying modifier effects depending on the context. In the quantitative analysis, only PM 2.5 showed a significant positive association to all-cause CVD-related hospitalisation. Other pollutants did not show any significant effect, likely due to the high inter-study heterogeneity and a limited number of cases. The application of advanced geospatial measurement and modelling of air pollution exposure, as well as its risk, is increasing. This review underscores the importance of accounting for unconventional neighbourhood-level confounders to enhance the understanding of the CVD risk associated with short-term pollution exposure.

Effect of PM2.5 Levels on ED Visits for Respiratory Causes in a Greek Semi-Urban Area

Fine particulate matter that have a diameter of <2.5 μm (PM2.5) are an important factor of anthropogenic pollution since they are associated with the development of acute respiratory illnesses. The aim of this prospective study is to examine the correlation between PM2.5 levels in the semi-urban city of Volos and Emergency Department (ED) visits for respiratory causes. ED visits from patients with asthma, pneumonia and upper respiratory infection (URI) were recorded during a one-year period. The 24 h PM2.5 pollution data were collected in a prospective manner by using twelve fully automated air quality monitoring stations. PM2.5 levels exceeded the daily limit during 48.6% of the study period, with the mean PM2.5 concentration being 30.03 ± 17.47 μg/m3. PM2.5 levels were significantly higher during winter. When PM2.5 levels were beyond the daily limit, there was a statistically significant increase in respiratory-related ED visits (1.77 vs. 2.22 visits per day; p: 0.018). PM2.5 levels were also statistically significantly related to the number of URI-related ED visits (0.71 vs. 0.99 visits/day; p = 0.01). The temperature was negatively correlated with ED visits (r: −0.21; p < 0.001) and age was found to be positively correlated with ED visits (r: 0.69; p < 0.001), while no statistically significant correlation was found concerning humidity (r: 0.03; p = 0.58). In conclusion, PM2.5 levels had a significant effect on ED visits for respiratory causes in the city of Volos.

City-level impact of extreme temperatures and mortality in Latin America

Climate change and urbanization are rapidly increasing human exposure to extreme ambient temperatures, yet few studies have examined temperature and mortality in Latin America. We conducted a nonlinear, distributed-lag, longitudinal analysis of daily ambient temperatures and mortality among 326 Latin American cities between 2002 and 2015. We observed 15,431,532 deaths among ≈2.9 billion person-years of risk. The excess death fraction of total deaths was 0.67% (95% confidence interval (CI) 0.58-0.74%) for heat-related deaths and 5.09% (95% CI 4.64-5.47%) for cold-related deaths. The relative risk of death was 1.057 (95% CI 1.046-1.067%) per 1 °C higher temperature during extreme heat and 1.034 (95% CI 1.028-1.040%) per 1 °C lower temperature during extreme cold. In Latin American cities, a substantial proportion of deaths is attributable to nonoptimal ambient temperatures. Marginal increases in observed hot temperatures are associated with steep increases in mortality risk. These risks were strongest among older adults and for cardiovascular and respiratory deaths.