Short and long term exposure to air pollution increases the risk of ischemic heart disease

Toxicity Risk Assessment Due to Particulate Matter Pollution from Regional Health Data: Case Study from Central Romania

Air pollution poses one of the greatest dangers to public well-being. This article outlines a study conducted in the Central Romania Region regarding the health risks associated with particulate matter (PM) of two sizes, viz., PM10 and PM2.5. The methodology used consists of the following: (i) an analysis of the effects of PM pollutants, (ii) an analysis of total mortality and cardiovascular-related mortality, and (iii) a general health risk assessment. The Central Region of Romania is situated in the Carpathian Mountains' inner arch (consisting of six counties). The total population of the region under investigation is about 2.6 million inhabitants. Health risk assessment is calculated based on the relative risk (RR) formula. During the study period, our simulations show that reducing these pollutants' concentrations below the new WHO guidelines (2021) will prevent over 172 total fatalities in Brasov alone, as an example. Furthermore, the potential benefit of reducing annual PM2.5 levels on total cardiovascular mortality is around 188 persons in Brasov. Although health benefits may also depend upon other physiological parameters, all general health indicators point towards a significant improvement in overall health by a general reduction in particulate matter, as is shown by the toxicity assessment of the particulate matter in the region of interest. The modality can be applied to other locations for similar studies.

Associations between short-term exposure to fine particulate matter and acute myocardial infarction: A case-crossover study

BACKGROUND

Previous studies evaluated the impact of particle matters (PM) on the risk of acute myocardial infarction (AMI) based on local registries.

HYPOTHESIS

This study aimed to evaluate possible short term effect of air pollutants on occurrence of AMI based on a specific case report sheet that was designed for this purpose.

METHODS

AMI was documented among 982 patients who referred to the emergency departments in Tehran, Iran, between July 2017 to March 2019. For each patient, case period was defined as 24 hour period preceding the time of emergency admission and referent periods were defined as the corresponding time in 1, 2, and 3 weeks before the admission. The associations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2 .5 ) and particulate matter with an aerodynamic diameter ≤10 μm (PM10 ) with AMI were analyzed using conditional logistic regression in a case-crossover design.

RESULT

Increase in PM2.5 and PM10 was significantly associated with the occurrence of AMI with and without adjustment for the temperature and humidity. In the adjusted model each 10 μg/m3 increase of PM10 and PM2.5 in case periods was significantly associated with increase myocardial infarction events (95% CI = 1.041-1.099, OR = 1.069 and 95% CI = 1.073-1.196, and OR = 1.133, respectively). Subgroup analysis showed that increase in PM10 did not increase AMI events in diabetic subgroup, but in all other subgroups PM10 and PM2 .5 concentration showed positive associations with increased AMI events.

CONCLUSION

Acute exposure to ambient air pollution was associated with increased risk of AMI irrespective of temperature and humidity.

Long-term exposure to ambient fine particulate matter and carotid intima media thickness at bilateral, left and right in adults from Mexico City: Results from GEA study

BACKGROUND

PM2.5 exposure has been associated with intima-media thickness (cIMT) increase. However, very few studies distinguished between left and right cIMT in relation to PM2.5 exposure.

AIM

To evaluate associations between chronic exposure to PM2.5 and cIMT at bilateral, left, and right in adults from Mexico City.

METHODS

This study comprised 913 participants from the control group, participants without personal or family history of cardiovascular disease, of the Genetics of Atherosclerosis Disease Mexican study (GEA acronym in Spanish), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. To assess the associations between chronic exposure to PM2.5 (per 5 μg/m3 increase) at different lag years (1-4 years) and cIMT (bilateral, left, and right) we applied distributed lag non-linear models (DLNMs).

