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Leinweber ME, Meisenbacher K, Schmandra T, Karl T, Torsello G, Walensi M, Geisbuesch P, Schmitz-Rixen T, Jung G, Hofmann AG. Exploring the Effects of Local Air Pollution on Popliteal Artery Aneurysms. J Clin Med 2024; 13:3250. [PMID: 38892961 PMCID: PMC11172973 DOI: 10.3390/jcm13113250] [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: 03/11/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: A growing body of evidence highlights the effects of air pollution on chronic and acute cardiovascular diseases, such as associations between PM10 and several cardiovascular events. However, evidence of the impact of fine air pollutants on the development and progression of peripheral arterial aneurysms is not available. Methods: Data were obtained from the multicenter PAA outcome registry POPART and the German Environment Agency. Means of the mean daily concentration of PM10, PM2.5, NO2, and O3 concentrations were calculated for 2, 10, and 3650 days prior to surgery for each patient. Additionally, weighted ten-year averages were analyzed. Correlation was assessed by calculating Pearson correlation coefficients, and regression analyses were conducted as multiple linear or multiple logistic regression, depending on the dependent variable. Results: For 1193 patients from the POPART registry, paired air pollution data were available. Most patients were male (95.6%) and received open surgical repair (89.9%). On a regional level, the arithmetic means of the daily means of PM10 between 2000 and 2022 were neither associated with average diameters nor runoff vessels. Negative correlations for mean PAA diameter and mean NO2, as well as a positive correlation with mean O3, were found; however, they were not statistically significant. On patient level, no evidence for an association of mean PM10 exposure over ten years prior to inclusion in the registry and PAA diameter or the number of runoff vessels was found. Weighted PM10, NO2, and O3 exposure over ten years also did not result in significant associations with aneurysm diameter or runoff vessels. Short-term air pollutant concentrations were not associated with symptomatic PAAs or with perioperative complications. Conclusions: We found no indication that long-term air pollutant concentrations are associated with PAA size or severity, neither on a regional nor individual level. Additionally, short-term air pollution showed no association with clinical presentation or treatment outcomes.
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Affiliation(s)
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Thomas Schmandra
- Department of Vascular Surgery, Sana Klinikum Offenbach, 63069 Offenbach, Germany
| | - Thomas Karl
- Department of Vascular and Endovascular Surgery, Klinikum am Plattenwald, SLK-Kliniken Heilbronn GmbH, 74177 Bad Friedrichshall, Germany
| | - Giovanni Torsello
- Department for Vascular Surgery, Franziskus Hospital Münster, 48145 Münster, Germany
| | - Mikolaj Walensi
- Department of Vascular Surgery and Phlebology, Contilia Heart and Vascular Center, 45138 Essen, Germany
| | - Phillip Geisbuesch
- Department of Vascular and Endovascular Surgery, Klinikum Stuttgart, 70199 Stuttgart, Germany
| | - Thomas Schmitz-Rixen
- German Society of Surgery, Langenbeck-Virchow-Haus, Luisenstraße 58/59, 10117 Berlin, Germany
| | - Georg Jung
- Department of Vascular and Endovascular Surgery, Luzerner Kantonsspital, 6000 Lucern, Switzerland
| | - Amun Georg Hofmann
- FIFOS—Forum for Integrative Research and Systems Biology, 1170 Vienna, Austria
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Vameghestahbanati M, Kingdom L, Hoffman EA, Kirby M, Allen NB, Angelini E, Bertoni A, Hamid Q, Hogg JC, Jacobs DR, Laine A, Maltais F, Michos ED, Sack C, Sin D, Watson KE, Wysoczanksi A, Couper D, Cooper C, Han M, Woodruff P, Tan WC, Bourbeau J, Barr RG, Smith BM. Airway tree caliber heterogeneity and airflow obstruction among older adults. J Appl Physiol (1985) 2024; 136:1144-1156. [PMID: 38420676 DOI: 10.1152/japplphysiol.00694.2022] [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: 11/15/2022] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
Smaller mean airway tree caliber is associated with airflow obstruction and chronic obstructive pulmonary disease (COPD). We investigated whether airway tree caliber heterogeneity was associated with airflow obstruction and COPD. Two community-based cohorts (MESA Lung, CanCOLD) and a longitudinal case-control study of COPD (SPIROMICS) performed spirometry and computed tomography measurements of airway lumen diameters at standard anatomical locations (trachea-to-subsegments) and total lung volume. Percent-predicted airway lumen diameters were calculated using sex-specific reference equations accounting for age, height, and lung volume. The association of airway tree caliber heterogeneity, quantified as the standard deviation (SD) of percent-predicted airway lumen diameters, with baseline forced expired volume in 1-second (FEV1), FEV1/forced vital capacity (FEV1/FVC) and COPD, as well as longitudinal spirometry, were assessed using regression models adjusted for age, sex, height, race-ethnicity, and mean airway tree caliber. Among 2,505 MESA Lung participants (means ± SD age: 69 ± 9 yr; 53% female, mean airway tree caliber: 99 ± 10% predicted, airway tree caliber heterogeneity: 14 ± 5%; median follow-up: 6.1 yr), participants in the highest quartile of airway tree caliber heterogeneity exhibited lower FEV1 (adjusted mean difference: -125 mL, 95%CI: -171,-79), lower FEV1/FVC (adjusted mean difference: -0.01, 95%CI: -0.02,-0.01), and higher odds of COPD (adjusted odds ratio: 1.42, 95%CI: 1.01-2.02) when compared with the lowest quartile, whereas longitudinal changes in FEV1 and FEV1/FVC did not differ significantly. Observations in CanCOLD and SPIROMICS were consistent. Among older adults, airway tree caliber heterogeneity was associated with airflow obstruction and COPD at baseline but was not associated with longitudinal changes in spirometry.NEW & NOTEWORTHY In this study, by leveraging two community-based samples and a case-control study of heavy smokers, we show that among older adults, airway tree caliber heterogeneity quantified by CT is associated with airflow obstruction and COPD independent of age, sex, height, race-ethnicity, and dysanapsis. These observations suggest that airway tree caliber heterogeneity is a structural trait associated with low baseline lung function and normal decline trajectory that is relevant to COPD.
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Affiliation(s)
| | - Leina Kingdom
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa, United States
| | - Miranda Kirby
- Department of Physics, Ryerson University, Toronto, Ontario, Canada
| | - Norrina B Allen
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois, United States
| | - Elsa Angelini
- Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Medicine, Columbia University, New York, New York, United States
| | - Alain Bertoni
- Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina, United States
| | - Qutayba Hamid
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Faculty of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - James C Hogg
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - David R Jacobs
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Andrew Laine
- Department of Medicine, Columbia University, New York, New York, United States
| | - Francois Maltais
- Faculty of Medicine , University of Laval, Laval, Quebec, Canada
| | - Erin D Michos
- Faculty of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Coralynn Sack
- Department of Medicine, University of Washington, Seattle, Washington, United States
| | - Don Sin
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karol E Watson
- Department of Medicine, University of California, Los Angeles, California, United States
| | - Artur Wysoczanksi
- Department of Medicine, Columbia University, New York, New York, United States
| | - David Couper
- Department of Biostatistics, University of North Carolina, North Carolina, United States
| | - Christopher Cooper
- Department of Medicine, University of California, Los Angeles, California, United States
| | - Meilan Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Prescott Woodruff
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, California, United States
| | - Wan C Tan
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean Bourbeau
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - R Graham Barr
- Department of Medicine, Columbia University, New York, New York, United States
| | - Benjamin M Smith
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Medicine, Columbia University, New York, New York, United States
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Pedde M, Larson TV, D’Souza J, Szpiro AA, Kloog I, Lisabeth LD, Jacobs D, Sheppard L, Allison M, Kaufman JD, Adar SD. Coarse Particulate Matter and Markers of Inflammation and Coagulation in the Multi-Ethnic Study of Atherosclerosis (MESA) Population: A Repeat Measures Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:27009. [PMID: 38381480 PMCID: PMC10880818 DOI: 10.1289/ehp12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND In contrast to fine particles, less is known of the inflammatory and coagulation impacts of coarse particulate matter (PM 10 - 2.5 , particulate matter with aerodynamic diameter ≤ 10 μ m and > 2.5 μ m ). Toxicological research suggests that these pathways might be important processes by which PM 10 - 2.5 impacts health, but there are relatively few epidemiological studies due to a lack of a national PM 10 - 2.5 monitoring network. OBJECTIVES We used new spatiotemporal exposure models to examine associations of both 1-y and 1-month average PM 10 - 2.5 concentrations with markers of inflammation and coagulation. METHODS We leveraged data from 7,071 Multi-Ethnic Study of Atherosclerosis and ancillary study participants 45-84 y of age who had repeated plasma measures of inflammatory and coagulation biomarkers. We estimated PM 10 - 2.5 at participant addresses 1 y and 1 month before each of up to four exams (2000-2012) using spatiotemporal models that incorporated satellite, regulatory monitoring, and local geographic data and accounted for spatial correlation. We used random effects models to estimate associations with interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, and D-dimer, controlling for potential confounders. RESULTS Increases in PM 10 - 2.5 were not associated with greater levels of inflammation or coagulation. A 10 - μ g / m 3 increase in annual average PM 10 - 2.5 was associated with a 2.5% decrease in CRP [95% confidence interval (CI): - 5.5 , 0.6]. We saw no association between annual average PM 10 - 2.5 and the other markers (IL-6: - 0.7 % , 95% CI: - 2.6 , 1.2; fibrinogen: - 0.3 % , 95% CI: - 0.9 , 0.3; D-dimer: - 0.2 % , 95% CI: - 2.6 , 2.4). Associations consistently showed that a 1 0 - μ g / m 3 increase in 1-month average PM 10 - 2.5 was associated with reduced inflammation and coagulation, though none were distinguishable from no association (IL-6: - 1.2 % , 95% CI: - 3.0 , 0.5; CRP: - 2.5 % , 95% CI: - 5.3 , 0.4; fibrinogen: - 0.4 % , 95% CI: - 1.0 , 0.1; D-dimer: - 2.0 % , 95% CI: - 4.3 , 0.3). DISCUSSION We found no evidence that PM 10 - 2.5 is associated with higher inflammation or coagulation levels. More research is needed to determine whether the inflammation and coagulation pathways are as important in explaining observed PM 10 - 2.5 health impacts in humans as they have been shown to be in toxicology studies or whether PM 10 - 2.5 might impact human health through alternative biological mechanisms. https://doi.org/10.1289/EHP12972.
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Affiliation(s)
- Meredith Pedde
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Timothy V. Larson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington, USA
| | - Jennifer D’Souza
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Lynda D. Lisabeth
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Matthew Allison
- Division of Preventive Medicine, University of California San Diego, San Diego, California, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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Yan S, Liu G, Chen X. Spatiotemporal distribution characteristics and influencing factors of the rate of cardiovascular hospitalization in Ganzhou city of China. Front Cardiovasc Med 2023; 10:1225878. [PMID: 38188258 PMCID: PMC10770874 DOI: 10.3389/fcvm.2023.1225878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Aims The objective of this study was to analyze hospitalization rates for cardiovascular diseases (CVD) in Ganzhou City, Jiangxi Province of China from 2015 to 2020 and to uncover the spatiotemporal distribution characteristics and influencing factors, and thus to provide reference for the prevention and control of CVD and public health resources planning. Methods The hospitalization data for CVDs from 2016 to 2020 was obtained from the First Affiliated Hospital of Gannan Medical University, and ArcGIS 10.8, SaTScan 9.5, and Matlab 20.0 were used to analyze the spatial autocorrelation, spatiotemporal scan statistics, and potential affecting factors of the hospitalization rates. Results The hospitalization rate for CVDs in Ganzhou City showed a slightly increasing trend from 2016 to 2020, with higher rates in winter and summer than that in spring and autumn, and the individuals aged 61 and above constitute a higher proportion compared to other age groups. Additionally, there was a positive correlation between hospitalization rates for CVDs and the counties and districts in Ganzhou City, with high-high aggregation areas mainly distributed in Nankang District, the western urban area of Ganzhou City. The spatial scan analysis identified three different types of significant aggregation areas: high-risk, low-risk, and middle-risk areas. The high-risk area was mainly centered around Zhanggong District or Shangyu County in the central and western regions, with a disease hospitalization rate 2-3 times higher than the rest areas. The study also found that environmental meteorological factors such as the annual average concentration of NO2, O3, average annual temperature, and annual maximum temperature diurnal range had a significant positive effect on hospitalization rates for CVDs in Ganzhou City, with O3 concentration and average annual temperature having significant positive indirect spatial spillover effects. Conclusion Winter and summer are the seasons with high hospitalization rate of cardiovascular diseases. County residents aged 61 and above are the higher-risk population that needs to pay more attention on for prevention and control of CVD in Ganzhou City, which exhibits significant spatiotemporal clustering. The urban areas of Zhanggong and Nankang in Ganzhou City are the key areas for prevention and control of CVD. The hospitalization rate of CVD in Ganzhou City is influenced by the aforementioned four environmental meteorological factors, with the annual maximum temperature diurnal range showing the most significant positive direct effect.
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Affiliation(s)
- Shanshan Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Guoqiu Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiaoyuan Chen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
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5
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Angelini ED, Yang J, Balte PP, Hoffman EA, Manichaikul AW, Sun Y, Shen W, Austin JHM, Allen NB, Bleecker ER, Bowler R, Cho MH, Cooper CS, Couper D, Dransfield MT, Garcia CK, Han MK, Hansel NN, Hughes E, Jacobs DR, Kasela S, Kaufman JD, Kim JS, Lappalainen T, Lima J, Malinsky D, Martinez FJ, Oelsner EC, Ortega VE, Paine R, Post W, Pottinger TD, Prince MR, Rich SS, Silverman EK, Smith BM, Swift AJ, Watson KE, Woodruff PG, Laine AF, Barr RG. Pulmonary emphysema subtypes defined by unsupervised machine learning on CT scans. Thorax 2023; 78:1067-1079. [PMID: 37268414 PMCID: PMC10592007 DOI: 10.1136/thorax-2022-219158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/03/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Treatment and preventative advances for chronic obstructive pulmonary disease (COPD) have been slow due, in part, to limited subphenotypes. We tested if unsupervised machine learning on CT images would discover CT emphysema subtypes with distinct characteristics, prognoses and genetic associations. METHODS New CT emphysema subtypes were identified by unsupervised machine learning on only the texture and location of emphysematous regions on CT scans from 2853 participants in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), a COPD case-control study, followed by data reduction. Subtypes were compared with symptoms and physiology among 2949 participants in the population-based Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study and with prognosis among 6658 MESA participants. Associations with genome-wide single-nucleotide-polymorphisms were examined. RESULTS The algorithm discovered six reproducible (interlearner intraclass correlation coefficient, 0.91-1.00) CT emphysema subtypes. The most common subtype in SPIROMICS, the combined bronchitis-apical subtype, was associated with chronic bronchitis, accelerated lung function decline, hospitalisations, deaths, incident airflow limitation and a gene variant near DRD1, which is implicated in mucin hypersecretion (p=1.1 ×10-8). The second, the diffuse subtype was associated with lower weight, respiratory hospitalisations and deaths, and incident airflow limitation. The third was associated with age only. The fourth and fifth visually resembled combined pulmonary fibrosis emphysema and had distinct symptoms, physiology, prognosis and genetic associations. The sixth visually resembled vanishing lung syndrome. CONCLUSION Large-scale unsupervised machine learning on CT scans defined six reproducible, familiar CT emphysema subtypes that suggest paths to specific diagnosis and personalised therapies in COPD and pre-COPD.
