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Cowan KN, Wyatt LH, Luben TJ, Sacks JD, Ward-Caviness C, Rappazzo KM. Effect measure modification of the association between short-term exposures to PM 2.5 and hospitalizations by longs-term PM 2.5 exposure among a cohort of people with Chronic Obstructive Pulmonary Disease (COPD) in North Carolina, 2002-2015. Environ Health 2023; 22:49. [PMID: 37386433 PMCID: PMC10308617 DOI: 10.1186/s12940-023-00999-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/08/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Approximately nine million adults in the United States are living with chronic obstructive pulmonary disease (COPD), and positive associations between short-term air pollution exposure and increased risk of COPD hospitalizations in older adults are consistently reported. We examined the association between short-term PM2.5 exposure and hospitalizations and assessed if there is modification by long-term exposure in a cohort of individuals with COPD. METHODS In a time-referent case-crossover design, we used a cohort of randomly selected individuals with electronic health records from the University of North Carolina Healthcare System, restricted to patients with a medical encounter coded with a COPD diagnosis from 2004-2016 (n = 520), and estimated ambient PM2.5 concentrations from an ensemble model. Odds ratios and 95% confidence intervals (OR (95%CI)) were estimated with conditional logistic regression for respiratory-related, cardiovascular (CVD), and all-cause hospitalizations. Exposures examined were 0-2 and 0-3 day lags of PM2.5 concentration, adjusting for daily census-tract temperature and humidity, and models were stratified by long-term (annual average) PM2.5 concentration at the median value. RESULTS We observed generally null or low-magnitude negative associations with short-term PM2.5 exposure and respiratory-related (OR per 5 µg/m3 increase in 3-day lag PM2.5: 0.971 (0.885, 1.066)), CVD (2-day lag: 0.976 (0.900, 1.058) and all-cause (3 day lag: 1.003 (0.927, 1.086)) hospitalizations. Associations between short-term PM2.5 exposure and hospitalizations were higher among patients residing in areas with higher levels of annual PM2.5 concentrations (OR per 5 µg/m3 in 3-day lag PM2.5 for all-cause hospitalizations: 1.066 (0.958, 1.185)) than those in areas with lower annual PM2.5 concentrations (OR per 5 µg/m3 in 3-day lag PM2.5 for all-cause hospitalizations: 0.914 (0.804, 1.039)). CONCLUISONS Differences in associations demonstrate that people in areas with higher annual PM2.5 exposure may be associated with higher risk of hospitalization during short-term increases in PM2.5 exposure.
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Affiliation(s)
- Kristen N Cowan
- Department of Epidemiology, GillingsSchool of Global Public Health, University of North Carolina, Chapel Hill, USA
- Oak Ridge Institute for Science and Education (ORISE) at US EPA, Oak Ridge, USA
| | - Lauren H Wyatt
- U.S. Environmental Protection Agency, Office of Research and Development, 109 T.W. Alexander Dr, MD 58C, Research Triangle Park, Durham, NC, 27711, USA
| | - Thomas J Luben
- U.S. Environmental Protection Agency, Office of Research and Development, 109 T.W. Alexander Dr, MD 58C, Research Triangle Park, Durham, NC, 27711, USA
| | - Jason D Sacks
- U.S. Environmental Protection Agency, Office of Research and Development, 109 T.W. Alexander Dr, MD 58C, Research Triangle Park, Durham, NC, 27711, USA
| | - Cavin Ward-Caviness
- U.S. Environmental Protection Agency, Office of Research and Development, 109 T.W. Alexander Dr, MD 58C, Research Triangle Park, Durham, NC, 27711, USA
| | - Kristen M Rappazzo
- U.S. Environmental Protection Agency, Office of Research and Development, 109 T.W. Alexander Dr, MD 58C, Research Triangle Park, Durham, NC, 27711, USA.
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Gómez González L, Linares C, Díaz J, Egea A, Calle-Martínez A, Luna MY, Navas MA, Ascaso-Sánchez MS, Ruiz-Páez R, Asensio C, Padrón-Monedero A, López-Bueno JA. Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region. ENVIRONMENTAL RESEARCH 2023; 224:115505. [PMID: 36805353 DOI: 10.1016/j.envres.2023.115505] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND A number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013-2018. METHODOLOGY Longitudinal ecological time series study analysed by Generalised Linear Models with Poisson regression, with the dependent variable being daily Emergency Hospital Mental Health Admissions (EHMHA) in the MAR, and the independent variable being mean daily concentrations of chemical pollutants, noise levels and meteorological variables. RESULTS EHMHA were related statistically significantly in the short term with diurnal noise levels. Relative risks (RRs) for total admissions due to mental disorders and self-inflicted injuries, in the case of diurnal noise was RR: 1.008 95%CI (1.003 1.013). Admissions attributable to diurnal noise account for 5.5% of total admissions across the study period. There was no association between hospital admissions and chemical air pollution. CONCLUSION Noise is a variable that shows a statistically significant short-term association with EHMHA across all age groups in the MAR region. The results of this study may serve as a basis for drawing up public health guidelines and plans, which regard these variables as risk factors for mental disorders, especially in the case of noise, since this fundamentally depends on anthropogenic activities in highly urbanised areas with high levels of traffic density.
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Affiliation(s)
- L Gómez González
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain
| | - C Linares
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain
| | - J Díaz
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain.
| | - A Egea
- Residente de Medicina Preventiva y Salud Pública Hospital General Universitario de Albacete, Madrid, Spain
| | - A Calle-Martínez
- Residente de Medicina Preventiva y Salud Pública, Hospital Universitario, Móstoles, Madrid, Spain
| | - M Y Luna
- State Meteorological Agency Agencia Estatal de Meteorología/AEMET, Madrid, Spain
| | - M A Navas
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain
| | - M S Ascaso-Sánchez
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain
| | | | - C Asensio
- Universidad Politéctnica de Madrid. Grupo de Investigación en Instrumentación y Acústica Aplicada Ctra. Valencia km 7 - Campus sur - 28031, Madrid, Spain
| | - A Padrón-Monedero
- National School of Public Health, National Institute of Health Carlos III, Madrid, Spain
| | - J A López-Bueno
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health Instituto de Salud Carlos III/ISCIII, Madrid, Spain
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Albahar S, Li J, Al-Zoughool M, Al-Hemoud A, Gasana J, Aldashti H, Alahmad B. Air Pollution and Respiratory Hospital Admissions in Kuwait: The Epidemiological Applicability of Predicted PM2.5 in Arid Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105998. [PMID: 35627536 PMCID: PMC9140349 DOI: 10.3390/ijerph19105998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023]
Abstract
Dust is a major component of fine particulate matter (PM2.5) in arid regions; therefore, concentrations of this pollutant in countries such as Kuwait exceed air quality standards. There is limited understanding on the impact and burden of high PM2.5 concentrations on morbidity in these countries. In this study, we explore the association of PM2.5 and the risk of respiratory hospital admissions in Kuwait. A time-series regression model was used to investigate daily variations in respiratory admissions and PM2.5 concentrations from 2010 to 2018. Due to the lack of historical air quality sampling in Kuwait, we used estimated daily PM2.5 levels from a hybrid PM2.5 prediction model. Individual and cumulative lag effects of PM2.5 over a 5-day period were estimated using distributed lag linear models. Associations were stratified by sex, age, and nationality. There were 218,749 total respiratory admissions in Kuwait during the study period. Results indicate that for every 10 μg/m3 increase in PM2.5, a 1.61% (95% CI = 0.87, 2.35%) increase in respiratory admissions followed over a 5-day cumulative lag. Our estimates show that a 10 μg/m3 reduction in average exposure will potentially avert 391 yearly respiratory admissions (95% CI = 211,571), with 265 fewer admissions among Kuwaitis (95% CI = 139,393) and 262 fewer admissions among children under 15 years of age (95% CI = 125,351). Different strata of the Kuwaiti population are vulnerable to respiratory hospitalization with short-term exposure to PM2.5, especially those under 15 years of age. The findings are informative for public health authorities in Kuwait and other dust-prone countries.
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Affiliation(s)
- Soad Albahar
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
- Correspondence: (S.A.); (J.L.)