RESULTS

The median and interquartile range for cIMT at bilateral, left, and right, were 630 (555, 735), 640 (550, 750), and 620 (530, 720) μm, respectively. Annual average PM2.5 exposure was 26.64 μg/m3, with median and IQR, of 24.46 (23.5-25.46) μg/m3. Results from DLNMs adjusted for age, sex, body mass index, low-density lipoproteins, and glucose, showed that PM2.5 exposure for year 1 and 2, were positively and significantly associated with right-cIMT [6.99% (95% CI: 3.67; 10.42) and 2.98% (0.03; 6.01), respectively]. Negative associations were observed for PM2.5 at year 3 and 4 and right-cIMT; however only year 3 was statistically significant [-2.83% (95% CI: 5.12; -0.50)]. Left-cIMT was not associated with PM2.5 exposure at any lag year. The increase in bilateral cIMT followed a similar pattern as that observed for right-cIMT, but with lower estimates.

CONCLUSIONS

Our results suggest different susceptibility between left and right cIMT associated with PM2.5 exposure highlighting the need of measuring both, left and right cIMT, regarding ambient air pollution in epidemiological studies.

Exposure to real ambient particulate matter inflicts cardiac electrophysiological disturbances, vascular calcification, and mitochondrial bioenergetics decline more than diesel particulate matter: consequential impact on myocardial ischemia-reperfusion injury

Particulate matter (PM) present in the air sample comprises different sizes and is derived from multiple sources, in particular from diesel engines. In the present study, we assessed the cardiotoxic effect of PM2.5 from real ambient air sample and diesel vehicular exhaust from a specific location and compared it with SRM-2975. Female Wistar rats were exposed to PM2.5 from real ambient PM (RA_PM), diesel particulate matter (DPM), and SRM-2975 for 3h daily for 21 days followed by cardiotoxicity assessment. Twenty-one days of daily PM2.5 exposure induced hypertrophy, vascular calcification, and alterations in cardiac electrophysiology, where the changes were more prominent in the animals exposed to RA_PM. The gross pathological changes were supported by altered mitochondrial function and increased oxidative stress in the myocardium. To evaluate the cardiac responsive ability, isolated rat hearts were subjected to ischemia-reperfusion injury (IR), and the results showed significantly low recovery in the RA_PM-exposed rat hearts. Chemical analysis of PM2.5 by ICPMS from different sources indicated the presence of additional metals like Cr, Ni, Ga, As, Rb, Cd, Ba, La, and Ce in the RA_PM sample. Additionally, the chelation of metals in the RA_PM enhanced the cell viability of H9c2 cells when compared to the non-chelated sample. Based on the above observations, we conclude that PM2.5 from the ambient air sample exhibited higher cardiovascular toxicity than DPM, emphasizing the contribution of non-diesel components of PM2.5 and the need for a comprehensive approach to tackle the PM2.5 in the air sample.

Association of long-term exposure to air pollutant mixture and incident cardiovascular disease in a highly polluted region of China

Despite growing evidence that links long-term air pollution exposure to cardiovascular disease (CVD), the combined effects of air pollutants and particulate matter with an aerodynamic diameter of less than 2.5 μm (PM_2.5) components are still limited. A prospective cohort study was performed based on the Cohort Study on Chronic Disease of the Community Natural Population in the Beijing-Tianjin-Hebei Region (CHCN-BTH) to assess the association of long-term air pollutants with incident CVD and the combined effect of the air pollutants mixture among 26,851 adults. Three-year residential exposure to air pollutants (PM_2.5, O₃, PM₁₀, PM₁, NO₂, SO₂ and CO) and PM_2.5 components [black carbon (BC), NH₄⁺, SO₄^2-, NO₃^- and organic matter (OM)] were calculated based on well-validated models. Proportional hazard models were applied to assess the association of air pollutants with incident CVD. Quantile g-Computation was used to examine the combined effect of the pollutant mixture. During the 56,090 person-years follow-up, 629 participants reported incident CVD. Adjusted hazard ratios with 95% confidence intervals (CIs) of CVD per interquartile range increase in O₃, PM_2.5, PM₁, NO₂, BC, and OM concentrations were 4.52 (95%CI: 2.61, 7.83), 2.39 (95%CI: 1.83, 3.13), 2.37 (95%CI: 1.20, 4.70), 1.36 (95%CI: 1.19, 1.56), 3.84 (95%CI: 2.38, 6.18), and 3.07 (95%CI: 2.01, 4.69), respectively. In multi-pollutant models, the combined effect of air pollutant mixture on incident CVD was 2.37 (95%CI: 2.30, 2.44). PM_2.5 and O₃ contributed 54.3% and 44.5% of the combined effect of the air pollutant mixture, respectively. After using PM_2.5 components instead of PM_2.5 as part of the mixture, OM drove 55.2% of the combined effect. The findings indicated associations of air pollutant mixtures with CVD incidence. PM_2.5 (especially OM) and O₃ might strongly contribute to air pollutant mixtures that lead to incident CVD.