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Affiliation(s)
- Elsa D Angelini
- Department of Biomedical Engineering, Columbia University, New York, New York, USA
- LTCI, Institut Polytechnique de Paris, Telecom Paris, Palaiseau, France
- NIHR Imperial Biomedical Research Centre, ITMAT Data Science Group, Imperial College, London, UK
| | - Jie Yang
- Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Pallavi P Balte
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Eric A Hoffman
- Departments of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Ani W Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | - Yifei Sun
- Department of Biostatistics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wei Shen
- Department of Pediatrics, Institute of Human Nutrition, Columbia University Irving Medical Center, New York, New York, USA
- Columbia Magnetic Resonance Research Center (CMRRC), Columbia University Irving Medical Center, New York, New York, USA
| | - John H M Austin
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Norrina B Allen
- Institute for Public Health and Medicine (IPHAM) - Center for Epidemiology and Population Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Eugene R Bleecker
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona, USA
| | - Russell Bowler
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - David Couper
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Christine Kim Garcia
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - MeiLan K Han
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Nadia N Hansel
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emlyn Hughes
- Department of Physics, Columbia University, New York, New York, USA
| | - David R Jacobs
- Division of Epidemiology and Community Public Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Silva Kasela
- Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA
- New York Genome Center, New York, New York, USA
| | - Joel Daniel Kaufman
- Departments of Environmental & Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA
| | - John Shinn Kim
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Tuuli Lappalainen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Joao Lima
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel Malinsky
- Department of Biostatistics, Columbia University Irving Medical Center, New York, New York, USA
| | - Fernando J Martinez
- Department of Medicine, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
| | - Elizabeth C Oelsner
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Victor E Ortega
- Department of Pulmonary Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Robert Paine
- Department of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Wendy Post
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tess D Pottinger
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Martin R Prince
- Department of Radiology, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | - Edwin K Silverman
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Benjamin M Smith
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Medicine, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrew J Swift
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Karol E Watson
- Department of Medicine, University of California, Los Angeles, California, USA
| | - Prescott G Woodruff
- Department of Medicine, University of California, San Francisco, California, USA
| | - Andrew F Laine
- Department of Biomedical Engineering, Columbia University, New York, New York, USA
- Columbia Magnetic Resonance Research Center (CMRRC), Columbia University Irving Medical Center, New York, New York, USA
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - R Graham Barr
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
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6
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Han Z, Zhao X, Xu Z, Wang J, Jin R, Liu Y, Wu Z, Zhang J, Li X, Guo X, Tao L. Associations of time-weighted individual exposure to ambient particulate matter with carotid atherosclerosis in Beijing, China. Environ Health 2023; 22:45. [PMID: 37248518 DOI: 10.1186/s12940-023-00995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/05/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Time-location information (time spent on commuting, indoors and outdoors around residential and work places and physical activity) and infiltrated outdoor pollution was less considered estimating individual exposure to ambient air pollution. Studies investigating the association between individual exposure to particulate matter (PM) with aerodynamic diameter < 10 μm (PM10) and < 2.5 μm (PM2.5) and carotid atherosclerosis presented inconsistent results. Moreover, combined effect of pollutants on carotid atherosclerosis was not fully explored. We aimed to investigate the association between long-term individual time-weighted average exposure to PM2.5 and PM10 and the risk of carotid atherosclerosis, and further explore the overall effect of co-exposure to pollutants on carotid atherosclerosis. METHODS The study population included 3069 participants derived from the Beijing Health Management Cohort (BHMC) study. Daily concentration of ambient air pollutants was estimated by land-use regression model at both residential and work addresses, and one- and two-year time-weighted average individual exposure was calculated by further considering personal activity pattern and infiltration of ambient air pollution indoors. We explored the association of PM2.5 and PM10 with carotid atherosclerosis and pooled the overall effect of co-exposure to ambient air pollutants by quantile g-computation. RESULTS A significant association between time-weighted average exposure to PM2.5 and PM10 and carotid atherosclerosis was observed. Per interquartile range increase in two-year exposure to PM2.5 (Hazard ratio (HR): 1.322, 95% confidence interval (CI): 1.219-1.434) and PM10 (HR:1.213, 95% CI: 1.116-1.319) showed the strongest association with carotid atherosclerosis, respectively. Individuals in higher quartiles of pollutants were at higher risk for carotid atherosclerosis compared with those in the lowest quartile group. Concentration response functions documented the nearly linear and nonlinear relationship and interpreted the upward trends of the risk for carotid atherosclerosis with increasing level of pollutant concentrations. Moreover, effect estimates for the mixture of pollutants and carotid atherosclerosis were larger than any of the individual pollutants (HR (95% CI) was 1.510 (1.338-1.704) and 1.613 (1.428-1.822) per quartile increase for one-year and two-year time-weighted average exposure, respectively). CONCLUSIONS Individual time-weighted average exposure to PM2.5 and PM10 was associated with carotid atherosclerosis. Co-exposure to ambient air pollution was also positively associated with carotid atherosclerosis.
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Affiliation(s)
- Ze Han
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Xiaoyu Zhao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zongkai Xu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Jinqi Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Rui Jin
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yueruijing Liu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zhiyuan Wu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Department of Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Jie Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, 3086, Australia
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Lixin Tao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
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7
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Kim SY, Blanco MN, Bi J, Larson TV, Sheppard L. Exposure assessment for air pollution epidemiology: A scoping review of emerging monitoring platforms and designs. ENVIRONMENTAL RESEARCH 2023; 223:115451. [PMID: 36764437 PMCID: PMC9992293 DOI: 10.1016/j.envres.2023.115451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/10/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Both exposure monitoring and exposure prediction have played key roles in assessing individual-level long-term exposure to air pollutants and their associations with human health. While there have been notable advances in exposure prediction methods, improvements in monitoring designs are also necessary, particularly given new monitoring paradigms leveraging low-cost sensors and mobile platforms. OBJECTIVES We aim to provide a conceptual summary of novel monitoring designs for air pollution cohort studies that leverage new paradigms and technologies, to investigate their characteristics in real-world examples, and to offer practical guidance to future studies. METHODS We propose a conceptual summary that focuses on two overarching types of monitoring designs, mobile and non-mobile, as well as their subtypes. We define mobile designs as monitoring from a moving platform, and non-mobile designs as stationary monitoring from permanent or temporary locations. We only consider non-mobile studies with cost-effective sampling devices. Then we discuss similarities and differences across previous studies with respect to spatial and temporal representation, data comparability between design classes, and the data leveraged for model development. Finally, we provide specific suggestions for future monitoring designs. RESULTS Most mobile and non-mobile monitoring studies selected monitoring sites based on land use instead of residential locations, and deployed monitors over limited time periods. Some studies applied multiple design and/or sub-design classes to the same area, time period, or instrumentation, to allow comparison. Even fewer studies leveraged monitoring data from different designs to improve exposure assessment by capitalizing on different strengths. In order to maximize the benefit of new monitoring technologies, future studies should adopt monitoring designs that prioritize residence-based site selection with comprehensive temporal coverage and leverage data from different designs for model development in the presence of good data compatibility. DISCUSSION Our conceptual overview provides practical guidance on novel exposure assessment monitoring for epidemiological applications.
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Affiliation(s)
- Sun-Young Kim
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Magali N Blanco
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jianzhao Bi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Timothy V Larson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
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8
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Feng S, Huang F, Zhang Y, Feng Y, Zhang Y, Cao Y, Wang X. The pathophysiological and molecular mechanisms of atmospheric PM 2.5 affecting cardiovascular health: A review. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114444. [PMID: 38321663 DOI: 10.1016/j.ecoenv.2022.114444] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 02/08/2024]
Abstract
BACKGROUND Exposure to ambient fine particulate matter (PM2.5, with aerodynamic diameter less than 2.5 µm) is a leading environmental risk factor for global cardiovascular health concern. OBJECTIVE To provide a roadmap for those new to this field, we reviewed the new insights into the pathophysiological and cellular/molecular mechanisms of PM2.5 responsible for cardiovascular health. MAIN FINDINGS PM2.5 is able to disrupt multiple physiological barriers integrity and translocate into the systemic circulation and get access to a range of secondary target organs. An ever-growing body of epidemiological and controlled exposure studies has evidenced a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality. A variety of cellular and molecular biology mechanisms responsible for the detrimental cardiovascular outcomes attributable to PM2.5 exposure have been described, including metabolic activation, oxidative stress, genotoxicity, inflammation, dysregulation of Ca2+ signaling, disturbance of autophagy, and induction of apoptosis, by which PM2.5 exposure impacts the functions and fates of multiple target cells in cardiovascular system or related organs and further alters a series of pathophysiological processes, such as cardiac autonomic nervous system imbalance, increasing blood pressure, metabolic disorder, accelerated atherosclerosis and plaque vulnerability, platelet aggregation and thrombosis, and disruption in cardiac structure and function, ultimately leading to cardiovascular events and death. Therein, oxidative stress and inflammation were suggested to play pivotal roles in those pathophysiological processes. CONCLUSION Those biology mechanisms have deepen insights into the etiology, course, prevention and treatment of this public health concern, although the underlying mechanisms have not yet been entirely clarified.
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Affiliation(s)
- Shaolong Feng
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin 541199, China; Guangdong Provincial Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou 510640, China; The State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China.
| | - Fangfang Huang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin 541199, China
| | - Yuqi Zhang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin 541199, China
| | - Yashi Feng
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin 541199, China
| | - Ying Zhang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin 541199, China
| | - Yunchang Cao
- The Department of Molecular Biology, School of Intelligent Medicine and Biotechnology, Guilin Medical University, Guilin 541199, China
| | - Xinming Wang
- Guangdong Provincial Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou 510640, China; The State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China
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9
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Abstract
Concerns about a crisis of mass irreplicability across scientific fields ("the replication crisis") have stimulated a movement for open science, encouraging or even requiring researchers to publish their raw data and analysis code. Recently, a rule at the US Environmental Protection Agency (US EPA) would have imposed a strong open data requirement. The rule prompted significant public discussion about whether open science practices are appropriate for fields of environmental public health. The aims of this paper are to assess (1) whether the replication crisis extends to fields of environmental public health; and (2) in general whether open science requirements can address the replication crisis. There is little empirical evidence for or against mass irreplicability in environmental public health specifically. Without such evidence, strong claims about whether the replication crisis extends to environmental public health - or not - seem premature. By distinguishing three concepts - reproducibility, replicability, and robustness - it is clear that open data initiatives can promote reproducibility and robustness but do little to promote replicability. I conclude by reviewing some of the other benefits of open science, and offer some suggestions for funding streams to mitigate the costs of adoption of open science practices in environmental public health.
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10
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Gwon JG, Park JH, Kim JS, Seo HM. Exposure to Long-Term Air Pollution and Incidence of Peripheral Arterial Disease in the General Population: A Korean National Population-Based Retrospective Cohort Study. Angiology 2022:33197221121010. [DOI: 10.1177/00033197221121010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the causal relationship between long-term outdoor air pollutants and incidence of peripheral arterial disease (PAD) using the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database. We included 292,091 subjects from the general population who had previously not been diagnosed with PAD by the NHIS-NSC between 2008 and 2014. Hourly air pollutant data (particulate and gaseous) and climate data were collected. Correlation analysis of the collected data confirmed the relationship between air pollution and PAD incidence. For 1,836,965.4 person-years, incident cases of PAD were observed in 5243 subjects (285.4/100,000 person-years). In the Cox proportional hazard analysis, exposure to long-term average concentration of sulfur dioxide (SO2) [hazard ratio (HR), 1.686; (95% confidence interval (CI), 1.108–2.565) for .01ppm] and nitrogen dioxide (NO2) [HR, 1.200; (95% CI, 1.077–1.336) for .01 ppm] significantly increased the risk of PAD occurrence after the adjustment for several variables. This study demonstrated that SO2 and NO2 exposure are independent predictors of PAD.
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Affiliation(s)
- Jun Gyo Gwon
- Division of Vascular Surgery, Department of Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ji Hun Park
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
| | - Joung Soo Kim
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
| | - Hyun-Min Seo
- Department of Dermatology, College of Medicine, Hanyang University, Hanyang University Guri Hospital, Guri-si, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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11
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Posadas-Sánchez R, Vargas-Alarcón G, Cardenas A, Texcalac-Sangrador JL, Osorio-Yáñez C, Sanchez-Guerra M. Long-Term Exposure to Ozone and Fine Particulate Matter and Risk of Premature Coronary Artery Disease: Results from Genetics of Atherosclerotic Disease Mexican Study. BIOLOGY 2022; 11:biology11081122. [PMID: 35892978 PMCID: PMC9332787 DOI: 10.3390/biology11081122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022]
Abstract
(1) Background: Epidemiological studies have identified associations between fine particulate matter (PM2.5) and ozone exposure with cardiovascular disease; however, studies linking ambient air pollution and premature coronary artery disease (pCAD) in Latin America are non-existing. (2) Methods: Our study was a case−control analysis nested in the Genetics of Atherosclerotic Disease (GEA) Mexican study. We included 1615 participants (869 controls and 746 patients with pCAD), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. We defined pCAD as history of myocardial infarction, angioplasty, revascularization surgery or coronary stenosis > 50% diagnosed before age 55 in men and age 65 in women. Controls were healthy individuals without personal or family history of pCAD and with coronary artery calcification equal to zero. Hourly measurements of ozone and PM2.5 from the Atmospheric Monitoring System in Mexico City (SIMAT in Spanish; Sistema de Monitero Atmosférico de la Ciudad de México) were used to calculate annual exposure to ozone and PM2.5 in the study participants. (3) Results: Each ppb increase in ozone at 1-year, 2-year, 3-year and 5-year averages was significantly associated with increased odds (OR = 1.10; 95% CI: 1.03−1.18; OR = 1.17; 95% CI: 1.05−1.30; OR = 1.18; 95% CI: 1.05−1.33, and OR = 1.13; 95% CI: 1.04−1.23, respectively) of pCAD. We observed higher risk of pCAD for each 5 µg/m3 increase only for the 5-year average of PM2.5 exposure (OR = 2.75; 95% CI: 1.47−5.16), compared to controls. (4) Conclusions: Ozone exposure at different time points and PM2.5 exposure at 5 years were associated with increased odds of pCAD. Our results highlight the importance of reducing long-term exposure to ambient air pollution levels to reduce the burden of cardiovascular disease in Mexico City and other metropolitan areas.
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Affiliation(s)
| | - Gilberto Vargas-Alarcón
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (R.P.-S.); (G.V.-A.)
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA;
| | | | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación en Medicina Traslacional, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
- Correspondence: (C.O.-Y.); (M.S.-G.); Tel.: +52-55-5573-2911 (ext. 27319) (C.O.-Y.); +52-55-5520-9900 (ext. 129) (M.S.-G.)
| | - Marco Sanchez-Guerra
- Instituto Nacional de Perinatología, Mexico City 11000, Mexico
- Correspondence: (C.O.-Y.); (M.S.-G.); Tel.: +52-55-5573-2911 (ext. 27319) (C.O.-Y.); +52-55-5520-9900 (ext. 129) (M.S.-G.)
