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

Oxidative potential of particulate matter and its association to respiratory health endpoints in high-altitude cities in Bolivia

Exposure to particulate matter (PM) pollution is a significant health risk, driving the search for innovative metrics that more accurately reflect the potential harm to human health. Among these, oxidative potential (OP) has emerged as a promising health-based metric, yet its application and relevance across different environments remain to be further explored. This study, set in two high-altitude Bolivian cities, aims to identify the most significant sources of PM-induced oxidation in the lungs and assess the utility of OP in assessing PM health impacts. Utilizing two distinct assays, OPDTT and OPDCFH, we measured the OP of PM samples, while also examining the associations between PM mass, OP, and black carbon (BC) concentrations with hospital visits for acute respiratory infections (ARI) and pneumonia over a range of exposure lags (0-2 weeks) using a Poisson regression model adjusted for meteorological conditions. The analysis also leveraged Positive Matrix Factorization (PMF) to link these health outcomes to specific PM sources, building on a prior source apportionment study utilizing the same dataset. Our findings highlight anthropogenic combustion, particularly from traffic and biomass burning, as the primary contributors to OP in these urban sites. Significant correlations were observed between both OPDTT and PM2.5 concentration exposure and ARI hospital visits, alongside a notable association with pneumonia cases and OPDTT levels. Furthermore, PMF analysis demonstrated a clear link between traffic-related pollution and increased hospital admissions for respiratory issues, affirming the health impact of these sources. These results underscore the potential of OPDTT as a valuable metric for assessing the health risks associated with acute PM exposure, showcasing its broader application in environmental health studies.

Indoor cooking and cleaning as a source of outdoor air pollution in urban environments

Indoor sources of air pollution, such as from cooking and cleaning, play a key role in indoor gas-phase chemistry. The focus of the impact of these activities on air quality tends to be indoors, with less attention given to the impact on air quality outside buildings. This study uses the INdoor CHEmical Model in Python (INCHEM-Py) and the Advanced Dispersion Modelling System (ADMS) to quantify the impact cooking and cleaning have on indoor and outdoor air quality for an idealised street of houses. INCHEM-Py has been developed to determine the concentrations of 106 indoor volatile organic compounds at the point they leave a building (defined as near-field concentrations). For a simulated 140 m long street with 10 equi-distant houses undertaking cooking and cleaning activities, the maximum downwind concentration of acetaldehyde increases from a background value of 0.1 ppb to 0.9 ppb post-cooking, whilst the maximum downwind chloroform concentrations increase from 1.2 to 6.2 ppt after cleaning. Although emissions to outdoors are higher when cooking and cleaning happen indoors, the contribution of these activities to total UK emissions of volatile organic compounds is low (less than 1%), and comprise about a quarter of those emitted from traffic across the UK. It is important to quantify these emissions, particularly as continued vehicle technology improvements lead to lower direct emissions outdoors, making indoor emissions relatively more important. Understanding how indoor pollution can affect outdoor environments, will allow better mitigation measures to be designed in the future that can take into account all sources of pollution that contribute to human exposure.

Beyond the Runway: Respiratory health effects of ultrafine particles from aviation in children

Aviation has been shown to cause high particle number concentrations (PNC) in areas surrounding major airports. Particle size distribution and composition differ from motorized traffic. The objective was to study short-term effects of aviation-related UFP on respiratory health in children. In 2017-2018 a study was conducted in a school panel of 7-11 year old children (n = 161) living North and South of Schiphol Airport. Weekly supervised spirometry and exhaled nitric oxide (eNO) measurements were executed. The school panel, and an additional group of asthmatic children (n = 19), performed daily spirometry tests at home and recorded respiratory symptoms. Hourly concentrations of various size fractions of PNC and black carbon (BC) were measured at three school yards. Concentrations of aviation-related particles were estimated at the residential addresses using a dispersion model. Linear and logistic mixed models were used to investigate associations between daily air pollutant concentrations and respiratory health. PNC20, a proxy for aviation-related UFP, was virtually uncorrelated with BC and PNC50-100 (reflecting primarily motorized traffic), supporting the feasibility of separating PNC from aviation and other combustion sources. No consistent associations were found between various pollutants and supervised spirometry and eNO. Major air pollutants were significantly associated with an increase in various respiratory symptoms. Odds Ratios for previous day PNC20 per 3,598pt/cm3 were 1.13 (95%CI 1.02; 1.24) for bronchodilator use and 1.14 (95%CI 1.03; 1.26) for wheeze. Modelled aviation-related UFP at the residential addresses was also positively associated with these symptoms, corroborating the PNC20 findings. PNC20 was not associated with daily lung function, but PNC50-100 and BC were negatively associated with FEV1. PNC of different sizes indicative of aviation and other combustion sources were independently associated with an increase of respiratory symptoms and bronchodilator use in children living near a major airport. No consistent associations between aviation-related UFP with lung function was observed.

Moss as a passive biomonitoring tool for the atmospheric deposition and spatial distribution pattern of toxic metals in an industrial city

Anthropogenic pollution impacts human and environmental health, climate change, and air quality. Karabük, an industrial area from the Black Sea Region in northern Türkiye, is vulnerable to environmental pollution, particularly soil and air. In this research on methodological aspects, we analyzed the concentrations of six potential toxic metals in the atmospheric deposition of the city using the passive method of moss biomonitoring. The ground-growing terrestrial moss, Hypnum cupressiforme Hedw., was collected during the dry season of August 2023 at 20 urban points. The concentrations of Cr, Cu, Cd, Ni, Pb, and Co were determined in mosses by the ICP-MS method. Descriptive statistical analysis was employed to evaluate the status and variance in the spatial distribution of the studied metals, and multivariate analysis, Pearson correlation, and cluster analysis were used to investigate the associations of elements and discuss the most probable sources of these elements in the study area. Cd and Co showed positive and significant inter-element correlations (r > 0.938), representing an anthropogenic association mostly present in the air particles emitted from several metal plants. The results showed substantial impacts from local industry, manufactured activity, and soil dust emissions. Steel and iron smelter plants and cement factories are the biggest emitters of trace metals in the Karabük area and the primary sources of Cr, Cd, Ni, and Co deposition.

Burden of cardiovascular disease attributed to air pollution: a systematic review

BACKGROUND

Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics.

METHODS

A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle-Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study.

RESULTS

Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016-2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014.

CONCLUSION

Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.

Air pollution, cardiorespiratory fitness and biomarkers of oxidative status and inflammation in the 4HAIE study

The aim of this study was to investigate the associations between cardiorespiratory fitness (CRF), long-term air pollution exposure and biochemical markers of oxidative status and inflammation. This is a cross-sectional investigation focusing on biochemical markers of oxidative status and inflammation. Participants were Caucasian (N = 1188; age 18-65 years) who lived for at least 5 years in a high air-polluted (Moravian-Silesian; MS) or low air-polluted (South Bohemia; SB) region of the Czech Republic. Healthy runners and inactive individuals were recruited. A multiple regression analysis was used to explain the relationship between multiple independent variables (CRF, trunk fat mass, sex, socioeconomic status, and region (MS region vs. SB region) and dependent variables (oxidative status, inflammation). CRF, trunk fat mass, age and sex significantly predicted almost all selected markers of oxidative status and inflammation (except GSSG, GSH/GSSG and BDNF). Participants living in the MS region presented significantly higher GPx (by 3.1%) and lower BDNF values (by 4.5%). All other investigated biochemical markers were not significantly influenced by region. We did not find meaningful interactions between long-term air-pollution exposure versus markers of oxidative status and inflammation. However, we showed various significant interactions with sex, age, CRF and body composition. The significant association of living in the high air polluted MS region with the BDNF level warrants further attention.

Relevance of radon progeny measurements for the assessment of inhalation doses in groundwater utilities

The high radon concentrations measured in the indoor air of groundwater facilities and the prevalence of the problem have been known for several years. Unlike in other workplaces, in groundwater plants, radon is released into the air from the water treatment processes. During the measurements of this study, the average radon concentrations varied from 500 to 8800 Bq m-3. In addition, the indoor air of the treatment plants is filtered and there are no significant internal aerosol sources. However, only a few published studies on groundwater plants have investigated the properties of the radon progeny aerosol, such as the equilibrium factor (F) or the size distribution of the aerosol, which are important for assessing the dose received by workers. Moreover, the International Commission on Radiological Protection has not provided generic aerosol parameter values for dose assessment in groundwater treatment facilities. In this study, radon and radon progeny measurements were carried out at three groundwater plants. The results indicate surprisingly high unattached fractions (fp= 0.27-0.58), suggesting a low aerosol concentration in indoor air. The correspondingFvalues were 0.09-0.42, well below those measured in previous studies. Based on a comparison of the effective dose rate calculations, either the determination of thefpor, with certain limitations, the measurement of radon is recommended. Dose rate calculation based on the potential alpha energy concentration alone proved unreliable.