A Review of the GSTM1 Null Genotype Modifies the Association between Air Pollutant Exposure and Health Problems

Air pollution is one of the significant environmental risks known as the cause of premature deaths. It has deleterious effects on human health, including deteriorating respiratory, cardiovascular, nervous, and endocrine functions. Exposure to air pollution stimulates reactive oxygen species (ROS) production in the body, which can further cause oxidative stress. Antioxidant enzymes, such as glutathione S-transferase mu 1 (GSTM1), are essential to prevent oxidative stress development by neutralizing excess oxidants. When the antioxidant enzyme function is lacking, ROS can accumulate and, thus, cause oxidative stress. Genetic variation studies from different countries show that GSTM1 null genotype dominates the GSTM1 genotype in the population. However, the impact of the GSTM1 null genotype in modifying the association between air pollution and health problem is not yet clear. This study will elaborate on GSTM1's null genotype role in modifying the relationship between air pollution and health problems.

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.

Health and economic impacts of ambient air pollution on hospital admissions for overall and specific cardiovascular diseases in Panzhihua, Southwestern China

Background

The associations of ambient air pollution with hospital admissions (HAs) for overall and specific causes of cardiovascular diseases (CVDs), as well as related morbidity and economic burdens remain understudied, especially in low-pollution areas of low- and middle-income countries (LMICs). We evaluated the short-term effects of exposure to PM_2.5 (particles with an aerodynamic diameter ≤2.5 μm), PM₁₀ (particles with an aerodynamic diameter ≤10 μm), and SO₂ (sulfur dioxide) on HAs for CVDs in Panzhihua, China, during 2016-2020, and calculated corresponding attributable risks and economic burden.

Methods

We used a generalized additive model (GAM) while controlling for time trends, meteorological conditions, holidays, and days of the week to estimate the associations. The cost of illness (COI) method was adopted to further assess corresponding hospitalization costs and productivity losses.

Results

A total of 27 660 HAs for CVDs were included in this study. PM₁₀ and SO₂ were significantly associated with elevated risks of CVDs hospitalizations. Each 10 μg/m³ increase in PM₁₀ and SO₂ at lag06 corresponded to an increase of 2.48% (95% confidence interval (CI) = 0.92%-4.06%), and 5.50% (95% CI = 3.09%-7.97%) in risk of HAs for CVDs, respectively. The risk estimates of PM₁₀ and SO₂ on CVD hospitalizations were generally robust after adjustment for other pollutants in two-pollutant models. We found stronger associations between air pollution (PM₁₀ and SO₂) and CVDs in cool seasons than in warm seasons. For specific causes of CVDs, significant associations of PM₁₀ and SO₂ exposure with cerebrovascular disease and ischaemic heart disease were observed. Using 0 μg/m³ as the reference concentrations, 11.91% (95%CI = 4.64%-18.56%) and 15.71% (95%CI = 9.30%-21.60%) of HAs for CVDs could be attributable to PM₁₀ and SO₂, respectively. During the study period, PM₁₀ and SO₂ brought 144.34 million Yuan economic losses for overall CVDs, accounting for 0.028% of local GDP.

Conclusions

Our results suggest that PM₁₀ and SO₂ exposure might be an important trigger of HAs for CVDs and accounted for substantial morbidity and economic burden.

Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study

Background

Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs).

Methods

To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment.

Results

A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking.

Conclusions

The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.

Does the Spatial Pattern of Plants and Green Space Affect Air Pollutant Concentrations? Evidence from 37 Garden Cities in China

Relevant studies have demonstrated that urban green spaces composed of various types of plants are able to alleviate the morbidity and mortality of respiratory diseases, by reducing air pollution levels. In order to explore the relationship between the spatial pattern of urban green spaces and air pollutant concentrations, this study takes 37 garden cities with subtropical monsoon climate in China as the research object and selects the urban air quality monitoring data and land use type data in 2019 to analyze the relationship between the spatial pattern and the air pollutant concentration through the landscape metrics model and spatial regression model. Moreover, the threshold effect of the impact of green space on air pollutant concentrations is estimated, as well. The results showed that the spatial pattern of urban green space was significantly correlated with the concentrations of PM_2.5 (PM with aerodynamic diameters of 2.5 mmor less), NO₂ (Nitrogen Dioxide), and SO₂ (Sulfur dioxide) pollutants in the air, while the concentrations of PM₁₀ (PM with aerodynamic diameters of 10 mmor less) pollutants were not significantly affected by the green space pattern. Among them, the patch shape index (LSI), patch density (PD) and patch proportion in landscape area (PLAND) of forest land can affect the concentration of PM_2.5, NO₂, and SO₂, respectively. The PLAND, PD, and LSI of grassland and farmland can also have an additional impact on the concentration of SO₂ pollutants. The study also found that there was a significant threshold effect within the impact mechanism of urban green space landscape pattern indicators (LSI, PD, PLAND) on the concentrations of PM_2.5, NO₂, and SO₂ air pollutants. The results of this study not only clarified the impact mechanism of the spatial pattern of urban green space on air pollutant concentrations but also provided quantitative reference and scientific basis for the optimization and updating of urban green space to promote public health.

Spatial and temporal characteristics of air pollutants and their health effects in China during 2019-2020

This work presents the temporal and spatial characteristics of the major air pollutants and their associated health risks in China from 2019 to 2020, by using the monitoring data from 367 cities. The annual average PM_2.5, PM₁₀, NO₂, SO₂, CO, and O₃ concentrations decreased by 10.9%, 13.2%, 9.3%, 10.1%, 9.4%, and 5.5% from 2019 to 2020. National average PM_2.5 concentration in 2020 met the standard of 35 μg/m³, and that of O₃ decreased from 2019. COVID-19 lockdown affected NO₂ level dramatically, yet influences on PM_2.5 and O₃ were less clear-cut. Positive correlations between PM_2.5 and O₃ were found, even in winter in all five key regions, e.g., Jing-Jin-Ji (JJJ), FenWei Plain (FWP), Yangtze River Delta (YRD), Pearl River Delta (PRD) and Chengdu-Chongqing Region (CCR), indicating importance of secondary production for both PM_2.5 and O₃. Large seasonal variability of PM_2.5-SO₂ correlation indicates a varying role of SO₂ to PM_2.5 pollution in different seasons; and generally weak correlations in winter between PM_2.5 and NO₂ or SO₂ reveal the complexity of secondary formation processes to PM_2.5 pollution in winter. Multilinear regression analysis between PM_2.5 and SO₂, NO₂ and CO demonstrates that PM_2.5 is more sensitive to the change of NO₂ than SO₂ in JJJ, FWP, PRD and CCR, suggesting a priority of NO_x emission control for future PM_2.5 reduction. Furthermore, the new World Health Organization Air Quality Guidelines (WHO AQG2021) were adopted to calculate the excess health risks (ER) as well as the health-risk based air quality index (HAQI_WHO) of the pollutants. Such assessment points out the severity of air pollution associated health risks under strict standards: 40.0% of days had HAQI_WHO>100, while only 14.4% days had AQI>100. PM_2.5 ER was generally larger than O₃ ER, but O₃ ER in low PM_2.5 region (PRD) and during summer became more serious. Notably, NO₂ ER became even more important than PM_2.5 due to its strict limit of WHO AQG2021. Overall, our results highlight the increasing importance of O₃ in both air quality evaluation and health risk assessment, and the importance of coordinated mitigation of multiple pollutants (mainly PM_2.5, O₃ and NO₂) in protecting the public health.

