Components of particulate air pollution and emergency department visits in Chile

Is short-term and long-term exposure to black carbon associated with cardiovascular and respiratory diseases? A systematic review and meta-analysis based on evidence reliability

OBJECTIVE

Adverse health effects of fine particles (particulate matter_2.5) have been well documented by a series of studies. However, evidences on the impacts of black carbon (BC) or elemental carbon (EC) on health are limited. The objectives were (1) to explored the effects of BC and EC on cardiovascular and respiratory morbidity and mortality, and (2) to verified the reliability of the meta-analysis by drawing p value plots.

DESIGN

The systematic review and meta-analysis using adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and p value plots approach.

DATA SOURCES

PubMed, Embase and Web of Science were searched from inception to 19 July 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Time series, case cross-over and cohort studies that evaluated the associations between BC/EC on cardiovascular or respiratory morbidity or mortality were included.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcomes were analysed via a random effects model and reported as relative risk (RR) with 95% CI. The certainty of evidences was assessed by adapted GRADE. The reliabilities of meta-analyses were analysed by p value plots.

RESULTS

Seventy studies met our inclusion criteria. (1) Short-term exposure to BC/EC was associated with 1.6% (95% CI 0.4% to 2.8%) increase in cardiovascular diseases per 1 µg/m³ in the elderly; (2) Long-term exposure to BC/EC was associated with 6.8% (95% CI 0.4% to 13.5%) increase in cardiovascular diseases and (3) The p value plot indicated that the association between BC/EC and respiratory diseases was consistent with randomness.

CONCLUSIONS

Both short-term and long-term exposures to BC/EC were related with cardiovascular diseases. However, the impact of BC/EC on respiratory diseases did not present consistent evidence and further investigations are required.

PROSPERO REGISTRATION NUMBER

CRD42020186244.

Relationship between Wildfire Smoke and Children’s Respiratory Health in the Metropolitan Cities of Central-Chile

Wildfire causes multiple problems for people living in cities. One of them is the deterioration of air quality as a result of wildfire smoke. This smoke can consequently have effects on human health. The present study aims to characterize the relationship between the occurrence of wildfires in central Chile and the effects on children’s respiratory health. Public databases provided the number of emergency care visits, wildfires, and concentration of air pollutants, demographics and meteorological variables for the regions of Santiago and Valparaiso from 2010 to 2013. Time series analysis was used monthly on health care visits to determine the relative health risk in children when in the presence of additional wildfires. Significant health risks were observed in Santiago for children younger than 1-year-old of bronchitis (RR 1.007, CI 95% 1.007–1.008; chronic lower respiratory diseases (RR 1.012, CI 95% 1.012–1.013); and pneumonia (RR 1.026 CI 95% 1.026–1.027) and in children aged one to four years old (RR 1.016 CI 95% 1.015–1.016). A dose-response relationship was also observed for pneumonia, showing that it affects younger children particularly when there is an increase in the number of wildfires. In the Region of Valparaíso, wildfires did not significantly change the risk of respiratory illness, this could be due to favorable ventilation. Currently, Santiago has an urgent need for monitoring and the evaluation of the damage to children’s respiratory health, along with the development of comprehensive prevention strategies.

Household air pollution and blood markers of inflammation: A cross-sectional analysis

Household air pollution (HAP) from biomass stoves is a leading risk factor for cardiopulmonary outcomes; however, its toxicity pathways and relationship with inflammation markers are poorly understood. Among 180 adult women in rural Peru, we examined the cross-sectional exposure-response relationship between biomass HAP and markers of inflammation in blood using baseline measurements from a randomized trial. We measured markers of inflammation (CRP, IL-6, IL-10, IL-1β, and TNF-α) with dried blood spots, 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM_2.5 ), black carbon (BC), and carbon monoxide (CO), and 48-h kitchen concentrations of nitrogen dioxide (NO₂ ) in a subset of 97 participants. We conducted an exposure-response analysis between quintiles of HAP levels and markers of inflammation. Markers of inflammation were more strongly associated with kitchen area concentrations of BC than PM_2.5 . As expected, kitchen area BC concentrations were positively associated with TNF-α (pro-inflammatory) concentrations and negatively associated with IL-10, an anti-inflammatory marker, controlling for confounders in single- and multi-pollutant models. However, contrary to expectations, kitchen area BC and NO₂ concentrations were negatively associated with IL-1β, a pro-inflammatory marker. No associations were identified for IL-6 or CRP, or for any marker in relation to personal exposures.