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12
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Liao SH, Chiu CS, Jang LH, Hu SY, How CK, Hsieh VCR, Hsieh MS. Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan. Front Cardiovasc Med 2022; 9:796423. [PMID: 35669470 PMCID: PMC9163433 DOI: 10.3389/fcvm.2022.796423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/15/2022] [Indexed: 11/25/2022] Open
Abstract
Air pollution is one of the most alarming environmental issues which causes multiple health hazards. An association between air pollution and cardiovascular diseases has been established through many prior studies. In this study, we aimed to evaluate the risk of long-term exposure to air pollution (PM2.5, CO, and NO2) and its association with the risk of developing peripheral arterial occlusive disease (PAOD). PAOD is a condition involving impairment of perfusion of blood in the distal parts of the aorta due to narrowing of the arteries (arterial stenosis) and has been reported as a risk factor for developing cardiovascular diseases. Furthermore, the risk of PAOD increases with age, and hence is a serious public health issue and a cause for concern, especially for an aging society such as Taiwan. Two national-scale databases from Taiwan, the national health insurance database (NHIRD) and the Taiwan air quality-monitoring database (TAQMD), were linked to conduct this cohort study between 2003 and 2013. Cox proportional hazards regression with time-dependent modeling was used to evaluate the hazard ratio (HR) for PAOD with respect to daily exposure to air pollutants. The concentrations of each of the pollutants of interest (PM2.5, NO2, and CO) were categorized into four categories according to the daily average concentration of air pollutants for every quarter of the year, Q1 to Q4 (Q4 = highest). The cumulative incidence of PAOD was examined by Kaplan–Meier analysis with two-tailed log-rank test. A total of 1,598 PAOD cases were identified during the 10-year follow-up period, along with 98,540 non-PAOD controls. In the multivariate analysis, after adjusting for age, gender, urbanization level, residential area, baseline comorbidities, and medications, the adjusted HRs were PM2.5 = 1.14 (95% CI 1.13–1.16), NO2 = 1.03 (95% CI 1.02–1.04), and CO = 2.35 (95% CI 1.95–2.84). Kaplan–Meier analysis showed that CO (P < 0.0001) and PM2.5 (P < 0.0001) concentrations were strongly and positively associated with the cumulative incidence of PAOD during the follow-up period. Findings from this study established that prolonged exposure to air pollutants CO and PM2.5 are significant factors that, among other well-known causes, may also play a potential role in PAOD pathogenesis.
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Affiliation(s)
- Shu-Hui Liao
- Department of Pathology and Laboratory, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, Taiwan
| | - Chien-Shan Chiu
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Li-Ho Jang
- Department of Critical Care, Saint Paul's Hospital, Taoyuan, Taiwan
| | - Sung-Yuan Hu
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chorng-Kuang How
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Vivian Chia-Rong Hsieh
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ming-Shun Hsieh
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, Taiwan
- *Correspondence: Ming-Shun Hsieh
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13
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C. Chi G, Liu Y, MacDonald JW, M. Reynolds L, Enquobahrie DA, L. Fitzpatrick A, Kerr KF, J. Budoff M, Lee SI, Siscovick D, D. Kaufman J. Epigenome-wide analysis of long-term air pollution exposure and DNA methylation in monocytes: results from the Multi-Ethnic Study of Atherosclerosis. Epigenetics 2022; 17:297-313. [PMID: 33818294 PMCID: PMC8920186 DOI: 10.1080/15592294.2021.1900028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Air pollution might affect atherosclerosis through DNA methylation changes in cells crucial to atherosclerosis, such as monocytes. We conducted an epigenome-wide study of DNA methylation in CD14+ monocytes and long-term ambient air pollution exposure in adults participating in the Multi-Ethnic Study of Atherosclerosis (MESA). We also assessed the association between differentially methylated signals and cis-gene expression. Using spatiotemporal models, one-year average concentrations of outdoor fine particulate matter (PM2.5) and oxides of nitrogen (NOX) were estimated at participants' homes. We assessed DNA methylation and gene expression using Illumina 450k and HumanHT-12 v4 Expression BeadChips, respectively (n = 1,207). We used bump hunting and site-specific approaches to identify differentially methylated signals (false discovery rate of 0.05) and used linear models to assess associations between differentially methylated signals and cis-gene expression. Four differentially methylated regions (DMRs) located on chromosomes 5, 6, 7, and 16 (within or near SDHAP3, ZFP57, HOXA5, and PRM1, respectively) were associated with PM2.5. The DMRs on chromosomes 5 and 6 also associated with NOX. The DMR on chromosome 5 had the smallest p-value for both PM2.5 (p = 1.4×10-6) and NOX (p = 7.7×10-6). Three differentially methylated CpGs were identified for PM2.5, and cg05926640 (near TOMM20) had the smallest p-value (p = 5.6×10-8). NOX significantly associated with cg11756214 within ZNF347 (p = 5.6×10-8). Several differentially methylated signals were also associated with cis-gene expression. The DMR located on chromosome 7 was associated with the expression of HOXA5, HOXA9, and HOXA10. The DMRs located on chromosomes 5 and 16 were associated with expression of MRPL36 and DEXI, respectively. The CpG cg05926640 was associated with expression of ARID4B, IRF2BP2, and TOMM20. We identified differential DNA methylation in monocytes associated with long-term air pollution exposure. Methylation signals associated with gene expression might help explain how air pollution contributes to cardiovascular disease.
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Affiliation(s)
- Gloria C. Chi
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,CONTACT Gloria C. Chi 1 DNA Way, South San Francisco, CA 94080
| | - Yongmei Liu
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - James W. MacDonald
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Lindsay M. Reynolds
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Daniel A. Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Annette L. Fitzpatrick
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, USA,Department of Global Health, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kathleen F. Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Matthew J. Budoff
- Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, California, USA
| | - Su-in Lee
- Department of Computer Science & Engineering, University of Washington, Seattle, Washington, USA,Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | | | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA,Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
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14
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Liu Q, Li H, Guo L, Chen Q, Gao X, Li PH, Tang N, Guo X, Deng F, Wu S. Effects of short-term personal exposure to air pollution on platelet mitochondrial DNA methylation levels and the potential mitigation by L-arginine supplementation. JOURNAL OF HAZARDOUS MATERIALS 2021; 417:125963. [PMID: 33984786 DOI: 10.1016/j.jhazmat.2021.125963] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/04/2021] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
The potential effect of short-term exposure to air pollution on mitochondrial DNA (mtDNA) methylation remains to be explored. This study adopted an experimental exposure protocol nested with an intervention study on L-arginine (L-Arg) supplementation among 118 participants. Participants walked along a traffic road for 2 hours in the last day of a 14-day intervention to investigate the effects of short-term personal exposure to air pollution on platelet mtDNA methylation and the possible modifying effects of L-Arg supplementation. Results showed that short-term personal exposure to air pollutants was associated with hypomethylation in platelet mtDNA in 110 participants who completed the study protocol. Specifically, 2-h fine particulate matter (PM2.5) exposure during the outdoor walk was significantly associated with hypomethylation in mt12sRNA; 24-h PM2.5 and black carbon (BC) exposures from the start of the walk till next morning were both significantly associated with hypomethylation in the D-loop region; 24-h BC exposure was also significantly associated with hypomethylation in ATP8_P1. Supplementation with L-Arg could mitigate the air pollution effects on platelet mtDNA methylation, especially the D-loop region. These findings suggest that platelet mtDNA methylation may be sensitive effect biomarker for short-term exposure to air pollution and may help deepen the understanding of the epigenetic mechanisms of adverse cardiovascular effects of air pollution.
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Affiliation(s)
- Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Liqiong Guo
- Institute of Disaster Medicine, Tianjin University, Tianjin, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Qiao Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Peng-Hui Li
- School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
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15
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Kirwa K, Szpiro AA, Sheppard L, Sampson PD, Wang M, Keller JP, Young MT, Kim SY, Larson TV, Kaufman JD. Fine-Scale Air Pollution Models for Epidemiologic Research: Insights From Approaches Developed in the Multi-ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Curr Environ Health Rep 2021; 8:113-126. [PMID: 34086258 PMCID: PMC8278964 DOI: 10.1007/s40572-021-00310-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Epidemiological studies of short- and long-term health impacts of ambient air pollutants require accurate exposure estimates. We describe the evolution in exposure assessment and assignment in air pollution epidemiology, with a focus on spatiotemporal techniques first developed to meet the needs of the Multi-ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Initially designed to capture the substantial variation in pollutant levels and potential health impacts that can occur over small spatial and temporal scales in metropolitan areas, these methods have now matured to permit fine-scale exposure characterization across the contiguous USA and can be used for understanding long- and short-term health effects of exposure across the lifespan. For context, we highlight how the MESA Air models compare to other available exposure models. RECENT FINDINGS Newer model-based exposure assessment techniques provide predictions of pollutant concentrations with fine spatial and temporal resolution. These validated models can predict concentrations of several pollutants, including particulate matter less than 2.5 μm in diameter (PM2.5), oxides of nitrogen, and ozone, at specific locations (such as at residential addresses) over short time intervals (such as 2 weeks) across the contiguous USA between 1980 and the present. Advances in statistical methods, incorporation of supplemental pollutant monitoring campaigns, improved geographic information systems, and integration of more complete satellite and chemical transport model outputs have contributed to the increasing validity and refined spatiotemporal spans of available models. Modern models for predicting levels of outdoor concentrations of air pollutants can explain a substantial amount of the spatiotemporal variation in observations and are being used to provide critical insights into effects of air pollutants on the prevalence, incidence, progression, and prognosis of diseases across the lifespan. Additional enhancements in model inputs and model design, such as incorporation of better traffic data, novel monitoring platforms, and deployment of machine learning techniques, will allow even further improvements in the performance of pollutant prediction models.
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Affiliation(s)
- Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Lianne Sheppard
- Departments of Biostatistics and Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Paul D Sampson
- Department of Statistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, NY, USA
| | - Joshua P Keller
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Michael T Young
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Sun-Young Kim
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Timothy V Larson
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Epidemiology, and Medicine, University of Washington, Seattle, WA, USA
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16
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Whitehouse A, Grigg J. Air pollution and children's health: where next? BMJ Paediatr Open 2021; 5:e000706. [PMID: 33907718 PMCID: PMC8051372 DOI: 10.1136/bmjpo-2020-000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Abigail Whitehouse
- Centre for Genomics and Child Health, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK
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Kirwa K, Eckert CM, Vedal S, Hajat A, Kaufman JD. Ambient air pollution and risk of respiratory infection among adults: evidence from the multiethnic study of atherosclerosis (MESA). BMJ Open Respir Res 2021; 8:e000866. [PMID: 33664125 PMCID: PMC7934778 DOI: 10.1136/bmjresp-2020-000866] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution may affect the risk of respiratory infection, though research has focused on uncommon infections or infections in children. Whether ambient air pollutants increase the risk of common acute respiratory infections among adults is uncertain, yet this may help understand whether pollutants influence spread of pandemic respiratory infections like COVID-19. OBJECTIVE To estimate the association between ambient air pollutant exposures and respiratory infections in adults. METHODS During five study examinations over 12 years, 6536 participants in the multiethnic study of atherosclerosis (MESA) reported upper respiratory tract infections, bronchitis, pneumonia or febrile illness in the preceding 2 weeks. Using a validated spatiotemporal model, we estimated residential concentrations of ambient PM2.5, NOx and NO2 for the 2-6 weeks (short-term) and year (long-term) prior to each examination. RESULTS In this population aged 44-84 years at baseline, 10%-32% of participants reported a recent respiratory infection, depending on month of examination and study region. PM2.5, NOx and NO2 concentrations over the prior 2-6 weeks were associated with increased reporting of recent respiratory infection, with risk ratios (95% CIs) of 1.04 (1.00 to 1.09), 1.15 (1.10 to 1.20) and 1.21 (1.10 to 1.33), respectively, per increase from 25th to 75th percentile in residential pollutant concentration. CONCLUSION Higher short-term exposure to PM2.5 and traffic-related pollutants are associated with increased risk of symptomatic acute respiratory infections among adults. These findings may provide an insight into the epidemiology of COVID-19.
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Affiliation(s)
- Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Carly M Eckert
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA
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18
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Betts J, Dewar EM, Stub D, Gao CX, Brown DW, Ikin JF, Zeleke BM, Biswas S, Abramson MJ, Liew D. Markers of Cardiovascular Disease among Adults Exposed to Smoke from the Hazelwood Coal Mine Fire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1587. [PMID: 33567509 PMCID: PMC7914645 DOI: 10.3390/ijerph18041587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022]
Abstract
Little research has examined the effects of high concentration, medium-duration smoke exposure on cardiovascular health. We investigated whether six weeks of exposure to smoke from the 2014 Hazelwood coal mine fire in Victoria (Australia), was associated with long-term clinical or subclinical cardiovascular disease approximately four years later, in adult residents of the towns of Morwell (exposed, n = 336) and Sale (unexposed, n = 162). The primary outcome was serum high sensitivity (hs) C-reactive protein (CRP). Blood pressure, electrocardiogram, flow mediated dilatation and serum levels of hs-troponin, N-terminal pro B-type natriuretic peptide and lipids were secondary outcomes. There was no significant difference in weighted median hsCRP levels between exposed and unexposed participants (1.9 mg/L vs. 1.6 mg/L, p = 0.273). Other outcomes were comparable between the groups. hsCRP was associated in a predictable manner with current smoking, obesity and use of lipid-lowering therapy. Four years after a 6-week coal mine fire, this study found no association between smoke exposure and markers of clinical or subclinical cardiovascular disease in exposed adults.
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Affiliation(s)
- Juliana Betts
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Elizabeth M. Dewar
- Department of Cardiology, Alfred Health, Melbourne, VIC 3004, Australia;
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Dion Stub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
- Department of Cardiology, Alfred Health, Melbourne, VIC 3004, Australia;
| | - Caroline X. Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - David W. Brown
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Jillian F. Ikin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Berihun M. Zeleke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Sinjini Biswas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Michael J. Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (J.B.); (D.S.); (C.X.G.); (D.W.B.); (J.F.I.); (B.M.Z.); (S.B.); (D.L.)
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19
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Lambrechtsen J, Mayntz SK, Engdam KB, Egstrup K, Nielsen J, Steffensen FH, Frohn LM, Brandt J, Ketzel M, Pyndt Diederichsen AC, Lindholt JS. Relation between Accumulated Air Pollution Exposure and Sub-Clinical Cardiovascular Disease in 33,723 Danish 60-74-Year-Old Males from the Background Population (AIR-CARD): A Method Article. Cardiology 2020; 146:19-26. [PMID: 33238279 DOI: 10.1159/000511128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/17/2020] [Indexed: 11/19/2022]
Abstract
Cardiovascular disease is one of the main causes of death and disability in the Western world, and there is increasing evidence that air pollution is a risk factor for developing sub-clinical cardiovascular diseases. Previous studies have shown a correlation between cardiovascular disease and short-term exposure to elevated air pollution levels. However, the literature on the impact of long-term effect of air pollution is limited. We have a unique opportunity to evaluate this correlation. The DEHM/UBM/AirGIS model system calculates air pollution in a high temporal and spatial resolution and traces air pollution retrospectively to year 1979. The model calculates accumulated exposure using annual exposure from PM2.5 in relation to home and work addresses and takes into account working hours and holidays. We link the results from this model system to a population-based cardiovascular screening cohort of 33,723 individuals in the age of 60-74 to assess the contribution of the specific accumulated air pollution to the presence of sub-clinical arteriosclerosis in the coronary vessels, abdominal aortic aneurysms, and peripheral arterial disease. This correlation will be further analyzed in relation to specific air pollutants. This study will introduce more precise data for a longer period of time and incorporate participant's home and work addresses.