Association of Environmental Injustice and Cardiovascular Diseases and Risk Factors in the United States

BACKGROUND

While the impacts of social and environmental exposure on cardiovascular risks are often reported individually, the combined effect is poorly understood.

METHODS AND RESULTS

Using the 2022 Environmental Justice Index, socio-environmental justice index and environmental burden module ranks of census tracts were divided into quartiles (quartile 1, the least vulnerable census tracts; quartile 4, the most vulnerable census tracts). Age-adjusted rate ratios (RRs) of coronary artery disease, strokes, and various health measures reported in the Prevention Population-Level Analysis and Community Estimates data were compared between quartiles using multivariable Poisson regression. The quartile 4 Environmental Justice Index was associated with a higher rate of coronary artery disease (RR, 1.684 [95% CI, 1.660-1.708]) and stroke (RR, 2.112 [95% CI, 2.078-2.147]) compared with the quartile 1 Environmental Justice Index. Similarly, coronary artery disease 1.057 [95% CI,1.043-1.0716] and stroke (RR, 1.118 [95% CI, 1.102-1.135]) were significantly higher in the quartile 4 than in the quartile 1 environmental burden module. Similar results were observed for chronic kidney disease, hypertension, diabetes, obesity, high cholesterol, lack of health insurance, sleep <7 hours per night, no leisure time physical activity, and impaired mental and physical health >14 days.

CONCLUSIONS

The prevalence of CVD and its risk factors is highly associated with increased social and environmental adversities, and environmental exposure plays an important role independent of social factors.

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.

Addressing disparities in the global epidemiology of stroke

Stroke is the second leading cause of death and the third leading cause of disability worldwide. Though the burden of stroke worldwide seems to have declined in the past three decades, much of this effect reflects decreases in high-income countries (HICs). By contrast, the burden of stroke has grown rapidly in low-income and middle-income countries (LMICs), where epidemiological, socioeconomic and demographic shifts have increased the incidence of stroke and other non-communicable diseases. Furthermore, even in HICs, disparities in stroke epidemiology exist along racial, ethnic, socioeconomic and geographical lines. In this Review, we highlight the under-acknowledged disparities in the burden of stroke. We emphasize the shifting global landscape of stroke risk factors, critical gaps in stroke service delivery, and the need for a more granular analysis of the burden of stroke within and between LMICs and HICs to guide context-appropriate capacity-building. Finally, we review strategies for addressing key inequalities in stroke epidemiology, including improvements in epidemiological surveillance and context-specific research efforts in under-resourced regions, development of the global workforce of stroke care providers, expansion of access to preventive and treatment services through mobile and telehealth platforms, and scaling up of evidence-based strategies and policies that target local, national, regional and global stroke disparities.

Toward Better and Healthier Air Quality: Global PM2.5 and O3 Pollution Status and Risk Assessment Based on the New WHO Air Quality Guidelines for 2021

To reduce the high burden of disease caused by air pollution, the World Health Organization (WHO) released new Air Quality Guidelines (AQG) on September 22, 2021. In this study, the daily fine particulate matter (PM2.5) and surface ozone (O3) data of 618 cities around the world is collected from 2019 to 2022. Based on the new AQG, the number of attainment days for daily average concentrations of PM2.5 (≤ 15 µg m-3) and O3 (≤ 100 µg m-3) is approximately 10% and 90%, respectively. China and India exhibit a decreasing trend in the number of highly polluted days (> 75 µg m-3) for PM. Every year over 68% and 27% of cities in the world are exposed to harmful PM2.5 (> 35 µg m-3) and O3 (> 100 µg m-3) pollution, respectively. Combined with the United Nations Sustainable Development Goals (SDGs), it is found that more than 35% of the world's cities face PM2.5-O3 compound pollution. Furthermore, the exposure risks in these cities (China, India, etc.) are mainly categorized as "High Risk", "Risk", and "Stabilization". In contrast, economically developed cities are mainly categorized as "High Safety", "Safety", and "Deep Stabilization." These findings indicate that global implementation of the WHO's new AQG will minimize the inequitable exposure risk from air pollution.

Changes in environmental exposures over decades may influence the genetic architecture of severe spermatogenic failure

STUDY QUESTION

Do the genetic determinants of idiopathic severe spermatogenic failure (SPGF) differ between generations?

SUMMARY ANSWER

Our data support that the genetic component of idiopathic SPGF is impacted by dynamic changes in environmental exposures over decades.

WHAT IS KNOWN ALREADY

The idiopathic form of SPGF has a multifactorial etiology wherein an interaction between genetic, epigenetic, and environmental factors leads to the disease onset and progression. At the genetic level, genome-wide association studies (GWASs) allow the analysis of millions of genetic variants across the genome in a hypothesis-free manner, as a valuable tool for identifying susceptibility risk loci. However, little is known about the specific role of non-genetic factors and their influence on the genetic determinants in this type of conditions.

STUDY DESIGN, SIZE, DURATION

Case-control genetic association analyses were performed including a total of 912 SPGF cases and 1360 unaffected controls.

PARTICIPANTS/MATERIALS, SETTING, METHODS

All participants had European ancestry (Iberian and German). SPGF cases were diagnosed during the last decade either with idiopathic non-obstructive azoospermia (n = 547) or with idiopathic non-obstructive oligozoospermia (n = 365). Case-control genetic association analyses were performed by logistic regression models considering the generation as a covariate and by in silico functional characterization of the susceptibility genomic regions.

MAIN RESULTS AND THE ROLE OF CHANCE

This analysis revealed 13 novel genetic association signals with SPGF, with eight of them being independent. The observed associations were mostly explained by the interaction between each lead variant and the age-group. Additionally, we established links between these loci and diverse non-genetic factors, such as toxic or dietary habits, respiratory disorders, and autoimmune diseases, which might potentially influence the genetic architecture of idiopathic SPGF.

LARGE SCALE DATA

GWAS data are available from the authors upon reasonable request.

LIMITATIONS, REASONS FOR CAUTION

Additional independent studies involving large cohorts in ethnically diverse populations are warranted to confirm our findings.

WIDER IMPLICATIONS OF THE FINDINGS

Overall, this study proposes an innovative strategy to achieve a more precise understanding of conditions such as SPGF by considering the interactions between a variable exposome through different generations and genetic predisposition to complex diseases.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the "Plan Andaluz de Investigación, Desarrollo e Innovación (PAIDI 2020)" (ref. PY20_00212, P20_00583), the Spanish Ministry of Economy and Competitiveness through the Spanish National Plan for Scientific and Technical Research and Innovation (ref. PID2020-120157RB-I00 funded by MCIN/ AEI/10.13039/501100011033), and the 'Proyectos I+D+i del Programa Operativo FEDER 2020' (ref. B-CTS-584-UGR20). ToxOmics-Centre for Toxicogenomics and Human Health, Genetics, Oncology and Human Toxicology, is also partially supported by the Portuguese Foundation for Science and Technology (Projects: UIDB/00009/2020; UIDP/00009/2020). The authors declare no competing interests.

TRIAL REGISTRATION NUMBER

N/A.

Determinants of Knowledge, Attitudes, Perceptions and Behaviors Regarding Air Pollution in Schoolchildren in Pristina, Kosovo

Air pollution poses a significant public health challenge, and Kosovo, a low-middle-income country in the Balkan peninsula, suffers from particularly poor air quality, especially around the area of the capital Pristina. The availability of accurate and timely information is crucial in mitigating the adverse effects of air pollution. This study aimed at evaluating the knowledge, attitudes, behaviors, and perceptions (KAPB) related to poor air quality in Pristina's low-middle schools. Furthermore, the study explored the connections between these factors and socio-demographic and health attributes and provided valuable inputs for the development of future strategies and policies in air pollution mitigation. Regression analysis provided insights into how these various factors interacted with KAPB scores. The results revealed limited knowledge about air pollution sources and risks among pupils, with insufficient awareness of reliable information sources. While attitudes were generally positive, they declined with higher grade levels. Parental education significantly influenced knowledge and attitudes, and better health correlated with more positive attitudes. Perceptions of air pollution risks were influenced by grade, gender, and parental education, with better-educated parents associated with improved perceptions. Overall behavior scores increased with higher levels of parental education. Understanding the factors that shape pupils' responses to air pollution is critical for strategy and policy development. These findings can guide strategies to enhance environmental awareness and promote healthy behavior, helping address the pressing issue of air pollution in the country.