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100871, China
- Correspondence: (S.A.); (J.L.)
| | - Mustafa Al-Zoughool
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
| | - Ali Al-Hemoud
- Environment and Life Sciences Research Center, Kuwait Institute of Scientific Research, Kuwait City 13109, Kuwait;
| | - Janvier Gasana
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
| | - Hassan Aldashti
- Meteorological Department, Directorate General of Civil Aviation, Kuwait City 13001, Kuwait;
| | - Barrak Alahmad
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Ting MJ, Tsai YH, Chuang SP, Wang PH, Cheng SL. Is PM 2.5 associated with emergency department visits for mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease? Am J Emerg Med 2021; 50:566-573. [PMID: 34583244 DOI: 10.1016/j.ajem.2021.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) can have recurrent exacerbations and acute respiratory failure (ARF) triggered by particulate matter with a diameter of ≤2.5 μm (PM2.5). To prevent ventilator shortages, this study investigated the short-term association between PM2.5 concentration and emergency department visits (EDVs) among patients with acute exacerbation of COPD (AECOPD) requiring mechanical ventilation (MV). METHODS We conducted a time-series study to predict the PM2.5 concentration and number of ventilators needed. Daily counts of EDVs among AECOPD patients requiring ventilation from 2015 to 2019 were obtained from a hospital. Generalized linear models extending Poisson regression were used to explore the association of AECOPD with PM2.5 after controlling for the time trend, seasonal variations, and meteorological variables. RESULTS Eight hundred seventy-five AECOPD patients receiving MV were recorded, of whom 734 received noninvasive ventilation and 141 received invasive ventilatory support. EDVs for AECOPD patients with ARF significantly increased by 3.5% (95% confidence interval [CI]: 2.51%-4.42%) per 10 μg m-3 increase in PM2.5 concentration. Among seasons, PM2.5 concentration had the strongest effect on AECOPD patients with ARF in spring (<24.5 °C), with a 1.64% (95% CI: -0.56% to 3.83%) increase in admissions per 10 μg m-3 increase in same-day PM2.5 concentration. The interquartile range increase of 20 μg m-3 between winter and spring was associated with an average EDV increase of 48.66%. CONCLUSION This is the first study to predict the number of ventilators required by calculating quantitative estimates of the short-term effects of PM2.5 on EDVs for AECOPD patients with ARF. Adverse effects of PM2.5 on AECOPD patients requiring MV are evident, especially in the spring. Establishing protective standards and reducing the PM2.5 concentration to below various thresholds are urgently needed.
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Affiliation(s)
- Man-Ju Ting
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan.
| | - Ya-Hui Tsai
- Division of Pediatric Surgery, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Shih-Ping Chuang
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Ping-Huai Wang
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Shih-Lung Cheng
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
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Yadav R, Nagori A, Mukherjee A, Singh V, Lodha R, Kabra SK, Yadav G, Saini JK, Singhal KK, Jat KR, Madan K, George MP, Mani K, Mrigpuri P, Kumar R, Guleria R, Pandey RM, Sarin R, Dhaliwal RS. Effects of ambient air pollution on emergency room visits of children for acute respiratory symptoms in Delhi, India. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:45853-45866. [PMID: 33881691 DOI: 10.1007/s11356-021-13600-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
The present study explored the association between daily ambient air pollution and daily emergency room (ER) visits due to acute respiratory symptoms in children of Delhi. The daily counts of ER visits (ERV) of children (≤15 years) having acute respiratory symptoms were obtained from two hospitals of Delhi for 21 months. Simultaneously, data on daily concentrations of particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) and weather variables were provided by the Delhi Pollution Control Committee. K-means clustering with time-series approach and multi-pollutant generalized additive models with Poisson link function was used to estimate the 0-6-day lagged change in daily ER visits with the change in multiple pollutants levels. Out of 1,32,029 children screened, 19,120 eligible children having acute respiratory symptoms for ≤2 weeks and residing in Delhi for the past 4 weeks were enrolled. There was a 29% and 21% increase in ERVs among children on high and moderate level pollution cluster days, respectively, compared to low pollution cluster days on the same day and previous 1-6 days of exposure to air pollutants. There was percentage increase (95% CI) 1.50% (0.76, 2.25) in ERVs for acute respiratory symptoms for 10 μg/m3 increase of NO2 on previous day 1, 46.78% (21.01, 78.05) for 10 μg/m3 of CO on previous day 3, and 13.15% (9.95, 16.45) for 10 μg/m3 of SO2 on same day of exposure. An increase in the daily ER visits of children for acute respiratory symptoms was observed after increase in daily ambient air pollution levels in Delhi.
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Affiliation(s)
- Rashmi Yadav
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Aditya Nagori
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, 110007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Aparna Mukherjee
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Varinder Singh
- Kalawati Saran Children Hospital and Lady Harding Medical College, New Delhi, ,110001, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sushil Kumar Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Geetika Yadav
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Jitendra Kumar Saini
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India
| | - Kamal Kumar Singhal
- Kalawati Saran Children Hospital and Lady Harding Medical College, New Delhi, ,110001, India
| | - Kana Ram Jat
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Karan Madan
- Pulmonology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 10029, India
| | - Mohan P George
- Delhi Pollution Control Committee, Kashmere Gate, New Delhi, 110006, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Parul Mrigpuri
- Vallabhbhai Patel Chest Institute, New Delhi, 110007, India
| | - Raj Kumar
- Vallabhbhai Patel Chest Institute, New Delhi, 110007, India
| | - Randeep Guleria
- Pulmonology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 10029, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rohit Sarin
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India
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Short-Term Associations of Ambient Fine Particulate Matter (PM 2.5) with All-Cause Hospital Admissions and Total Charges in 12 Japanese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084116. [PMID: 33924698 PMCID: PMC8070111 DOI: 10.3390/ijerph18084116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 01/27/2023]
Abstract
The short-term association between ambient particulate matter ≤2.5 microns in diameter (PM2.5) and hospital admissions is not fully understood. Studies of this association with hospital admission costs are also scarce, especially in entire hospitalized populations. We examined the association between ambient PM2.5 and all-cause hospital admissions, the corresponding total charges, and the total charges per patient by analyzing the hospital admission data of 2 years from 628 hospitals in 12 cities in Japan. We used generalized additive models with quasi-Poisson regression for hospital admissions and generalized additive models with log-linear regression for total charges and total charges per patient. We first estimated city-specific results and the combined results by random-effect models. A total of 2,017,750 hospital admissions were identified. A 10 µg/m3 increase in the 2 day moving average was associated with a 0.56% (95% CI: 0.14–0.99%) increase in all-cause hospital admissions and a 1.17% (95% CI: 0.44–1.90%) increase in total charges, and a 10 µg/m3 increase in the prior 2 days was associated with a 0.75% (95% CI: 0.34–1.16%) increase in total charges per patient. Short-term exposure to ambient PM2.5 was associated with increased all-cause hospital admissions, total charges, and total charges per patient.
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Benefit Analysis of the 1st Spanish Air Pollution Control Programme on Health Impacts and Associated Externalities. ATMOSPHERE 2020. [DOI: 10.3390/atmos12010032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper aims to provide scientific support for decision-making in the field of improving air quality by evaluating pollution reduction measures included in the current Spanish policy framework of the 1st National Air Pollution Control Programme (NAPCP). First, the health impacts of air quality are estimated by using the concentrations estimated by multiscale air quality modeling and the recommended concentration–response functions (CRF), specifically as a result of exposure to particulate matter (PM), nitrogen dioxide (NO2), and ozone (O3). Second, the associated external costs are calculated by monetization techniques. Two scenarios are analyzed: a package including existing measures (WM2030) and a package with additional measures (WAM2030). Compared with the baseline scenario, an improvement was found in the health effects of NO2, PM10, and PM2.5, while for O3 there was a slight worsening, mainly due to the increase in the O3 metric used (SOMO35), which increases over some urban areas. Despite this, the monetary valuation of the total effects on health as a whole shows external benefits due to the adoption of measures (WM2030), compared with the reference scenario (no measures) of more than € 17.5 billion and, when considering the additional measures (WAM2030), benefits of about € 58.1 billion.
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Navares R, Diaz J, Aznarte JL, Linares C. Direct assessment of health impacts on hospital admission from traffic intensity in Madrid. ENVIRONMENTAL RESEARCH 2020; 184:109254. [PMID: 32126373 DOI: 10.1016/j.envres.2020.109254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 05/18/2023]
Abstract
In this paper we establish the attributable risk on respiratory and cardiovascular disorders related to traffic intensity in Madrid. In contrast to previous related studies, the proposed approach directly associates road traffic counts to patient emergency admission rates instead of using primary air pollutants. By applying Shapley values over gradient boosting machines, a first selection step is performed among all traffic observation points based on their influence on patient emergency admissions at Gregorio Marañon hospital. A subsequent quantification of the relative risk associated to traffic intensity of the selected point is calculated via ARIMA and log-linear Poisson regression models. The results obtained show that 13% of respiratory cases are related to traffic intensity while, in the case of cardiovascular disorders, the percentage increases to 39%.