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Affiliation(s)
- Jess Lambrechtsen
- Cardiovascular Research Unit, Odense University Hospital - Svendborg, Svendborg, Denmark,
| | - Stephan Krog Mayntz
- Cardiovascular Research Unit, Odense University Hospital - Svendborg, Svendborg, Denmark
| | | | - Kenneth Egstrup
- Cardiovascular Research Unit, Odense University Hospital - Svendborg, Svendborg, Denmark
| | - Jan Nielsen
- Department of Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | | | - Lise M Frohn
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
| | | | - Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery T, Odense University Hospital, Odense, Denmark
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20
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Abstract
Diabetes mellitus (DM) is a complication of chronic pancreatitis (CP). Whether pancreatogenic diabetes associated with CP-DM represents a discrete pathophysiologic entity from type 2 DM (T2DM) remains uncertain. Addressing this question is needed for development of specific measures to manage CP-DM. We approached this question from a unique standpoint, hypothesizing that if CP-DM and T2DM are separate disorders, they should be genetically distinct. To test this hypothesis, we sought to determine whether a genetic risk score (GRS) based on validated single nucleotide polymorphisms for T2DM could distinguish between groups with CP-DM and T2DM.
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21
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Smith BM, Kirby M, Hoffman EA, Kronmal RA, Aaron SD, Allen NB, Bertoni A, Coxson HO, Cooper C, Couper DJ, Criner G, Dransfield MT, Han MK, Hansel NN, Jacobs DR, Kaufman JD, Lin CL, Manichaikul A, Martinez FJ, Michos ED, Oelsner EC, Paine R, Watson KE, Benedetti A, Tan WC, Bourbeau J, Woodruff PG, Barr RG. Association of Dysanapsis With Chronic Obstructive Pulmonary Disease Among Older Adults. JAMA 2020; 323:2268-2280. [PMID: 32515814 PMCID: PMC7284296 DOI: 10.1001/jama.2020.6918] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 04/15/2020] [Indexed: 12/23/2022]
Abstract
Importance Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), yet much of COPD risk remains unexplained. Objective To determine whether dysanapsis, a mismatch of airway tree caliber to lung size, assessed by computed tomography (CT), is associated with incident COPD among older adults and lung function decline in COPD. Design, Setting, and Participants A retrospective cohort study of 2 community-based samples: the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, which involved 2531 participants (6 US sites, 2010-2018) and the Canadian Cohort of Obstructive Lung Disease (CanCOLD), which involved 1272 participants (9 Canadian sites, 2010-2018), and a case-control study of COPD: the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), which involved 2726 participants (12 US sites, 2011-2016). Exposures Dysanapsis was quantified on CT as the geometric mean of airway lumen diameters measured at 19 standard anatomic locations divided by the cube root of lung volume (airway to lung ratio). Main Outcomes and Measures Primary outcome was COPD defined by postbronchodilator ratio of forced expired volume in the first second to vital capacity (FEV1:FVC) less than 0.70 with respiratory symptoms. Secondary outcome was longitudinal lung function. All analyses were adjusted for demographics and standard COPD risk factors (primary and secondhand tobacco smoke exposures, occupational and environmental pollutants, and asthma). Results In the MESA Lung sample (mean [SD] age, 69 years [9 years]; 1334 women [52.7%]), 237 of 2531 participants (9.4%) had prevalent COPD, the mean (SD) airway to lung ratio was 0.033 (0.004), and the mean (SD) FEV1 decline was -33 mL/y (31 mL/y). Of 2294 MESA Lung participants without prevalent COPD, 98 (4.3%) had incident COPD at a median of 6.2 years. Compared with participants in the highest quartile of airway to lung ratio, those in the lowest had a significantly higher COPD incidence (9.8 vs 1.2 cases per 1000 person-years; rate ratio [RR], 8.12; 95% CI, 3.81 to 17.27; rate difference, 8.6 cases per 1000 person-years; 95% CI, 7.1 to 9.2; P < .001) but no significant difference in FEV1 decline (-31 vs -33 mL/y; difference, 2 mL/y; 95% CI, -2 to 5; P = .30). Among CanCOLD participants (mean [SD] age, 67 years [10 years]; 564 women [44.3%]), 113 of 752 (15.0%) had incident COPD at a median of 3.1 years and the mean (SD) FEV1 decline was -36 mL/y (75 mL/y). The COPD incidence in the lowest airway to lung quartile was significantly higher than in the highest quartile (80.6 vs 24.2 cases per 1000 person-years; RR, 3.33; 95% CI, 1.89 to 5.85; rate difference, 56.4 cases per 1000 person-years; 95% CI, 38.0 to 66.8; P<.001), but the FEV1 decline did not differ significantly (-34 vs -36 mL/y; difference, 1 mL/y; 95% CI, -15 to 16; P=.97). Among 1206 SPIROMICS participants (mean [SD] age, 65 years [8 years]; 542 women [44.9%]) with COPD who were followed up for a median 2.1 years, those in the lowest airway to lung ratio quartile had a mean FEV1 decline of -37 mL/y (15 mL/y), which did not differ significantly from the decline in MESA Lung participants (P = .98), whereas those in highest quartile had significantly faster decline than participants in MESA Lung (-55 mL/y [16 mL/y ]; difference, -17 mL/y; 95% CI, -32 to -3; P = .004). Conclusions and Relevance Among older adults, dysanapsis was significantly associated with COPD, with lower airway tree caliber relative to lung size associated with greater COPD risk. Dysanapsis appears to be a risk factor associated with COPD.
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Affiliation(s)
- Benjamin M. Smith
- Department of Medicine, Columbia University Medical Center, New York, New York
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Miranda Kirby
- Department of Physics, Ryerson University, Toronto, Ontario, Canada
| | - Eric A. Hoffman
- Department of Radiology, University of Iowa, Iowa City
- Department of Biomedical Engineering, University of Iowa, Iowa City
- Department of Internal Medicine, University of Iowa, Iowa City
| | | | - Shawn D. Aaron
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Norrina B. Allen
- Department of Medicine, Northwestern University, Chicago, Illinois
| | - Alain Bertoni
- Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Harvey O. Coxson
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Chris Cooper
- Department of Medicine, University of California, Los Angeles
| | - David J. Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill
| | - Gerard Criner
- Department of Medicine, Temple University, Philadelphia, Pennsylvania
| | | | - MeiLan K. Han
- Department of Medicine, University of Michigan, Ann Arbor
| | - Nadia N. Hansel
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - David R. Jacobs
- Division of Epidemiology and Community Health School of Public Health, University of Minnesota, Minneapolis
| | - Joel D. Kaufman
- Department of Epidemiology, University of Washington, Seattle
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
| | - Ching-Long Lin
- Department of Mechanical Engineering, University of Iowa, Iowa City
| | - Ani Manichaikul
- Department of Public Health Sciences, University of Virginia, Charlottesville
| | | | - Erin D. Michos
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Robert Paine
- Department of Medicine, University of Utah, Salt Lake City
| | - Karol E. Watson
- Department of Medicine, University of California, Los Angeles
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Wan C. Tan
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Jean Bourbeau
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - R. Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York
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22
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Oelsner EC, Ortega VE, Smith BM, Nguyen JN, Manichaikul AW, Hoffman EA, Guo X, Taylor KD, Woodruff PG, Couper DJ, Hansel NN, Martinez FJ, Paine R, Han MK, Cooper C, Dransfield MT, Criner G, Krishnan JA, Bowler R, Bleecker ER, Peters S, Rich SS, Meyers DA, Rotter JI, Barr RG. A Genetic Risk Score Associated with Chronic Obstructive Pulmonary Disease Susceptibility and Lung Structure on Computed Tomography. Am J Respir Crit Care Med 2020; 200:721-731. [PMID: 30925230 DOI: 10.1164/rccm.201812-2355oc] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Chronic obstructive pulmonary disease (COPD) has been associated with numerous genetic variants, yet the extent to which its genetic risk is mediated by variation in lung structure remains unknown.Objectives: To characterize associations between a genetic risk score (GRS) associated with COPD susceptibility and lung structure on computed tomography (CT).Methods: We analyzed data from MESA Lung (Multi-Ethnic Study of Atherosclerosis Lung Study), a U.S. general population-based cohort, and SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study). A weighted GRS was calculated from 83 SNPs that were previously associated with lung function. Lung density, spatially matched airway dimensions, and airway counts were assessed on full-lung CT. Generalized linear models were adjusted for age, age squared, sex, height, principal components of genetic ancestry, smoking status, pack-years, CT model, milliamperes, and total lung volume.Measurements and Main Results: MESA Lung and SPIROMICS contributed 2,517 and 2,339 participants, respectively. Higher GRS was associated with lower lung function and increased COPD risk, as well as lower lung density, smaller airway lumens, and fewer small airways, without effect modification by smoking. Adjustment for CT lung structure, particularly small airway measures, attenuated associations between the GRS and FEV1/FVC by 100% and 60% in MESA and SPIROMICS, respectively. Lung structure (P < 0.0001), but not the GRS (P > 0.10), improved discrimination of moderate-to-severe COPD cases relative to clinical factors alone.Conclusions: A GRS associated with COPD susceptibility was associated with CT lung structure. Lung structure may be an important mediator of heritability and determinant of personalized COPD risk.
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Affiliation(s)
- Elizabeth C Oelsner
- Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York
| | - Victor E Ortega
- Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Benjamin M Smith
- Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York
| | - Jennifer N Nguyen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Ani W Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Eric A Hoffman
- Department of Radiology.,Department of Medicine, and.,Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
| | | | | | - Prescott G Woodruff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - David J Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Robert Paine
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Meilan K Han
- Division of Pulmonary and Critical Care Medicine, Michigan Medicine, Ann Arbor, Michigan
| | - Christopher Cooper
- Department of Medicine, and.,Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Mark T Dransfield
- Division of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerard Criner
- Department of Thoracic Medicine, Temple University, Philadelphia, Pennsylvania
| | - Jerry A Krishnan
- Division of Pulmonary and Critical Care, University of Illinois, Chicago, Illinois
| | - Russell Bowler
- Division of Pulmonary and Critical Care, National Jewish, Denver, Colorado; and
| | | | - Stephen Peters
- Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | | | | | - R Graham Barr
- Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York
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23
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Kulick ER, Elkind MSV, Boehme AK, Joyce NR, Schupf N, Kaufman JD, Mayeux R, Manly JJ, Wellenius GA. Long-term exposure to ambient air pollution, APOE-ε4 status, and cognitive decline in a cohort of older adults in northern Manhattan. ENVIRONMENT INTERNATIONAL 2020; 136:105440. [PMID: 31926436 PMCID: PMC7024003 DOI: 10.1016/j.envint.2019.105440] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 05/18/2023]
Abstract
BACKGROUND There is mounting evidence that long-term exposure to air pollution is related to accelerated cognitive decline in aging populations. Factors that influence individual susceptibility remain largely unknown, but may involve the apolipoprotein E genotype E4 (APOE-ε4) allele. OBJECTIVES We assessed whether the association between long-term exposure to ambient air pollution and cognitive decline differed by APOE-ε4 status and cognitive risk factors. METHODS The Washington Heights Inwood Community Aging Project (WHICAP) is a prospective study of aging and dementia. Neuropsychological testing and medical examinations occur every 18-24 months. We used mixed-effects models to evaluate whether the association between markers of ambient air pollution (nitrogen dioxide [NO2]), fine [PM2.5], and coarse [PM10] particulate matter) and the rate of decline in global and domain-specific cognition differed across strata defined by APOE-ε4 genotypes and cognitive risk factors, adjusting for sociodemographic factors and temporal trends. RESULTS Among 4821 participants with an average of 6 years follow-up, higher concentrations of ambient air pollution were associated with more rapid cognitive decline. This association was more pronounced among APOE-ε4 carriers (p < 0.001). A one interquartile range increase in NO2 was associated with an additional decline of 0.09 standard deviations (SD) (95%CI -0.1, -0.06) in global cognition across biennial visits among APOE-ε4 positive individuals and a 0.07 SD (95%CI -0.09, -0.05) decline among APOE-ε4 negative individuals. Results for PM2.5, PM10 and cognitive domains were similar. The association between air pollutants and rate of cognitive decline also varied across strata of race-ethnicity with the association strongest among White non-Hispanic participants. CONCLUSIONS These results add to the body of evidence on the adverse impact of ambient air pollution on cognitive aging and brain health and provide new insights into the genetic and behavioral factors that may impact individual susceptibility.
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Affiliation(s)
- Erin R Kulick
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amelia K Boehme
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Nina R Joyce
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Nicole Schupf
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer Disease and the Aging Brain, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, and Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Richard Mayeux
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer Disease and the Aging Brain, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jennifer J Manly
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer Disease and the Aging Brain, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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24
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Chen RY, Ho KF, Hong GB, Chuang KJ. Houseplant, indoor air pollution, and cardiovascular effects among elderly subjects in Taipei, Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135770. [PMID: 31972932 DOI: 10.1016/j.scitotenv.2019.135770] [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: 08/28/2019] [Revised: 11/10/2019] [Accepted: 11/24/2019] [Indexed: 05/11/2023]
Abstract
Previous studies have documented the linkage between houseplant usage and indoor air quality (IAQ) improvement. However, the effect of houseplant on the association between indoor air quality and cardiovascular health is still unknown. We recruited 100 elderly subjects from 100 houses with (50) or without houseplants (50) in Taipei and conducted six 24-hour house visits for each elderly subject between 2015 and 2016. The particulate matter less than or equal to 2.5 μm in diameter (PM2.5), total volatile compounds (TVOCs), heart rate (HR) and blood pressure (BP) were continuously measured in each house visit. The association between indoor air pollution, BP and HR was investigated by mixed-effects. We found that the elderly subjects in houses without houseplants were exposed to higher indoor PM2.5 and TVOCs levels compared to the elderly subjects' exposures in houses with houseplants. Also, the elderly subjects' HR, systolic BP (SBP) and diastolic BP (DBP) were higher in houses without houseplants than those in houses with houseplants. Moreover, high indoor air pollution levels were associated with elevated BP and HR, especially among subjects in houses without houseplants. Accordingly, we concluded that indoor air pollution was associated with cardiovascular effects. Houseplant could improve IAQ and cardiovascular health among elderly subjects in Taipei, Taiwan.
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Affiliation(s)
- Ruey-Yu Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Gui-Bing Hong
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Kai-Jen Chuang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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25
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Song L, Smith GS, Adar SD, Post WS, Guallar E, Navas-Acien A, Kaufman JD, Jones MR. Ambient air pollution as a mediator in the pathway linking race/ethnicity to blood pressure elevation: The multi-ethnic study of atherosclerosis (MESA). ENVIRONMENTAL RESEARCH 2020; 180:108776. [PMID: 31639655 DOI: 10.1016/j.envres.2019.108776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Racial/ethnic disparities in blood pressure and hypertension have been evident in previous studies, as were associations between race/ethnicity with ambient air pollution and those between air pollution with hypertension. The role of air pollution exposure to racial/ethnic differences in hypertension has not been explored. OBJECTIVE To assess the potential mediating effects of ambient air pollution on the association between race/ethnicity and blood pressure levels. METHODS We studied 6,463 White, Black, Hispanic and Chinese adults enrolled across 6 US cities. Systolic (SBP) and diastolic blood pressure (DBP) were measured at Exam 1 (2000-2002) and Exam 2 (2002-2004). Household-level annual average concentrations of fine particulate matter (PM2.5), oxides of nitrogen (NOX), and ozone (O3) for the year 2000 were estimated for participants. RESULTS The difference in SBP levels by race/ethnicity that was related to higher PM2.5 concentrations compared with White men ("indirect associations") was 0.3 (95% CI: 0.1, 0.6) mmHg for Black men, 0.3 (95% CI: 0.1, 0.6) mmHg for Hispanic men and 1.0 (95% CI: 0.2, 1.8) mmHg for Chinese men. Findings were similar although not statistically significant for women. PM2.5 did not mediate racial/ethnic differences in DBP. Indirect associations were significant for O3 for SBP among women and men and for DBP among men. In contrast, racial/ethnic disparities were attenuated due to exposure to NOX. CONCLUSION Racial disparities in blood pressure were reduced after accounting for PM2.5 and ozone while increased after accounting for NOX.
