An association between air pollution and daily most frequently visits of eighteen outpatient diseases in an industrial city

Long- and Intermediate-Term Ambient Particulate Pollution Is Associated with Increased Osteoarthritis Risk: A Population-Based Prospective Analysis

Recent studies found the intrusion and retention of exogenous fine particles into joints, but epidemiological data for long- and intermediate-term exposure associations are scare. Here, all urban working, retired employee, and rural residents (16.78 million) in Beijing from January 1, 2011 to December 31, 2019 were included to investigate the effects of long- and intermediate-term ambient particulate exposure on development of osteoarthritis. We identified 1,742,067 participants as first-visit patients with osteoarthritis. For each interquartile range increase in annual PM2.5 (23.32 μg/m3) and PM10 (23.92 μg/m3) exposure concentration, the pooled hazard ratios were respectively 1.238 (95% CI: 1.228, 1.249) and 1.178 (95% CI: 1.168, 1.189) for first osteoarthritis outpatient visits. Moreover, age at first osteoarthritis outpatient visits significantly decreased by 4.52 (95% CI: 3.45 to 5.40) days per μg/m3 for annual PM2.5 exposure at below 67.85 μg/m3. Finally, among the six constituents analyzed, black carbon appears to be the most important component associated with the association between PM2.5 exposure and the three osteoarthritis-related outcomes.

Molecular mechanisms of environmental pollutant-induced cartilage damage: from developmental disorders to osteoarthritis

The objective of the present study was to review the molecular mechanisms of the adverse effects of environmental pollutants on chondrocytes and extracellular matrix (ECM). Existing data demonstrate that both heavy metals, including cadmium (Cd), lead (Pb), and arsenic (As), as well as organic pollutants, including polychlorinated dioxins and furans (PCDD/Fs) and polychlorinated biphenyls (PCB), bisphenol A, phthalates, polycyclic aromatic hydrocarbons (PAH), pesticides, and certain other organic pollutants that target cartilage ontogeny and functioning. Overall, environmental pollutants reduce chondrocyte viability through the induction apoptosis, senescence, and inflammatory response, resulting in cell death and impaired ECM production. The effects of organic pollutants on chondrocyte development and viability were shown to be mediated by binding to the aryl hydrocarbon receptor (AhR) signaling and modulation of non-coding RNA expression. Adverse effects of pollutant exposures were observed in articular and growth plate chondrocytes. These mechanisms also damage chondrocyte precursors and subsequently hinder cartilage development. In addition, pollutant exposure was shown to impair chondrogenesis by inhibiting the expression of Sox9 and other regulators. Along with altered Runx2 signaling, these effects also contribute to impaired chondrocyte hypertrophy and chondrocyte-to-osteoblast trans-differentiation, resulting in altered endochondral ossification. Several organic pollutants including PCDD/Fs, PCBs and PAHs, were shown to induce transgenerational adverse effects on cartilage development and the resulting skeletal deformities. Despite of epidemiological evidence linking human environmental pollutant exposure to osteoarthritis or other cartilage pathologies, the data on the molecular mechanisms of adverse effects of environmental pollutant exposure on cartilage tissue were obtained from studies in laboratory rodents, fish, or cell cultures and should be carefully extrapolated to humans, although they clearly demonstrate that cartilage should be considered a putative target for environmental pollutant toxicity.

Assessment of the health impacts of air pollution exposure in East African countries

The health effects of air pollution remain a public concern worldwide. Using data from the Global Burden of Disease 2019 report, we statistically analyzed total mortality, disability-adjusted life years (DALY), and years of life lost (YLL) attributable to air pollution in eight East African countries between 1990 and 2019. We acquired ambient ozone (O3), PM2.5 concentrations and household air pollution (HAP) from the solid fuel from the State of Global Air report. The multilinear regression model was used to evaluate the predictability of YLLs by the air pollutants. We estimated the ratio rate for each health burden attributable to air pollution to compare the country's efforts in the reduction of air pollution health burden. This study found that the total number of deaths attributable to air pollution decreased by 14.26% for 30 years. The drop came from the reduction of 43.09% in mortality related to Lower Respiratory tract Infection (LRI). However, only five out of eight countries managed to decrease the total number of deaths attributable to air pollution with the highest decrease observed in Ethiopia (40.90%) and the highest increase in Somalia (67.49%). The linear regression model showed that HAP is the pollutant of the most concern in the region, with a 1% increase in HAP resulting in a 31.06% increase in regional YLL (R2 = 0.93; p < 0.05). With the increasing ground-level ozone, accompanied by the lack of adequate measures to reduce particulate pollutants, the health burdens attributable to air pollution are still a threat in the region.

Phenome-wide causal associations between osteoarthritis and other complex traits through the latent causal variable analysis

BACKGROUND

Individuals with osteoarthritis present with comorbidities, and the potential causal associations remain incompletely elucidated. The present study undertook a large-scale investigation about the causality between osteoarthritis and variable traits, using the summary-level data of genome-wide association studies (GWAS).