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Affiliation(s)
| | - Julio Diaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - Jose L Aznarte
- Department of Artificial Inteligence, UNED, Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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Luong LTM, Dang TN, Thanh Huong NT, Phung D, Tran LK, Van Dung D, Thai PK. Particulate air pollution in Ho Chi Minh city and risk of hospital admission for acute lower respiratory infection (ALRI) among young children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 257:113424. [PMID: 31672367 DOI: 10.1016/j.envpol.2019.113424] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/12/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
High levels of air pollutants in Vietnam, especially particulate matters including PM2.5, can be important risk factors for respiratory diseases among children of the country. However, few studies on the effects of ambient air pollution on human health have been conducted in Vietnam so far. The aim of this study is to examine the association between PM2.5 and hospital admission due to acute lower respiratory infection (ALRI) among children aged < 5 years old in Ho Chi Minh city, the largest city of Vietnam. Data relating PM2.5 and hospital admission were collected from February 2016-December 2017 and a time series regression analysis was performed to examine the relationship between PM2.5 and hospital admission including the delayed effect up to three days prior to the admission. We found that each 10 μg/m3 increase in PM2.5 was associated with an increase of 3.51 (95%CI: 0.96-6.12) risk of ALRI admission among children. According to the analysis, male children are more sensitive to exposure to PM2.5 than females, while children exposed to PM2.5 are more likely to be infected with acute bronchiolitis than with pneumonia. The study demonstrated that young children in HCMC are at increased risk of ALRI admissions due to the high level of PM2.5 concentration in the city's ambient air.
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Affiliation(s)
- Ly Thi Mai Luong
- Faculty of Environmental Sciences, VNU University of Science, Vietnam National University, Hanoi, Viet Nam
| | - Tran Ngoc Dang
- The Institute of Research and Development, Duy Tan University, Da Nang City, Viet Nam; Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam.
| | - Nguyen Thi Thanh Huong
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia.
| | - Long K Tran
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
| | - Do Van Dung
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Phong K Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, 4102, Australia.
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Amsalu E, Wang T, Li H, Liu Y, Wang A, Liu X, Tao L, Luo Y, Zhang F, Yang X, Li X, Wang W, Guo X. Acute effects of fine particulate matter (PM 2.5) on hospital admissions for cardiovascular disease in Beijing, China: a time-series study. Environ Health 2019; 18:70. [PMID: 31370900 PMCID: PMC6670159 DOI: 10.1186/s12940-019-0506-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 07/12/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND Air pollution and cardiovascular disease are increasing problems in China. However, the short-term association between fine particulate matter (PM2.5) and cardiovascular disease (CVD) is not well documented. The purpose of this study is to estimate the short-term effects of PM2.5 on CVD admissions in Beijing, China. METHODS In total, 460,938 electronic hospitalization summary reports for CVD between 2013 and 2017 were obtained. A generalized additive model using a quasi-Poisson distribution was used to investigate the association between exposure to PM2.5 and hospitalizations for total and cause-specific CVD, including coronary heart disease (CHD), atrial fibrillation (AF), and heart failure (HF) after controlling for the season, the day of the week, public holidays, and weather conditions. A stratified analysis was also conducted for age (18-64 and ≥ 65 years), sex and season. RESULTS For every 10 μg/m3 increase in the PM2.5 concentration from the previous day to the current (lag 0-1) there was a significant increase in total CVD admissions (0.30, 95% CI: 0.20, 0.39%), with a strong association for older adults (aged ≥65 years), CHD (0.34, 95% CI: 0.22 to 0.45%) and AF (0.29, 95% CI, 0.03 to 0.55%). However, the observed increased risk was not statistically significant for HF hospitalizations. The associations in the single-pollutant models were robust to the inclusion of other pollutants in a two-pollutant model. No differences were found after stratification by sex and season. CONCLUSIONS Exposure to PM2.5 increased the risk of hospitalizations from CVD, especially for CHD, and appeared to have more influence in the elderly. Precautions and protective measures and efforts to reduce exposure to PM2.5 should be strengthened, especially for the elderly.
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Affiliation(s)
- Endawoke Amsalu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Tianqi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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Tsai SS, Tsai CY, Yang CY. Fine particulate air pollution associated with increased risk of hospital admissions for hypertension in a tropical city, Kaohsiung, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:567-575. [PMID: 29667508 DOI: 10.1080/15287394.2018.1460788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/01/2018] [Indexed: 05/19/2023]
Abstract
The aim of this study was to assess whether a correlation exists between fine particles (PM2.5) levels and number of hospital admissions for hypertension in Kaohsiung, Taiwan. Hospital admission frequency and ambient air pollution data were obtained for Kaohsiung for 2009-2013. A time-stratified case-crossover method was used to estimate relative risk for hospital admissions, controlling for weather, day of the week, seasonality, and long-term time trends. Odds ratios and 95% confidence intervals were calculated for a 10 µg/m3 increment of PM2.5 for lags from days 0 to 6. Data showed no significant associations between PM2.5 levels and number of hypertension-related hospital admissions on warm days (>25°C). However, on cool days (<25°C), a significant positive association was found with frequency of hypertension admissions in the single-pollutant model (without adjusting for other pollutants) with a 10 µg/m3 rise in PM2.5 on day of admission (lag 0) associated with a 12% increase in number of admissions for hypertension. In the two-pollutant model, the association of PM2.5 with rate of hypertension hospitalizations remained significant after including SO2 or O3 on lag day 0. Data demonstrate that an association between short-term exposure to PM2.5 and elevated risk of hypertension-related hospital admissions may exist in Kaohsiung, Taiwan, a tropical city.
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Affiliation(s)
- Shang-Shyue Tsai
- a Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
| | - Chia-Ying Tsai
- b Department of Management , Kaohsiung Municipal Cijin Hospital, Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Chun-Yuh Yang
- c Department of Public Health , College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- d Division of Environmental Health and Occupational Medicine , National Health Research Institute , Miaoli , Taiwan
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Chen CC, Yang CY. Association between fine particulate air pollution and hospital admissions for chest pain in a subtropical city: Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2017; 80:1269-1275. [PMID: 28956714 DOI: 10.1080/15287394.2017.1376407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study determined the association between fine particles (PM2.5) levels and hospital admissions for chest pain (CP) in Taipei, Taiwan. Hospital admissions for CP and ambient air pollution data for Taipei were obtained for the period 2009-2013. The relative risk of hospital admissions was estimated using a case-crossover approach, after controlling for weather variables, day of the week, seasonality, and long-term time trends. For single-pollutant models (without adjustment for other pollutants), increased frequency of CP admissions was significantly associated with PM2.5 levels on warm days (>23°C), with an interquartile range rise correlated with a 15% (95% confidence interval = 11-31%) elevation in number of CP admissions. In two-pollutant models, PM2.5 remained significant after inclusion of each of the other four pollutants: sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) on warm days. Generally, no marked associations were observed between PM2.5 levels and risk of CP admissions on cool days in both single- and two-pollutant models. This study provides evidence that higher PM2.5 concentrations enhance the risk of hospital admissions for CP on warm days.
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Affiliation(s)
- Chih-Cheng Chen
- a Department of Pediatrics, College of Medicine, Kaohsiung Chang-Gung , Memorial Hospital and Chang-Gung University , Kaohsiung , Taiwan
| | - Chun-Yuh Yang
- b Department of Public Health, College of Health Sciences , Kaohsiung Medical University , Kaohsiung , Taiwan
- c National Institute of Environmental Health Sciences , National Health Research Institute , Miaoli , Taiwan
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13
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Chiu HF, Tsai SS, Yang CY. Short-term effects of fine particulate air pollution on hospital admissions for hypertension: A time-stratified case-crossover study in Taipei. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2017; 80:258-265. [PMID: 28598272 DOI: 10.1080/15287394.2017.1321095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particle (PM2.5) levels and hospital admissions for hypertension in Taipei, Taiwan. Hospital admissions for hypertension and ambient air pollution data for Taipei were obtained for the period from 2009 to 2013. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants), the risk of hospital admissions for hypertension was estimated to increase by 12% on warm days (>23°C) and 2% on cool days (<23°C), respectively. There was no indication of an association between levels of PM2.5 and risk of hospital admissions for hypertension. In two-pollutant model, PM2.5 remained nonsignificant after inclusion of any of the other air pollutants (SO2, NO2, CO, or O3) both on warm and cool days, but a numerically greater response was seen on warm days. Data thus indicate that in Taipei, hospital admissions for hypertension occur as a consequence of factors not related to ambient air exposure.
