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Wang R, Liu J, Qin Y, Chen Z, Li J, Guo P, Shan L, Li Y, Hao Y, Jiao M, Qi X, Meng N, Jiang S, Kang Z, Wu Q. Global attributed burden of death for air pollution: Demographic decomposition and birth cohort effect. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 860:160444. [PMID: 36435245 DOI: 10.1016/j.scitotenv.2022.160444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/19/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND To identify the high-risk pollutants and evolving patterns of attributed mortality burden, more detailed evidence is needed to examine the contribution of different air pollutants to death across the disease spectrum, particularly considering population change as well as the context of the era. METHODS We explored the evolving patterns of all-cause and disease-specific deaths attributed to overall air pollution and its main subcategories by using the estimated annual percentage change and additionally assessing the contribution of population growth and ageing to death burden using the decomposition method. Age-period-cohort model and Joinpoint analysis were used to evaluate birth cohort effects specific-disease death burden owing to high-risk air pollution subcategories. FINDINGS The number of deaths caused by air pollution increased by 2.62 %, which was driven by ambient particulate matter pollution and ambient ozone pollution, whereas household air pollution decreased. Population ageing contributed 28.88 % of the deaths increase change for air pollution. Compared with other subcategories, the age-standardized mortality rate (ASMR) attributed to ambient particulate matter pollution remained the heaviest attributed death burden, comprehensively considering of bivariate burden. In 2019, ischemic heart disease attributed to ambient particulate matter pollution exhibited the highest ASMR, which may be impacted by a rapid increase era from 1950 to 1980 birth cohort in woman and 1970 to 1990 birth cohort in man. Diabetes mellitus attributed to ambient particulate matter pollution showed the largest increase for ASMR, which was driven primarily by men born 1910-1975 and women born 1950-1975.Uzbekistan showed the highest ASMR for ischemic heart disease, with Equatorial Guinea showing the fastest increase for diabetes mellitus. CONCLUSION Priority intervention targets for air pollution and health should emphasize the susceptibility of the elderly population as well as the structural factors of the era, in particular sensitive diseases to the ambient particulate matter pollution.
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Affiliation(s)
- Rizhen Wang
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Jingjing Liu
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Yinghua Qin
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China; Department of Health Economy and Social Security, College of Humanities and Management, Guilin Medical University, Guilin 541199, China
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens 30602, GA, USA; School of Economics, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Jiacheng Li
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Pengfei Guo
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Linghan Shan
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Ye Li
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Yanhua Hao
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Mingli Jiao
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Xinye Qi
- Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Nan Meng
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Shengchao Jiang
- Department of Personnel Department, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Zheng Kang
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Qunhong Wu
- Department of Health Policy, School of Health Management, Harbin Medical University, Harbin 150081, China.
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Wang Q, Liu S. The Effects and Pathogenesis of PM2.5 and Its Components on Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:493-506. [PMID: 37056681 PMCID: PMC10086390 DOI: 10.2147/copd.s402122] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD), a heterogeneous disease, is the leading cause of death worldwide. In recent years, air pollution, especially particulate matter (PM), has been widely studied as a contributing factor to COPD. As an essential component of PM, PM2.5 is associated with COPD prevalence, morbidity, and acute exacerbations. However, the specific pathogenic mechanisms were still unclear and deserve further research. The diversity and complexity of PM2.5 components make it challenging to get its accurate effects and mechanisms for COPD. It has been determined that the most toxic PM2.5 components are metals, polycyclic aromatic hydrocarbons (PAHs), carbonaceous particles (CPs), and other organic compounds. PM2.5-induced cytokine release and oxidative stress are the main mechanisms reported leading to COPD. Nonnegligibly, the microorganism in PM 2.5 may directly cause mononuclear inflammation or break the microorganism balance contributing to the development and exacerbation of COPD. This review focuses on the pathophysiology and consequences of PM2.5 and its components on COPD.
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Affiliation(s)
- Qi Wang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
| | - Sha Liu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, People’s Republic of China
- Correspondence: Sha Liu, Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital, Hengyang Medical School, University of South China, 35 Jiefang Avenue, Zhengxiang District, Hengyang, Hunan, 421001, People’s Republic of China, Email
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Sun J, Cui N, Han W, Li Q, Wang H, Li Z, Cheng W, Luo H, Zhao M. Implementation of Nurse-Led, Goal-Directed Lung Physiotherapy for Older Patients With Sepsis and Pneumonia in the ICU. Front Med (Lausanne) 2021; 8:753620. [PMID: 34881259 PMCID: PMC8647879 DOI: 10.3389/fmed.2021.753620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/31/2021] [Indexed: 01/26/2023] Open
Abstract
Objectives: This study aimed to investigate the effect of nurse-led, goal-directed lung physiotherapy (GDLPT) on the prognosis of older patients with sepsis caused by pneumonia in the intensive care unit. Methods: We conducted a prospective, two-phase (before-and-after) study over 3 years called the GDLPT study. All patients received standard lung therapy for sepsis caused by pneumonia and patients in phase 2 also received GDLPT. In this study, 253 older patients (age ≥ 65 years) with sepsis and pneumonia were retrospectively analyzed. The main outcome was 28 day mortality. Results: Among 742 patients with sepsis, 253 older patients with pneumonia were divided into the control group and the treatment group. Patients in the treatment group had a significantly shorter duration of mechanical ventilation [5 (4, 6) vs. 5 (4, 8) days; P = 0.045], and a lower risk of intensive care unit (ICU) mortality [14.5% (24/166) vs. 28.7% (25/87); P = 0.008] and 28 day mortality [15.1% (25/166) vs. 31% (27/87); P = 0.005] compared with those in the control group. GDLPT was an independent risk factor for 28 day mortality [odds ratio (OR), 0.379; 95% confidence interval (CI), 0.187-0.766; P = 0.007]. Conclusions: Nurse-led GDLPT shortens the duration of mechanical ventilation, decreases ICU and 28-day mortality, and improves the prognosis of older patients with sepsis and pneumonia in the ICU.