Associations between PM2.5 metal components and QT interval length in the Normative Aging Study

BACKGROUND

Several studies have found associations between increases in QT interval length, a marker of cardiac electrical instability, and short-term fine particulate matter (PM2.5) exposures. To our knowledge, this is the first study to examine the association between specific PM2.5 metal components and QT interval length.

METHODS

We measured heart-rate corrected QT interval (QTc) duration among 630 participants in the Normative Aging Study (NAS) based in Eastern Massachusetts between 2000 and 2011. We utilized time-varying linear mixed-effects regressions with a random intercept for each participant to analyze associations between QTc interval and moving averages (0-7 day moving averages) of 24-h mean concentrations of PM2.5 metal components (vanadium, nickel, copper, zinc and lead) measured at the Harvard Supersite monitoring station. Models were adjusted for daily PM2.5 mass estimated at a 1 km × 1 km grid cell from a previously validated prediction model and other covariates. Bayesian kernel machine regression (BKMR) was utilized to assess the overall joint effect of the PM2.5 metal components.

RESULTS

We found consistent results with higher lead (Pb) associated with significant higher QTc intervals for both the multi-pollutant and the two pollutant (PM2.5 mass and a PM2.5 component) models across the moving averages. The greatest effect of lead on QTc interval was detected for the 4-day moving average lead exposure. In the multi-pollutant model, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with a 7.91 ms (95% CI: 3.63, 12.18) increase in QTc interval. In the two-pollutant models with PM2.5 mass and lead, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with an 8.50 ms (95% CI: 4.59, 12.41) increase in QTc interval. We found that 4-day moving average of copper has a negative association with QTc interval when compared to the other PM2.5 metal components. In the multi-pollutant model, each 1.81 ng/m3 increase in daily copper levels for a 4-day moving average was associated with an -3.89 ms (95% CI: -6.98, -0.79) increase in QTc interval. Copper's essential function inside the human body could mediate its cardiotoxicity on cardiac conductivity and explain why we found that copper in comparison to the other metals was less harmful for QTc interval.

CONCLUSIONS

Exposure to metals contained in PM2.5 are associated with acute changes in ventricular repolarization as indicated by QT interval characteristics.

Predicting PM2.5 and PM10 Levels during Critical Episodes Management in Santiago, Chile, with a Bivariate Birnbaum-Saunders Log-Linear Model

Improving air quality is an important environmental challenge of our time. Chile currently has one of the most stable and emerging economies in Latin America, where human impact on natural resources and air quality does not go unperceived. Santiago, the capital of Chile, is one of the cities in which particulate matter (PM) levels exceed national and international limits. Its location and climate cause critical conditions for human health when interaction with anthropogenic emissions is present. In this paper, we propose a predictive model based on bivariate regression to estimate PM levels, related to PM2.5 and PM10, simultaneously. Birnbaum-Saunders distributions are used in the joint modeling of real-world PM2.5 and PM10 data by considering as covariates some relevant meteorological variables employed in similar studies. The Mahalanobis distance is utilized to assess bivariate outliers and to detect suitability of the distributional assumption. In addition, we use the local influence technique for analyzing the impact of a perturbation on the overall estimation of model parameters. In the predictions, we check the categorization for the observed and predicted cases of the model according to the primary air quality regulations for PM.

The Respiratory Risks of Ambient/Outdoor Air Pollution

Globally, exposure to ambient air pollutants is responsible for premature mortality and is implicated in the development and exacerbation of several acute and chronic lung disease across all ages. In this article, we discuss the source apportionment of ambient pollutants and the respiratory health effects in humans. We specifically discuss the evidence supporting ambient pollution in the development of asthma and chronic obstructive pulmonary disease and acute exacerbations of each condition. Practical advice is given to health care providers in how to promote a healthy environment and advise patients with chronic conditions to avoid unsafe air quality.