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Affiliation(s)
- Hui-Fen Chiu
- a Department of Pharmacology , College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Shang-Shyue Tsai
- b Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
| | - Chun-Yuh Yang
- c Department of Public Health , College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- d Division of Environmental Health and Occupational Medicine, National Health Research Institute , Miaoli , Taiwan
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Arroyo V, Díaz J, Carmona R, Ortiz C, Linares C. Impact of air pollution and temperature on adverse birth outcomes: Madrid, 2001-2009. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 218:1154-1161. [PMID: 27589893 DOI: 10.1016/j.envpol.2016.08.069] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND/OBJECTIVES Low birth weight (<2500 g) (LBW), premature birth (<37 weeks of gestation) (PB), and late foetal death (<24 h of life) (LFD) are causes of perinatal morbi-mortality, with short- and long-term social and economic health impacts. This study sought to identify gestational windows of susceptibility during pregnancy and to analyse and quantify the impact of different air pollutants, noise and temperature on the adverse birth outcomes. METHODS Time-series study to assess the impact of mean daily PM2.5, NO2 and O3 (μg/m3), mean daily diurnal (Leqd) and nocturnal (Leqn) noise levels (dB(A)), maximum and minimum daily temperatures (°C) on the number of births with LBW, PB or LFD in Madrid across the period 2001-2009. We controlled for linear trend, seasonality and autoregression. Poisson regression models were fitted for quantification of the results. The final models were expressed as relative risk (RR) and population attributable risk (PAR). RESULTS Leqd was observed to have the following impacts in LBW: at onset of gestation, in the second trimester and in the week of birth itself. NO2 had an impact in the second trimester. In the case of PB, the following: Leqd in the second trimester, Leqn in the week before birth and PM2.5 in the second trimester. In the case of LFD, impacts were observed for both PM2.5 in the third trimester, and minimum temperature. O3 proved significant in the first trimester for LBW and PB, and in the second trimester for LFD. CONCLUSIONS Pollutants concentrations, noise and temperature influenced the weekly average of new-borns with LBW, PB and LFD in Madrid. Special note should be taken of the effect of diurnal noise on LBW across the entire pregnancy. The exposure of pregnant population to the environmental factors analysed should therefore be controlled with a view to reducing perinatal morbi-mortality.
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Affiliation(s)
- Virginia Arroyo
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain; University of Salamanca Health Care Complex (Complejo Asistencial Universitario de Salamanca/CAUSA), Salamanca, Spain
| | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Rocío Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Cristina Ortiz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
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Díaz J, Arroyo V, Ortiz C, Carmona R, Linares C. Effect of Environmental Factors on Low Weight in Non-Premature Births: A Time Series Analysis. PLoS One 2016; 11:e0164741. [PMID: 27788159 PMCID: PMC5082809 DOI: 10.1371/journal.pone.0164741] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/29/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Exposure to pollutants during pregnancy has been related to adverse birth outcomes. LBW can give rise to lifelong impairments. Prematurity is the leading cause of LBW, yet few studies have attempted to analyse how environmental factors can influence LBW in infants who are not premature. This study therefore sought to analyse the influence of air pollution, noise levels and temperature on LBW in non-premature births in Madrid during the period 2001-2009. METHODS Ecological time-series study to assess the impact of PM2.5, NO2 and O3 concentrations, noise levels, and temperatures on LBW among non-premature infants across the period 2001-2009. Our analysis extended to infants having birth weights of 1,500 g to 2,500 g (VLBW) and less than 1,500 g (ELBW). Environmental variables were lagged until 37 weeks with respect to the date of birth, and cross-correlation functions were used to identify explaining lags. Results were quantified using Poisson regression models. RESULTS Across the study period 298,705 births were registered in Madrid, 3,290 of which had LBW; of this latter total, 1,492 were non-premature. PM2.5 was the only pollutant to show an association with the three variables of LBW in non-premature births. This association occurred at around the third month of gestation for LBW and VLBW (LBW: lag 23 and VLBW: lag 25), and at around the eighth month of gestation for ELBW (lag 6). Leqd was linked to LBW at lag zero. The RR of PM2.5 on LBW was 1.01 (1.00 1.03). The RR of Leqd on LBW was 1.09 (0.99 1.19)(p<0.1). CONCLUSIONS The results obtained indicate that PM2.5 had influence on LBW. The adoption of measures aimed at reducing the number of vehicles would serve to lower pregnant women's exposure. In the case of noise should be limited the exposure to high levels during the final weeks of pregnancy.
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Affiliation(s)
- Julio Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Virginia Arroyo
- Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
| | - Cristina Ortiz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Rocío Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- * E-mail:
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Bono R, Romanazzi V, Bellisario V, Tassinari R, Trucco G, Urbino A, Cassardo C, Siniscalco C, Marchetti P, Marcon A. Air pollution, aeroallergens and admissions to pediatric emergency room for respiratory reasons in Turin, northwestern Italy. BMC Public Health 2016; 16:722. [PMID: 27492006 PMCID: PMC4974813 DOI: 10.1186/s12889-016-3376-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/09/2016] [Indexed: 11/20/2022] Open
Abstract
Background Air pollution can cause respiratory symptoms or exacerbate pre-existing respiratory diseases, especially in children. This study looked at the short-term association of air pollution concentrations with Emergency Room (ER) admissions for respiratory reasons in pediatric age (0–18 years). Methods Daily number of ER admissions in a children’s Hospital, concentrations of urban-background PM2.5, NO2, O3 and total aeroallergens (Corylaceae, Cupressaceae, Gramineae, Urticaceae, Ambrosia, Betula) were collected in Turin, northwestern Italy, for the period 1/08/2008 to 31/12/2010 (883 days). The associations between exposures and ER admissions were estimated, at time lags between 0 and 5 days, using generalized linear Poisson regression models, adjusted for non-meteorological potential confounders. Results In the study period, 21,793 ER admissions were observed, mainly (81 %) for upper respiratory tract infections. Median air pollution concentrations were 22.0, 42.5, 34.1 μg/m3 for urban-background PM2.5, NO2, and O3, respectively, and 2.9 grains/m3 for aeroallergens. We found that ER admissions increased by 1.3 % (95 % CI: 0.3-2.2 %) five days after a 10 μg/m3 increase in NO2, and by 0.7 % (95 % CI: 0.1-1.2 %) one day after a 10 grains/m3 increase in aeroallergens, while they were not associated with PM2.5 concentrations. ER admissions were negatively associated with O3 and aeroallergen concentrations at some time lags, but these association shifted to the null when meteorological confounders were adjusted for in the models. Conclusions Overall, these findings confirm adverse short-term health effects of air pollution on the risk of ER admission in children and encourage a careful management of the urban environment to health protection. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3376-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, via Santena, 5 bis, 10126, Turin, Italy.
| | - Valeria Romanazzi
- Department of Public Health and Pediatrics, University of Turin, via Santena, 5 bis, 10126, Turin, Italy
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Turin, via Santena, 5 bis, 10126, Turin, Italy
| | - Roberta Tassinari
- Department of Public Health and Pediatrics, University of Turin, via Santena, 5 bis, 10126, Turin, Italy
| | - Giulia Trucco
- Department of Public Health and Pediatrics, University of Turin, via Santena, 5 bis, 10126, Turin, Italy
| | - Antonio Urbino
- Pediatrics Emergency, Regina Margherita Children's Hospital, Piazza Polonia, 94, 10126, Turin, Italy
| | - Claudio Cassardo
- Department of Physics, University of Turin, Via P. Giuria, 1, 10125, Turin, Italy
| | - Consolata Siniscalco
- Department of Life Sciences and Systems Biology, University of Turin, Viale P. A. Mattioli, 25, 10125, Turin, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada le Grazie, 8, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada le Grazie, 8, Verona, Italy
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Royé D, Taboada JJ, Martí A, Lorenzo MN. Winter circulation weather types and hospital admissions for respiratory diseases in Galicia, Spain. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:507-520. [PMID: 26307637 DOI: 10.1007/s00484-015-1047-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 06/04/2023]
Abstract
The link between various pathologies and atmospheric conditions has been a constant topic of study over recent decades in many places across the world; knowing more about it enables us to pre-empt the worsening of certain diseases, thereby optimizing medical resources. This study looked specifically at the connections in winter between respiratory diseases and types of atmospheric weather conditions (Circulation Weather Types, CWT) in Galicia, a region in the north-western corner of the Iberian Peninsula. To do this, the study used hospital admission data associated with these pathologies as well as an automatic classification of weather types. The main result obtained was that weather types giving rise to an increase in admissions due to these diseases are those associated with cold, dry weather, such as those in the east and south-east, or anticyclonic types. A second peak was associated with humid, hotter weather, generally linked to south-west weather types. In the future, this result may help to forecast the increase in respiratory pathologies in the region some days in advance.