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Affiliation(s)
- Lanxin Song
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Genee S Smith
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sara D Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wendy S Post
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, School of Public Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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26
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Zusman M, Schumacher CS, Gassett AJ, Spalt EW, Austin E, Larson TV, Carvlin G, Seto E, Kaufman JD, Sheppard L. Calibration of low-cost particulate matter sensors: Model development for a multi-city epidemiological study. ENVIRONMENT INTERNATIONAL 2020; 134:105329. [PMID: 31783241 PMCID: PMC7363217 DOI: 10.1016/j.envint.2019.105329] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 05/21/2023]
Abstract
Low-cost air monitoring sensors are an appealing tool for assessing pollutants in environmental studies. Portable low-cost sensors hold promise to expand temporal and spatial coverage of air quality information. However, researchers have reported challenges in these sensors' operational quality. We evaluated the performance characteristics of two widely used sensors, the Plantower PMS A003 and Shinyei PPD42NS, for measuring fine particulate matter compared to reference methods, and developed regional calibration models for the Los Angeles, Chicago, New York, Baltimore, Minneapolis-St. Paul, Winston-Salem and Seattle metropolitan areas. Duplicate Plantower PMS A003 sensors demonstrated a high level of precision (averaged Pearson's r = 0.99), and compared with regulatory instruments, showed good accuracy (cross-validated R2 = 0.96, RMSE = 1.15 µg/m3 for daily averaged PM2.5 estimates in the Seattle region). Shinyei PPD42NS sensor results had lower precision (Pearson's r = 0.84) and accuracy (cross-validated R2 = 0.40, RMSE = 4.49 µg/m3). Region-specific Plantower PMS A003 models, calibrated with regulatory instruments and adjusted for temperature and relative humidity, demonstrated acceptable performance metrics for daily average measurements in the other six regions (R2 = 0.74-0.95, RMSE = 2.46-0.84 µg/m3). Applying the Seattle model to the other regions resulted in decreased performance (R2 = 0.67-0.84, RMSE = 3.41-1.67 µg/m3), likely due to differences in meteorological conditions and particle sources. We describean approach to metropolitan region-specific calibration models for low-cost sensors that can be used with cautionfor exposure measurement in epidemiological studies.
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Affiliation(s)
- Marina Zusman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Cooper S Schumacher
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Amanda J Gassett
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Elizabeth W Spalt
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Timothy V Larson
- Department of Civil & Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Graeme Carvlin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
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27
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Hajat A, Hazlehurst MF, Golden SH, Merkin SS, Seeman T, Szpiro AA, Kaufman JD, Roux AD. The cross-sectional and longitudinal association between air pollution and salivary cortisol: Evidence from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENT INTERNATIONAL 2019; 131:105062. [PMID: 31491811 PMCID: PMC6994173 DOI: 10.1016/j.envint.2019.105062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cortisol, a stress hormone released by the activation of the hypothalamic-pituitary-adrenal (HPA) axis, is critical to the body's adaptive response to physiological and psychological stress. Cortisol has also been implicated in the health effects of air pollution through the activation of the sympathetic nervous system. This study evaluates the cross-sectional and longitudinal association between several air pollutants and salivary cortisol. METHODS We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort of 45-85 years old participants from six US cities. Salivary cortisol was evaluated at two time points between 2004 and 2006 and then again from 2010 to 2012. Cortisol samples were taken several times per day on two or three consecutive days. Particulate matter <2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2) and nitrogen oxides (NOx) in the year prior to cortisol sampling were examined. We used piecewise linear mixed models that were adjusted for demographics, socioeconomic status and cardiovascular risk factors to examine both cross-sectional and longitudinal associations. Longitudinal models evaluated change in cortisol over time. RESULTS The pooled cross-sectional results revealed largely null results with the exception of a 9.7% higher wake-up cortisol associated with a 10 ppb higher NO2 (95% CI, -0.2%, 20.5%). Among all participants, the features of the cortisol curve became flatter over 5 years. The wake-to-bed slope showed a more pronounced flattening over time (0.014, 95% CI, 0.0, 0.03) with a 10 ppb higher NO2 level. Other air pollutants were not associated with change in cortisol over time. CONCLUSIONS Our results suggest only a moderate association between traffic related air pollution and cortisol. Very few epidemiologic studies have examined the long-term impact of air pollution on the stress response systems, thus warranting further exploration of these findings.
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Affiliation(s)
- Anjum Hajat
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Marnie F Hazlehurst
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Sherita Hill Golden
- Johns Hopkins University, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, 1830 E. Monument Street, Room 9052, Baltimore, MD 21287, USA.
| | - Sharon Stein Merkin
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Teresa Seeman
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Adam A Szpiro
- University of Washington, Department of Biostatistics, Box 357232, Seattle, WA 98195, USA.
| | - Joel D Kaufman
- University of Washington, Departments of Environmental and Occupational Health Sciences and Epidemiology, Box 354695, Seattle, WA 98195, USA.
| | - Ana Diez Roux
- Drexel University Dornsife School of Public Health, Urban Health Collaborative Nesbitt Hall 3215 Market Street Philadelphia, PA 19104, USA.
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Calverley PMA, Walker PP. Genetics, Chronic Obstructive Pulmonary Disease, and the Arrow of Time. Am J Respir Crit Care Med 2019; 200:654-655. [PMID: 31059281 PMCID: PMC6775883 DOI: 10.1164/rccm.201904-0813ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Peter M. A. Calverley
- Institute of Ageing and Chronic DiseaseUniversity of LiverpoolLiverpool, United Kingdomand
- Aintree Chest CentreUniversity Hospital AintreeLiverpool, United Kingdom
| | - Paul P. Walker
- Institute of Ageing and Chronic DiseaseUniversity of LiverpoolLiverpool, United Kingdomand
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29
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Wang M, Aaron CP, Madrigano J, Hoffman EA, Angelini E, Yang J, Laine A, Vetterli TM, Kinney PL, Sampson PD, Sheppard LE, Szpiro AA, Adar SD, Kirwa K, Smith B, Lederer DJ, Diez-Roux AV, Vedal S, Kaufman JD, Barr RG. Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. JAMA 2019; 322:546-556. [PMID: 31408135 PMCID: PMC6692674 DOI: 10.1001/jama.2019.10255] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/24/2019] [Indexed: 12/20/2022]
Abstract
Importance While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema. Objective To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function. Design, Setting, and Participants This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018. Exposures Residence-specific air pollutant concentrations (O3, PM2.5, NOx, and black carbon) were estimated by validated spatiotemporal models incorporating cohort-specific monitoring, determined from 1999 through the end of follow-up. Main Outcomes and Measures Percent emphysema, defined as the percent of lung pixels less than -950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-2007) and equivalent regions on lung CT scans (2010-2018). Spirometry was performed up to 3 times per participant (2004-2018). Results Among 7071 study participants (mean [range] age at recruitment, 60 [45-84] years; 3330 [47.1%] were men), 5780 were assigned outdoor residential air pollution concentrations in the year of their baseline examination and during the follow-up period and had at least 1 follow-up CT scan, and 2772 had at least 1 follow-up spirometric assessment, over a median of 10 years. Median percent emphysema was 3% at baseline and increased a mean of 0.58 percentage points per 10 years. Mean ambient concentrations of PM2.5 and NOx, but not O3, decreased substantially during follow-up. Ambient concentrations of O3, PM2.5, NOx, and black carbon at study baseline were significantly associated with greater increases in percent emphysema per 10 years (O3: 0.13 per 3 parts per billion [95% CI, 0.03-0.24]; PM2.5: 0.11 per 2 μg/m3 [95% CI, 0.03-0.19]; NOx: 0.06 per 10 parts per billion [95% CI, 0.01-0.12]; black carbon: 0.10 per 0.2 μg/m3 [95% CI, 0.01-0.18]). Ambient O3 and NOx concentrations, but not PM2.5 concentrations, during follow-up were also significantly associated with greater increases in percent emphysema. Ambient O3 concentrations, but not other pollutants, at baseline and during follow-up were significantly associated with a greater decline in forced expiratory volume in 1 second per 10 years (baseline: 13.41 mL per 3 parts per billion [95% CI, 0.7-26.1]; follow-up: 18.15 mL per 3 parts per billion [95% CI, 1.59-34.71]). Conclusions and Relevance In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to ambient air pollutants was significantly associated with increasing emphysema assessed quantitatively using CT imaging and lung function.
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Affiliation(s)
- Meng Wang
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
- Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, New York
| | | | - Jaime Madrigano
- Department of Environmental Health Sciences, Epidemiology, Mailman School of Public Health; Columbia University, New York, New York
- RAND Corporation, Arlington, Virginia
| | | | - Elsa Angelini
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Jie Yang
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Andrew Laine
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Thomas M. Vetterli
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | | | - Lianne E. Sheppard
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
- Department of Biostatistics, School of Public Health, University of Washington, Seattle
| | - Adam A. Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle
| | - Sara D. Adar
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | - Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
| | - Benjamin Smith
- Department of Medicine, Columbia University Medical Center, New York, New York
- Department of Medicine, McGill University Health Centre, Montréal, Canada
| | - David J. Lederer
- Department of Medicine, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ana V. Diez-Roux
- Department of Epidemiology, School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
- Departments of Medicine and Epidemiology, University of Washington, Seattle
| | - R. Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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30
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Aaron CP, Hoffman EA, Kawut SM, Austin JHM, Budoff M, Michos ED, Hinckley Stukovsky K, Sack C, Szpiro AA, Watson KD, Kaufman JD, Barr RG. Ambient air pollution and pulmonary vascular volume on computed tomography: the MESA Air Pollution and Lung cohort studies. Eur Respir J 2019; 53:13993003.02116-2018. [PMID: 31167881 DOI: 10.1183/13993003.02116-2018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/14/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Air pollution alters small pulmonary vessels in animal models. We hypothesised that long-term ambient air pollution exposure would be associated with differences in pulmonary vascular volumes in a population-based study. METHODS The Multi-Ethnic Study of Atherosclerosis recruited adults in six US cities. Personalised long-term exposures to ambient black carbon, nitrogen dioxide (NO2), oxides of nitrogen (NO x ), particulate matter with a 50% cut-off aerodynamic diameter of <2.5 μm (PM2.5) and ozone were estimated using spatiotemporal models. In 2010-2012, total pulmonary vascular volume was measured as the volume of detectable pulmonary arteries and veins, including vessel walls and luminal blood volume, on noncontrast chest computed tomography (TPVVCT). Peripheral TPVVCT was limited to the peripheral 2 cm to isolate smaller vessels. Linear regression adjusted for demographics, anthropometrics, smoking, second-hand smoke, renal function and scanner manufacturer. RESULTS The mean±sd age of the 3023 participants was 69.3±9.3 years; 46% were never-smokers. Mean exposures were 0.80 μg·m-3 black carbon, 14.6 ppb NO2 and 11.0 μg·m-3 ambient PM2.5. Mean±sd peripheral TPVVCT was 79.2±18.2 cm3 and TPVVCT was 129.3±35.1 cm3. Greater black carbon exposure was associated with a larger peripheral TPVVCT, including after adjustment for city (mean difference 0.41 (95% CI 0.03-0.79) cm3 per interquartile range; p=0.036). Associations for peripheral TPVVCT with NO2 were similar but nonsignificant after city adjustment, while those for PM2.5 were of similar magnitude but nonsignificant after full adjustment. There were no associations for NO x or ozone, or between any pollutant and TPVVCT. CONCLUSIONS Long-term black carbon exposure was associated with a larger peripheral TPVVCT, suggesting diesel exhaust may contribute to remodelling of small pulmonary vessels in the general population.
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Affiliation(s)
- Carrie P Aaron
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Eric A Hoffman
- Dept of Radiology, University of Iowa, Iowa City, IA, USA
| | - Steven M Kawut
- Depts of Medicine and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John H M Austin
- Dept of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Matthew Budoff
- Dept of Medicine, University of California, Los Angeles, CA, USA
| | - Erin D Michos
- Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Coralynn Sack
- Dept of Medicine, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Dept of Biostatistics, University of Washington, Seattle, WA, USA
| | - Karol D Watson
- Dept of Medicine, University of California, Los Angeles, CA, USA
| | - Joel D Kaufman
- Dept of Medicine, University of Washington, Seattle, WA, USA.,Dept of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.,Dept of Epidemiology, University of Washington, Seattle, WA, USA
| | - R Graham Barr
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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31
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Wang M, Sampson PD, Sheppard LE, Stein JH, Vedal S, Kaufman JD. Long-Term Exposure to Ambient Ozone and Progression of Subclinical Arterial Disease: The Multi-Ethnic Study of Atherosclerosis and Air Pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:57001. [PMID: 31063398 PMCID: PMC6791411 DOI: 10.1289/ehp3325] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Long-term ozone ([Formula: see text]) exposure is associated with cardiovascular mortality, but little is known about the associations between [Formula: see text] and subclinical arterial disease. OBJECTIVES We studied the longitudinal association of exposure to [Formula: see text] and progression of key subclinical arterial markers in adults: intima-media thickness of common carotid artery ([Formula: see text]), carotid plaque (CP) burden, and coronary artery calcification (CAC). METHODS CAC was measured one to four times at baseline and at follow-up exams (1999–2012) by computed tomography (CT) in 6,619 healthy adults, recruited at age 45-84 y without cardiovascular disease (CVD), over a mean of 6.5 y (standard deviation: 3.5 y). [Formula: see text] and CP burden were quantified in 3,392 participants using carotid artery ultrasound imaging acquired over a mean of 9 y (1.7 y). Over 91% and 89% participants had at least one follow-up [Formula: see text] and CAC measurement, respectively. Residence-specific [Formula: see text] concentrations were estimated by a validated spatiotemporal model spanning from 1999 to 2012. This model relied on comprehensive monitoring data and geographical variables to predict individualized long-term average concentrations since baseline. Linear mixed models and logistic regression model were used to evaluate relationships of long-term average exposure to [Formula: see text] with longitudinal change in [Formula: see text], CAC, and CP formation, respectively. RESULTS Mean progression rates of [Formula: see text] and CAC were [Formula: see text] and [Formula: see text]. CP formation was identified in 55% of the subjects. A [Formula: see text] increase in long-term average [Formula: see text] exposure was associated with a [Formula: see text] [95% confidence interval (CI): 1.4, 9.7] greater increase in [Formula: see text] over 10 y. A [Formula: see text] increase in [Formula: see text] was also associated with new CP formation [odds ratio (OR): 1.2 (95% CI: 1.1, 1.4)] but not CAC progression [[Formula: see text] (95% CI: [Formula: see text], 2)]. Associations were robust in the analysis with extended covariate adjustment, including copollutants, i.e., nitrogen oxides ([Formula: see text]) and particulate matter with diameter [Formula: see text] ([Formula: see text]). CONCLUSION Over almost a decade of follow-up, outdoor [Formula: see text] concentrations were associated with increased rate of carotid wall thickness progression and risk of new plaque formation, suggesting arterial injury in this cohort. https://doi.org/10.1289/EHP3325.