METHODS

The present study included the summary-level GWS data of knee osteoarthritis, hip osteoarthritis, hip or knee osteoarthritis, hand osteoarthritis, and other 1355 traits. Genetic correlation analysis was conducted between osteoarthritis and other traits through cross-trait bivariate linkage disequilibrium score regression. Subsequently, latent causal variable analysis was performed to explore the causal association when there was a significant genetic correlation. Genetic correlation and latent causal variable analysis were conducted on the Complex Traits Genomics Virtual Lab platform ( https://vl.genoma.io/ ).

RESULTS

We found 133 unique phenotypes showing causal relationships with osteoarthritis. Our results confirmed several well-established risk factors of osteoarthritis, such as obesity, weight, BMI, and meniscus derangement. Additionally, our findings suggested putative causal links between osteoarthritis and multiple factors. Socioeconomic determinants such as occupational exposure to dust and diesel exhaust, extended work hours exceeding 40 per week, and unemployment status were implicated. Furthermore, our analysis revealed causal associations with cardiovascular and metabolic disorders, including heart failure, deep venous thrombosis, type 2 diabetes mellitus, and elevated cholesterol levels. Soft tissue and musculoskeletal disorders, such as hallux valgus, internal derangement of the knee, and spondylitis, were also identified to be causally related to osteoarthritis. The study also identified the putative causal associations of osteoarthritis with digestive and respiratory diseases, such as Barrett's esophagus, esophagitis, and asthma, as well as psychiatric conditions including panic attacks and manic or hyperactive episodes. Additionally, we observed osteoarthritis causally related to pharmacological treatments, such as the use of antihypertensive medications, anti-asthmatic drugs, and antidepressants.

CONCLUSION

Our study uncovered a wide range of traits causally associated with osteoarthritis. Further studies are needed to validate and illustrate the detailed mechanism of those causal associations.

Advances in Smart Photovoltaic Textiles

Energy harvesting textiles have emerged as a promising solution to sustainably power wearable electronics. Textile-based solar cells (SCs) interconnected with on-body electronics have emerged to meet such needs. These technologies are lightweight, flexible, and easy to transport while leveraging the abundant natural sunlight in an eco-friendly way. In this Review, we comprehensively explore the working mechanisms, diverse types, and advanced fabrication strategies of photovoltaic textiles. Furthermore, we provide a detailed analysis of the recent progress made in various types of photovoltaic textiles, emphasizing their electrochemical performance. The focal point of this review centers on smart photovoltaic textiles for wearable electronic applications. Finally, we offer insights and perspectives on potential solutions to overcome the existing limitations of textile-based photovoltaics to promote their industrial commercialization.

Tumor necrosis factor mediates the impact of PM2.5 on bone mineral density: Inflammatory proteome Mendelian randomization and colocalization analyses

To assess the causal effect of particulate matter 2.5 (PM2.5) on human bone mineral density (BMD) and to explore the possible mechanism and proportion mediated by inflammation-related protein. The genetic correlation between PM2.5 and BMD was assessed using the Linkage Disequilibrium Score (LDSC), and the causal effect between PM2.5 and BMD was assessed by two-sample Mendelian randomization (TSMR). A 2-step Mendelian randomization (MR) approach was employed to evaluate the potential role of inflammation-associated protein as the mediator in the causal association between PM2.5 and BMD. The multivariate Mendelian randomization (MVMR) study was designed to perform mediation analyses, exclude possible confounders and calculate the proportion of mediation. Subsequently, we used Bayesian colocalization analysis to consolidate the MR results. Finally, using drug-target MR design, we evaluated the potential repurposing of tumor necrosis factor (TNF) inhibitors for the treatment of osteoporosis (OP). The results of the analyses show that BMD is negatively influenced by PM2.5 (Inverse variance weighted [IVW] beta [β] = -0.288, 95% confidence interval [CI]: -0.534 - -0.042, P < 0.05). PM2.5 has a positive causal association with TNF (IVW β = 1.564, 95% CI: 0.155 - 2.973, P < 0.05) and a negative causal association with protachykinin-1 (TAC-1) (IVW β = -1.654, 95% CI: -3.063 - -0.244, P < 0.05). TNF has a negative causal association with BMD (Wald ratio β = -0.082, 95% CI: -0.165 - 0.000, P < 0.05) and TAC-1 has a positive causal association with BMD (IVW β = 0.042, 95% CI: 0.007 - 0.077, P < 0.05). After adjusting TNF and TAC-1, PM2.5 has no causal association with BMD (IVW β = -0.200, 95% CI: -0.579 - 0.179, P > 0.05). After adjusting PM2.5 and TAC-1, there was still a negative causal association between TNF and BMD (IVW β = -0.089, 95% CI: -0.166 - -0.012, P < 0.05). In the final drug-target MR study, the protective effect of TNF/TNF receptor 1 (TNFR1) inhibition on BMD was observed. For every 10% decrease of circulating C-reactive protein (CRP) achieved by TNF/TNF receptor 1 (TNFR1) blockade, β was 0.540 (95% CI: 0.040-1.040) for BMD. We found a negative causal association between PM2.5 and BMD and that causal association was mediated by TNF. The results of drug-target MR do support TNFR1 as a promising target for OP prevention among the general population.