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Affiliation(s)
- D Royé
- Facultad de Geografía e Historia, Departamento de Geografía, Universidad de Santiago de Compostela, Praza da Universidade 1, 15782, Santiago de Compostela, Spain.
| | - J J Taboada
- Consellera de Medio Ambiente, Territorio e Infraestruturas, Meteogalicia, Rúa Roma 6, 15707, Santiago de Compostela, Spain
| | - A Martí
- Facultad de Geografía e Historia, Departamento de Geografía, Universidad de Santiago de Compostela, Praza da Universidade 1, 15782, Santiago de Compostela, Spain
| | - M N Lorenzo
- Facultad de Ciencias, Departamento de Física Aplicada, Universidad de Vigo, Campus As Lagoas, 32004, Ourense, Spain
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To T, Feldman L, Simatovic J, Gershon AS, Dell S, Su J, Foty R, Licskai C. Health risk of air pollution on people living with major chronic diseases: a Canadian population-based study. BMJ Open 2015; 5:e009075. [PMID: 26338689 PMCID: PMC4563262 DOI: 10.1136/bmjopen-2015-009075] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The objective of this study was to use health administrative and environmental data to quantify the effects of ambient air pollution on health service use among those with chronic diseases. We hypothesised that health service use would be higher among those with more exposure to air pollution as measured by the Air Quality Health Index (AQHI). SETTING Health administrative data was used to quantify health service use at the primary (physician office visits) and secondary (emergency department visits, hospitalisations) level of care in Ontario, Canada. PARTICIPANTS We included individuals who resided in Ontario, Canada, from 2003 to 2010, who were ever diagnosed with one of 11 major chronic diseases. OUTCOME MEASURES Rate ratios (RR) from Poisson regression models were used to estimate the short-term impact of incremental unit increases in AQHI, nitrogen dioxide (NO2; 10 ppb), fine particulate matter (PM2.5; 10 µg/m(3)) and ozone (O3; 10 ppb) on health services use among individuals with each disease. We adjusted for age, sex, day of the week, temperature, season, year, socioeconomic status and region of residence. RESULTS Increases in outpatient visits ranged from 1% to 5% for every unit increase in the 10-point AQHI scale, corresponding to an increase of about 15,000 outpatient visits on a day with poor versus good air quality. The greatest increases in outpatient visits were for individuals with non-lung cancers (AQHI:RR=1.05; NO2:RR=1.14; p<0.0001) and COPD (AQHI:RR=1.05; NO2:RR=1.12; p<0.0001) and in hospitalisations, for individuals with diabetes (AQHI:RR=1.04; NO2:RR=1.07; p<0.0001) and COPD (AQHI:RR=1.03; NO2:RR=1.09; p<1.001). The impact remained 2 days after peak AQHI levels. CONCLUSIONS Among individuals with chronic diseases, health service use increased with higher levels of exposure to air pollution, as measured by the AQHI. Future research would do well to measure the utility of targeted air quality advisories based on the AQHI to reduce associated health service use.
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Affiliation(s)
- Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, North York, Ontario, Canada
| | - Laura Feldman
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Jacqueline Simatovic
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea S Gershon
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, North York, Ontario, Canada
- Sunnybrook Health Sciences Centre, North York, Ontario, Canada
| | - Sharon Dell
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Jiandong Su
- Institute for Clinical Evaluative Sciences, North York, Ontario, Canada
| | - Richard Foty
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Christopher Licskai
- Western University, London, Ontario, Canada
- St. Joseph's Health Care, London, Ontario, Canada
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Association between Fine Particulate Air Pollution and Daily Clinic Visits for Migraine in a Subtropical City: Taipei, Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4697-708. [PMID: 25938912 PMCID: PMC4454934 DOI: 10.3390/ijerph120504697] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/17/2015] [Accepted: 04/23/2015] [Indexed: 11/17/2022]
Abstract
This study was undertaken to determine whether there was an association between fine particle (PM2.5) levels and daily clinic visits for migraine in Taipei, Taiwan. Daily clinic visits for migraine and ambient air pollution data for Taipei were obtained for the period from 2006–2011. The odds ratio of clinic visits was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. Generally, no significant associations between PM2.5 levels and migraine visits were observed on cool days. On warm days, however, for the single pollutant model (without adjustment for other pollutants), increased clinic visits for migraine were significantly associated with PM2.5 levels, with an interquartile range (IQR) rise associated with a 13% (95% CI = 8%–19%) elevation in number of migraine visits. In bi-pollutant model, PM2.5 remained significant after the inclusion of sulfur dioxide (SO2) or ozone (O3) on warm days. This study provides evidence that higher levels of PM2.5 increase the risk of clinic visits for migraine in Taipei, Taiwan.
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Perez-Martinez PJ, Miranda RM. Temporal distribution of air quality related to meteorology and road traffic in Madrid. ENVIRONMENTAL MONITORING AND ASSESSMENT 2015; 187:220. [PMID: 25827898 DOI: 10.1007/s10661-015-4452-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/18/2015] [Indexed: 06/04/2023]
Abstract
The impact of climatology--air temperature, precipitation and wind speed--and road traffic--volume, vehicle speed and percentage of heavy-duty vehicles (HDVs)--on air quality in Madrid was studied by estimating the effect for each explanatory variable using generalized linear regression models controlling for monthly variations, days of week and parameter levels. Every 1 m/s increase in wind speed produced a decrease in PM10 concentrations by 10.3% (95% CI 12.6-8.6) for all weekdays and by 12.4% (95% CI 14.9-9.8) for working days (up to the cut-off of 2.4 m/s). Increases of PM10 concentrations due to air temperature (7.2% (95% CI 6.2-8.3)) and traffic volume (3.3% (95% CI 2.9-3.8)) were observed at every 10 °C and 1 million vehicle-km increases for all weekdays; oppositely, slight decreases of PM10 concentrations due to percentage of HDVs (3.2% (95% CI 2.7-3.7)) and vehicle speed (0.7% (95% CI 0.6-0.8)) were observed at every 1% and 1 km/h increases. Stronger effects of climatology on air quality than traffic parameters were found.
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Affiliation(s)
- Pedro J Perez-Martinez
- ETSIM-Grupo en Economía Sostenible del Medio Natural (ECSEN), Universidad Politécnica de Madrid, C/Ramiro de Maeztu s/n, 28040, Madrid, Spain,
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Chang CC, Chen PS, Yang CY. Short-term effects of fine particulate air pollution on hospital admissions for cardiovascular diseases: a case-crossover study in a tropical city. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:267-277. [PMID: 25674828 DOI: 10.1080/15287394.2014.960044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was undertaken to determine whether there was an association between fine particles (PM2.5) levels and hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions for CVD (including ischemic heart disease [IHD], stroke, congestive heart failure [CHF], and arrhythmias) and ambient air pollution data for Kaohsiung were obtained for the period from 2006-2010. The relative risk of hospital admissions for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), elevated number of admissions for CVD were significantly associated with higher PM2.5 levels only on cool days (<25°C), with an interquartile range rise associated with a 47% (95% CI = 39-56%), 48% (95% CI = 40-56%), 47% (95% CI = 34-61%), and 51% (95% CI = 34-70%) increase in IHD, stroke, CHF, and arrhythmias admissions, respectively. No significant associations between PM2.5 and hospital admissions for CVD were observed on warm days. In the two-pollutant models, PM2.5 levels remained significant even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5 enhance the risk of hospital admissions for CVD in Kaohsiung, Taiwan.
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Affiliation(s)
- Chih-Ching Chang
- a Department of Environmental and Occupational Health , National Cheng Kung University , Tainan , Taiwan , Taiwan
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Chang CC, Chiu HF, Yang CY. Fine particulate air pollution and outpatient department visits for headache in Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:506-15. [PMID: 25849767 DOI: 10.1080/15287394.2015.1010465] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study was undertaken to determine whether there was an association between fine particle matter (PM(2.5)) levels and daily outpatient department visits (OPD) for headaches in Taipei, Taiwan. Daily OPD visits for headaches and ambient air pollution data for Taipei were obtained for the period 2006-2011. The relative risk of visits for OPD headaches was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased OPD visits for headaches were significantly associated with levels of PM(2.5) both on warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 12% (95% CI = 10-14%) and 3% (95% CI = 1-5%) elevation in OPD visits for headaches, respectively. In the two-pollutant models, PM(2.5) remained significant after inclusion of sulfur dioxide (SO₂) or ozone (O₃) on both warm and cool days. This study provides evidence that higher levels of PM(2.5) increase the risk of OPD visits for headaches in Taipei, Taiwan.
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Affiliation(s)
- Chih-Ching Chang
- a Department of Environmental and Occupational Health , National Cheng Kung University , Tainan , Taiwan , Taiwan
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Tsai SS, Chang CC, Liou SH, Yang CY. The effects of fine particulate air pollution on daily mortality: a case-crossover study in a subtropical city, Taipei, Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:5081-93. [PMID: 24823666 PMCID: PMC4053914 DOI: 10.3390/ijerph110505081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/05/2014] [Accepted: 05/05/2014] [Indexed: 01/07/2023]
Abstract
This study was undertaken to determine whether there was an association between PM2.5 levels and daily mortality in Taipei, Taiwan, the largest metropolitan city with a subtropical climate. Daily mortality, air pollution, and weather data for Taipei were obtained for the period from 2006–2008. The relative risk of daily mortality was estimated using a time-stratified case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model, PM2.5 showed association with total mortality both on warm (>23 °C) and cool days (<23 °C). There is no indication of an association between PM2.5 and risk of death due to respiratory diseases both on warm and cool days. PM2.5 had effects on the risk of death from cardiovascular diseases only on cool days. In the two-pollutant models, PM2.5 remained effects on the risk of mortality for all cause and cardiovascular disease after the inclusion of SO2 and O3 both on warm and cool days. This study provides evidence that short-term exposure to PM2.5 increased the risk of death for all cause and cardiovascular disease.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung 824, Taiwan.
| | - Chih-Ching Chang
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan 701, Taiwan.
| | - Saou-Hsing Liou
- Division of Environmental Health and Occupational Medicine, National Health Research Institute, Miaoli 350, Taiwan.
| | - Chun-Yuh Yang
- Division of Environmental Health and Occupational Medicine, National Health Research Institute, Miaoli 350, Taiwan.