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Affiliation(s)
- Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
- RENEW Institute, University at Buffalo, Buffalo, New York, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, Washington, USA
| | - Lianne E. Sheppard
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - James H. Stein
- University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, Wisconsin, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
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32
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Hajat A, Diez Roux AV, Castro-Diehl C, Cosselman K, Golden SH, Hazlehurst MF, Szpiro A, Vedal S, Kaufman JD. The Association between Long-Term Air Pollution and Urinary Catecholamines: Evidence from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:57007. [PMID: 31095432 PMCID: PMC6791118 DOI: 10.1289/ehp3286] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Autonomic nervous system effects have been hypothesized as a mechanism of air pollutant health effects, though scant prior epidemiologic research has examined the association between air pollutants and catecholamines. OBJECTIVES To examine the association of long-term air pollutants with three urinary catecholamines: dopamine (DA), epinephrine (EPI), and norepinephrine (NE). As a secondary aim, we also examined the association between short-term (or acute) exposure to fine particulate matter [particulate matter with aerodynamic diameter [Formula: see text] ([Formula: see text])] and those catecholamines. METHODS We used data from the Multi-Ethnic Study of Atherosclerosis (MESA) and two of its ancillary studies, the MESA Air Pollution Study and the MESA Stress Study, to provide exposure and outcome data. DA, EPI, and NE from urine samples were collected from 2004 to 2006 from 1,002 participants in the New York, New York, and Los Angeles, California, study sites. Spatiotemporal models incorporated cohort-specific monitoring and estimated annual average pollutant concentrations ([Formula: see text], [Formula: see text], [Formula: see text] and black carbon) at participants' homes the year prior to urine collection. Secondarily, short-term [Formula: see text] was evaluated (day of, day prior, and 2- to 5-d lags prior to urine collection). Several covariates were considered confounders (age, race, sex, site, socioeconomic status, cardiovascular disease risk factors, psychosocial stressors, and medication use) in linear regression models. RESULTS A [Formula: see text] higher annual [Formula: see text] concentration was associated with 6.3% higher mean EPI level [95% confidence interval (CI): 0.3%, 12.6%]. A 2-[Formula: see text] higher annual ambient [Formula: see text] concentration was associated with 9.1% higher mean EPI (95% CI: 3.2%, 15.3%) and 4.4% higher DA level (95% CI: 1%, 7.9%). [Formula: see text], black carbon, and short-term [Formula: see text] exposures were not significantly associated with any of the catecholamines. CONCLUSIONS We found an association between EPI and long-term concentrations of [Formula: see text] and [Formula: see text] and an association between DA and long-term ambient [Formula: see text]. These novel findings provide modest support for the hypothesis that air pollutant exposures are related to sympathetic nervous system activation. https://doi.org/10.1289/EHP3286.
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Affiliation(s)
- Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Ana V. Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Cecilia Castro-Diehl
- Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kristen Cosselman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Sherita Hill Golden
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marnie F. Hazlehurst
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
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Riffo-Campos AL, Fuentes-Trillo A, Tang WY, Soriano Z, De Marco G, Rentero-Garrido P, Adam-Felici V, Lendinez-Tortajada V, Francesconi K, Goessler W, Ladd-Acosta C, Leon-Latre M, Casasnovas JA, Chaves FJ, Navas-Acien A, Guallar E, Tellez-Plaza M. In silico epigenetics of metal exposure and subclinical atherosclerosis in middle aged men: pilot results from the Aragon Workers Health Study. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0084. [PMID: 29685964 DOI: 10.1098/rstb.2017.0084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 12/14/2022] Open
Abstract
We explored the association of metal levels with subclinical atherosclerosis and epigenetic changes in relevant biological pathways. Whole blood DNA Infinium Methylation 450 K data were obtained from 23 of 73 middle age men without clinically evident cardiovascular disease (CVD) who participated in the Aragon Workers Health Study in 2009 (baseline visit) and had available baseline urinary metals and subclinical atherosclerosis measures obtained in 2010-2013 (follow-up visit). The median metal levels were 7.36 µg g-1, 0.33 µg g-1, 0.11 µg g-1 and 0.07 µg g-1, for arsenic (sum of inorganic and methylated species), cadmium, antimony and tungsten, respectively. Urine cadmium and tungsten were associated with femoral and carotid intima-media thickness, respectively (Pearson's r = 0.27; p = 0.03 in both cases). Among nearest genes to identified differentially methylated regions (DMRs), 46% of metal-DMR genes overlapped with atherosclerosis-DMR genes (p < 0.001). Pathway enrichment analysis of atherosclerosis-DMR genes showed a role in inflammatory, metabolic and transport pathways. In in silico protein-to-protein interaction networks among proteins encoded by 162 and 108 genes attributed to atherosclerosis- and metal-DMRs, respectively, with proteins known to have a role in atherosclerosis pathways, we observed hub proteins in the network associated with both atherosclerosis and metal-DMRs (e.g. SMAD3 and NOP56), and also hub proteins associated with metal-DMRs only but with relevant connections with atherosclerosis effectors (e.g. SSTR5, HDAC4, AP2A2, CXCL12 and SSTR4). Our integrative in silico analysis demonstrates the feasibility of identifying epigenomic regions linked to environmental exposures and potentially involved in relevant pathways for human diseases. While our results support the hypothesis that metal exposures can influence health due to epigenetic changes, larger studies are needed to confirm our pilot results.This article is part of a discussion meeting issue 'Frontiers in epigenetic chemical biology'.
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Affiliation(s)
- Angela L Riffo-Campos
- Area of Cardiometabolic Risk, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Azahara Fuentes-Trillo
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Wan Y Tang
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Zoraida Soriano
- Instituto de Investigación Sanitaria de Aragon, 50009 Zaragoza, Spain
| | - Griselda De Marco
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Pilar Rentero-Garrido
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Victoria Adam-Felici
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Veronica Lendinez-Tortajada
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | | | - Walter Goessler
- Institute of Chemistry, University of Graz, 8010 Graz, Austria
| | | | - Montse Leon-Latre
- Instituto de Investigación Sanitaria de Aragon, 50009 Zaragoza, Spain.,Servicio Aragones de Salud, 50071 Zaragoza, Spain
| | - Jose A Casasnovas
- Instituto de Investigación Sanitaria de Aragon, 50009 Zaragoza, Spain.,Instituto Aragonés de Ciencias de Salud, 50009 Zaragoza, Spain.,Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - F Javier Chaves
- Genomics and Genetic Diagnostic Unit, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.,Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Maria Tellez-Plaza
- Area of Cardiometabolic Risk, Institute for Biomedical Research Hospital Clinic of Valencia, Menendez Pelayo 4 Accesorio, 46010 Valencia, Spain .,Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
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Miller KA, Spalt EW, Gassett AJ, Curl CL, Larson TV, Avol E, Allen RW, Vedal S, Szpiro AA, Kaufman JD. Estimating ambient-origin PM 2.5 exposure for epidemiology: observations, prediction, and validation using personal sampling in the Multi-Ethnic Study of Atherosclerosis. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:227-237. [PMID: 30166581 PMCID: PMC6380932 DOI: 10.1038/s41370-018-0053-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/26/2018] [Accepted: 04/08/2018] [Indexed: 05/19/2023]
Abstract
OBJECTIVES We aim to characterize the qualities of estimation approaches for individual exposure to ambient-origin fine particulate matter (PM2.5), for use in epidemiological studies. METHODS The analysis incorporates personal, home indoor, and home outdoor air monitoring data and spatio-temporal model predictions for 60 participants from the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). We compared measurement-based personal PM2.5 exposure with several measured or predicted estimates of outdoor, indoor, and personal exposures. RESULTS The mean personal 2-week exposure was 7.6 (standard deviation 3.7) µg/m3. Outdoor model predictions performed far better than outdoor concentrations estimated using a nearest-monitor approach (R = 0.63 versus R = 0.43). Incorporating infiltration indoors of ambient-derived PM2.5 provided better estimates of the measurement-based personal exposures than outdoor concentration predictions (R = 0.81 versus R = 0.63) and better scaling of estimated exposure (mean difference 0.4 versus 5.4 µg/m3 higher than measurements), suggesting there is value to collecting data regarding home infiltration. Incorporating individual-level time-location information into exposure predictions did not increase correlations with measurement-based personal exposures (R = 0.80) in our sample consisting primarily of retired persons. CONCLUSIONS This analysis demonstrates the importance of incorporating infiltration when estimating individual exposure to ambient air pollution. Spatio-temporal models provide substantial improvement in exposure estimation over a nearest monitor approach.
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Affiliation(s)
| | | | | | | | | | - Ed Avol
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Dastoorpoor M, Sekhavatpour Z, Masoumi K, Mohammadi MJ, Aghababaeian H, Khanjani N, Hashemzadeh B, Vahedian M. Air pollution and hospital admissions for cardiovascular diseases in Ahvaz, Iran. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 652:1318-1330. [PMID: 30586817 DOI: 10.1016/j.scitotenv.2018.10.285] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/16/2018] [Accepted: 10/21/2018] [Indexed: 04/13/2023]
Abstract
Cardiovascular disease is one of the main causes of death in Iran. The aim of this study was to determine the relation between air pollution and cardiovascular hospital admissions in Ahwaz, Iran. Daily information about cardiovascular hospital admissions (based on the ICD-10) and data on air pollutants during 2008-2018 were inquired. A quasi-Poisson regression combined with linear distributed lag models; adjusted for trend, seasonality, temperature, relative humidity, weekdays and holidays was used to assess the relation between hospital admission for cardiovascular diseases and the average daily air pollution. The results of this study showed a significant increase in cardiovascular hospital admissions in the total population and women's population in relation to O3. There was a significant increase in hospital admissions for cardiovascular diseases in the whole population as well as gender and age groups associated with NO2 and NO. A significant increase was found in hospital admissions for cardiovascular diseases in relation to CO in the 65-74-year-old population. Finally, the results of this study showed that there was a significant increase in hospital admissions for cardiovascular disease associated with SO2. The main results of the present study confirm the deleterious short term impact of air pollution on cardiovascular morbidity in Ahvaz city. This evidence empasizes the need to implement policies for reducing air pollution.
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Affiliation(s)
- Maryam Dastoorpoor
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zohreh Sekhavatpour
- Department of Anesthesiology, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Kambiz Masoumi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mostafa Vahedian
- Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran.
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Meng X, Hand JL, Schichtel BA, Liu Y. Space-time trends of PM 2.5 constituents in the conterminous United States estimated by a machine learning approach, 2005-2015. ENVIRONMENT INTERNATIONAL 2018; 121:1137-1147. [PMID: 30413295 DOI: 10.1016/j.envint.2018.10.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 05/12/2023]
Abstract
Particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) is a complex mixture of chemical constituents emitted from various emission sources or through secondary reactions/processes; however, PM2.5 is regulated mostly based on its total mass concentration. Studies to identify the impacts on climate change, visibility degradation and public health of different PM2.5 constituents are hindered by limited ground measurements of PM2.5 constituents. In this study, national models were developed based on random forest algorithm, one of machine learning methods that is of high predictive capacity and able to provide interpretable results, to predict concentrations of PM2.5 sulfate, nitrate, organic carbon (OC) and elemental carbon (EC) across the conterminous United States from 2005 to 2015 at the daily level. The random forest models achieved high out-of-bag (OOB) R2 values at the daily level, and the mean OOB R2 values were 0.86, 0.82, 0.71 and 0.75 for sulfate, nitrate, OC and EC, respectively, over 2005-2015. The long-term temporal trends of PM2.5 sulfate, nitrate, OC and EC predictions agreed well with their corresponding ground measurements. The annual mean of predicted PM2.5 sulfate and EC levels across the conterminous United States decreased substantially from 2005 to 2015; while concentrations of predicted PM2.5 nitrate and OC decreased and fluctuated during the study period. The annual prediction maps captured the characterized spatial patterns of the PM2.5 constituents. The distributions of annual mean concentrations of sulfate and nitrate were generally regional in the extent that sulfate decreased from east to west smoothly with enhancement in California and nitrate had higher concentration in Midwest, Metro New York area, and California. OC and EC had regional high concentrations in the Southeast and Northwest as well as localized high levels around urban centers. The spatial patterns of PM2.5 constituents were consistent with the distributions of their emission sources and secondary processes and transportation. Hence, the national models developed in this study could provide supplementary evaluations of spatio-temporal distributions of PM2.5 constituents with full time-space coverages in the conterminous United States, which could be beneficial to assess the impacts of PM2.5 constituents on radiation budgets and visibility degradation, and support exposure assessment for regional to national health studies at county or city levels to understand the acute and chronic toxicity and health impacts of PM2.5 constituents, and consequently provide scientific evidence for making targeted and effective regulations of PM2.5 pollution.