Short-term exposure to gaseous pollutants is neglected factors for knee osteoarthritis: evidence from a humid subtropical region of China

Few studies were performed on the impact of exposure to gaseous pollutants on the risk of knee osteoarthritis (KOA). We conducted this study to analyze the association between short-term exposure to gaseous pollutants and the risk of hospitalizations for KOA. A total of 2952 KOA hospitalizations derived from two hospitals in Hefei, and the relationship between gaseous pollutants and KOA hospitalizations was analyzed by a distributed lag non-linear model combined with a generalized linear model. We found that the decreased risk of hospitalizations for KOA were both related to exposure to NO2 (RR = 0.993, lag19 day) and O3 (RR = 0.984, lag0 day), while exposure to CO could increase the risk of hospitalizations for KOA (RR = 1.076, lag2 day). Stratified analyses suggested that the KOA patients < 65 years were more susceptible to O3 exposure, and the female, male, patients ≥ 65 years, and patients < 65 years were both more sensitive to CO exposure. Our findings demonstrated that exposure to NO2, O3 resulted in a decreased risk for KOA hospitalizations, and CO exposure might increase the risk of KOA hospitalizations.

Challenges of developing a green gastroenterology evidence base and how trainee research networks can fill the gaps

Trainee research networks are a collaborative effort to enable high-quality multicentre audits or research that is more widely accessible to trainees. Such networks lead, design and deliver research at a far higher scale than could be achieved locally and are carried out solely by trainees. There is an increasing focus on delivering research that is not only environmentally sustainable but also focuses on areas that can reduce the carbon footprint of service provision in gastroenterology and hepatology. In this manuscript, we performed a scoping review to understand the current evidence base of the impact of gastroenterology and hepatology services on the environment as well as exploring any association between pollution and climate change with gastrointestinal and liver disease. We further discuss the barriers that researchers face in delivering environmentally sustainable research, the limitation in clinical guidelines related to practicing environmentally sustainable gastroenterology and hepatology and how the trainee research networks are ideally placed to initiate change by developing, disseminating and implementing best practice in ‘green Gastroenterology’.

A comprehensive review on environmental pollutants and osteoporosis: Insights into molecular pathways

A significant problem that has an impact on community wellbeing is environmental pollution. Environmental pollution due to air, water, or soil pollutants might pose a severe risk to global health, necessitating intense scientific effort. Osteoporosis is a common chronic condition with substantial clinical implications on mortality, morbidity, and quality of life. It is closely linked to bone fractures. Worldwide, osteoporosis affects around 200 million people, and every year, there are almost 9 million fractures. There is evidence that certain environmental factors may increase the risk of osteoporosis in addition to traditional risk factors. It is crucial to understand the molecular mechanisms at play because there is a connection between osteoporosis and exposure to environmental pollutants such as heavy metals, air pollutants, endocrine disruptors, metal ions and trace elements. Hence, in this scoping review, we explore potential explanations for the link between pollutants and bone deterioration through deep insights into molecular pathways. Understanding and recognizing these pollutants as modifiable risk factors for osteoporosis would possibly help to enhance environmental policy thereby aiding in the improvement of bone health and improving patient quality of life.

Impact of short-term exposure to ambient air pollution on osteoarthritis: a multi-city time-series analysis in Central-Eastern China

Osteoarthritis (OA) is a threat to public health issue with high morbidity and disability worldwide. However, unequivocal evidence on the link between air pollution and OA remains little, especially in multi-study sites. This study aimed to explore the relationship between short-term exposure to main air pollutants and the risk of OA outpatient visits in multi-study sites. A multi-city time-series analysis was performed in Anhui Province, Central-Eastern China from January 1, 2015, to December 31, 2020. We used a two-stage analysis to assess the association between air pollution and daily OA outpatient visits. City-specific associations were estimated with a distributed lag nonlinear model and then pooled by random-effects or fixed-effects meta-analysis. Stratified analysis was conducted by gender, age, and season. Additionally, the disease burden of OA attributable to air pollutant exposure was calculated. A total of 35,700 OA outpatients were included during the study period. The pooled exposure-response curves showed that PM2.5 and PM10 concentrations below the reference values could increase the risk of OA outpatient visits. Concretely, per 10 ug/m3 increase in PM2.5 concentration was linked to an elevated risk of OA outpatient visits at lag 2 and lag 3 days, where the effect reached its highest value on lag 2 day (RR: 1.023, 95%CI: 1.005-1.041). We observed that a 10 μg/m3 increase in PM10 was positively correlated with OA outpatient visits (lag2 day, RR: 1.011, 95%CI: 1.001-1.025). Nevertheless, no statistical significance was discovered in gaseous pollutants (including SO2, O3, and CO). Additionally, a significant difference was found between cold and warm seasons, but not between different genders or age groups. This study reveals that particulate matter is an important factor for the onset of OA in Anhui Province, China. However, there is no evidence of a relationship of gaseous pollutants with OA in this area.