Health effects of carbonaceous PM2.5 compounds from residential fuel combustion and road transport in Europe

Exposure to fine particulate matter (PM2.5) is associated with an increased risk of morbidity and mortality. In Europe, residential fuel combustion and road transport emissions contribute significantly to PM2.5. Toxicological studies indicate that PM2.5 from these sources is relatively more hazardous, owing to its high content of black and organic carbon. Here, we study the contribution of the emissions from these sectors to long-term exposure and excess mortality in Europe. We quantified the impact of anthropogenic carbonaceous aerosols on excess mortality and performed a sensitivity analysis assuming that they are twice as toxic as inorganic particles. We find that total PM2.5 from residential combustion leads to 72,000 (95% confidence interval: 48,000-99,000) excess deaths per year, with about 40% attributed to carbonaceous aerosols. Similarly, road transport leads to about 35,000 (CI 23,000-47,000) excess deaths per year, with 6000 (CI 4000-9000) due to carbonaceous particles. Assuming that carbonaceous aerosols are twice as toxic as other PM2.5 components, they contribute 80% and 37%, respectively, to residential fuel combustion and road transport-related deaths. We uncover robust national variations in the contribution of each sector to excess mortality and emphasize the importance of country-specific emission reduction policies based on national characteristics and sectoral shares.

Trace elements and microbial community composition associated with airborne PM2.5 in wetlands: A case study in Tablas de Daimiel National Park

Tablas de Daimiel National Park (TDNP) is one of the most important wetlands in the Iberian Peninsula. Due to its location near various cities and new industries focused on agricultural waste revalorization, we investigated concurrently the concentrations of particulate matter 2.5 (PM2.5) mass, trace element composition, and associated microbial communities (bacteria and fungi) during a year-long study. The goal of this study was to explore the dependencies among these physicochemical and microbiological parameters on a seasonal time scale. Additionally, we assessed meteorological conditions and back trajectories to shed light on atmospheric mechanisms and sources related to these elements. We found the variability of PM2.5 to be influenced by local meteorological parameters. Through the analysis of crustal enrichment factors (EFs), bivariate correlations, and air mass patterns, we determined that soil resuspension was the primary contributor to elevated metal concentrations in PM2.5 within the park, followed by other minor sources, such as traffic emissions and Sahara dust intrusions. The measured metal levels were used to calculate the ecological risk in the area, resulting in a low ecological risk index (RI) of 52. Shifts in microbial community structure were observed to be mainly driven by changes in air temperature and Cu concentration. The results from this study contribute to a better understanding of the environmental dynamics in TDNP. Taken together, our findings will aid in the development of effective strategies for its conservation and management.

Effects of long-term exposure to ambient fine particulate air pollution on all-cause mortality in Taiwan

According to the US Environmental Protection Agency's Integrated Science Assessment (ISA), there is a causal relationship between fine particulate matter (PM2.5) exposure and increased mortality rates. A similar association was also reported by the International Agency for Research on Cancer (IARC). While many studies are available on this relationship between PM exposure and elevated mortality frequency in Europe and North America, there are limited investigations in Asia. Thus, the aim of this study was to perform an ecological investigation to determine the relationship between exposure to ambient PM2.5 levels and all-cause mortality in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized all-cause mortality rates were calculated for male and female residents of these areas from 2010 to 2020. Weighted-multiple regression analyses were used to obtain adjusted risk ratio (RR) controlling for possible confounding by urbanization level, physician density, and annual mean household income. Annual PM2.5 levels of each municipality were divided into tertiles. Data demonstrated that men residing in areas with intermediate tertile PM2.5 levels (21.06 to 27.29 µg/m3) and the highest tertiles levels (27.30-33.11 µg/m3) exhibited adjusted RRs of 1.06 (95% CI = 1.03-1.08) and 1.13 (95% CI = 1.10-1.16), respectively. Women in these locations displayed a similar risk, 1.03 (0.99-1.06) and 1.07 (1.04-1.11), respectively. These findings indicate that ambient exposure to PM2.5 increased risk for all-cause mortality rates in both men and women in Taiwan during this time period.

The cardiovascular disease burden attributable to particulate matter pollution in South America: analysis of the 1990-2019 global burden of disease

OBJECTIVES

Fine particulate matter <2.5 microns (PM2.5) is the most studied air pollutant. Both short- and long-term exposure to PM2.5 have been linked to cardiovascular disease (CVD). Studies evaluating air pollution in South America are scarce. Therefore, the impact of exposure to PM2.5, household air pollution (HAP), and ambient air pollution (AAP) on CVD mortality and CVD disability-adjusted life years (DALYs) in South American countries from 1990 to 2019 was explored.

STUDY DESIGN AND METHODS

The Global Burden of Disease initiative exposure-response function was used to analyze the total PM2.5, ambient PM2.5, and household PM2.5-related CVD deaths and DALYs rates, per 100,000 individuals, in 12 South American countries between 1990 and 2019. The relative change in burden was also assessed by comparing the 1990-1994 to 2015-2019 periods.

RESULTS

In 2019, 70,668 deaths and 1,736,414 DALYs due to CVD were attributed to total PM2.5 exposure in South America. Substantial regional heterogeneity was observed concerning the absolute change in PM2.5 concentration levels comparing 1990 to 2019. All South American countries observed a relative decline in CVD deaths and DALYs comparing the 1990-1994 to 2015-2019 periods. No country was able to reach the current World Health Organization 5 μg/m3 recommended limit in 2019. Predominantly, AAP was the greatest contributor to the CVD burden.

CONCLUSION

Air pollution substantially impacted CVD in South America; however, this impact was heterogenous, and the relative reduction of HAP and AAP burden was also not uniform. Recognizing PM2.5 importance is key for developing target population and individual-level interventions, which could ultimately alleviate its burden.

A meta-analysis of particulate matter and nitrogen dioxide air quality monitoring associated with the burden of disease in sub-Saharan Africa

Exposure to air pollution is a fundamental obstacle that makes it complex to realize the Sustainable Development Goals (SDGs 3) for good health and wellbeing. It is for this reason that air pollution has been characterized as the global environmental health risk facing the current generation. The risks of air pollution on morbidity, and life expectancy are well documented. This feeds directly to the substantial body of the literature that exists regarding the burden of diseases associated with ambient air pollution. However, the bulk of this literature originates from developed countries. Whilst most of the sub-Saharan African studies extrapolate literature from developed countries to contextualize the risks of elevated air pollution exposure levels associated with the burden of disease. However, extrapolation of epidemiological evidence from developed countries is problematic given that it disregards the social vulnerability. Therefore, given this observation, it is ideal to evaluate if the monitoring executions of hazardous particulate matter and nitrogen dioxide do take into consideration the concerted necessary efforts to associate monitored air pollution exposure levels with the burden of disease. Therefore, based on this background, the current meta-analysis evaluated air quality monitoring associated with the burden of disease across sub-Saharan Africa. To this extent, the current meta-analysis strictly included peer-reviewed published journal articles from the sub-Saharan African regions to gain insight on air quality monitoring associated with the burden of disease. The collected meta-analysis data was captured and subsequently analyzed using Microsoft Excel 2019. This program facilitated the presentation of the meta-analysis data in the form of graphs and numerical techniques. Generally, the results indicate that the sub-Saharan Africa is characterized by a substantial gap in the number of regional studies that evaluate the burden of disease in relation with exposure to air quality.Implications: The work presented here is an original contribution and provides a comprehensive yet succinct overview of the monitoring associated with the burden of disease in sub-Saharan Africa. The author explores if the monitoring executions of hazardous particulate matter and nitrogen dioxide do take into considerations the concerted necessary efforts to associate monitored air pollution exposure levels with the burden of disease. The manuscript includes the most relevant and current literature in a field of study that has not received a deserving degree of research attention in recent years. This is especially true in sub-Saharan Africa, characterized by insufficient monitoring of air quality exposure concentrations.