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Hsieh YL, Tsai SS, Yang CY. Fine particulate air pollution and hospital admissions for congestive heart failure: a case-crossover study in Taipei. Inhal Toxicol 2014; 25:455-60. [PMID: 23876070 DOI: 10.3109/08958378.2013.804609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was undertaken to determine whether there was an association between fine particles (PM₂.₅) levels and hospital admissions for congestive heart failure (CHF) in Taipei, Taiwan. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased CHF admissions were significantly associated with PM₂.₅ both on warm days (>23 °C) and cool days (<23 °C), with an interquartile range increase associated with a 13% (95% CI = 9-17%) and 3% (95% CI = 0-7%) increase in CHF admissions, respectively. In the two-pollutant models, PM₂.₅ remained significant after the inclusion of SO₂ or O₃ both on warm and cool days. This study provides evidence that higher levels of PM₂.₅ increase the risk of hospital admissions for CHF.
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Affiliation(s)
- Ya-Lun Hsieh
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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25
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Chiu HF, Chang CC, Yang CY. Relationship between hemorrhagic stroke hospitalization and exposure to fine particulate air pollution in Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:1154-1163. [PMID: 25119737 DOI: 10.1080/15287394.2014.926801] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particle (PM2.5) levels and hospital admissions for hemorrhagic stroke (HS) in Taipei, Taiwan. Hospital admissions for HS and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased HS admissions were significantly associated with PM2.5 levels both on warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 12% (95% CI = 7-18%) and 4% (95% CI = 0-8%) elevation in admissions for HS, respectively. In the two-pollutant models, PM2.5 remained significantly high after inclusion of SO2 or O3 on both warm and cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for HS.
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Affiliation(s)
- Hui-Fen Chiu
- a Department of Pharmacology, College of Medicine , Kaohsiung Medical University , Kaohsiung , Taiwan
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Tsai SS, Chen CC, Yang CY. Short-term effect of fine particulate air pollution on daily mortality: a case-crossover study in a tropical city, Kaohsiung, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:467-477. [PMID: 24628000 DOI: 10.1080/15287394.2014.881247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Many studies have examined the short-term effects of air pollution on frequency of daily mortality over the past two decades. However, information on the relationship between levels of fine particles (PM(2.5)) and daily mortality is relatively sparse due to limited availability of monitoring data. Further the results are inconsistent. This study was undertaken to determine whether there was an association between PM(2.5) levels and daily mortality rate in Kaohsiung, Taiwan, a large industrial city with a tropical climate. Daily mortality rate, air pollution parameters, and weather data for Kaohsiung were obtained for the period from 2006 through 2008. The relative risk of daily mortality occurrence was estimated using a time-stratified case-crossover approach, controlling for (1) weather variables, (2) day of the week, (3) seasonality, and (4) long-term time trends. For the single-pollutant model (without adjustment for other pollutants), no significant effects were found between PM(2.5) and frequency of daily mortality on warm days (≥25°C). On cool days, PM(2.5) showed significant correlation with increased risk of mortality rate for all causes and circulatory diseases in single-pollutant model. There was no indication of an association between PM(2.5) and deaths due to respiratory diseases. The relationship appeared to be stronger on cool days. This study provided evidence of associations between short-term exposure to PM(2.5) and elevated risk of death for all cause and circulatory diseases.
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Affiliation(s)
- Shang-Shyue Tsai
- a Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
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Reyes M, Díaz J, Tobias A, Montero JC, Linares C. Impact of Saharan dust particles on hospital admissions in Madrid (Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 24:63-72. [PMID: 23544440 DOI: 10.1080/09603123.2013.782604] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Saharan dust intrusions make a major contribution to levels of particulate matter (PM) present in the atmosphere of large cities. We analysed the impact of different PM fractions during periods with and without Saharan dust intrusions, using time-series analysis with Poisson regression models, based on: concentrations of coarse PM (PM10 and PM10-2.5) and fine PM (PM2.5); and daily all-, circulatory- and respiratory-cause hospital admissions. While periods without Saharan dust intrusions were marked by a statistically significant association between daily mean PM2.5 concentrations and all- and circulatory-cause hospital admissions, periods with such intrusions saw a significant increase in respiratory-cause admissions associated with fractions corresponding to PM10 and PM10-2.5.
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Affiliation(s)
- María Reyes
- a Departament of Preventive Medicine , Complejo Hospitalario de Navarra , Pamplona , Spain
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Tsai SS, Yang CY. Fine particulate air pollution and hospital admissions for pneumonia in a subtropical city: Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:192-201. [PMID: 24555678 DOI: 10.1080/15287394.2013.853337] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for pneumonia in Taipei, Taiwan. Hospital admissions for pneumonia and ambient air pollution data for Taipei were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for pneumonia was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased numbers of admissions for pneumonia were significantly associated with higher PM2.5 levels both on warm days (>23°C) and on cool days (<23°C). This was accompanied by an interquartile range elevation correlated with a 12% (95% CI = 16%-13%) and 4% (95% CI = 3%-6%) rise in number of admissions for pneumonia, respectively. In the two-pollutant models, PM2.5 remained significant after inclusion of sulfur dioxide (SO₂) or ozone (O₃) both on warm and on cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for pneumonia.
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Affiliation(s)
- Shang-Shyue Tsai
- a Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
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Cheng MH, Chen CC, Chiu HF, Yang CY. Fine particulate air pollution and hospital admissions for asthma: a case-crossover study in Taipei. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:1075-1083. [PMID: 25072894 DOI: 10.1080/15287394.2014.922387] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for asthma in Taipei, Taiwan. Hospital admissions for asthma and ambient air pollution data for Taipei were obtained for the period of 2006-2010. The relative risk of hospital admissions for asthma was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased asthma admissions were significantly associated with PM2.5 levels both on warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 12% (95% CI = 6-18%) and 3% (95% CI = 0-8%) elevation in admissions for asthma, respectively. In the two-pollutant models, PM2.5 levels remained significant for increased asthma admissions after inclusion of SO2 or O3 both on warm and cool days. This study provides evidence that higher levels of PM2.5 elevate the risk of hospital admissions for asthma in Taiwan.
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Affiliation(s)
- Meng-Hsuan Cheng
- a Division of pulmonary and Critical Medicine, Department of Internal Medicine , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan
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Tsai SS, Chiu HF, Liou SH, Yang CY. Short-term effects of fine particulate air pollution on hospital admissions for respiratory diseases: a case-crossover study in a tropical city. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:1091-1101. [PMID: 25072896 DOI: 10.1080/15287394.2014.922388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for respiratory diseases in Kaohsiung, Taiwan. Hospital admissions for respiratory diseases including pneumonia, asthma, and chronic obstructive pulmonary disease (COPD) and ambient air pollution data for Kaohsiung were obtained for the period 2006-2010. The relative risk (RR) of hospital admissions for respiratory diseases was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and chronic time trends. For the single-pollutant model (without adjustment for other pollutants), increased number of admissions for respiratory diseases were significantly associated with higher PM2.5 levels only on cool days (<25°C), with an interquartile range rise associated with a 50 (95% CI% = 45-55%), 40% (95% CI = 25-58%), and 46% (95% CI = 36-57%) elevation in frequency of admissions for pneumonia, asthma, and COPD, respectively. In the two-pollutant models, PM2.5 levels remained significant even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for respiratory diseases in Taiwan.
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Affiliation(s)
- Shang-Shyue Tsai
- a Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
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Li P, Xin J, Wang Y, Wang S, Li G, Pan X, Liu Z, Wang L. The acute effects of fine particles on respiratory mortality and morbidity in Beijing, 2004-2009. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2013; 20:6433-44. [PMID: 23589266 DOI: 10.1007/s11356-013-1688-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/26/2013] [Indexed: 05/13/2023]
Abstract
Recent epidemiological and toxicological studies have shown associations between particulate matter and human health. However, the estimates of adverse health effects are inconsistent across many countries and areas. The stratification and interaction models were employed within the context of the generalized additive Poisson regression equation to examine the acute effects of fine particles on respiratory health and to explore the possible joint modification of temperature, humidity, and season in Beijing, China, for the period 2004-2009. The results revealed that the respiratory health damage threshold of the PM2.5 concentration was mainly within the range of 20-60 μg/m(3), and the adverse effect of excessively high PM2.5 concentration maintained a stable level. In the most serious case, an increase of 10 μg/m(3) PM2.5 results in an elevation of 4.60 % (95 % CI 3.84-4.60 %) and 4.48 % (95 % CI 3.53-5.41 %) with a lag of 3 days, values far higher than the average level of 0.69 % (95 % CI 0.54-0.85 %) and 1.32 % (95 % CI 1.02-1.61 %) for respiratory mortality and morbidity, respectively. There were strong seasonal patterns of adverse effects with the seasonal variation of temperature and humidity. The growth rates of respiratory mortality and morbidity were highest in winter. And, they increased 1.4 and 1.8 times in winter, greater than in the full year as PM2.5 increased 10 μg/m(3).