Predicting particle deposition using a simplified 8-path in silico human lung prototype

Understanding particle deposition in the human lung is crucial for the assessment of environmental pollutants and the design of new drug delivery systems. Traditionally, research has been carried out by experimental analysis, but this generally requires expensive equipment and exposure of volunteers to radiation, resulting in limited data. To overcome these drawbacks, there is an emphasis on the development of numerical models capable of accurate predictive analysis. The most advanced of these computer simulations are based on three-dimensional computational fluid dynamics. Solving the flow equations in a complete, fully resolved lung airway model is currently not feasible due to the computational resources required. In the present work, a simplified lung model is presented and validated for accurate prediction of particle deposition. Simulations are performed for an 8-path approximation to a full lung airway model. A novel boundary condition method is used to ensure accurate results in truncated flow branches. Simulations are performed at a steady inhalation flow rate of 18 l min-1, corresponding to a low activity breathing rate, while the effects of particle size and density are investigated. Comparison of the simulation results with available experimental data shows that reasonably accurate results can be obtained at a small fraction of the cost of a full airway model. The simulations clearly evaluate the effect of both particle size and particle density. Most importantly, the results show an improvement over a previously documented single-path model, both in terms of accuracy and the ability to obtain regional deposition rates. The present model represents an improvement over previously used simplified models, including single-path models. The multi-path reduced airway approach described can be used by researchers for general and patient-specific analyses of particle deposition and for the design of effective drug delivery systems.

Short-Term Effect of Moderate Level Air Pollution on Outpatient Visits for Multiple Clinic Departments: A Time-Series Analysis in Xi'an China

There is limited evidence concerning the association between air pollution and different outpatient visits in moderately polluted areas. This paper investigates the effects of moderate-level air pollution on outpatient visits associated with six categories of clinic department. We analyzed a total of 1,340,791 outpatient visits for the pediatric, respiratory, ear-nose-throat (ENT), cardiovascular, ophthalmology, and orthopedics departments from January 2016 to December 2018. A distributed lag nonlinear model was used to analyze the associations and was fitted and stratified by age and season (central heating season and nonheating season). We found SO2 had the largest effect on pediatrics visits (RR = 1.105 (95%CI: 1.090, 1.121)). Meanwhile, PM2.5 and SO2 had greater effects on ENT visits for people under 50 years old. The results showed a strong association between O3 and cardiovascular outpatient visits in the nonheating season (RR = 1.273, 95% CI: 1.189,1.358). The results showed every 10 μg/m3 increase in SO2 was associated with a lower number of respiratory outpatient visits. Significant different associations were observed in PM2.5, NO2, CO, and O3 on ophthalmology visits between the heating and nonheating seasons. Although no significant association has been found in existing studies, our findings showed PM2.5 and NO2 were significantly related to orthopedic outpatient visits for people under 60 (RR = 1.063 (95%CI: 1.032, 1.095), RR = 1.055 (95%CI: 1.011, 1.101)). This study also found that the effect-level concentrations of air pollutants for some clinic departments were lower than the national standards, which means that people should also pay more attention when the air quality is normal.

Low-Cost Nitric Oxide Sensors: Assessment of Temperature and Humidity Effects

High equipment cost is a significant entry barrier to research for small organizations in developing solutions to air pollution problems. Low-cost electrochemical sensors show sensitivity at parts-per-billion by volume mixing ratios but are subject to variation due to changing environmental conditions, in particular temperature. In this study, we demonstrate a low-cost Internet of Things (IoT)-based sensor system for nitric oxide analysis. The sensor system used a four-electrode electrochemical sensor exposed to a series of isothermal/isohume conditions. When deployed under these conditions, stable baseline responses were achieved, in contrast to ambient air conditions where temperature and humidity conditions may be variable. The interrelationship between working and auxiliary electrodes was linear within an environmental envelope of 20-40 °C and 30-80% relative humidity, with correlation coefficients from 0.9980 to 0.9999 when measured under isothermal/isohume conditions. These data enabled the determination of surface functions that describe the working to auxiliary electrode offsets and calibration curve gradients and intercepts. The linear and reproducible nature of individual calibration curves for stepwise nitric oxide (NO) additions under isothermal/isohume environments suggests the suitability of these sensors for applications aside from their role in air quality monitoring. Such applications would include nitric oxide kinetic studies for atmospheric applications or measurement of the potential biocatalytic activity of nitric oxide consuming enzymes in biocatalytic coatings, both of which currently employ high-capital-cost chemiluminescence detectors.