Endogenous doesn't always mean innocuous: a scoping review of iron toxicity by inhalation

Ambient air pollution is a leading risk factor for the global burden of disease. One possible pathway of particulate matter (PM)-induced toxicity is through iron (Fe), the most abundant metal in the atmosphere. The aim of the review was to consider the complexity of Fe-mediated toxicity following inhalation exposure focusing on the chemical and surface reactivity of Fe as a transition metal and possible pathways of toxicity via reactive oxygen species (ROS) generation as well as considerations of size, morphology, and source of PM. A broad term search of 4 databases identified 2189 journal articles and reports examining exposure to Fe via inhalation in the past 10 years. These were sequentially analyzed by title, abstract and full-text to identify 87 articles publishing results on the toxicity of Fe-containing PM by inhalation or instillation to the respiratory system. The remaining 87 papers were examined to summarize research dealing with in vitro, in vivo and epidemiological studies involving PM containing Fe or iron oxide following inhalation or instillation. The major findings from these investigations are summarized and tabulated. Epidemiological studies showed that exposure to Fe oxide is correlated with an increased incidence of cancer, cardiovascular diseases, and several respiratory diseases. Iron PM was found to induce inflammatory effects in vitro and in vivo and to translocate to remote locations including the brain following inhalation. A potential pathway for the PM-containing Fe-mediated toxicity by inhalation is via the generation of ROS which leads to lipid peroxidation and DNA and protein oxidation. Our recommendations include an expansion of epidemiological, in vivo and in vitro studies, integrating research improvements outlined in this review, such as the method of particle preparation, cell line type, and animal model, to enhance our understanding of the complex biological interactions of these particles.

Size-segregated deposition of atmospheric elemental carbon (EC) in the human respiratory system: A case study of the Pearl River Delta, China

It has increasingly become apparent in recent years that atmospheric elemental carbon (EC) is potentially a more sensitive indicator of human health risks from ambient aerosol exposure compared to particulate mass. However, a comprehensive evaluation of the factors affecting EC exposure is lacking so far. To address this, we performed measurements of size-segregated EC in Guangzhou, China, followed by an estimation of deposition in the human respiratory system. Most ambient EC was in the fine mode suggesting significant cloud processing, and ~40% was deposited in the human respiratory tract, with predominant deposition in the head region (47%), followed by the pulmonary (30%) and tracheobronchial (23%) regions. A significant fraction (36%) of deposited EC were coarse particles indicating the need to consider coarse-mode EC in future health effect studies. Infants and children exhibited greater vulnerability to EC exposure than adults, and the deposition amount varied linearly with breathing rate, a proxy for physical exertion. The nature of breathing was found to constrain EC inhalation significantly, with oronasal breathing associated with lower total deposition and nasal breathing leading to lower deposition in the tracheobronchial and pulmonary regions. Overall, these observations strengthen the need to include EC as an additional air quality indicator.

A Methodology for Data-Driven Decision-Making in the Monitoring of Particulate Matter Environmental Contamination in Santiago of Chile

Atmospheric pollution derives mainly from anthropogenic activities that use combustion and may lead to adverse effects in exposed populations. It is generally accepted that air contamination causes cardiovascular and pulmonary morbidity in addition to increased mortality after exposure, but other epidemiological associations have also been described, including cancer as well as reproductive and immunological toxicity. Thus the concentration of chemicals in the air must be controlled. We propose that monitoring of air quality may be achieved by employing data analytics to generate information within the context of data-driven decision making to prevent and/or adequately alert the population about possible critical episodes of air contamination. In this paper, we propose a methodology for monitoring particulate matter pollution in Santiago of Chile which is based on bivariate control charts with heavy-tailed asymmetric distributions. This methodology is useful for monitoring environmental risk when the particulate matter concentrations follow bivariate Birnbaum-Saunders or Birnbaum-Saunders-t-Student distributions. A case study with real particulate matter pollution from Santiago is provided, which shows that the methodology is suitable to alert early episodes of extreme air pollution. The results are in agreement with the critical episodes reported with the current model used by the Chilean health authority.