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Affiliation(s)
- Pei Li
- Key Laboratory of Semi-arid Climate Change of Ministry of Education, College of Atmospheric Science, Lanzhou University, Lanzhou, Gansu, China, 730000
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Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F. Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:1026-33. [PMID: 23777832 PMCID: PMC3764077 DOI: 10.1289/ehp.1206151] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 06/17/2013] [Indexed: 05/18/2023]
Abstract
BACKGROUND Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent. OBJECTIVES We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project. METHODS City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5-10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration-response curves were estimated using a meta-smoothing approach. RESULTS We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5-10, and 14.4 μg/m3 in PM10 (lag 0-1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0-5 days). CONCLUSIONS PM2.5 and PM2.5-10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy.
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Chiu HF, Tsai SS, Weng HH, Yang CY. Short-term effects of fine particulate air pollution on emergency room visits for cardiac arrhythmias: a case-crossover study in Taipei. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:614-23. [PMID: 23859081 DOI: 10.1080/15287394.2013.801763] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study was undertaken to determine whether there was an association between fine particles (PM₂.₅) levels and number of emergency room (ER) visits for cardiac arrhythmias in Taipei, Taiwan. ER visits for cardiac arrhythmias and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk (RR) of ER visits was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased numbers of ER cardiac arrhythmia visits were significantly associated with PM₂.₅ on both warm days (>23°C) and cool days (< 23°C), with an interquartile range rise associated with a 10% (95% CI = -15%) and 4% (95% CI = 0-8%) elevation in number of ER visits for cardiac arrhythmias, respectively. In the two-pollutant models, PM₂.₅ levels remained significant after inclusion of sulfur dioxide (SO₂) or ozone (O₃) on both warm and cool days. This study provides evidence that higher levels of PM₂.₅ increase the risk of number of ER visits for cardiac arrhythmias.
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Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chiu HF, Yang CY. Short-term effects of fine particulate air pollution on ischemic stroke occurrence: a case-crossover study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:1188-97. [PMID: 24283370 DOI: 10.1080/15287394.2013.842463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for ischemic stroke (IS) in Taipei, Taiwan. Hospital admissions for IS and ambient air pollution data for Taipei were obtained for the period from 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased admissions for IS were significantly associated with higher levels of PM2.5 on both warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 11% (95% CI = 8-14%) and 4% (95% CI = 2-7%) elevation in admissions for IS, respectively. In the two-pollutant models, PM2.5 remained significantly increased after inclusion of sulfur dioxide (SO2) or ozone (O3) on both warm and cool days. This study provides evidence that higher levels of PM2.5 enhance the risk of hospital admissions for IS.
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Affiliation(s)
- Hui-Fen Chiu
- a Department of Pharmacology, College of Medicine , Kaohsiung Medical University , Kaohsiung , Taiwan
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35
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Chang CC, Kuo CC, Liou SH, Yang CY. Fine particulate air pollution and hospital admissions for myocardial infarction in a subtropical city: Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:440-448. [PMID: 23611182 DOI: 10.1080/15287394.2013.771559] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and hospital admissions for myocardial infarction (MI) in Taipei, Taiwan. Hospital admissions for MI and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions for MI was estimated using a casecrossover approach, controlling for weather variables, day of the week, seasonality, and longterm time trends. For the single-pollutant model (without adjustment for other pollutants), increased numbers of MI admissions were significantly associated with higher PM2.5 levels both on warm days (>23°C) and on cool days (<23°C). This was accompanied by an interquartile range elevation correlated with a 10% (95% CI = 6-15%) and 5% (95% CI = 1-9%) rise in number of MI admissions, respectively. In the two-pollutant models, PM2.5 remained significant after inclusion of SO2 or O3 on both warm and cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for MI.
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Affiliation(s)
- Chih-Ching Chang
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
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36
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Billionnet C, Sherrill D, Annesi-Maesano I. Estimating the health effects of exposure to multi-pollutant mixture. Ann Epidemiol 2012; 22:126-41. [PMID: 22226033 DOI: 10.1016/j.annepidem.2011.11.004] [Citation(s) in RCA: 199] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 11/10/2011] [Accepted: 11/15/2011] [Indexed: 01/08/2023]
Abstract
PURPOSE Air pollution constitutes a major public health concern because of its ubiquity and of its potential health impact. Because individuals are exposed to many air pollutants at once that are highly correlated with each other, there is a need to consider the multi-pollutant exposure phenomenon. The characteristics of multiple pollutants that make statistical analysis of health-related effects of air pollution complex include the high correlation between pollutants prevents the use of standard statistical methods, the potential existence of interaction between pollutants, the common measurement errors, the importance of the number of pollutants to consider, and the potential nonlinear relationship between exposure and health. METHODS We made a review of statistical methods either used in the literature to study the effect of multiple pollutants or identified as potentially applicable to this problem. We reported the results of investigations that applied such methods. RESULTS Eighteen publications have investigated the multi-pollutant effects, 5 on indoor pollution, 10 on outdoor pollution, and 3 on statistical methodology with application on outdoor pollution. Some other publications have only addressed statistical methodology. CONCLUSIONS The use of Hierarchical Bayesian approach, dimension reduction methods, clustering, recursive partitioning, and logic regression are some potential methods described. Methods that provide figures for risk assessments should be put forward in public health decisions.
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Hori A, Hashizume M, Tsuda Y, Tsukahara T, Nomiyama T. Effects of weather variability and air pollutants on emergency admissions for cardiovascular and cerebrovascular diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2012; 22:416-430. [PMID: 22384943 DOI: 10.1080/09603123.2011.650155] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We examined the effect of ambient temperature, air pressure and air pollutants on daily emergency admissions by identifying the cause of admission for each type of stroke and cardiovascular disease using generalized linear Poisson regression models allowing for overdispersion, and controlling for seasonal and inter-annual variations, days of the week and public holidays, levels of influenza and respiratory syncytial viruses. Every 1°C decrease in mean temperature was associated with an increase in the daily number of emergency admissions by 7.83% (95% CI 2.06-13.25) for acute coronary syndrome (ACS) and heart failure, by 35.57% (95% CI 15.59-59.02) for intracerebral haemorrhage (ICH) and by 11.71% (95% CI 4.1-19.89) for cerebral infarction. An increase of emergency admissions due to ICH (3.25% (95% CI 0.94-5.51)), heart failure (3.56% (95% CI 1.09-5.96)) was observed at every 1 hPa decrease in air pressure from the previous days. We found stronger detrimental effect of cold on stroke than cardiovascular disease.
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Affiliation(s)
- Aya Hori
- Department of Preventive Medicine and Public Health , Shinshu University School of Medicine, Matsumoto, Japan.
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Jiménez E, Linares C, Martínez D, Díaz J. Particulate air pollution and short-term mortality due to specific causes among the elderly in Madrid (Spain): seasonal differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:372-90. [PMID: 21547809 DOI: 10.1080/09603123.2011.560251] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A time-series study was conducted to ascertain the short-term effects of different-sized airborne particulate matter (PM) on daily respiratory and cardiovascular cause-specific mortality in winter and summer, among subjects aged over 75 years in Madrid. Poisson regression was used to analyse the time-series, in which the dependent variable was daily mortality due to different specific respiratory and circulatory causes, and the principal independent variables were daily mean PM10, PM2.5 and PM10-2.5 concentrations; other variables: other air pollutants (chemicals, biotic and acoustic), influenza, trend, seasonality and autocorrelation of the series. The results indicated an association between coarser PM fractions (PM10 and PM10-2.5) and respiratory-specific mortality on the one hand, and between PM2.5 and cardiovascular-specific mortality on the other. While the risk of mortality due to exposure to particulate matter was greater in summer than in winter, this difference was statistically significant solely for total organic-cause mortality.