Hepatoprotective Effect of Morin Hydrate in Type 2 Diabetic Wistar Rats Exposed to Diesel Exhaust Particles

Studies have shown that exposure to air pollutants such as diesel exhaust particles (DEP) exacerbate diabetes complications. Morin hydrate (MH), a plant bioflavonoid, provides hepatoprotection due to its diverse pharmacological properties. This study examines the hepatoprotective effects of MH in Wistar rats with type 2 diabetes exposed to diesel exhaust (DE). Procured male Wistar rats (n = 60) were separated into 12 groups of five rat each. Type 2 diabetes was induced following oral therapy with fructose solution and one-time injection of 45 mg/kg of streptozotocin (STZ). The DEP extract was administered by nasal instillation, whereas MH was administered via oral gavage. Biochemical assays were used to determine the effect of MH on diabetic rats and DEP-exposed diabetic rats with respect to liver function indices (AST and ALT), liver antioxidants (SOD, CAT, Gpx, and GSH), lipid profile, and oxidative stress marker (conjugated diene and lipid peroxidation). The mRNA expression of PI3K/AKT/GLUT4 and AMPK/GLUT4 signaling pathways were quantified using RT-PCR. The results show that normal rats, diabetic rats, and diabetic rats exposed to DEP exhibited a substantial decrease in oxidative stress indicators, serum lipid profile, and levels of AST and ALP, as well as an increase in liver natural antioxidants following oral administration of MH. The gene expression study demonstrated that MH promotes the activation of the insulin signaling pathways which facilitates the uptake of glucose from the blood. This study suggests that MH offered hepatoprotection in type 2 diabetic rats and DEP exposed diabetic rats.

Development of a Self-Assessment Audit Instrument to Support Climate-Conscious Community Pharmacy Practice and Education

Climate breakdown continues to occur at an alarming pace, and the need for all citizens and professionals to respond has never been so urgent. Healthcare work contributes significantly to greenhouse gas (GHG) emissions, representing an opportunity and responsibility for pharmacists to engage in more climate-conscious practices. A key informant interview-based qualitative research method was undertaken to identify options and strategies for community pharmacists to contribute positively to achieving climate-related carbon footprint reduction goals. A total of 10 thought leaders in climate-conscious pharmacy practice were interviewed using a semi-structured protocol, and a constant comparative data analysis method was used to identify common themes and priorities. A self-assessment audit instrument (SAAI) was identified as a positive first step to build awareness, knowledge, skills, and confidence amongst community pharmacists regarding actionable climate-conscious community pharmacy practice. The SAAI supported both self-reflection and self-assessment, while signposting additional resources that could be accessed by pharmacists to continue their learning and professional development. Further work in this area is required if community pharmacy is to contribute positively to climate reduction targets locally and globally.

Association of Long-term Exposure to Air Pollution and Dementia Risk: The Role of Homocysteine, Methionine, and Cardiovascular Burden

BACKGROUND AND OBJECTIVES

Growing evidence links air pollution with dementia risk, but the biological mechanisms are largely unknown. We investigated the role played by homocysteine (tHcy) and methionine in this association and explored whether this could be explained by cardiovascular diseases (CVDs).

METHODS

Data were extracted from the ongoing Swedish National study on Aging and Care in Kungsholmen (SNAC-K), a longitudinal population-based study. At baseline, 2,512 dementia-free participants were examined up to 2013 (mean follow-up: 5.18 ± 2.96 years). Two air pollutants (particulate matter ≤2.5 μm [PM2.5] and nitrogen oxides [NOx]) were assessed yearly from 1990 until 2013 using dispersion models at residential addresses. The hazard ratio of dementia over air pollution levels was estimated using Cox models adjusted for age, sex, education, smoking, socioeconomic status, physical activity, retirement age, creatinine, year of assessment, and the use of supplements. The total effect of air pollutants on dementia was decomposed into 4 pathways involving tHcy/methionine: (1) direct effect; (2) indirect effect (mediation); (3) effect due to interaction; and (4) effect due to both mediation and interaction. To test whether the association was independent from CVDs (ischemic heart disease, atrial fibrillation, heart failure, and stroke), we repeated the analyses excluding those individuals who developed CVDs.

RESULTS

The mean age of the study participants was 73.4 years (SD: 10.4), and 62.1% were female individuals. During an average period of 5 years (mean: 5.18; SD: 2.96 years), 376 cases with incident dementia were identified. There was a 70% increased hazard of dementia per unit increase of PM2.5 during the 5 years before baseline (hazard ratio [HR]: 1.71; 95% CI 1.33-2.09). Overall, 50% (51.6%; 95% CI 9.0-94.1) of the total effect of PM2.5 on dementia was due to mediation of tHcy (6.6%; 95% CI 1.6-11.6) and/or interaction (47.8%; 95% CI 4.9-91.7) with tHcy and 48.4% (p = 0.03) to the direct effect of PM2.5 on dementia. High levels of methionine reduced the dementia hazard linked to PM2.5 by 31% (HR: 0.69; 95% CI 0.56-0.85) with 24.8% attributable to the interaction with methionine and 25.9% (p = 0.001) to the direct effect of PM2.5. No mediation effect was found through methionine. Attenuated results were obtained for NOx. Findings for tHcy were attenuated after excluding those who developed CVDs, while remained similar for methionine.

DISCUSSION

High levels of homocysteine enhanced the dementia risk attributed to air pollution, while high methionine concentrations reduced this risk. The impact of homocysteine on cardiovascular conditions partly explains this association. Alternative pathways other than cardiovascular mechanisms may be at play between methionine and dementia.

Genome-wide DNA methylation sequencing identifies epigenetic perturbations in the upper airways under long-term exposure to moderate levels of ambient air pollution

While the link between exposure to high levels of ambient particulate matter (PM) and increased incidences of respiratory and cardiovascular diseases is widely recognized, recent epidemiological studies have shown that low PM concentrations are equally associated with adverse health effects. As DNA methylation is one of the main mechanisms by which cells regulate and stabilize gene expression, changes in the methylome could constitute early indicators of dysregulated signaling pathways. So far, little is known about PM-associated DNA methylation changes in the upper airways, the first point of contact between airborne pollutants and the human body. Here, we focused on cells of the upper respiratory tract and assessed their genome-wide DNA methylation pattern to explore exposure-associated early regulatory changes. Using a mobile epidemiological laboratory, nasal lavage samples were collected from a cohort of 60 adults that lived in districts with records of low (Simmerath) or moderate (Stuttgart) PM10 levels in Germany. PM10 concentrations were verified by particle measurements on the days of the sample collection and genome-wide DNA methylation was determined by enzymatic methyl sequencing at single-base resolution. We identified 231 differentially methylated regions (DMRs) between moderately and lowly PM10 exposed individuals. A high proportion of DMRs overlapped with regulatory elements, and DMR target genes were involved in pathways regulating cellular redox homeostasis and immune response. In addition, we found distinct changes in DNA methylation of the HOXA gene cluster whose methylation levels have previously been linked to air pollution exposure but also to carcinogenesis in several instances. The findings of this study suggest that regulatory changes in upper airway cells occur at PM10 levels below current European thresholds, some of which may be involved in the development of air pollution-related diseases.

Machine learning strengthened prediction of tracheal, bronchus, and lung cancer deaths due to air pollution

This work pointed out the use of machine learning tools to predict the effect of CO, O3, CH4, and CO2 on TBL (tracheal, bronchus, and lung cancer) deaths from 1990 to 2019. In this study, data from 203 countries/locations were used. We used evaluation metrics like accuracy, area under curve (AUC), recall, precision, and Matthews correlation coefficient (MCC) to determine the prediction efficiency of the models. The models that yielded accuracy between 89 and 90 were selected in this study. The essential features in the prediction process were extracted, and it was found that CO influenced the prediction process. Extra trees classifier, random forest classifier, gradient boosting classifier, and light gradient boosting machine were selected from 14 other classifiers based on the accuracy metric. The best-performing models, according to our benchmark standards, are the extra trees classifier (90.83%), random forest classifier (89.17%), gradient boosting classifier (89.17%), and light gradient boosting machine (89.17). We conclude that machine learning models can be used in predicting mortality, i.e., the number of deaths, and could assist us in predicting the role of air pollutants on TBL deaths globally.