Examining Joint Effects of Air Pollution Exposure and Social Determinants of Health in Defining "At-Risk" Populations Under the Clean Air Act: Susceptibility of Pregnant Women to Hypertensive Disorders of Pregnancy

Pregnant women are uniquely susceptible to adverse effects of air pollution exposure due to vulnerabilities and health consequences during pregnancy (e.g., hypertensive disorders of pregnancy [HDP]) compared to the general population. Because the Clean Air Act (CAA) creates a duty to protect at-risk groups, the regulatory assessment of at-risk populations has both policy and scientific foundations. Previously, pregnant women have not been specially protected in establishing the margin of safety for the ozone and particulate matter (PM) standards. Due to physiological changes, pregnant women can be at greater risk of adverse effects of air pollution and should be considered an at-risk population. Women with preexisting conditions, women experiencing poverty, and groups that suffer systematic discrimination may be particularly susceptible to cardiac effects of air pollutants during pregnancy. We rigorously reviewed 11 studies of over 1.3 million pregnant women in the United States to characterize the relationship between ozone or PM exposure and HDP. Findings were generally mixed, with a few studies reporting a joint association between ozone or PM and social determinants or pre-existing chronic health conditions related to HDP. Adequate evidence associates exposure to PM with an adverse effect of HDP among pregnant women not evident among non-gravid populations.

Ozone Exposure, Cardiopulmonary Health, and Obesity: A Substantive Review

From 1999-2014, obesity prevalence increased among adults and youth. Obese individuals may be uniquely susceptible to the proinflammatory effects of ozone because obese humans and animals have been shown to experience a greater decline in lung function than normal-weight subjects. Obesity is independently associated with limitations in lung mechanics with increased ozone dose. However, few epidemiologic studies have examined the interaction between excess weight and ozone exposure among adults. Using PubMed keyword searches and reference lists, we reviewed epidemiologic evidence to identify potential response-modifying factors and determine if obese or overweight adults are at increased risk of ozone-related health effects. We initially identified 170 studies, of which seven studies met the criteria of examining the interaction of excess weight and ozone exposure on cardiopulmonary outcomes in adults, including four short-term ozone exposure studies in controlled laboratory settings and three community epidemiologic studies. In the studies identified, obesity was associated with decreased lung function and increased inflammatory mediators. Results were inconclusive about the effect modification when data were stratified by sex. Obese and overweight populations should be considered as candidate at-risk groups for epidemiologic studies of cardiopulmonary health related to air pollution exposures. Air pollution is a modifiable risk factor that may decrease lung function among obese individuals with implications for environmental and occupational health policy.

Air pollution, PM2.5 composition, source factors, and respiratory symptoms in asthmatic and nonasthmatic children in Santiago, Chile

The objective of this study was to determine the association of respiratory symptoms and medication use and exposure to various air pollutants, PM_2.5 components, and source factors in a panel of asthmatic and nonasthmatic children in Santiago, Chile. To this end, 174 children (90 asthmatics and 84 nonasthmatics) were followed throughout the winter months of 2010 and 2011. During the study period, children filled out daily diaries to record respiratory symptoms and medication use. Air pollution data were obtained from government central site measurements and a PM_2.5 characterization campaign. PM_2.5 source factors were obtained using positive matrix factorization (PMF). Associations of symptoms and exposure to pollutants and source-factor daily scores were modeled separately for asthmatic and nonasthmatic children using mixed logistic regression models with random intercepts, controlling for weather, day of the week, year, and viral outbreaks. Overall, high concentrations of air pollutants and PM_2.5 components were observed. Six source factors were identified by PMF (motor vehicles, marine aerosol, copper smelter, secondary sulfates, wood burning, and soil dust). Overall, single pollutant models showed significant and strong associations between 7-day exposures for several criteria pollutants (PM_2.5, NO₂, O₃), PM_2.5 components (OC, K, S, Se, V), and source factors (secondary sulfate) and coughing, wheezing and three other respiratory symptoms in both in asthmatic and nonasthmatic children. No associations were found for use of rescue inhalers in asthmatics. Two-pollutant models showed that several associations remained significant after including PM_2.5, and other criteria pollutants, in the models, particularly components and source factors associated with industrial sources. In conclusion, exposure to air pollutants, especially PM_2.5, NO₂, and O₃, were found to exacerbate respiratory symptoms in both asthmatic and nonasthmatic children. Some of the results suggest that PM_2.5 components associated with a secondary sulfate source may have a greater impact on some symptoms than PM_2.5. In general, the results of this study show important associations at concentrations close or below current air quality standards.