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Affiliation(s)
- Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jenny L Hand
- Cooperative Institute for Research in the Atmosphere, Colorado State University, Fort Collins, CO, USA
| | - Bret A Schichtel
- National Park Service, Air Resources Division, Lakewood, CO, USA
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Oelsner EC, Balte PP, Cassano PA, Couper D, Enright PL, Folsom AR, Hankinson J, Jacobs DR, Kalhan R, Kaplan R, Kronmal R, Lange L, Loehr LR, London SJ, Navas Acien A, Newman AB, O’Connor GT, Schwartz JE, Smith LJ, Yeh F, Zhang Y, Moran AE, Mwasongwe S, White WB, Yende S, Barr RG. Harmonization of Respiratory Data From 9 US Population-Based Cohorts: The NHLBI Pooled Cohorts Study. Am J Epidemiol 2018; 187:2265-2278. [PMID: 29982273 PMCID: PMC6211239 DOI: 10.1093/aje/kwy139] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 12/13/2022] Open
Abstract
Chronic lower respiratory diseases (CLRDs) are the fourth leading cause of death in the United States. To support investigations into CLRD risk determinants and new approaches to primary prevention, we aimed to harmonize and pool respiratory data from US general population-based cohorts. Data were obtained from prospective cohorts that performed prebronchodilator spirometry and were harmonized following 2005 ATS/ERS standards. In cohorts conducting follow-up for noncardiovascular events, CLRD events were defined as hospitalizations/deaths adjudicated as CLRD-related or assigned relevant administrative codes. Coding and variable names were applied uniformly. The pooled sample included 65,251 adults in 9 cohorts followed-up for CLRD-related mortality over 653,380 person-years during 1983-2016. Average baseline age was 52 years; 56% were female; 49% were never-smokers; and racial/ethnic composition was 44% white, 22% black, 28% Hispanic/Latino, and 5% American Indian. Over 96% had complete data on smoking, clinical CLRD diagnoses, and dyspnea. After excluding invalid spirometry examinations (13%), there were 105,696 valid examinations (median, 2 per participant). Of 29,351 participants followed for CLRD hospitalizations, median follow-up was 14 years; only 5% were lost to follow-up at 10 years. The NHLBI Pooled Cohorts Study provides a harmonization standard applied to a large, US population-based sample that may be used to advance epidemiologic research on CLRD.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Body Weights and Measures
- Bronchiectasis/epidemiology
- Bronchiectasis/physiopathology
- Chronic Disease
- Cohort Studies
- Ethnicity/statistics & numerical data
- Female
- Hispanic or Latino/statistics & numerical data
- Hospitalization/statistics & numerical data
- Humans
- Indians, North American/statistics & numerical data
- Inhalation Exposure/statistics & numerical data
- Lung Diseases, Obstructive/epidemiology
- Lung Diseases, Obstructive/ethnology
- Lung Diseases, Obstructive/mortality
- Lung Diseases, Obstructive/physiopathology
- Male
- Middle Aged
- National Heart, Lung, and Blood Institute (U.S.)/organization & administration
- National Heart, Lung, and Blood Institute (U.S.)/standards
- Phenotype
- Racial Groups/statistics & numerical data
- Respiratory Function Tests
- Risk Factors
- Smoking/epidemiology
- Socioeconomic Factors
- United States/epidemiology
- White People/statistics & numerical data
- Young Adult
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Affiliation(s)
- Elizabeth C Oelsner
- Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Pallavi P Balte
- Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Patricia A Cassano
- Division of Nutritional Sciences, Weill Cornell Medical College, Ithaca, New York
| | - David Couper
- Collaborative Studies Coordinating Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Paul L Enright
- Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, New York
| | - Richard Kronmal
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Leslie Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado, Denver, Colorado
| | - Laura R Loehr
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Ana Navas Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Anne B Newman
- Department of Epidemiology, Pitt Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - George T O’Connor
- Department of Medicine, School of Medicine, Boston University, Boston, Massachusetts
| | - Joseph E Schwartz
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stony Brook University, Stony Brook, New York
| | | | - Fawn Yeh
- Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yiyi Zhang
- Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Andrew E Moran
- Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | | | - Wendy B White
- Jackson Heart Study, Undergraduate Training and Education Center, Tougaloo College, Tougaloo, Mississippi
| | - Sachin Yende
- Division of Pulmonary and Critical Care, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - R Graham Barr
- Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Manichaikul A, Wang XQ, Li L, Erdmann J, Lettre G, Bis JC, Waterworth D, Cushman M, Jenny NS, Post WS, Palmas W, Tsai MY, Wallentin L, White H, Schunkert H, O’Donnell CJ, Herrington DM, Rich SS, O’Donoghue ML, Rodriguez A. Lp-PLA2, scavenger receptor class B type I gene (SCARB1) rs10846744 variant, and cardiovascular disease. PLoS One 2018; 13:e0204352. [PMID: 30289950 PMCID: PMC6173398 DOI: 10.1371/journal.pone.0204352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/06/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We previously reported association of SCARB1 SNP rs10846744 with common carotid IMT (cIMT) and cardiovascular disease (CVD) events. Since rs10846744 has been reported in association with Lp-PLA2 mass and activity, we hypothesized that inflammatory pathways might mediate the association of rs10846744 with atherosclerosis. METHODS We first examined association of rs10846744 in CVD in multiple large-scale consortium-based genome-wide association studies. We further examined 27 parameters of interest, including Lp-PLA2 mass and activity, inflammatory markers, and plasma phospholipid fatty acids, and fatty acid ratios in participants from the Multi-Ethnic Study of Atherosclerosis (MESA), as potential mediators in the pathway linking rs10846744 with cIMT and incident CVD. Finally, we examined the association of rs10846744 with Lp-PLA2 activity, cardiovascular outcomes, and interaction with the Lp-PLA2 inhibitor, darapladib, in the Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy (STABILITY) and Stabilization of Plaque using Darapladib-Thrombolysis in Myocardial Infarction 52 (SOLID-TIMI 52) studies. RESULTS SCARB1 rs10846744 was associated with coronary artery disease events in CARDIoGRAMplusC4D (odds ratio 1.05; 95% CI [1.02, 1.07]; P = 1.4x10-4). In combined analysis across race/ethnic groups in MESA, rs10846744 was associated with Lp-PLA2 mass (P = 0.04) and activity (P = 0.001), homocysteine (P = 0.03), LDL particle number (P = 0.01), docosahexaenoic acid [DHA] (P = 0.01), docosapentaenoic acid [DPA] (P = 0.04), DPA/ eicosapentaenoic acid [EPA] ratio (P = 0.002), and DHA/EPA ratio (P = 0.008). Lp-PLA2 activity was identified as a mediator of rs10846744 with cIMT in a basic model (P = 8x10-5), but not after adjustment for CVD risk factors. There was no interaction or modifier effect of the Lp-PLA2 inhibitor darapladib assignment on the relationship between rs10846744 and major CVD events in either STABILITY or SOLID-TIMI 52. SUMMARY SCARB1 rs10846744 is significantly associated with Lp-PLA2 activity, atherosclerosis, and CVD events, but Lp-PLA2 activity is not a mediator in the association of rs10846744 with cIMT in MESA.
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Affiliation(s)
- Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, United States of America
- Department of Public Health Sciences, Biostatistics Section, University of Virginia, Charlottesville, VA, United States of America
| | - Xin-Qun Wang
- Department of Public Health Sciences, Biostatistics Section, University of Virginia, Charlottesville, VA, United States of America
| | - Li Li
- Genomic Medicine, PAREXEL International, Durham, NC, United States of America
| | - Jeanette Erdmann
- Institut für Integrative und Experimentelle Genomik, University of Lübeck, Lübeck, Germany
- DZHK (German Research Centre for Cardiovascular Research), partner site Hamburg, Kiel, Lübeck, Germany
| | - Guillaume Lettre
- Montreal Heart Institute, Montreal, Quebec, Canada
- Université de Montréal, Montreal, Quebec, Canada
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, United States of America
- Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Dawn Waterworth
- Genetics, GlaxoSmithKline, King of Prussia, PA, United States of America
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT, United States of America
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States of America
| | - Nancy S. Jenny
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States of America
| | - Wendy S. Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Walter Palmas
- Division of General Medicine, Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY, United States of America
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States of America
| | - Lars Wallentin
- Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Harvey White
- Auckland City Hospital Green Lane Cardiovascular Sciences, Auckland, New Zealand
| | - Heribert Schunkert
- DZHK (German Research Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Christopher J. O’Donnell
- Cardiology Section, Boston Veteran’s Administration Healthcare, Boston, MA, United States of America
- NHLBI and Boston University Framingham Heart Study, Framingham, MA, United States of America
| | - David M. Herrington
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, United States of America
- Department of Public Health Sciences, Biostatistics Section, University of Virginia, Charlottesville, VA, United States of America
| | - Michelle L. O’Donoghue
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston MA, United States of America
| | - Annabelle Rodriguez
- Department of Cell Biology, Center for Vascular Biology, University of Connecticut Health, Farmington, CT, United States of America
- * E-mail:
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39
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Adar SD, Chen YH, D'Souza JC, O'Neill MS, Szpiro AA, Auchincloss AH, Park SK, Daviglus ML, Diez Roux AV, Kaufman JD. Longitudinal Analysis of Long-Term Air Pollution Levels and Blood Pressure: A Cautionary Tale from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:107003. [PMID: 30392401 PMCID: PMC6371645 DOI: 10.1289/ehp2966] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Air pollution exposures are hypothesized to impact blood pressure, yet few longitudinal studies exist, their findings are inconsistent, and different adjustments have been made for potentially distinct confounding by calendar time and age. OBJECTIVE We aimed to investigate the associations of long- and short-term [Formula: see text] and [Formula: see text] concentrations with systolic and diastolic blood pressures and incident hypertension while also accounting for potential confounding by age and time. METHODS Between 2000 and 2012, Multi-Ethnic Study of Atherosclerosis participants were measured for systolic and diastolic blood pressure at five exams. We estimated annual average and daily [Formula: see text] and [Formula: see text] concentrations for 6,569 participants using spatiotemporal models and measurements, respectively. Associations of exposures with blood pressure corrected for medication were studied using mixed-effects models. Incident hypertension was examined with Cox regression. We adjusted all models for sex, race/ethnicity, socioeconomic status, smoking, physical activity, diet, season, and site. We compared associations from models adjusting for time-varying age with those that adjusted for both time-varying age and calendar time. RESULTS We observed decreases in pollution and blood pressures (adjusted for age and medication) over time. Strong, positive associations of long- and short-term exposures with blood pressure were found only in models with adjustment for time-varying age but not adjustment for both time-varying age and calendar time. For example, [Formula: see text] higher annual average [Formula: see text] concentrations were associated with 2.7 (95% CI: 1.5, 4.0) and [Formula: see text] (95% CI: [Formula: see text] 1.0) mmHg in systolic blood pressure with and without additional adjustment for time, respectively. Associations with incident hypertension were similarly weakened by additional adjustment for time. Sensitivity analyses indicated that air pollution did not likely cause the temporal trends in blood pressure. CONCLUSIONS In contrast to experimental evidence, we found no associations between long- or short-term exposures to air pollution and blood pressure after accounting for both time-varying age and calendar time. This research suggests that careful consideration of both age and time is needed in longitudinal studies with trending exposures. https://doi.org/10.1289/EHP2966.
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Affiliation(s)
- Sara D Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Yeh-Hsin Chen
- Harris County Public and Environmental Services, Houston, Texas, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jennifer C D'Souza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Marie S O'Neill
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Martha L Daviglus
- Institute of Minority Health Research, University of Illinois College of Medicine, Chicago, Illinois, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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40
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Tibuakuu M, Michos ED, Navas-Acien A, Jones MR. Air Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide. CURR EPIDEMIOL REP 2018; 5:370-378. [PMID: 30931239 DOI: 10.1007/s40471-018-0166-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose of review Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations. Recent findings Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations. Summary Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.
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Affiliation(s)
- Martin Tibuakuu
- St. Luke's Hospital, Department of Medicine, Chesterfield, MO, USA.,Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University School of Public Health, New York, NY, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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41
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Burkart KM, Sofer T, London SJ, Manichaikul A, Hartwig FP, Yan Q, Soler Artigas M, Avila L, Chen W, Davis Thomas S, Diaz AA, Hall IP, Horta BL, Kaplan RC, Laurie CC, Menezes AM, Morrison JV, Oelsner EC, Rastogi D, Rich SS, Soto-Quiros M, Stilp AM, Tobin MD, Wain LV, Celedón JC, Barr RG. A Genome-Wide Association Study in Hispanics/Latinos Identifies Novel Signals for Lung Function. The Hispanic Community Health Study/Study of Latinos. Am J Respir Crit Care Med 2018; 198:208-219. [PMID: 29394082 PMCID: PMC6058984 DOI: 10.1164/rccm.201707-1493oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
RATIONALE Lung function and chronic obstructive pulmonary disease (COPD) are heritable traits. Genome-wide association studies (GWAS) have identified numerous pulmonary function and COPD loci, primarily in cohorts of European ancestry. OBJECTIVES Perform a GWAS of COPD phenotypes in Hispanic/Latino populations to identify loci not previously detected in European populations. METHODS GWAS of lung function and COPD in Hispanic/Latino participants from a population-based cohort. We performed replication studies of novel loci in independent studies. MEASUREMENTS AND MAIN RESULTS Among 11,822 Hispanic/Latino participants, we identified eight novel signals; three replicated in independent populations of European Ancestry. A novel locus for FEV1 in ZSWIM7 (rs4791658; P = 4.99 × 10-9) replicated. A rare variant (minor allele frequency = 0.002) in HAL (rs145174011) was associated with FEV1/FVC (P = 9.59 × 10-9) in a region previously identified for COPD-related phenotypes; it remained significant in conditional analyses but did not replicate. Admixture mapping identified a novel region, with a variant in AGMO (rs41331850), associated with Amerindian ancestry and FEV1, which replicated. A novel locus for FEV1 identified among ever smokers (rs291231; P = 1.92 × 10-8) approached statistical significance for replication in admixed populations of African ancestry, and a novel SNP for COPD in PDZD2 (rs7709630; P = 1.56 × 10-8) regionally replicated. In addition, loci previously identified for lung function in European samples were associated in Hispanic/Latino participants in the Hispanic Community Health Study/Study of Latinos at the genome-wide significance level. CONCLUSIONS We identified novel signals for lung function and COPD in a Hispanic/Latino cohort. Including admixed populations when performing genetic studies may identify variants contributing to genetic etiologies of COPD.
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Affiliation(s)
- Kristin M. Burkart
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Stephanie J. London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Fernando P. Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Qi Yan
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - María Soler Artigas
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Lydiana Avila
- Division of Pediatric Pulmonology, Hospital Nacional de Niños, San José, Costa Rica
| | - Wei Chen
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sonia Davis Thomas
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Alejandro A. Diaz
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ian P. Hall
- Division of Respiratory Medicine, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Bernardo L. Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Cathy C. Laurie
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Ana M. Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Jean V. Morrison
- Department of Human Genetics and Statistics, University of Chicago, Chicago, Illinois
| | - Elizabeth C. Oelsner
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Deepa Rastogi
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Manuel Soto-Quiros
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Adrienne M. Stilp
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Martin D. Tobin
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom; and
| | - Louise V. Wain
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom; and
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - R. Graham Barr
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Pollutant composition modification of the effect of air pollution on progression of coronary artery calcium: the Multi-Ethnic Study of Atherosclerosis. Environ Epidemiol 2018; 2. [PMID: 30854505 PMCID: PMC6402342 DOI: 10.1097/ee9.0000000000000024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Differences in traffic-related air pollution (TRAP) composition may cause heterogeneity in associations between air pollution exposure and cardiovascular health outcomes. Clustering multipollutant measurements allows investigation of effect modification by TRAP profiles. Methods: We measured TRAP components with fixed-site and on-road instruments for two 2-week periods in Baltimore, Maryland. We created representative TRAP profiles for cold and warm seasons using predictive k-means clustering. We predicted cluster membership for 1005 participants in the Multi-Ethnic Study of Atherosclerosis and Air Pollution with follow-up between 2000 and 2012. We estimated cluster-specific relationships between coronary artery calcification (CAC) progression and long-term exposure to fine particulate matter (PM2.5) and oxides of nitrogen (NOX). Results: We identified two clusters in the cold season, notable for higher ratios of gases and ultrafine particles, respectively. A 5-μg/m3 difference in PM2.5 was associated with 17.0 (95% confidence interval [CI] = 7.2, 26.7) and 42.6 (95% CI = 25.7, 59.4) Agatston units/year CAC progression among participants in clusters 1 and 2, respectively (effect modification P = 0.006). A 40 ppb difference in NOX was associated with 22.2 (95% CI = 7.7, 36.7) and 41.9 (95% CI = 23.7, 60.2) Agatston units/year CAC progression in clusters 1 and 2, respectively (P = 0.08). Similar trends occurred using clusters identified from warm season measurements. Clusters correlated highly with baseline pollution level. Conclusions: Clustering TRAP measurements identified spatial differences in composition. We found evidence of greater CAC progression rates per unit PM2.5 exposures among people living in areas characterized by high ratios of ultrafine particle counts relative to NOX concentrations.
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Hazlehurst MF, Spalt EW, Nicholas TP, Curl CL, Davey ME, Burke GL, Watson KE, Vedal S, Kaufman JD. Contribution of the in-vehicle microenvironment to individual ambient-source nitrogen dioxide exposure: the Multi-Ethnic Study of Atherosclerosis and Air Pollution. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:371-380. [PMID: 29511286 PMCID: PMC6013355 DOI: 10.1038/s41370-018-0025-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/12/2017] [Accepted: 12/17/2017] [Indexed: 05/31/2023]
Abstract
Exposure estimates that do not account for time in-transit may underestimate exposure to traffic-related air pollution, but exact contributions have not been studied directly. We conducted a 2-week monitoring, including novel in-vehicle sampling, in a subset of the Multi-Ethnic Study of Atherosclerosis and Air Pollution cohort in two cities. Participants spent the majority of their time indoors and only 4.4% of their time (63 min/day) in-vehicle, on average. The mean ambient-source NO2 concentration was 5.1 ppb indoors and 32.3 ppb in-vehicle during drives. On average, indoor exposure contributed 69% and in-vehicle exposure contributed 24% of participants' ambient-source NO2 exposure. For participants in the highest quartile of time in-vehicle (≥1.3 h/day), indoor and in-vehicle contributions were 60 and 31%, respectively. Incorporating infiltrated indoor and measured in-vehicle NO2 produced exposure estimates 5.6 ppb lower, on average, than using only outdoor concentrations. The indoor microenvironment accounted for the largest proportion of ambient-source exposure in this older population, despite higher concentrations of NO2 outdoors and in vehicles than indoors. In-vehicle exposure was more influential among participants who drove the most and for participants residing in areas with lower outdoor air pollution. Failure to characterize exposures in these microenvironments may contribute to exposure misclassification in epidemiologic studies.