Simulating the impact of particulate matter exposure on health-related behaviour: A comparative study of stochastic modelling and personal monitoring data

Epidemiological and exposure studies concerning particulate matter (PM) often rely on data from sparse governmental stations. While low-cost personal monitors have some drawbacks, recent developments have shown that they can provide fairly accurate and fit-for-purpose data. Comparing a stochastic, i.e., agent-based model (ABM), with environmental, biometric and activity data, collected with personal monitors, could provide insight into how the two approaches assess PM exposure and dose. An ABM was constructed, simulating a PM exposure/dose assessment of 100 agents. Their actions were governed by inherent probabilities of performing an activity, based on population data. Each activity was associated with an intensity level, and a PM pollution level. The ABM results were compared with real-world results. Both approaches had comparable results, showing similar trends and a mean dose. Discrepancies were seen in the activities with the highest mean dose values. A stochastic model, based on population data, does not capture well some specifics of a local population. Combined, personal sensors could provide input for calibration, and an ABM approach can help offset a low number of participants. Implementing a function of agents influencing others transport choice, increased the importance of cycling/walking in the overall dose estimate. Activists, agents with an increased transport influence, did not play an important role at low PM levels. As concentrations rose, higher shares of activists (and their influence) caused the dose to increase. Simulating a person's PM exposure/dose in different scenarios and activities in a virtual environment provides researchers and policymakers with a valuable tool.

The health impact of freight transport-related air pollution on vulnerable population groups

Every year, over 364,200 people in Europe die prematurely due to the effects of air pollution, in which the transportation sector plays an important role. In Brussels, freight transport generates €61,604 of air pollution health costs daily. Research has shown that dynamic spatiotemporal modeling of both emission sources and exposed people (using mobile phone data) renders more accurate impact results when analyzed in microenvironments. However, mobile data underrepresent population segments that are more sensitive to the effects of air pollution, such as toddlers, children and elderly individuals. This paper examined the link between vulnerable people aged 0-3, 3-18 and >65 years and freight transport-related air pollution concentrations in the Brussels-Capital Region (BCR). To this end, dynamic tailpipe emissions and their spatiotemporal dispersion were calculated using output from the Transport Agent-Based Model (TRABAM) on a daily basis. Population densities were calculated as a function of the residences' occupancy rate and school/class size and opening hours. The effects of exposure were then evaluated using age- and sex-differentiated exposure-response functions and monetized using local hospital cost factors. Data were compiled for 2021. A strong overlap between people's presence at the institutions' locations was noticed with a peak in (freight) transportation movements in the city. The results showed that €37,000 [€34,517.47-€40,047.13] of freight transport-related air pollution health costs were incurred daily by vulnerable population segments. While these vulnerable groups made up 25.34% of the total BCR population, they incurred 60% [56.03%-65.01%] of the engendered transportation air pollution costs. The results were then geographically analyzed to identify 465 traffic-related air pollution hotspots across the territory, which accounted for €36,000 [€33,677.85-€39,101.31] of total costs. The latter can be used in future studies to assess sector-specific freight transportation policies, which should take into consideration spatiotemporal population densities on the local level.

Placental-fetal distribution of carbon particles in a pregnant rabbit model after repeated exposure to diluted diesel engine exhaust

BACKGROUND

Airborne pollution particles have been shown to translocate from the mother's lung to the fetal circulation, but their distribution and internal placental-fetal tissue load remain poorly explored. Here, we investigated the placental-fetal load and distribution of diesel engine exhaust particles during gestation under controlled exposure conditions using a pregnant rabbit model. Pregnant dams were exposed by nose-only inhalation to either clean air (controls) or diluted and filtered diesel engine exhaust (1 mg/m³) for 2 h/day, 5 days/week, from gestational day (GD) 3 to GD27. At GD28, placental and fetal tissues (i.e., heart, kidney, liver, lung and gonads) were collected for biometry and to study the presence of carbon particles (CPs) using white light generation by carbonaceous particles under femtosecond pulsed laser illumination.

RESULTS

CPs were detected in the placenta, fetal heart, kidney, liver, lung and gonads in significantly higher amounts in exposed rabbits compared with controls. Through multiple factor analysis, we were able to discriminate the diesel engine exposed pregnant rabbits from the control group taking all variables related to fetoplacental biometry and CP load into consideration. Our findings did not reveal a sex effect, yet a potential interaction effect might be present between exposure and fetal sex.

CONCLUSIONS

The results confirmed the translocation of maternally inhaled CPs from diesel engine exhaust to the placenta which could be detected in fetal organs during late-stage pregnancy. The exposed can be clearly discriminated from the control group with respect to fetoplacental biometry and CP load. The differential particle load in the fetal organs may contribute to the effects on fetoplacental biometry and to the malprogramming of the fetal phenotype with long-term effects later in life.

Air Pollution: A Silent Key Driver of Dementia

In 2017, the Lancet Commission on Dementia Prevention, Intervention, and Care included air pollution in its list of potential risk factors for dementia; in 2018, the Lancet Commission on Pollution concluded that the evidence for a causal relationship between fine particulate matter (PM) and dementia is encouraging. However, few interventions exist to delay or prevent the onset of dementia. Air quality data are becoming increasingly available, and the science underlying the associated health effects is also evolving rapidly. Recent interest in this area has led to the publication of population-based cohort studies, but these studies have used different approaches to identify cases of dementia. The purpose of this article is to review recent evidence describing the association between exposure to air pollution and dementia with special emphasis on fine particulate matter of 2.5 microns or less. We also summarize here the proposed detailed mechanisms by which air pollutants reach the brain and activate the innate immune response. In addition, the article also provides a short overview of existing limitations in the treatment of dementia.

Outdoor air pollution exposure, bone mineral density, osteoporosis, and osteoporotic fractures: A systematic review and meta-analysis

BACKGROUND

The prevalence of osteoporosis and osteoporotic fractures is expected to increase with the aging of the population in the coming decades. In this study, we systematically reviewed the evidence on the association between exposure to air pollution and osteoporosis-related outcomes.

METHODS

We systematically searched evidence according to the PRISMA on PubMed, Scopus, and Web of Science (until August 2022). The risk of bias (RoB) was assessed using the Risk of Bias in the Non-randomized Studies of Exposures (ROBINS-E) tool. Random effects meta-analysis was applied to calculate combined estimates. We evaluated the heterogeneity using Cochran's Q test and quantified it by I² and tau² statistics. The overall body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) tool.

RESULTS

Out of 5254 retrieved articles, 19 studies (11 cross-sectional, seven cohorts, and one case-control) met our inclusion criteria. Most of the studies had a high probability of RoB (n = 17), and only two had a moderate RoB. Different outcomes including bone mineral density, bone mineral content, osteoporotic fracture, osteoporosis, and osteopenia were reported across the studies. The associations were reported for different air pollutants including PM2.5, PM10, nitrogen oxides, nitrogen dioxide, ozone, black carbon, carbon monoxide, sulfur dioxide, nitrogen oxide, and coarse particulate matter. Evidence was suggestive of the negative role of PM10, PM2.5, and nitrogen dioxide (e.g. bone mineral density pooled estimate: -0.02, 95%CI: -0.03: -0.01). The overall body of evidence for most of the exposure-outcome pairs was low and very low.

CONCLUSIONS

The evidence on the association between air pollution exposure and osteoporosis-related outcomes is heterogenic. However, the evidence suggests an increased risk of osteoporotic fracture and osteoporosis in outdoor air pollutants. Due to the small number of studies in each group, also observed heterogeneity, and publication bias, the results should be interpreted with caution.

Change in Air Quality during 2014-2021 in Jinan City in China and Its Influencing Factors

Air pollution affects climate change, food production, traffic safety, and human health. In this paper, we analyze the changes in air quality index (AQI) and concentrations of six air pollutants in Jinan during 2014-2021. The results indicate that the annual average concentrations of PM₁₀, PM_2.5, NO₂, SO₂, CO, and O₃ and AQI values all declined year after year during 2014-2021. Compared with 2014, AQI in Jinan City fell by 27.3% in 2021. Air quality in the four seasons of 2021 was obviously better than that in 2014. PM_2.5 concentration was the highest in winter and PM_2.5 concentration was the lowest in summer, while it was the opposite for O₃ concentration. AQI in Jinan during the COVID epoch in 2020 was remarkably lower compared with that during the same epoch in 2021. Nevertheless, air quality during the post-COVID epoch in 2020 conspicuously deteriorated compared with that in 2021. Socioeconomic elements were the main reasons for the changes in air quality. AQI in Jinan was majorly influenced by energy consumption per 10,000-yuan GDP (ECPGDP), SO₂ emissions (SDE), NOx emissions (NOE), particulate emissions (PE), PM_2.5, and PM₁₀. Clean policies in Jinan City played a key role in improving air quality. Unfavorable meteorological conditions led to heavy pollution weather in the winter. These results could provide a scientific reference for the control of air pollution in Jinan City.