Hydrogen sulfide alleviates particulate matter-induced emphysema and airway inflammation by suppressing ferroptosis

BACKGROUND

Redox imbalance is an vital mechanism for COPD. At present, insufficient researches have been conducted on the protective effect of hydrogen sulfide (H₂S) on PM-induced COPD. However, whether H₂S exerts the anti-injury role by blocking ferroptosis and restoring redox equilibrium remain to be investigated.

METHODS

Human lung tissue samples were collected for IHC staining, and the expressions of Nrf2, ferritinophagy- and ferroptosis-related proteins were observed. The WT C57BL/6 and Nrf2 knockout mice models were established with PM(200 μg per mouse). NaHS(Exogenous H₂S) was injected intraperitoneally 30 min in advance. Twenty-nine days later, mice lung tissues were evaluated by HE's and PERLS-DAB's staining. Meanwhile, inflammation and oxidative stress indicators and iron levels were assessed by corresponding ELISA kit. Related protein expressions were detected through Western blot. BEAS-2B cells with or without H₂S were exposed to PM2.5 for 36 h. Cell viability, mitochondrial morphology, inflammatory cytokines, antioxidant factors, iron levels, autophagic flux and the levels of ROS, LIP ROS, MitoROS, MMP, as well as related protein expressions were detected by specific methods, respectively. In addition, V5-Nrf2, Nrf2 siRNA, Nrf2 inhibitor ML385, PPAR-γ inhibitor GW9662, autophagy inhibitor CQ, iron chelator DFO and ferroptosis inhibitor Fer-1 were used to verify the target signaling pathways.

RESULTS

We found that the expressions of LIP ROS, ROS, COX2, MDA and other oxidative factors increased, while the antioxidant markers GPX4, GSH and GSH-Px significantly decreased, as well as active iron accumulation in COPD patients, PM-exposured WT and Nrf2-KO mice models and PM2.5-mediated cell models. NaHS pretreatment markedly inhibited PM-induced emphysema and airway inflammation by alleviating ferroptotic changes in vivo and vitro. With the use of V5-Nrf2 overexpression plasmid, Nrf2 siRNA and pathway inhibitors, we found NaHS activates the expressions of Nrf2 and PPAR-γ, and inhibites ferritinophagy makers LC3B, NCOA4 and FTH1 in BEAS-2B cells. Moreover, the anti-ferroptotic effect of NaHS was further verified to be related to the activation of Nrf2 signal in MEF cells.

CONCLUSION

This research suggested that H₂S alleviated PM-induced emphysema and airway inflammation via restoring redox balance and inhibiting ferroptosis through regulating Nrf2-PPAR-ferritinophagy signaling pathway.

Appealing Renewable Materials in Green Chemistry

In just a few years, chemists have significantly changed their approach to the synthesis of organic molecules in the laboratory and industry. Researchers are encouraged to approach “greener” reagents, solvents, and methodologies, to go hand in hand with the world’s environmental matter, such as water, soil, and air pollution. The employment of plant and animal derivates that are commonly regarded as “waste material” has paved the way for the development of new green strategies. In this review, the most important innovations in this field have been highlighted, paying due attention to those materials that have played a crucial role in organic reactions: wool, silk, and feather. Moreover, we decided to focus on the other most important supports and catalysts in green syntheses, such as proteins and their derivates. Different materials have shown prominent activity in the adsorption of metals and organic dyes, which has constituted a relevant scope in the last two decades. We intend to furnish a complete screening of the application given to these materials and contribute to their potential future utilization.

Interactions of chemical components in ambient PM2.5 with influenza viruses

The significance of this work is that ambient PM_2.5 is a direct transmission mode for influenza virus infection to the human alveolar epithelium. The concentration of PM_2.5 was 11.7 ± 5.5 μg/m³ in Taipei during 24 December 2019-13 January 2020. Approximately 79% of inhaled PM_2.5 is able to reach the upper-to-lower airway, and 47% of PM_2.5 is able to reach the alveolar epithelium for influenza virus infection. Influenza A and B viruses were detected in PM_2.5 on 9 days, and the influenza A/H5 virus was detected on 15 days during the study period. FL and Pyr were negatively correlated with the influenza A virus. D(ah)P and Acp were positively correlated with the influenza B and A/H5 viruses, respectively. Cd, V, and Zn were positively correlated with the influenza A, B, and A/H5 viruses, respectively. Next, influenza A, B, and A/H5 viral plasmids interacted with carbon black, H₂O₂, DEPs, and UD. We observed that H₂O₂ significantly decreased levels of complementary DNA of the three influenza viruses. DEPs and UD significantly decreased influenza A and A/H5 viral levels. In conclusion, chemicals in PM_2.5 may play vital roles in terms of viable influenza virus in the atmosphere.