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Affiliation(s)
- Eva Jiménez
- Department of Preventive Medicine, San Carlos University Teaching Hospital, Madrid, Spain
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Guaita R, Pichiule M, Maté T, Linares C, Díaz J. Short-term impact of particulate matter (PM(2.5)) on respiratory mortality in Madrid. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:260-74. [PMID: 21644129 DOI: 10.1080/09603123.2010.544033] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES This paper sought to quantify the particulate matter (PM(2.5)) pollutant's impact on short-term daily respiratory-cause mortality in the city of Madrid. METHODS As our dependent variable, we took daily mortality registered in Madrid from 1 January 2003 to 31 December 2005, attributed to all diseases of the respiratory system as classified under heads J00-J99 of the ICD 10 and broken down as follows: J12-J18, pneumonia; J40-J44, chronic diseases of the respiratory system except asthma; J45-J46, asthma; and J96, respiratory failure. RESULTS The relative risk (RR) for daily overall respiratory mortality was RR 1.0281 (1.0043-1.0520), with a proportional attributable risk (PAR) of 2.74%. This effect occurred in lag 1; respiratory failure, RR 1.0816 (1.0119-1.1512) and PAR 7.54% at lag 5; and pneumonia, RR 1.0438 (1.0001-1.0875) and PAR 4.19% at lag 6. CONCLUSIONS Our results reflect the association that exists between PM(2.5) concentrations and daily respiratory-cause mortality.
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Affiliation(s)
- Rosana Guaita
- Departments of Preventive Medicine, Doctor Peset University Teaching Hospital, Valencia
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Boldo E, Linares C, Lumbreras J, Borge R, Narros A, García-Pérez J, Fernández-Navarro P, Pérez-Gómez B, Aragonés N, Ramis R, Pollán M, Moreno T, Karanasiou A, López-Abente G. Health impact assessment of a reduction in ambient PM(2.5) levels in Spain. ENVIRONMENT INTERNATIONAL 2011; 37:342-8. [PMID: 21056471 DOI: 10.1016/j.envint.2010.10.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/05/2010] [Accepted: 10/08/2010] [Indexed: 05/04/2023]
Abstract
BACKGROUND Health effects linked to exposure to high air pollutant levels have been described in depth, and many recent epidemiologic studies have also consistently reported positive associations between exposure to air pollutants at low concentrations (particularly PM(2.5)) and adverse health outcomes. OBJECTIVE To estimate the number of avoidable deaths associated with reducing PM(2.5) levels in Spain. MATERIALS AND METHODS For exposure assessment, we used the US Environmental Protection Agency's Community Multiscale Air Quality model to simulate air pollution levels with a spatial resolution of 18×18 km(2). Two different scenarios were compared, namely, a baseline 2004 scenario based on Spain's National Emissions Inventory and a projected 2011 scenario in which a reduction in PM(2.5) was estimated on the basis of the benefits that might be attained if specific air quality policies were implemented. Using an 18×18 km(2) grid, air pollution data were estimated for the entire Iberian Peninsula, the Balearic Islands, Ceuta and Melilla. For these strata, crude all-cause mortality rates (ICD-10: A00-Y98) were then calculated for the over-30 and 25-74 age groups, taking into account the 2004 population figures corresponding to these same age groups, selected in accordance with the concentration-response functions (Pope CA 3rd, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287:1132-41; Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173:667-72.). Health impacts were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP). RESULTS Air quality improvement was defined as an average annual reduction of 0.7 μg/m(3) in PM(2.5) levels. Using long-term health impact assessment analysis, we estimated that 1720 (673-2760) all-cause deaths (6 per 100,000 population) in the over-30 age group and 1450 (780-2108) all-cause deaths (5 per 100,000 population) in the 25-74 age group could be prevented annually. CONCLUSIONS The results showed the potential benefits in general mortality which could be expected if pollution control policies were successfully implemented by 2011. A specifically adapted BenMAP could be used as a tool for estimating health impacts associated with changes in air pollution in Spain.
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Affiliation(s)
- Elena Boldo
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
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Jiménez E, Linares C, Martínez D, Díaz J. Role of Saharan dust in the relationship between particulate matter and short-term daily mortality among the elderly in Madrid (Spain). THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:5729-36. [PMID: 20855107 DOI: 10.1016/j.scitotenv.2010.08.049] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 08/23/2010] [Accepted: 08/26/2010] [Indexed: 05/19/2023]
Abstract
BACKGROUND Saharan dust outbreaks are a common phenomenon in the Madrid atmosphere. The current Directive 2008/50 CE governing air quality in European cities, draws no distinction between which particulate matter (PM(10), PM(2.5) or PM(10-2.5)) would be the best indicator on days with/without Saharan dust intrusions. This study sought to identify the role played by Saharan dust in the relationship between particulate matter (PM(10), PM(2.5) and PM(10-2.5)) concentrations and daily mortality among the elderly in the city of Madrid. METHODS We conducted an ecological longitudinal time-series study on daily mortality among the over-75 age group, from 2003 to 2005. Poisson regression models were constructed for days with and without Saharan dust intrusions. The following causes of daily mortality were analysed: total organic causes except accidents (International Classification of Diseases-10th revision (ICD-10): A00-R99); circulatory causes (ICD-10: I00-I99); and respiratory causes (ICD-10: J00-J99). Daily mean PM(10), PM(2.5) and PM(10-2.5) levels were used as independent variables. Control variables were: other ambient pollutants (chemical, biotic and acoustic); trend; seasonalities; influenza epidemics; and autocorrelations between mortality series. RESULTS While daily mean PM(2.5) concentrations in Madrid displayed a significant statistical association with daily mortality for all the above causes on days without Saharan dust intrusions, this association was not in evidence for PM(10) or PM(10-2.5) in the multivariate models. The relative risks (RRs) obtained for an increase of 10 μg/m(3) in PM(2.5) concentrations were: 1.023 (1.010-1.036) for total organic causes; 1.033 (1.031-1.035) for circulatory causes; and 1.032 (1.004-1.059) for respiratory causes. On Saharan dust days, a significant statistical association was detected between PM(10) (though not PM(2.5) or PM(10-2.5)) and mortality for all 3 causes analysed, with RRs statistically similar to those reported for PM(2.5). CONCLUSIONS The best air quality indicators for evaluating the short-term health effects of particulate matter in Madrid are therefore PM(10) concentrations on days with, and PM(2.5) concentrations on days without Saharan dust outbreaks. This fact should be taken into account in a European Directive regulating ambient air quality in almost all countries in the Mediterranean area.
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Affiliation(s)
- E Jiménez
- Department of Preventive Medicine, San Carlos University Teaching Hospital, Madrid, Spain
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Maté T, Guaita R, Pichiule M, Linares C, Díaz J. Short-term effect of fine particulate matter (PM 2.5) on daily mortality due to diseases of the circulatory system in Madrid (Spain). THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:5750-7. [PMID: 20825976 DOI: 10.1016/j.scitotenv.2010.07.083] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/27/2010] [Accepted: 07/30/2010] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Owing to their small size, fine particles, i.e., those having a diameter ≤ 2.5 μm (PM(2.5)), have a high alveolar penetration capacity, thereby triggering a local inflammatory process with circulatory repercussion. Despite being linked to respiratory and cardiovascular morbidities, there is limited evidence of an association between this type of particulate matter and short-term increases in mortality. OBJECTIVE The aim of this study was to analyse and quantify the short-term impact of PM(2.5) on daily mortality due to diseases of the circulatory system, registered in Madrid from 1 January 2003 to 31 December 2005. METHODS An ecological longitudinal time-series study was conducted, with risks being quantified by means of Poisson regression models. As a dependent variable, we took daily mortality registered in Madrid from 1 January 2003 to 31 December 2005, attributed to all diseases of the circulatory system as classified under heads I00-I99 of the International Classification of Diseases-10th revision (ICD-10) and broken down as follows: I21, acute myocardial infarction (AMI); I20, I22-I25, other ischemic heart diseases; and I60-I69, cerebrovascular diseases. The independent variable was daily mean PM(2.5) concentration. The other variables controlled for were: chemical pollution (PM(10), O(3), SO(2), NO(2) and NO(x)); acoustic and biotic pollution; influenza; minimum and maximum temperatures; seasonalities; trend; and autocorrelation of the series. RESULTS A linear relationship was observed between PM(2.5) levels and mortality due to diseases of the circulatory system. For every increase of 10 μg/m(3) in daily mean PM(2.5) concentration, the relative risks (RR) were as follows: for overall circulatory mortality, associations were established at lags 2 and 6, with RR of 1.022 (1.005-1.039) and 1.025 (1.007-1.043) respectively; and for AMI mortality, there was an association at lag 6, with an RR of 1.066 (1.032-1.100). The corresponding attributable risks percent (AR%) were 2.16%, 2.47% and 6.21% respectively. No statistically significant association was found with other ischemic heart diseases or with cerebrovascular diseases. CONCLUSION PM(2.5) concentrations are an important risk factor for daily circulatory-cause mortality in Madrid. From a public health point of view, the planning and implementation of specific measures targeted at reducing these levels constitute a pressing need.
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Affiliation(s)
- T Maté
- Department of Preventive Medicine, Clinical University Teaching Hospital, Valladolid, Spain
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