Short-term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment

INTRODUCTION

The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013-2018, and its economic impact.

METHODS

Time series study analysing emergency hospital admissions in the MAR due to all causes (ICD-10: A00-R99), respiratory causes (ICD-10: J00-J99) and circulatory causes (ICD-10: I00-I99) across the period 2013-2018. The main independent variables were mean daily PM_2.5, PM₁₀, NO₂, 8-h ozone concentrations, and noise. We controlled for meteorological variables, Public Holidays, seasonality, and the trend and autoregressive nature of the series, and fitted generalised linear models with a Poisson regression link to ascertain the relative risks and attributable risks. In addition, we made an economic assessment of these hospitalisations.

RESULTS

The following associations were found: NO₂ with admissions due to natural (RR: 1.007, 95% CI: 1.004-1.011) and respiratory causes (RR: 1.012, 95% CI: 1.005-1.019); 8-h ozone with admissions due to natural (RR: 1.049, 95% CI: 1.014-1.046) and circulatory causes (RR: 1.088, 95% CI: 1.039-1.140); and diurnal noise (L_Aeq7-23h) with admissions due to natural (RR: 1.001, 95% CI: 1.001-1.002), respiratory (RR: 1.002, 95% CI: 1.001-1.003) and circulatory causes (RR: 1.003, 95% CI: 1.002-1.005). Every year, a total of 8246 (95% CI: 4580-11,905) natural-cause admissions are attributable to NO₂, with an estimated cost of close on €120 million and 5685 (95% CI: 2533-8835) attributed to L_Aeq7-23h with an estimated cost of close on €82 million.

CONCLUSIONS

Nitrogen dioxide, ozone and noise are the main pollutants to which a large number of hospitalisations in the MAR are attributed, and are thus responsible for a marked deterioration in population health and high related economic impact.

Ambient air pollution exposure and telomere length: a systematic review and meta-analysis

OBJECTIVE

This study aimed to provide evidence of the associations between pre- and post-birth and adulthood air pollution exposure with telomere length.

STUDY DESIGN

The databases of PubMed, Embase, and Web of Science were searched up to June 1st, 2022 in order to include relevant observational studies and perform a systematic review and meta-analysis.

METHODS

The random-effects meta-analysis was grouped by air pollutant and exposure window (pre- and post-birth and adulthood) to evaluate the summary effect estimate. Cochran's Q and I² statistics were used to evaluate the heterogeneity among the included studies. The quality of individual studies was evaluated using the national toxicology program/office of health assessment and translation risk of bias rating tool.

RESULTS

We identified 18 studies, covering 8506 children and 2263 adults from multiple countries. We found moderate evidence that particulate matter less than 2.5 μm (PM_2.5) exposure during the entire pregnancy (-0.043, 95% CI: -0.067, -0.018), nitrogen dioxide (NO₂) exposure during the first trimester (-0.016, 95% confidence interval [CI]: -0.027, -0.005), long-term adulthood PM_2.5 exposure were associated with shortening telomere length. Mild to high between-study heterogeneity was observed for the most tested air pollutant-telomere length combinations in different exposure windows.

CONCLUSIONS

This systematic review and meta-analysis provides the evidence which strongly supports that prenatal PM_2.5 and NO₂ exposures were related to reduced telomere length, while prenatal sulfur dioxide (SO₂) and carbon monoxide (CO) exposures, childhood PM_2.5, particulate matter less than 10 μm (PM₁₀), NO₂ exposures and short-term adulthood PM_2.5 and PM₁₀ exposures were not associated with telomere length. Further high-quality studies are needed to elaborate our suggestive associations.

Low-Cost Sensor Node for Air Quality Monitoring: Field Tests and Validation of Particulate Matter Measurements

Air pollution is still a major public health issue, which makes monitoring air quality a necessity. Mobile, low-cost air quality measurement devices can potentially deliver more coherent data for a region or municipality than stationary measurement stations are capable of due to their improved spatial coverage. In this study, air quality measurements obtained during field tests of our low-cost air quality sensor node (sensor-box) are presented and compared to measurements from the regional air quality monitoring network. The sensor-box can acquire geo-tagged measurements of several important pollutants, as well as other environmental quantities such as light and sound. The field test consists of sensor-boxes mounted on utility vehicles operated by municipalities located in Central Switzerland. Validation is performed against a measurement station that is part of the air quality monitoring network of Central Switzerland. Often not discussed in similar studies, this study tests and discusses several data filtering methods for the removal of outliers and unfeasible values prior to further analysis. The results show a coherent measurement pattern during the field tests and good agreement to the reference station during the side-by-side validation test.

Polycyclic aromatic hydrocarbons in coarse particles (PM10) over the coastal urban region in Poland: Distribution, source analysis and human health risk implications

In this study, the results of PM10-bound PAH measurements were subjected to positive matrix factorization (PMF) approach and diagnostic ratios to investigate their levels, seasonal variability, impact of primary anthropogenic sources, and human health risk via the inhalation route. Daily ground-based observations were carried out at a representative coastal site in Gdynia (northern Poland), from April to December 2019. The concentrations of Σ13PAHs in PM10 varied between 0.45 ng m-3 and 54.02 ng m-3, with a mean of 5.22 ± 8.67 ng m-3. A clear seasonality and distribution profiles of PM10-bound PAHs were observed as a result of local/remote sources and meteorological conditions. The highest Σ13PAH concentration was found in December (18.56 ± 16.45 ng m-3) and the lowest values were observed between June and September (3.89 ± 0.52 ng m-3). The PMF-based analysis revealed five factors, suggesting the importance of primary anthropogenic sources of PAHs, i.e. coal combustion, biomass burning, gasoline/diesel vehicles, industrial and shipping activities as well as natural gas combustion. In summer, PAH levels were mostly controlled by local shipping emissions as well as traffic-related and non-combustion sources such as photochemical decomposition. The winter PAH maxima were attributed to a strong increase in residential coal combustion. A Spearman's rank correlation and multilinear regression analysis showed that ambient temperature and NO× had a significant impact on intra-annual variability in PM10-bound PAH transformation in this region. PAH congeners in coarse-size fraction were positively correlated with SO2, indicating their shared anthropogenic sources. The annual mean of epidemiologically based ILCR value was 6.6 × 10-5. This work indicates a potential carcinogenic risk for the local population and a significant difference in BaPeq levels between the individual seasons in this region.

Air Pollution and Cardiovascular Disease Burden: Changing Patterns and Implications for Public Health in India

INTRODUCTION

The link between air pollution-attributed cardiovascular disease (APACVD) burden and its contributing factors can aid in detecting vulnerabilities and providing forewarnings for India.

METHODS

We examined the association between the status and trends of the APACVD burden obtained from the Global Burden of Diseases and Injuries study with the two development metrics in India; the human development index (HDI) and indirect indices of economic development, namely annual new motor vehicle registration and the number of functional factories for 10 years from 2009 to 2019. Lorenz curves and concentration index were used to estimate the inequalities in the state-APACVD burden and the burden per 100,000 population.

RESULTS

At the state level, APACVD burden was inversely related to the HDI value in India for the years 2009 (r=-0.48), 2014 (r=-0.47), and 2019 (r=-0.37), and the association was statistically significant (p<0.05). The correlation between state-level APACVD burden with the annual new motor vehicle registration and the number of functional factories in India for these years was also positive and significant (p<0.05). The APACVD was 53% unequally distributed across the states, with a concentration index of 0.53 in 2009.

DISCUSSION

We observed that at the state level, the APACVD burden was inversely related to HDI. But the APACVD burden increased with the country's economic development. Also, the excess APACVD burden appears to be attributable to the economically developed states.

CONCLUSION

At the state level, APACVD burden decreased as HDI rose over time, indicating that the burden increased with the country's economic development. It is noticeable that the economically developed states may be contributing a higher share of the APACVD burden in India.

Population Aging Driven Slowdown in the Reduction of Economic Cost-Attributed to PM2.5 Pollution after 2013 in China

Since seniors are more susceptible to ambient fine particulate matter (PM2.5), the high economic cost to protect the aged population from PM2.5 exposure is expected. Significant efforts have been made in China to mitigate PM2.5 since 2013 under the Air Pollution Prevention and Control Action (APPCA) Plan, which remarkably reduced PM2.5 contamination and its associated economic and health burdens. However, to what extent population aging could influence the economic benefits from the APPCA Plan is unclear. Here, we estimate five driving factors contributing to the economic cost of mortality attributable to PM2.5 pollution. The results show that the economic cost attributed to PM2.5 pollution increased from 1980 to 2013 and decreased from 2013 to 2019 in China, benefiting from the APPCA Plan. Since 2013, population aging becomes the most significant positive driver that almost offsets declining economic cost from significantly declining PM2.5. Rapid aging has become an enormous burden to PM2.5-associated health and economic loss. Our findings suggest that we should further improve air quality and enhance health care for the elderly population.