Detecting Air Pollutant Molecules Using Tube-Shaped Single Electron Transistor

An air pollution detector is proposed based on a tube-shaped single-electron transistor (SET) sensor. By monitoring the flow control component of the detector, each air pollutant molecule can be placed at the center of a SET nanopore and is treated as an island of the SET device in the same framework. Electron transport in the SET was incoherent, and the performances of the SET were sensitive at the single molecule level. Employing first-principles calculations, electronic features of an air pollutant molecule within a tube-shaped SET environment were found to be independent of the molecule rotational orientations with respect to axis of symmetry, unlike the electronic features in a conventional SET environment. Charge stability diagrams of the island molecules were demonstrated to be distinct for each molecule, and thus they can serve as electronic fingerprints for detection. Using the same setup, quantification of the air pollutant can be realized at room temperature as well. The results presented herein may help provide guidance for the identification and quantification of various types of air pollutants at the molecular level by treating the molecule as the island of the SET component in the proposed detector.

Geospatial Correlation Analysis between Air Pollution Indicators and Estimated Speed of COVID-19 Diffusion in the Lombardy Region (Italy)

Background: the Lombardy region in Italy was the first area in Europe to record an outbreak of COVID-19 and one of the most affected worldwide. As this territory is strongly polluted, it was hypothesized that pollution had a role in facilitating the diffusion of the epidemic, but results are uncertain. Aim: the paper explores the effect of air pollutants in the first spread of COVID-19 in Lombardy, with a novel geomatics approach addressing the possible confounding factors, the reliability of data, the measurement of diffusion speed, and the biasing effect of the lockdown measures. Methods and results: all municipalities were assigned to one of five possible territorial classes (TC) according to land-use and socio-economic status, and they were grouped into districts of 100,000 residents. For each district, the speed of COVID-19 diffusion was estimated from the ambulance dispatches and related to indicators of mean concentration of air pollutants over 1, 6, and 12 months, grouping districts in the same TC. Significant exponential correlations were found for ammonia (NH₃) in both prevalently agricultural (R² = 0.565) and mildly urbanized (R² = 0.688) areas. Conclusions: this is the first study relating COVID-19 estimated speed of diffusion with indicators of exposure to NH₃. As NH₃ could induce oxidative stress, its role in creating a pre-existing fragility that could have facilitated SARS-CoV-2 replication and worsening of patient conditions could be speculated.

Health impacts of air pollution exposure from 1990 to 2019 in 43 European countries

Air pollution is the fourth greatest overall risk factor for human health. Despite declining levels in Europe, air pollution still represents a major health and economic burden. We collected data from the Global Burden of Disease Study 2019 regarding overall, as well as ischemic heart disease (IHD), stroke, and tracheal, bronchus and lung cancer-specific disability adjusted life years (DALYs), years of life lost (YLL) and mortality attributable to air pollution for 43 European countries between 1990 and 2019. Concentrations of ambient particulate matter (aPM_2.5), ozone, and household air pollution from solid fuels were obtained from State of Global Air 2020. We analysed changes in air pollution parameters, as well as DALYs, YLL, and mortality related to air pollution, also taking into account gross national income (GNI) and socio-demographic index (SDI). Using a novel calculation, aPM_2.5 ratio (PMR) change and DALY rate ratio (DARR) change were used to assess each country's ability to decrease its aPM_2.5 pollution and DALYs to at least the extent of the European median decrease within the analysed period. Finally, we created a multiple regression model for reliably predicting YLL using aPM_2.5 and household air pollution. The average annual population-weighted aPM_2.5 exposure in Europe in 1990 was 20.8 μg/m³ (95% confidence interval (CI) 18.3-23.2), while in 2019 it was 33.7% lower at 13.8 μg/m³ (95% CI 12.0-15.6). There were in total 368 006 estimated deaths in Europe in 2019 attributable to air pollution, a 42.4% decrease compared to 639 052 in 1990. The majority (90.4%) of all deaths were associated with aPM_2.5. IHD was the primary cause of death making up 44.6% of all deaths attributable to air pollution. The age-standardised DALY rate and YLL rate attributable to air pollution were more than 60% lower in 2019 compared to 1990. There was a strong positive correlation (r = 0.911) between YLL rate and aPM_2.5 pollution in 2019 in Europe. Our multiple regression model predicts that for 10% increase in aPM_2.5, YLL increases by 16.7%. Furthermore, 26 of 43 European countries had a positive DARR change. 31 of 43 European countries had a negative PMR change, thus not keeping up with the European median aPM_2.5 concentration decrease. When categorising countries by SDI and GNI, countries in the higher brackets had significantly lower aPM_2.5 concentration and DALY rate for IHD and stroke. Overall, air pollution levels, air pollution-related morbidity and mortality have decreased considerably in Europe in the last three decades. However, with the growing European population, air pollution remains an important public health and economic issue. Policies targeting air pollution reduction should continue to be strongly enforced to further reduce one of the greatest risk factors for human health.