Analysis and Dynamic Monitoring of Indoor Air Quality Based on Laser-Induced Breakdown Spectroscopy and Machine Learning

The air quality of the living area influences human health to a certain extent. Therefore, it is particularly important to detect the quality of indoor air. However, traditional detection methods mainly depend on chemical analysis, which has long been criticized for its high time cost. In this research, a rapid air detection method for the indoor environment using laser-induced breakdown spectroscopy (LIBS) and machine learning was proposed. Four common scenes were simulated, including burning carbon, burning incense, spraying perfume and hot shower which often led to indoor air quality changes. Two steps of spectral measurements and algorithm analysis were used in the experiment. Moreover, the proposed method was found to be effective in distinguishing different kinds of aerosols and presenting sensitivity to the air compositions. In this paper, the signal was isolated by the forest, so the singular values were filtered out. Meanwhile, the spectra of different scenarios were analyzed via the principal component analysis (PCA), and the air environment was classified by K-Nearest Neighbor (KNN) algorithm with an accuracy of 99.2%. Moreover, based on the establishment of a high-precision quantitative detection model, a back propagation (BP) neural network was introduced to improve the robustness and accuracy of indoor environment. The results show that by taking this method, the dynamic prediction of elements concentration can be realized, and its recognition accuracy is 96.5%.

Associations between differences in anemia-related blood cell parameters and short-term exposure to ambient particle pollutants in middle-aged and elderly residents in Beijing, China

Anemia is a highly prevalent disease among older populations, with multiple adverse health outcomes, and particles exposure is a potential risk factor for anemia. However, evidence on associations of exposure to particles with small size with anemia-related blood cell parameters levels in the elderly is limited, and the underlying mechanisms are unclear. Based on a panel study in Beijing, we found that in 135 elderly participants, mass concentrations of particle with an aerodynamic diameter ≤ 2.5 μm (PM_2.5), black/elemental carbon (BC/EC, particle size range: 0-2.5 μm), and number concentrations of ultrafine particles (UFPs, particle size range: 5.6-93.1 nm) and accumulated mode particles (Acc, size range: 93.1-560 nm) were significantly associated with levels of red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC). The mean ± SD for PM_2.5, UFPs, Acc, BC, OC, and EC were 69.7 ± 61.1 μg/m³, 12.5 ± 4.3 × 10³/cm³, 1.6 ± 1.2 × 10³/cm³, 3.0 ± 2.0 μg/m³, 8.7 ± 6.7 μg/m³, and 2.1 ± 1.6 μg/m³, respectively. Cotinine (higher than 50 ng/mL) is used as an indicator of smoking exposure. The association between MCHC difference and per interquartile range (IQR) increase in average UFPs concentration 14 d before clinical visits was -0.7% (95% CI: -1.1% to -0.3%). Significant associations of UFPs and Acc exposure with MCHC and MCH levels remain robust after adjustment for other pollutants. Furthermore, 25.2% (95% CI: 7.4% to 64.8%) and 29.8% (95% CI: 5.3% to 214.4%) of the difference in MCHC associated with average UFPs and Acc concentrations 14 d before clinical visits were mediated by the level of tumor necrosis factor α (TNF α), a biomarker of systemic inflammation. Our findings for the first time provide the evidence that short-term UFPs and Acc exposure contributed to the damage of anemia-related blood cell in the elderly, and systemic inflammation was a potential internal mediator.