Air pollution impacts on public health: Evidence from 110 cities in Yangtze River Economic Belt of China

This study intends to further reveal the relationship between air pollution and public health on a city scale in China and explore the spillover effect among cities. On the basis of collecting the panel data of 110 cities in the Yangtze River Economic Belt from 2010 to 2018, we establish a spatial econometric model to analyze the impacts of air pollution, economic development, and other factors on public health. According to the results, a significant spatial correlation exists between the public health and air pollution levels in all of the cities in the Yangtze River Economic Belt. Air pollution also shows a spillover effect among these cities; the relationships between the industrial fume (dust) emissions, industrial sulfur dioxide emissions, and particulate matter (PM 2.5) concentration and the public health level are not simple linear relationships, but instead U-shaped curvilinear relationships. The economic development in recent years has contributed to the improvement of the public health level of the cities in the Yangtze River Economic Belt. The economic development of their neighboring cities, however, has adversely affected the public health levels of these cities.

Air pollution attributed disease burden and economic growth in India: Estimating trends and inequality between states

Background

Air pollution is one of the major contributors to the disease burden in India after malnutrition. We examined the relation, and state-wise disparities in air pollution attributed to disease burden (APADB) concerning gross state domestic product (GSDP) and growth in motor vehicles in India.

Methods

We retrieved disability-adjusted life year (DALY) estimates for India due to air pollution from the Global Burden of Disease Studies, injuries, and Risk Factors Study (GBD). We examined the association between APADB with GSDP and the growth in the number of registered motor vehicles in India during the 2011 to 2019 period. Concentration indices and Lorenz curves were used to explore the variation in APADB across individual states.

Findings

Except for a few states, APADB is inversely proportional to GSDP. Growth in motor vehicles was also negatively correlated with the APADB in n=19 states. The concentration index explained a 47% inequality in APADB between individual states and exhibited a decline (45%) during 2019 compared to 2011. The unevenness in APADB among Indian states is evident from the analysis as the states occupying the 6^th or 7^th decile and above in terms of GDP, urbanization and population contribute more than 60 per cent of the total APADB.

Interpretation

The APADB is inversely correlated with GSDP for most of the states, and the negative correlations were conspicuous when APADB per 100,000 population was analysed. The concentration index and Lorenz revealed the presence of APADB inequality between states in terms of GSDP, population, urbanisation, and total factories.

Funding

Not applicable.

Association of household fuel with acute respiratory infection (ARI) under-five years children in Bangladesh

In developing countries, acute respiratory infections (ARIs) cause a significant number of deaths among children. According to Bangladesh Demographic and Health Survey (BDHS), about 25% of the deaths in children under-five years are caused by ARI in Bangladesh every year. Low-income families frequently rely on wood, coal, and animal excrement for cooking. However, it is unclear whether using alternative fuels offers a health benefit over solid fuels. To clear this doubt, we conducted a study to investigate the effects of fuel usage on ARI in children. In this study, we used the latest BDHS 2017-18 survey data collected by the Government of Bangladesh (GoB) and estimated the effects of fuel use on ARI by constructing multivariable logistic regression models. From the analysis, we found that the crude (the only type of fuel in the model) odds ratio (OR) for ARI is 1.69 [95% confidence interval (CI): 1.06-2.71]. This suggests that children in families using contaminated fuels are 69.3% more likely to experience an ARI episode than children in households using clean fuels. After adjusting for cooking fuel, type of roof material, child's age (months), and sex of the child-the effect of solid fuels is similar to the adjusted odds ratio (AOR) for ARI (OR: 1.69, 95% CI: 1.05-2.72). This implies that an ARI occurrence is 69.2% more likely when compared to the effect of clean fuel. This study found a statistically significant association between solid fuel consumption and the occurrence of ARI in children in households. The correlation between indoor air pollution and clinical parameters of ARI requires further investigation. Our findings will also help other researchers and policymakers to take comprehensive actions by considering fuel type as a risk factor as well as taking proper steps to solve this issue.

Burden of Disease (BoD) Assessment to Estimate Risk Factors Impact in a Real Nanomanufacturing Scenario

An industrial nanocoating process air emissions impact on public health was quantified by using the burden of disease (BoD) concept. The health loss was calculated in Disability Adjusted Life Years (DALYs), which is an absolute metric that enables comparisons of the health impacts of different causes. Here, the health loss was compared with generally accepted risk levels for air pollution. Exposure response functions were not available for Ag nanoform. The health loss for TiO₂ nanoform emissions were 0.0006 DALYs per 100,000 persons per year. Moreover, the exposure risk characterization was performed by comparing the ground level air concentrations with framework values. The exposure levels were ca. 3 and 18 times lower than the derived limit values of 0.1 μg-TiO₂/m³ and 0.01 μg-Ag/m³ for the general population. The accumulations of TiO₂ and Ag nanoforms on the soil top layer were estimated to be up to 85 μg-TiO₂/kg and 1.4 μg-Ag/kg which was considered low as compared to measured elemental TiO₂ and Ag concentrations. This assessment reveals that the spray coating process air emissions are adequately controlled. This study demonstrated how the BoD concept can be applied to quantify health impacts of nanoform outdoor air emissions from an industrial site.

The Significance of Software Engineering to Forecast the Public Health Issues: A Case of Saudi Arabia

In the recent years, public health has become a core issue addressed by researchers. However, because of our limited knowledge, studies mainly focus on the causes of public health issues. On the contrary, this study provides forecasts of public health issues using software engineering techniques and determinants of public health. Our empirical findings show significant impacts of carbon emission and health expenditure on public health. The results confirm that support vector machine (SVM) outperforms the forecasting of public health when compared to multiple linear regression (MLR) and artificial neural network (ANN) technique. The findings are valuable to policymakers in forecasting public health issues and taking preemptive actions to address the relevant health concerns.

The association of meteorological parameters and AirQ+ health risk assessment of PM2.5 in Ratchaburi province, Thailand

Air quality is heavily influenced by rising pollution distribution levels which are a consequence of many artificial activities from numerous sources. This study aims to determine the relationship between meteorological data and air pollutants. The health effects of long-term PM_2.5 were estimated on expected life remaining (ELR) and years of life lost (YLL) indices in Ratchaburi province during the years 2015–2019 using AirQ+ software. Values obtained from the PM_2.5 averaging, and YLL data were processed for the whole population in the age range of 0–29, 30–60 and over 60. These values were entered into AirQ+ software. The mean annual concentration of PM_2.5 was highly variable, with the highest concentration being 136.42 μg/m³ and the lowest being 2.33 μg/m³. The results estimated that the highest and lowest YLL in the next 10 years for all age groups would be 24,970.60 and 11,484.50 in 2017 and 2019, respectively. The number of deaths due to COPD, IHD, and stroke related to long-term exposure to ambient PM_2.5 were 125, 27 and 26, respectively. The results showed that older people (> 64) had a higher YLL index than the groups aged under 64 years. The highest and lowest values for all ages were 307.15 (2015) and 159 (2017). Thus, this study demonstrated that the PM_2.5 effect to all age groups, especially the the elderly people, which the policy level should be awared and fomulated the stratergies to protecting the sensitive group.