Respiratory hospitalizations in association with fine PM and its components in New York State

Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5-hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5-2.0% per interquartile range [IQR] increase). Primarily in the summer months, the greatest associations with respiratory hospitalizations were observed per IQR increase in the secondary species sulfate and ammonium concentrations at lags of 1-4 days (1.0-2.0%). Although there were subtle differences in associations observed between mass fraction tertiles, there was no strong evidence to support modification of the PM2.5-respiratory disease association by a particular constituent. We conclude that ambient concentrations of PM2.5 and secondary aerosols including sulfate, ammonium, and nitrate were positively associated with respiratory hospitalizations, although patterns varied by season. Exposure to specific fine PM constituents is a plausible risk factor for respiratory hospitalization in New York State.

IMPLICATIONS

The association between ambient concentrations of PM2.5 components has been evaluated in only a small number of epidemiologic studies with refined spatial and temporal scale data. In New York State, fine PM and several of its constituents, including sulfate, ammonium, and nitrate, were positively associated with respiratory hospitalizations. Results suggest that PM species relationships and their influence on respiratory endpoints are complex and season dependent. Additional work is needed to better understand the relative toxicity of PM species, and to further explore the role of co-pollutant relationships and exposure prediction error on observed PM-respiratory disease associations.

Short-term effects of particulate matter constituents on daily hospitalizations and mortality in five South-European cities: results from the MED-PARTICLES project

BACKGROUND

Few recent studies examined acute effects on health of individual chemical species in the particulate matter (PM) mixture, and most of them have been conducted in North America. Studies in Southern Europe are scarce. The aim of this study is to examine the relationship between particulate matter constituents and daily hospital admissions and mortality in five cities in Southern Europe.

METHODS

The study included five cities in Southern Europe, three cities in Spain: Barcelona (2003-2010), Madrid (2007-2008) and Huelva (2003-2010); and two cities in Italy: Rome (2005-2007) and Bologna (2011-2013). A case-crossover design was used to link cardiovascular and respiratory hospital admissions and total, cardiovascular and respiratory mortality with a pre-defined list of 16 PM10 and PM2.5 constituents. Lags 0 to 2 were examined. City-specific results were combined by random-effects meta-analysis.

RESULTS

Most of the elements studied, namely EC, SO4(2-), SiO2, Ca, Fe, Zn, Cu, Ti, Mn, V and Ni, showed increased percent changes in cardiovascular and/or respiratory hospitalizations, mainly at lags 0 and 1. The percent increase by one interquartile range (IQR) change ranged from 0.69% to 3.29%. After adjustment for total PM levels, only associations for Mn, Zn and Ni remained significant. For mortality, although positive associations were identified (Fe and Ti for total mortality; EC and Mg for cardiovascular mortality; and NO3(-) for respiratory mortality) the patterns were less clear.

CONCLUSIONS

The associations found in this study reflect that several PM constituents, originating from different sources, may drive previously reported results between PM and hospital admissions in the Mediterranean area.

Multifactorial airborne exposures and respiratory hospital admissions--the example of Santiago de Chile

Our results provide evidence for respiratory effects of combined exposure to airborne pollutants in Santiago de Chile. Different pollutants account for varying adverse effects. Ozone was not found to be significantly associated with respiratory morbidity.

BACKGROUND

High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of respiratory diseases. The findings of different studies vary in effect strength and are sometimes inconsistent.

OBJECTIVES

We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to respiratory disease groups under the special orographic and meteorological conditions of Santiago de Chile.

METHODS

The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5 - particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for respiratory illnesses.

RESULTS

We found for CO, NO2, PM10 and PM2.5 adverse relationships to respiratory admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were CO and PM10 followed by PM2.5, while in 2-pollutant models effects of NO2 persisted in most cases whereas other effects weakened and significant effects remain for PM2.5, only. In addition the strongest effects seemed to be immediate or with a delay of up to one day, but effects were found until day 7, too. Adverse effects of ozone could not be detected.

CONCLUSIONS

Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants especially CO, NO2, and PM10.