The impacts of pollution and its associated spatial spillover effects on ill-health in China

While the adverse health effects of air pollution and its associated spatial spillovers have been extensively explored, there are a paucity of studies examining and comparing the effects of air pollution, water pollution, and their associated spatial spillover consequences for health. This study aims to evaluate and compare the impacts of water pollution, air pollution, and their associated spillover effects on ill-health. This study combined individual-level health data acquired from three waves of the China Health and Retirement Longitudinal Study (CHARLS) for 25,504 residents from 28 Chinese provinces with provincial-level pollution data for 2011, 2013 and 2015. We used Moran's I statistic to examine the existence and direction of the spatial spillover effects of pollution. The Spatial Durbin Model was then employed to assess the impacts of pollution and its associated spatial spillover effects on ill-health. A province's ill-health score increased by 6.649 for every 1 ton per capita per annum increase in the average amount of soot/dust discharged by its adjacent provinces. For every 1 ton per capita per annum increase in wastewater discharged, a province's ill-health score increased by 0.004. Targeted actions through the construction of cooperative action with adjacent provinces are suggested by our study to improve the efficiency of policy interventions.

Aging, Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why?

Perceived social support represents an important predictor of healthy aging. The global COVID-19 pandemic has dramatically changed the face of social relationships and revealed elderly to be particularly vulnerable to the effects of social isolation. Social distancing may represent a double-edged sword for older adults, protecting them against COVID-19 infection while also sacrificing personal interaction and attention at a critical time. Here, we consider the moderating role of social relationships as a potential influence on stress resilience, allostatic load, and vulnerability to infection and adverse health outcomes in the elderly population. Understanding the mechanisms how social support enhances resilience to stress and promotes mental and physical health into old age will enable new preventive strategies. Targeted social interventions may provide effective relief from the impact of COVID-19-related isolation and loneliness. In this regard, a pandemic may also offer a window of opportunity for raising awareness and mobilizing resources for new strategies that help build resilience in our aging population and future generations.

Impact of Exposure to Ambient Fine Particulate Matter Pollution on Adults with Knee Osteoarthritis

The impact of exposure to fine particulate matter (PM_2.5) on the incidence of knee osteoarthritis is unclear, especially in Beijing which is a highly polluted city. We conducted a time-series study to examine the correlation between PM_2.5 exposure and outpatient visits for knee osteoarthritis in Beijing. Changes (in percentage) in the number of outpatient visits corresponding to every 10-μg/m³ increase in the PM_2.5 concentration were determined using a generalized additive quasi-Poisson model. There were records of 9,797,446 outpatient visits for knee osteoarthritis in the study period from 1 January 2010 to 31 December 2017. The daily concentration of PM_2.5 was 86.8 (74.3) μg/m³ over this period. A 10-μg/m³ increase in PM_2.5 concentrations on lag days 0–3 was associated with a 1.41% (95% confidence interval: 1.40–1.41%) increase in outpatient visits for knee osteoarthritis. Females and patients aged above 65 years were more sensitive to the adverse effects of PM_2.5 exposure. The present findings demonstrate that short-term exposure to PM_2.5 resulted in an increase in the number of outpatient visits for knee osteoarthritis in Beijing. The findings shed light on the effects of air pollution on knee osteoarthritis and could guide risk-mitigating strategies in cities such as Beijing.

Particulate Air Pollution and Osteoporosis: A Systematic Review

Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case-control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM2.5 and PM10. Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects' characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.

Transmission modes of COVID-19 disease pandemic in the light of ancient wisdom of Ayurveda medicine: a review

Human-to-human transmission of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs most often when people are in the incubation stage of the disease or are carriers and have no symptoms. SARS-CoV-2 transmission on different levels showed that the cold and dry climate, hot wind and relative humid wind, maximum wind speed, turbulent wind, intensified recirculating flow were causing transmission higher than factors. The role of environmental factors described in Ayurveda like air, water, soil, season, frequent earthquakes, sunlight exposure, frequent thunderstorm with lightening, and factors from arthropods were revalidated in perspective of COVID-19 transmission. The authors searched the information regarding epidemic diseases in Ayurveda textbooks. Pubmed, Science Direct, Wikipedia, Elsevier, Lancet, and Springer were approached for the latest knowledge relating to SARS-CoV-2 and COVID-19. Google Scholar search engine was thoroughly checked upon for scientific evidence regarding the Ayurveda drugs. Various environmental factors like soil, air, water, frequent earthquake disasters, wildlife animals, aquatic birds, space, inevitable disastrous factors, weather or seasonal hazards, violent thunderstorm with lightning, intermediate hosts, sunlight exposure etc. were considered for their role in the genesis of the disease. The Ayurvedic concepts behind the etiology and development of epidemics are the same as modern epidemiological theories. The mysteries of many aspects of the current pandemic might be deciphered by traditional medicine knowledge and thus adding upon to the integrative medicine concept.