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Affiliation(s)
- Jianhua Sun
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Na Cui
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Wen Han
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Qi Li
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Hao Wang
- Department of Critical Care Medicine, Beijing Jishuitan Hospital, Beijing, China
| | - Zunzhu Li
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Wei Cheng
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Hongbo Luo
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Mingxi Zhao
- Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
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Nieckarz Z, Zoladz JA. Low-cost air pollution monitoring system-an opportunity for reducing the health risk associated with physical activity in polluted air. PeerJ 2020; 8:e10041. [PMID: 33062442 PMCID: PMC7533060 DOI: 10.7717/peerj.10041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/04/2020] [Indexed: 01/13/2023] Open
Abstract
The issue of air pollution by particulate matter (PM) concerns many places in the world. At the same time, many residents undertake physical activity (recreation, rehabilitation, sport) in the open air. Generally, the amount of dust concentration depends on both the place (center or periphery of the city) and the time of day. In the present study we describe the outcome of monitoring of the state of air pollution by particle matter (PM10) in the Kraków agglomeration area in order to show that it can provide information concerning air quality in the area where people practice varied kinds of sports in the open air. The measurements of PM10 have been made by a few stations with identical construction working as one network. The details of the air pollution monitoring system and its data quality verification have been described. The network stations made multipoint observations across the Kraków Metropolitan Area during the year 2017 in eight locations. The locations selected represent a diverse spectrum of terrain conditions in which the Kraków agglomeration community undertakes physical activity. For most months of 2017, the minimum monthly average 4-hour PM10 concentrations were recorded between 10–14 h, regardless of location, whereas the maximum was between 18–22. We also noticed a huge differences in the average monthly value of PM10 in some locations within the Kraków agglomeration—ranging between 4.9–339.0 µg m−3. This indicates that some regions of the city are more suitable for performance of physical activity in the open air than others. In conclusion, we postulate that a low-cost air pollution monitoring system is capable of providing valuable information concerning air quality in a given region, which seems to be of importance also to people who practice varied sports activities in the open air.
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Affiliation(s)
- Zenon Nieckarz
- Experimental Computer Physics Department, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland.,Department of Muscle Physiology, Institute of Basic Sciences, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
| | - Jerzy A Zoladz
- Department of Muscle Physiology, Institute of Basic Sciences, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
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Brighton LJ, Evans CJ, Man WDC, Maddocks M. Improving Exercise-Based Interventions for People Living with Both COPD and Frailty: A Realist Review. Int J Chron Obstruct Pulmon Dis 2020; 15:841-855. [PMID: 32368030 PMCID: PMC7182688 DOI: 10.2147/copd.s238680] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
Background People living with both chronic obstructive pulmonary disease (COPD) and frailty have high potential to benefit from exercise-based interventions, including pulmonary rehabilitation, but face challenges completing them. Research to understand ways to optimise exercise-based interventions in this group is lacking. We aimed to understand how exercise-based interventions might improve outcomes for people living with both COPD and frailty. Methods This realist review used database searches and handsearching until October 2019 to identify articles of relevance to exercise-based interventions for people living with COPD and frailty. A scoping search explored what is important about the context of living with COPD and frailty, and what mechanisms might be important in how exercise-based interventions result in their intended outcomes. Through discussion with stakeholders, the review scope was refined to areas deemed pertinent to improving care. We retained articles within this refined scope and identified additional articles through targeted handsearching. Data were extracted and synthesised in a narrative, prioritised by relevance and rigour. Results Of 344 records identified, 35 were included in the review and 20 informed the final synthesis. Important contextual factors to consider included: negative beliefs about themselves and exercise-based interventions; heterogenous presentation and comorbidities; decreased reserves and multidimensional loss; and experiencing unpredictable health and disruptions. In these circumstances, mechanisms that may help maximise outcomes from exercise-based interventions included: trusting relationships; creating a shared understanding of needs; having the capacity to address multidimensional concerns; being able to individualise approaches to needs and priorities; and flexible approaches to intervention delivery. Mixed-methods research and explicit theorising were often absent. Conclusion Building trusting relationships, understanding priorities, using individualised and multidisciplinary approaches, and flexible service delivery can improve the value of exercise-based interventions for people living with both COPD and frailty. Development and evaluation of new and adapted interventions should consider these principles.
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Affiliation(s)
- Lisa Jane Brighton
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
| | - Catherine J Evans
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
- Brighton General Hospital, Sussex Community NHS Foundation Trust, Brighton, UK
| | - William D C Man
- National Heart and Lung Institute, Imperial College, London, UK
- Harefield Respiratory Research Group, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
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