Public health and components of particulate matter: the changing assessment of black carbon

In 2012, the WHO classified diesel emissions as carcinogenic, and its European branch suggested creating a public health standard for airborne black carbon (BC). In 2011, EU researchers found that life expectancy could be extended four to nine times by reducing a unit of BC, vs reducing a unit of PM2.5. Only recently could such determinations be made. Steady improvements in research methodologies now enable such judgments. In this Critical Review, we survey epidemiological and toxicological literature regarding carbonaceous combustion emissions, as research methodologies improved over time. Initially, we focus on studies of BC, diesel, and traffic emissions in the Western countries (where daily urban BC emissions are mainly from diesels). We examine effects of other carbonaceous emissions, e.g., residential burning of biomass and coal without controls, mainly in developing countries. Throughout the 1990s, air pollution epidemiology studies rarely included species not routinely monitored. As additional PM2.5. chemical species, including carbonaceous species, became more widely available after 1999, they were gradually included in epidemiological studies. Pollutant species concentrations which more accurately reflected subject exposure also improved models. Natural "interventions"--reductions in emissions concurrent with fuel changes or increased combustion efficiency; introduction of ventilation in highway tunnels; implementation of electronic toll payment systems--demonstrated health benefits of reducing specific carbon emissions. Toxicology studies provided plausible biological mechanisms by which different PM species, e.g, carbonaceous species, may cause harm, aiding interpretation of epidemiological studies. Our review finds that BC from various sources appears to be causally involved in all-cause, lung cancer and cardiovascular mortality, morbidity, and perhaps adverse birth and nervous system effects. We recommend that the US. EPA rubric for judging possible causality of PM25. mass concentrations, be used to assess which PM2.5. species are most harmful to public health.

IMPLICATIONS

Black carbon (BC) and correlated co-emissions appear causally related with all-cause, cardiovascular, and lung cancer mortality, and perhaps with adverse birth outcomes and central nervous system effects. Such findings are recent, since widespread monitoring for BC is also recent. Helpful epidemiological advances (using many health relevant PM2.5 species in models; using better measurements of subject exposure) have also occurred. "Natural intervention" studies also demonstrate harm from partly combusted carbonaceous emissions. Toxicology studies consistently find biological mechanisms explaining how such emissions can cause these adverse outcomes. A consistent mechanism for judging causality for different PM2.5 species is suggested.

Short-term associations of cause-specific emergency hospitalizations and particulate matter chemical components in Hong Kong

Despite an increasing number of recent studies, the overall epidemiologic evidence associating specific particulate matter chemical components with health outcomes has been mixed. The links between components and hospitalizations have rarely been examined in Asia. We estimated associations between exposures to 18 chemical components of particulate matter with aerodynamic diameter less than 10 μm (PM10) and daily emergency cardiorespiratory hospitalizations in Hong Kong, China, between 2001 and 2007. Carbonaceous particulate matter, sulfate, nitrate, and ammonium accounted for two-thirds of the PM10 mass. After adjustment for time-varying confounders, a 3.4-μg/m(3) increment in 2-day moving average of same-day and previous-day nitrate concentrations was associated with the largest increase of 1.32% (95% confidence interval: 0.73, 1.92) in cardiovascular hospitalizations; elevation in manganese level (0.02 μg/m(3)) was linked to a 0.91% (95% confidence interval: 0.19, 1.64) increase in respiratory hospitalizations. Upon further adjustment for gaseous copollutants, nitrate, sodium ion, chloride ion, magnesium, and nickel remained significantly associated with cardiovascular hospitalizations, whereas sodium ion, aluminum, and magnesium, components abundantly found in coarser PM10, were associated with respiratory hospitalizations. Most positive links were seen during the cold season. These findings lend support to the growing body of literature concerning the health associations of particulate matter composition and provide important insight into the differential health risks of components found in fine and coarse modes of PM10.

Differential effects of source-specific particulate matter on emergency hospitalizations for ischemic heart disease in Hong Kong

BACKGROUND

Ischemic heart disease (IHD) is a major public health concern. Although many epidemiologic studies have reported evidence of adverse effects of particulate matter (PM) mass on IHD, significant knowledge gaps remain regarding the potential impacts of different PM sources. Much the same as PM size, PM sources may influence toxicological characteristics.

OBJECTIVES

We identified contributing sources to PM10 mass and estimated the acute effects of PM10 sources on daily emergency IHD hospitalizations in Hong Kong.