Indoor air pollution effects on pediatric asthma are submicron aerosol particle-dependent

The school environment is crucial for the child's health and well-being. On the other hand, the data about the role of school's aerosol pollution on the etiology of chronic non-communicable diseases remain scarce. This study aims to evaluate the level of indoor aerosol pollution in primary schools and its relation to the incidence of doctor's diagnosed asthma among younger school-age children. The cross-sectional study was carried out in 11 primary schools of Vilnius during 1 year of education from autumn 2017 to spring 2018. Particle number (PNC) and mass (PMC) concentrations in the size range of 0.3-10 µm were measured using an Optical Particle Sizer (OPS, TSI model 3330). The annual incidence of doctor's diagnosed asthma in each school was calculated retrospectively from the data of medical records. The total number of 6-11 years old children who participated in the study was 3638. The incidence of asthma per school ranged from 1.8 to 6.0%. Mean indoor air pollution based on measurements in classrooms during the lessons was calculated for each school. Levels of PNC and PMC in schools ranged between 33.0 and 168.0 particles/cm³ and 1.7-6.8 µg/m³, respectively. There was a statistically significant correlation between the incidence of asthma and PNC as well as asthma and PMC in the particle size range of 0.3-1 µm (r = 0.66, p = 0.028) and (r = 0.71, p = 0.017) respectively. No significant correlation was found between asthma incidence and indoor air pollution in the particle size range of 0.3-2.5 and 0.3-10 µm.   Conclusion: We concluded that the number and mass concentrations of indoor air aerosol pollution in primary schools in the particle size range of 0.3-1 µm are primarily associated with the incidence of doctor's diagnosed asthma among younger school-age children. What is Known: • Both indoor and outdoor aerosol pollution is associated with bronchial asthma in children. What is New: • The incidence of bronchial asthma among younger school age children is related to indoor air quality in primary schools. • Aerosol pollutants in the size range of 0.3-1 µm in contrast to larger size range particles can play major role in the etiology of bronchial asthma in children.

Cluster Modeling of Environmental and Occupational Health and Safety Management Systems for Integration Support

Many organizations around the world recognize the complementarity of public and environmental health and focus their attention on the effective management of both health and environmental risks. For this purpose, they often use the international standards ISO 14001 and ISO 45001. However, when a company intends to implement multiple standards simultaneously, the challenge of overlapping increases. Therefore, the objective of article is to analyze the requirements and documented information of two management system standards: environmental management systems (EMS), according to ISO 14001, and occupational health and safety management systems (OH&S), according to ISO 45001. A combination of content analysis and clustering methods was used to conduct the research. Visualization of the interrelationships between the requirements of the standards was done using TouchGraph Navigator. The outputs of the analysis can serve managers in the integrated implementation of these management systems as well as auditors during the review and check process when formulating recommendations for the improvement of management systems. Integrated implementation comes with multiple benefits, including reduced bureaucracy and management costs, a simplified certification process, improved internal management, and facilitation of continuous improvement.

Association between the Use of Biomass as Fuel for Cooking and Acute Respiratory Infections in Children under 5 Years of Age in Peru: An Analysis of a Population-Based Survey, 2019

Background

Acute respiratory infections (ARIs) are the most frequent respiratory diseases associated with the use of biomass as fuel within the home. ARIs are the main cause of mortality in children under 5 years of age. We aimed to evaluate the association between the use of biomass as cooking fuel and ARI in children under 5 years of age in Peru in 2019.

Methods

A secondary data analysis of the 2019 Peru Demographic and Family Health Survey (ENDES) has been performed. The outcome variable was a history of ARI. The exposure variable was the use of biomass as fuel for cooking food. To evaluate the association of interest, generalized linear models from the Poisson family with logarithmic link function considering complex sampling to estimate crude prevalence ratio (cPR) and adjusted prevalence ratio (aPR) with their respective 95% confidence intervals have been performed. P values <0.05 were considered statistically significant.

Results

A total of 16,043 children were included in the analysis. Of the total, biomass was used as fuel to cook food in the homes of 3,479 (20.0%) children. Likewise, 2,185 (14.3%) of the children had a history of ARI. In the adjusted model, it was found that children living in homes in which biomass was used as cooking fuel had a greater probability of presenting ARI (aPR = 1.13; 95% CI: 1.01–1.28).

Conclusions

It has been found that biomass was used to cook food in two of every 10 households. Likewise, almost one-seventh of children under 5 years old presented an ARI. The use of biomass as a source of energy for cooking in the home was associated with a higher probability of presenting ARIs.

The Labin Region, an ecologically vulnerable geographical area in Croatia: Mortality characteristics in an area polluted by industrial over a 40-year period

The history of the Labin region in Croatia includes intensive industrial development with repercussions of pollution on environment and health. Assuming that prolonged exposure to polluted environments causes qualitative changes in mortality, the aim was to analyse the mortality characteristics of the population of the Labin Region for the 1968-2008 period based on data from the Croatian Bureau of Statistics. Public health and social opportunities in this geographical area carry a long-term burden of exposure to an industrial polluted environment with outcomes expressed by mortality or/and morbidity in the population. This study includes data on 11,903 deaths, most of which due to diseases of the circulatory, respiratory and digestive systems as well as neoplasms. In the third and fourth decade of the study period, a group of neoplasms showed significant increases, while the increase in respiratory diseases were more gradual. The female population died mostly from diseases of the circulatory and endocrine system as well as neoplasms, while the male population mainly died from diseases of the digestive system and external causes. This research provides guidelines that could create better public health, raising the quality of life and contribute to a future environmental protection in local communities by targeted policies.

Household Ability of Expenditures on Electricity and Energy Resources in the Countries That Joined the EU after 2004

The purpose of the following article is to present the situation of the energy market from a household perspective between 2010 and 2020 in selected EU countries (the group of member states which joined EU after 2004). The selected countries when joining the EU had similar economic indicators and to some extent were similar in other macro-economic situations (personal income, unemployment rate, GDP level and annual growth). This article analyzes the past and current situation of the household ability expenditure on electricity and energy resources (petrol—eurosuper 95 and diesel and natural gas), taking into account price, tax conditions and the real possibility to purchase the analyzed energy sources (based on annual net salaries). The paper includes the conclusions and prospects for the future. The main objective of the study is to determine the ability amount of expenditure on electricity, natural gas and liquid fuels by household in the countries that joined the European Union after 2004. The specific objectives of the work include: the evolution of retail prices of energy sources in those countries and prices of electricity, natural gas and liquid fuels—petrol and diesel oil—in the research period from 2010 to 2020. The element that influences the final price, as assessed in this paper, is the share of taxes and compulsory charges imposed by the EU countries covered in this study. The result of the study presented inter alia that energy consumption structure did not change significantly, electricity prices were steadily growing in the countries under assessment, the use of liquid fuels—petrol and diesel oil—in the countries under study, grew over the study period. Furthermore, prices of fuel fluctuated over the period from 2010 to 2020 and during the COVID-19 pandemic, which broke out in March 2020, but did not cause any significant changes in the prices of energy carriers in the analyzed period, apart from the declines in the prices of eurosuper 95 and diesel.

Household Air Pollution and High Blood Pressure: A Secondary Analysis of the 2016 Albania Demographic Health and Survey Dataset

Background: Hypertension is a significant public health problem in low- and middle-income countries (LMICs). This study aimed to examine the association between household air pollution (HAP) and blood pressure using data from the 2016 Albania Demographic Health and Survey (DHS). Methods: We computed the odds ratio (OR) for the prevalence of hypertension between respondents exposed to clean fuels (e.g., electricity, liquid petroleum gas, natural gas, and biogas) and respondents exposed to polluting fuel (e.g., kerosene, coal/lignite, charcoal, wood, straw/shrubs/grass, and animal dung). Result: The results show that participants exposed to household polluting fuels in Albania were 17% more likely to develop hypertension than those not exposed to household air pollution (OR = 1.17, 95% CI 1.10 to 1.24). Subgroup analysis revealed that the odds of hypertension were more significant among women (OR = 1.22, 95% CI 1.13 to 1.31), rural residents (OR = 1.12, 95% CI 1.04 to 1.22), and participants aged >24 years (OR = 1.35, 95% CI 1.12 to 1.62) who were exposed to household polluting fuels compared to their counterparts who were not exposed. In summary, the results of the study show significant associations between household air pollution and hypertension risk overall, especially among women, rural dwellers, and people aged >24 years in Albania. Conclusion: In this study, an association between household air pollution and the risk of hypertension was found, particularly among low-income households, those with no education, women, and those who live in rural areas.

Air Pollution in Poland: A 2022 Narrative Review with Focus on Respiratory Diseases

According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland. Thus, ambient air pollution and its detrimental health effects are a matter of immense importance in Poland. This narrative review aims to analyse current findings on air pollution and health in Poland, with a focus on respiratory diseases, including COVID-19, as well as the Poles’ awareness of air pollution. PubMed, Scopus and Google Scholar databases were searched. In total, results from 71 research papers were summarized qualitatively. In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality rates, higher prevalence of respiratory diseases, including asthma, lung cancer and COVID-19 infections, reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The proximity of high traffic areas exacerbates respiratory health problems. People living in more polluted regions (south of Poland) and in the winter season have a higher level of air pollution awareness. There is an urgent need to reduce air pollution levels and increase public awareness of this threat. A larger number of multi-city studies are needed in Poland to consistently track the burden of diseases attributable to air pollution.