Health impact assessment of air pollution in an area of the largest coal mine in Brazil

Coal exploration and burning activities are among the activities with the greatest potential to cause atmospheric pollution due to the combustion process of this mineral and the consequent release of particles that, in significant quantities, can pose a potential health risk, mainly respiratory and cardiovascular diseases. The Candiota region, in the extreme south of Brazil, concentrates 40% of the national reserves of mineral coal, and its burning is capable of releasing air pollutants, including particulate matter (PM). Some environmental and epidemiological studies have been carried out in the region, but so far, there is no investigation to estimate the impact of PM on health outcomes. The current study aimed to estimate the mortality attributed to the PM, as well as the benefits in health indicators associated with the reduction of air pollution to the limits set forth in local legislation and the WHO. Daily data on PM levels collected from an air quality monitoring station over a year were used, as well as population data and health indicators from 7 cities influenced by mining activities, such as total mortality and cardiovascular diseases and hospitalizations for cardiac and respiratory problems. In a scenario where PM levels are within legal limits, a percentage greater than 11% of cardiovascular deaths was attributed to pollution by PM2.5, and the reduction in PM10 and PM2.5 levels may be responsible for the increase in the expectation of life in up to 17 months and monetary gains of more than $ 24 million, due to the reduction in hospitalizations and mortality. Studies of this nature should be important tools made available to decision-makers, with a view to improving environmental laws and a consequent improvement in the quality of life and health indicators of the population.

Global magnitude and long-term trend of ischemic heart disease burden attributed to household air pollution from solid fuels in 204 countries and territories, 1990-2019

Understanding the spatiotemporal variation in the household air pollution from solid fuels (HAP)-related ischemic heart disease (IHD) burden on a global scale from 1990 to 2019 is essential to reduce IHD burden, as well as control HAP exposure. Based on the Global Burden of Disease Study 2019, the numbers and age-standardized rates of IHD mortality and disability-adjusted life years (DALYs) (ASMR and ASDR) attributed to HAP were analyzed by sex and age at global, regional, and national levels. The estimated annual percentage change was calculated to evaluate the temporal trend in burden rates. In 2019, IHD attributed to HAP resulted in 511 170 deaths and 13.18 million DALYs globally. The corresponding ASMR and ASDR were higher in males, increased with age peaking at about 80-94 years, and varied greatly across the world. Despite a remarkable decline in HAP-related IHD was achieved across the world over the past decades, an undesirable increase could be observed in some low-income but with high-burden countries. Sustained and comprehensive efforts are needed to control HAP and reduce the IHD burden, especially in countries and territories with a heavy or increasing burden, such as the Solomon Islands, Vanuatu, Afghanistan, Philippines, Zimbabwe, Lesotho, and Somalia.

Association between air pollution and chronic rhinosinusitis: a nested case-control study using meteorological data and national health screening cohort data

BACKGROUND

Inconsistent results about the effect of air pollution on chronic rhinosinusitis (CRS) have been reported. This study aimed to evaluate the impact of meteorological conditions/air pollution on the prevalence of CRS in adult Koreans.

METHODOLOGY

The data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 through 2015 were used. A CRS group (defined as ICD-10 codes J32, n=6159) was matched with a control group (n=24,636) in 1:4 ratios by age, sex, income, and region of residence. The meteorological conditions and air pollution data included the daily mean, highest, and lowest temperature (°C), daily temperature range (°C), relative humidity (%), ambient atmospheric pressure (hPa), sunshine duration (hr), and the rainfall (mm), SO2 (ppm), NO2 (ppm), O3 (ppm), CO (ppm), and PM10 (μg/m3) levels before the CRS diagnosis. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for CRS were analyzed using logistic regression analyses.

RESULTS

When the NO2 level increased by 0.1 ppm, the odds for CRS increased 5.40 times, and when the CO level increased by 1 ppm and PM10 increased by 10 μg/m3, the odds for CRS decreased 0.75 times and 0.93 times, respectively. Other meteorological conditions, such as the mean/highest/lowest temperature, temperature range, rainfall and other air pollution, such as SO2 and O3, were not statistically significant. NO2 for 90 days before the index date increased the risk of CRS in all subgroups, except for the nasal polyp and older age subgroups.

CONCLUSION

CRS is related to high concentrations of NO2.