METHODS

We analyzed the concentration data of 19 PM10 chemical components measured between 2001 and 2007 by positive matrix factorization to apportion PM10 mass, and used generalized additive models to estimate associations of interquartile range (IQR) increases in PM10 exposures with IHD hospitalization for different lag periods (up to 5 days), adjusted for potential confounders.

RESULTS

We identified 8 PM10 sources: vehicle exhaust, soil/road dust, regional combustion, residual oil, fresh sea salt, aged sea salt, secondary nitrate, and secondary sulfate. Vehicle exhaust, secondary nitrate, and secondary sulfate contributed more than half of the PM10 mass. Although associations with IQR increases in 2-day moving averages (lag01) were statistically significant for most sources based on single-source models, only PM10 from vehicle exhaust [1.87% (95% CI: 0.66, 3.10); IQR = 4.9 μg/m3], secondary nitrate [2.28% (95% CI: 1.15, 3.42); IQR = 8.6 μg/m3], and aged sea salt [1.19% (95% CI: 0.04, 2.36); IQR = 5.9 μg/m3] were significantly associated with IHD hospitalizations in the multisource model. Analysis using chemical components provided similar findings.

CONCLUSION

Emergency IHD hospitalization was significantly linked with PM10 from vehicle exhaust, nitrate-rich secondary PM, and sea salt-related PM. Findings may help prioritize toxicological research and guide future monitoring and emission-control polices.

Relationship between fine particulate matter events with respect to synoptic weather patterns and the implications for circulatory and respiratory disease in Taipei, Taiwan

The aim of the study is to assess the relationship between PM2.5, synoptic weather patterns, and admissions for circulatory and respiratory disease. A PM2.5 event is defined as a day when the daily mean PM2.5 concentration exceeds 65 μg/m(3). PM2.5 events that coincided with the occurrence of PM attributed to Asian dust storm (ADS) and photochemical smog (PCS) were removed from the study in order to focus solely on the health effects from PM2.5. A one-tailed z-test and a relative risk (RR) estimate were performed. Hospital admissions for respiratory diseases were greater than those for circulatory diseases, and asthma-related diseases had a higher impact in the Adults group, and the maximum RR was 1.94 [1.37 2.77] on the first day after the event. It is evident that PM2.5 episodes connected to particular synoptic weather patterns pose a risk to health as large as ADS and PCS events.

Air contaminant statistical distributions with application to PM10 in Santiago, Chile

The use of statistical distributions to predict air quality is valuable for determining the impact of air chemical contaminants on human health. Concentrations of air pollutants are treated as random variables that can be modeled by a statistical distribution that is positively skewed and starts from zero. The type of distribution selected for analyzing air pollution data and its associated parameters depend on factors such as emission source and local meteorology and topography. International environmental guideline use appropriate distributions to compute exceedance probabilities and percentiles for setting administrative targets and issuing environmental alerts. The distribution bears a relationship to the normal distribution, and there are theoretical - and physical-based mechanistic arguments that support its use when analyzing air-pollutant data. Others distribution have also been used to model air population data, such as the beta, exponential, gamma, Johnson, log-logistic, Pearson, and Weibull distribution. One model also developed from physical-mechanistic considerations that has received considerable interest in recent year is the Birnbaum-Saunders distribution. This distribution has theoretical arguments and properties similar to those of the log-normal distribution, which renders it useful for modeling air contamination data. In this review, we have addressed the range of common atmospheric contaminants and the health effects they cause. We have also reviewed the statistical distributions that have been use to model air quality, after which we have detailed the problem of air contamination in Santiago, Chile. We have illustrated a methodology that is based on the Birnbaum-Saunders distributions to analyze air contamination data from Santiago, Chile. Finally, in the conclusions, we have provided a list of synoptic statements designed to help readers understand the significance of air pollution in Chile, and in Santiago, in particular, but that can be useful to other cites and countries.

Elemental concentrations of ambient particles and cause specific mortality in Santiago, Chile: a time series study

BACKGROUND

The health effects of particulate air pollution are widely recognized and there is some evidence that the magnitude of these effects vary by particle component. We studied the effects of ambient fine particles (aerodynamic diameter < 2.5 μm, PM(2.5)) and their components on cause-specific mortality in Santiago, Chile, where particulate pollution is a major public health concern.