PM2.5 facilitates IL-6 production in human osteoarthritis synovial fibroblasts via ASK1 activation

Osteoarthritis (OA) is a progressive degenerative joint disorder characterized by synovial inflammation. Interleukin-6 (IL-6) is a key proinflammatory cytokine in OA progression. Particulate matter 2.5 (PM2.5) exposure increases the risk of different diseases, including OA. Up until now, no studies have described any association between PM2.5 and IL-6 expression in human OA synovial fibroblasts (OASFs). Here, our data show that PM2.5 concentration- and time-dependently promoted IL-6 synthesis in human OASFs. We also found that reactive oxygen species (ROS) generation potentiated the effects of PM2.5 on IL-6 production. ASK1, ERK, p38, and JNK inhibitors reduced PM2.5-induced increases of IL-6 expression. Treatment of OASFs with PM2.5 promoted phosphorylation of these signaling cascades. We also found that PM2.5 enhanced c-Jun phosphorylation and its translocation into the nucleus. Thus, PM2.5 increases IL-6 production in human OASFs via the ROS, ASK1, ERK, p38, JNK, and AP-1 signaling pathways. Our evidence links PM2.5 with OA progression.

Low emission zones and population health

Air pollution has a detrimental impact on population health, but the effectiveness of policy measures targeting pollution is underexplored. I exploit the natural experiment generated by the staggered implementation of low emission zones in large cities across Germany to assess their impact on health. Using register data on outpatient and inpatient health care, I find that low emission zones reduce the number of patients with cardiovascular disease by 2-3%. This effect is particularly pronounced for those over the age of 65. The findings suggest that low emission zones can be an effective way to reduce air pollution and improve health.

The Condition of Air Pollution in Kraków, Poland, in 2005-2020, with Health Risk Assessment

Aims: Air quality changes with human health risk assessment were investigated. Methods: The measurement results obtained by the Regional Environmental Protection Inspectorate (REPI) in Kraków and our deposited particulate-matter (PM) analysis, as well as United States Environmental Protection Agency (USEPA) methodology of risk assessment were used in the study. Results: Annual pollutant contents kept decreasing, with the exception of O₃. However, the permissible annual levels were exceeded in the cases of PM10, PM2.5, and NO₂. Increased contents of SO₂, CO, C₆H₆, PM10, and PM2.5, as well as of As, Pb, Cd, Ni, and polycyclic aromatic hydrocarbons (PAHs) in PM particles during winter months indicated that house heating was the source of pollution. Due to no significant change in the monthly NO₂ contents, this measurement was used as an indicator of traffic sources of pollution. In winter months, the allowable 24 h PM2.5 and PM10 contents were constantly exceeded. PM was identified as the most significant air pollutant. Enrichment factors revealed that deposited PM was enriched with heavy metals. The potential ecological risk (ERI) was determined to be very high for Cd, considerable for Zn, and low for As, Co, Cr, Cu, Ni, Pb, and Tl. The total non-carcinogenic risk indices (HQ) for both adults (HQ = 15.0) and children (HQ = 26.4) exceeded the acceptable value of 1. The total carcinogenic risk indices (CR) for both adults (CR = 1.51 × 10⁻⁴) and children (CR = 1.77 × 10⁻⁴) exceeded the acceptable level of 1 × 10⁻⁴. Conclusions: In the years 2005–2020, a general decreasing tendency of annual pollutant contents was observed. However, the permissible contaminant contents were still exceeded. PM2.5, BaP, PM10, and NO₂ were determined as the most dangerous pollutants in inhalational pathway.

Peaks of Fine Particulate Matter May Modulate the Spreading and Virulence of COVID-19

A probe of a patient, seeking help in an emergency ward of a French hospital in late December 2019 because of Influenza like symptoms, was retrospectively tested positive to COVID-19. Despite the early appearance of the virus in Europe, the prevalence and virulence appeared to be low for several weeks, before the spread and severity of symptoms increased exponentially, yet with marked spatial and temporal differences. Here, we compare the possible linkages between peaks of fine particulate matter (PM2.5) and the sudden, explosive increase of hospitalizations and mortality rates in the Swiss Canton of Ticino, and the Greater Paris and London regions. We argue that these peaks of fine particulate matter are primarily occurring during thermal inversion of the boundary layer of the atmosphere. We also discuss the influence of Saharan dust intrusions on the COVID-19 outbreak observed in early 2020 on the Canary Islands. We deem it both reasonable and plausible that high PM2.5 concentrations-favored by air temperature inversions or Saharan dust intrusions-are not only modulating but even more so boosting severe outbreaks of COVID-19. Moreover, desert dust events-besides enhancing PM2.5 concentrations-can be a vector for fungal diseases, thereby exacerbating COVID-19 morbidity and mortality. We conclude that the overburdening of the health services and hospitals as well as the high over-mortality observed in various regions of Europe in spring 2020 may be linked to peaks of PM2.5 and likely particular weather situations that have favored the spread and enhanced the virulence of the virus. In the future, we recommended to monitor not only the prevalence of the virus, but also to consider the occurrence of weather situations that can lead to sudden, very explosive COVID-19 outbreaks.