METHODS

Air pollution was collected in a residential area in the center of Santiago. Daily mortality counts were obtained from the National Institute of Statistic. The associations between PM(2.5) and cause-specific mortality were studied by time series analysis controlling for time trends, day of the week, temperature and relative humidity. We then included an interaction term between PM(2.5) and the monthly averages of the mean ratios of individual elements to PM2.5 mass.

RESULTS

We found significant effects of PM(2.5) on all the causes analyzed, with a 1.33% increase (95% CI: 0.87-1.78) in cardiovascular mortality per 10 μg/m(3) increase in the two days average of PM(2.5). We found that zinc was associated with higher cardiovascular mortality. Particles with high content of chromium, copper and sulfur showed stronger associations with respiratory and COPD mortality, while high zinc and sodium content of PM(2.5) amplified the association with cerebrovascular disease.

CONCLUSIONS

Our findings suggest that PM(2.5) with high zinc, chromium, copper, sodium, and sulfur content have stronger associations with mortality than PM(2.5) mass alone in Santiago, Chile. The sources of particles containing these elements need to be determined to better control their emissions.

Obesity enhanced respiratory health effects of ambient air pollution in Chinese children: the Seven Northeastern Cities study

OBJECTIVE

Experimental data suggest that obesity enhances the effects of ambient air pollutants on exacerbation of asthma; however, there is little supporting epidemiological evidence. The aim of present study is to evaluate whether obesity modifies the association between ambient air pollution and respiratory symptoms and asthma in children.

METHODS

In Northeast China, 30 056 children aged 2-14 years were selected from 25 districts of seven cities. Parents of the children completed questionnaires that characterized the children's histories of respiratory symptoms and illness, and associated risk factors. Overweight and obesity were calculated with an age and sex-specific body mass index (BMI, kg m(-2)), with BMIs of greater than the 85th and 95th percentiles defining overweight and obesity, respectively. Average annual ambient exposure to particulate matter with an aerodynamic diameter 10 μm (PM(10)), sulfur dioxide (SO(2)), nitrogen dioxides (NO(2)) and ozone (O(3)) was estimated from data collected at monitoring stations in each of the 25 study districts.

RESULTS

We observed consistent and significant interactions between exposure and obesity on respiratory symptoms and asthma. The associations between each pollutant's yearly concentrations and respiratory symptoms and asthma were consistently larger for overweight/obese children than for normal-weight children, with odds ratios (ORs) ranging from 1.17 per 31 μg m(-3) for PM(10) on wheeze (95% confidence interval (CI): 1.01, 1.36) to 1.50 per 10 μg m(-3) for NO(2) on phlegm (95% CI: 1.21, 1.87) and cough (95% CI: 1.24, 1.81).

CONCLUSION

These results showed that overweight/obesity enhanced respiratory health effects of air pollution in the study children.

Black carbon as an additional indicator of the adverse health effects of airborne particles compared with PM10 and PM2.5

BACKGROUND

Current air quality standards for particulate matter (PM) use the PM mass concentration [PM with aerodynamic diameters ≤ 10 μm (PM(10)) or ≤ 2.5 μm (PM(2.5))] as a metric. It has been suggested that particles from combustion sources are more relevant to human health than are particles from other sources, but the impact of policies directed at reducing PM from combustion processes is usually relatively small when effects are estimated for a reduction in the total mass concentration.

OBJECTIVES

We evaluated the value of black carbon particles (BCP) as an additional indicator in air quality management.

METHODS

We performed a systematic review and meta-analysis of health effects of BCP compared with PM mass based on data from time-series studies and cohort studies that measured both exposures. We compared the potential health benefits of a hypothetical traffic abatement measure, using near-roadway concentration increments of BCP and PM(2.5) based on data from prior studies.

RESULTS

Estimated health effects of a 1-μg/m3 increase in exposure were greater for BCP than for PM(10) or PM(2.5), but estimated effects of an interquartile range increase were similar. Two-pollutant models in time-series studies suggested that the effect of BCP was more robust than the effect of PM mass. The estimated increase in life expectancy associated with a hypothetical traffic abatement measure was four to nine times higher when expressed in BCP compared with an equivalent change in PM(2.5) mass.

CONCLUSION

BCP is a valuable additional air quality indicator to evaluate the health risks of air quality dominated by primary combustion particles.