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Affiliation(s)
- Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Elizabeth W Spalt
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Tyler P Nicholas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Cynthia L Curl
- Department of Community and Environmental Health, Boise State University, Boise, ID, USA
| | - Mark E Davey
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Karol E Watson
- Department of Medicine/Cardiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
- Department of Medicine, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
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44
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Oelsner EC, Smith BM, Hoffman EA, Kalhan R, Donohue KM, Kaufman JD, Nguyen JN, Manichaikul AW, Rotter JI, Michos ED, Jacobs DR, Burke GL, Folsom AR, Schwartz JE, Watson K, Barr RG. Prognostic Significance of Large Airway Dimensions on Computed Tomography in the General Population. The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study. Ann Am Thorac Soc 2018; 15:718-727. [PMID: 29529382 PMCID: PMC6137677 DOI: 10.1513/annalsats.201710-820oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/12/2018] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Large airway dimensions on computed tomography (CT) have been associated with lung function, symptoms, and exacerbations in chronic obstructive pulmonary disease (COPD), as well as with symptoms in smokers with preserved spirometry. Their prognostic significance in persons without lung disease remains undefined. OBJECTIVES To examine associations between large airway dimensions on CT and respiratory outcomes in a population-based cohort of adults without prevalent lung disease. METHODS The Multi-Ethnic Study of Atherosclerosis recruited participants ages 45-84 years without cardiovascular disease in 2000-2002; we excluded participants with prevalent chronic lower respiratory disease (CLRD). Spirometry was measured in 2004-2006 and 2010-2012. CLRD hospitalizations and deaths were classified by validated criteria through 2014. The average wall thickness for a hypothetical airway of 10-mm lumen perimeter on CT (Pi10) was calculated using measures of airway wall thickness and lumen diameter. Models were adjusted for age, sex, principal components of ancestry, body mass index, smoking, pack-years, scanner, percent emphysema, genetic risk score, and initial forced expiratory volume in 1 second (FEV1) percent predicted. RESULTS Greater Pi10 was associated with 9% faster FEV1 decline (95% confidence interval [CI], 2 to 15%; P = 0.012) and increased incident COPD (odds ratio, 2.22; 95% CI, 1.43-3.45; P = 0.0004) per standard deviation among 1,830 participants. Over 78,147 person-years, higher Pi10 was associated with a 57% higher risk of first CLRD hospitalization or mortality (P = 0.0496) per standard deviation. Of Pi10's component measures, both greater airway wall thickness and narrower lumen predicted incident COPD and CLRD clinical events. CONCLUSIONS In adults without CLRD, large airway dimensions on CT were prospectively associated with accelerated lung function decline and increased risks of COPD and CLRD hospitalization and mortality.
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Affiliation(s)
- Elizabeth C. Oelsner
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Benjamin M. Smith
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
- Respiratory Division, McGill University, Montreal, Quebec, Canada
| | - Eric A. Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa
| | - Ravi Kalhan
- Division of Pulmonary, Northwestern University, Chicago, Illinois
| | - Kathleen M. Donohue
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Jennifer N. Nguyen
- Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Ani W. Manichaikul
- Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Jerome I. Rotter
- Division of Genomic Outcomes, University of California, Los Angeles, School of Medicine, Torrance, California
| | - Erin D. Michos
- Department of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - David R. Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Gregory L. Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina; and
| | - Aaron R. Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Joseph E. Schwartz
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
| | - Karol Watson
- Division of Cardiology, University of California, Los Angeles, School of Medicine, Los Angeles, California
| | - R. Graham Barr
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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45
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Kulick ER, Wellenius GA, Boehme AK, Sacco RL, Elkind MS. Residential Proximity to Major Roadways and Risk of Incident Ischemic Stroke in NOMAS (The Northern Manhattan Study). Stroke 2018. [PMID: 29540609 DOI: 10.1161/strokeaha.117.019580] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The evidence supporting the deleterious cardiovascular health effects of living near a major roadway is growing, although this association is not universal. In primary analyses, we hypothesized that residential proximity to a major roadway would be associated with incident ischemic stroke and that cardiovascular risk factors would modify that association. METHODS NOMAS (The Northern Manhattan Study) is an ongoing, population-based cohort study designed to measure cardiovascular risk factors, stroke incidence, and other outcomes in a multiethnic urban population. Recruitment occurred from 1993 to 2001 and participants are followed-up annually by telephone. Residential addresses at baseline were geocoded and Euclidean distance to nearest major roadway was estimated and categorized as in prior studies. We used Cox proportional hazard models to calculate hazard ratios and 95% confidence intervals for the association of this distance to incidence of stroke and other outcomes, adjusting for sociodemographic and cardiovascular risk factors, year at baseline, and neighborhood socioeconomic status. We assessed whether these associations varied by age, sex, smoking status, diabetes mellitus, and hypertension. RESULTS During a median follow-up period of 15 years (n=3287), 11% of participants were diagnosed with ischemic stroke. Participants living <100 m from a roadway had a 42% (95% confidence interval, 1.01-2.02) higher rate of ischemic stroke versus those living >400 m away. This association was more pronounced among noncurrent smokers (hazard ratio, 1.54; 95% confidence interval, 1.05-2.26) and not evident among smokers (hazard ratio, 0.69; 95% confidence interval, 0.23-2.06). There was no clear pattern of association between proximity to major roadways and other cardiovascular events including myocardial infarction, all-cause death, or vascular death. CONCLUSIONS In this urban multiethnic cohort, we found evidence supporting that within-city variation in residential proximity to major roadway is associated with higher risk of ischemic stroke. An individual's smoking history modified this association, with the association remaining only among participants not currently smokers.
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Affiliation(s)
- Erin R Kulick
- From the Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., M.S.E.) and Department of Neurology, College of Physicians and Surgeons (E.R.K., A.K.B., M.S.E.), Columbia University, New York, NY; Department of Epidemiology, Brown University School of Public Health, Providence, RI (G.A.W.); and Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.).
| | - Gregory A Wellenius
- From the Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., M.S.E.) and Department of Neurology, College of Physicians and Surgeons (E.R.K., A.K.B., M.S.E.), Columbia University, New York, NY; Department of Epidemiology, Brown University School of Public Health, Providence, RI (G.A.W.); and Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.)
| | - Amelia K Boehme
- From the Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., M.S.E.) and Department of Neurology, College of Physicians and Surgeons (E.R.K., A.K.B., M.S.E.), Columbia University, New York, NY; Department of Epidemiology, Brown University School of Public Health, Providence, RI (G.A.W.); and Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.)
| | - Ralph L Sacco
- From the Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., M.S.E.) and Department of Neurology, College of Physicians and Surgeons (E.R.K., A.K.B., M.S.E.), Columbia University, New York, NY; Department of Epidemiology, Brown University School of Public Health, Providence, RI (G.A.W.); and Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.)
| | - Mitchell S Elkind
- From the Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., M.S.E.) and Department of Neurology, College of Physicians and Surgeons (E.R.K., A.K.B., M.S.E.), Columbia University, New York, NY; Department of Epidemiology, Brown University School of Public Health, Providence, RI (G.A.W.); and Departments of Neurology, Public Health Sciences, and Human Genetics, Miller School of Medicine, University of Miami, FL (R.L.S.)
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Angiotensin-Converting Inhibitors and Angiotensin II Receptor Blockers and Longitudinal Change in Percent Emphysema on Computed Tomography. The Multi-Ethnic Study of Atherosclerosis Lung Study. Ann Am Thorac Soc 2018; 14:649-658. [PMID: 28207279 DOI: 10.1513/annalsats.201604-317oc] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Although emphysema on computed tomography (CT) is associated with increased morbidity and mortality in patients with and without spirometrically defined chronic obstructive pulmonary disease, no available medications target emphysema outside of alpha-1 antitrypsin deficiency. Transforming growth factor-β and endothelial dysfunction are implicated in emphysema pathogenesis, and angiotensin II receptor blockers (ARBs) inhibit transforming growth factor-β, improve endothelial function, and restore airspace architecture in murine models. Evidence in humans is, however, lacking. OBJECTIVES To determine whether angiotensin-converting enzyme (ACE) inhibitor and ARB dose is associated with slowed progression of percent emphysema by CT. METHODS The Multi-Ethnic Study of Atherosclerosis researchers recruited participants ages 45-84 years from the general population from 2000 to 2002. Medication use was assessed by medication inventory. Percent emphysema was defined as the percentage of lung regions less than -950 Hounsfield units on CTs. Mixed-effects regression models were used to adjust for confounders. RESULTS Among 4,472 participants, 12% used an ACE inhibitor and 6% used an ARB at baseline. The median percent emphysema was 3.0% at baseline, and the rate of progression was 0.64 percentage points over a median of 9.3 years. Higher doses of ACE or ARB were independently associated with a slower change in percent emphysema (P = 0.03). Over 10 years, in contrast to a predicted mean increase in percent emphysema of 0.66 percentage points in those who did not take ARBs or ACE inhibitors, the predicted mean increase in participants who used maximum doses of ARBs or ACE inhibitors was 0.06 percentage points (P = 0.01). The findings were of greatest magnitude among former smokers (P < 0.001). Indications for ACE inhibitor or ARB drugs (hypertension and diabetes) and other medications for hypertension and diabetes were not associated independently with change in percent emphysema. There was no evidence that ACE inhibitor or ARB dose was associated with decline in lung function. CONCLUSIONS In a large population-based study, ACE inhibitors and ARBs were associated with slowed progression of percent emphysema by chest CT, particularly among former smokers. Randomized clinical trials of ACE and ARB agents are warranted for the prevention and treatment of emphysema.
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Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Basu NN, Baldé AB, Bertollini R, Bose-O'Reilly S, Boufford JI, Breysse PN, Chiles T, Mahidol C, Coll-Seck AM, Cropper ML, Fobil J, Fuster V, Greenstone M, Haines A, Hanrahan D, Hunter D, Khare M, Krupnick A, Lanphear B, Lohani B, Martin K, Mathiasen KV, McTeer MA, Murray CJL, Ndahimananjara JD, Perera F, Potočnik J, Preker AS, Ramesh J, Rockström J, Salinas C, Samson LD, Sandilya K, Sly PD, Smith KR, Steiner A, Stewart RB, Suk WA, van Schayck OCP, Yadama GN, Yumkella K, Zhong M. The Lancet Commission on pollution and health. Lancet 2018; 391:462-512. [PMID: 29056410 DOI: 10.1016/s0140-6736(17)32345-0] [Citation(s) in RCA: 1681] [Impact Index Per Article: 280.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 05/09/2017] [Accepted: 08/02/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Philip J Landrigan
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | | | - Olusoji Adeyi
- Department of Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA
| | - Robert Arnold
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, USA
| | - Niladri Nil Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Canada
| | | | - Roberto Bertollini
- Scientific Committee on Health, Environmental and Emerging Risks of the European Commission, Luxembourg City, Luxembourg; Office of the Minister of Health, Ministry of Public Health, Doha, Qatar
| | - Stephan Bose-O'Reilly
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of LMU Munich, Munich, Germany; Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | | | - Patrick N Breysse
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Chiles
- Department of Biology, Boston College, Chestnut Hill, MA, USA
| | | | | | - Maureen L Cropper
- Department of Economics, University of Maryland, College Park, MD, USA; Resources for the Future, Washington, DC, USA
| | - Julius Fobil
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Valentin Fuster
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | | | - Andy Haines
- Department of Social and Environmental Health Research and Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - David Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mukesh Khare
- Department of Civil Engineering, Indian Institute of Technology, Delhi, India
| | | | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Bindu Lohani
- Centennial Group, Washington, DC, USA; The Resources Center, Lalitpur, Nepal
| | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC, USA
| | - Karen V Mathiasen
- Office of the US Executive Director, The World Bank, Washington, DC, USA
| | | | | | | | - Frederica Perera
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Janez Potočnik
- UN International Resource Panel, Paris, France; SYSTEMIQ, London, UK
| | - Alexander S Preker
- Department of Environmental Medicine and Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA; Health Investment & Financing Corporation, New York, NY, USA
| | | | - Johan Rockström
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | | | - Leona D Samson
- Department of Biological Engineering and Department of Biology, Center for Environmental Health Sciences, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Kirk R Smith
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, CA, USA
| | - Achim Steiner
- Oxford Martin School, University of Oxford, Oxford, UK
| | - Richard B Stewart
- Guarini Center on Environmental, Energy, and Land Use Law, New York University, New York, NY, USA
| | - William A Suk
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Gautam N Yadama
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Kandeh Yumkella
- United Nations Industrial Development Organization, Vienna, Austria
| | - Ma Zhong
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
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Barratt B, Lee M, Wong P, Tang R, Tsui TH, Cheng W, Yang Y, Lai PC, Tian L, Thach TQ, Allen R, Brauer M. A Dynamic Three-Dimensional Air Pollution Exposure Model for Hong Kong. Res Rep Health Eff Inst 2018; 2018:1-65. [PMID: 31883241 PMCID: PMC7266374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION High-density high-rise cities have become a more prominent feature globally. Air quality is a significant public health risk in many of these cities. There is a need to better understand the extent to which vertical variation in air pollution and population mobility in such cities affect exposure and exposure-response relationships in epidemiological studies. METHODS We used a novel strategy to execute a staged model development that incorporated horizontal and vertical pollutant dispersion, building infiltration, and population mobility patterns in estimating traffic-related air pollution (TRAP) exposures in the Hong Kong Special Administrative Region (HK SAR). Two street-level spatial monitoring campaigns were undertaken to facilitate the creation of a two-dimensional land-use regression (LUR) model. A network of approximately 100 passive nitric oxide-nitrogen dioxide (NO-NO2) monitors was deployed for two-week periods during the cool and warm seasons. Sampling locations were selected based on population and road network density with a range of physical and geographical characteristics represented. Eight sets of portable monitors for black carbon (BC) and particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) were rotated so as to be deployed at 80 locations for a 24-hour period. Land-use, geographical, and emissions layers were combined with the spatial monitoring campaign results to create spatiotemporal exposure models. Vertical air pollution monitoring was carried out at six strategic locations for two weeks in the warm season and two weeks in the cool season. Continuous measurements were carried out at four different heights of a residential building and on both sides of a street canyon. The heights ranged from as close to street level as practically possible up to a maximum of 50 meters (i.e., below the 20th floor). Paired indoor monitoring was included to allow the calculation of infiltration coefficients to feed into the dynamic component of the exposure model. The final phase of model development addressed population mobility. A population-representative travel behavior survey (n = 89,358) was used to produce the dynamic component of the model, with time-weighted exposure estimates split between home and work or school. Transport microenvironment exposures were taken from published literature. Time-activity exposure estimates were split by age, sex, and employment status. Development of the exposure model in distinct packages allowed the application of a staged approach to an existing cohort data set. Mortality risk estimates for an elderly cohort of 66,000 Hong Kong residents were calculated using increasing exposure model complexity. RESULTS The street-level (2-dimensional [2D]) LUR modeling captured important spatial parameters and represented spatial patterns of air quality in Hong Kong that were consistent with the literature. Higher concentrations of gaseous pollutants were centered in Kowloon and the northern region of Hong Kong Island. PM2.5 and BC predictions exhibited a north-south/west-east gradient, with higher concentrations in the northwest due to regional transport of particulate pollutants from Mainland China. While the degree of explained variance of the models was in line with other LUR modeling efforts in Asia, R2 values ranged from 0.46 (NO2) to 0.59 (PM2.5). Exponential decay rates (k) were calculated at each monitoring location. While it was clear that k values were higher during the warm season than the cool season, no robust patterns were identified relating to the canyon physical parameters. Therefore, a single decay rate was used for each pollutant across the whole region for derivation of the 3-dimensional (3D) exposure layer (k = 0.004 and 0.012 for PM2.5 and BC, respectively). An alternative decay profile that capped decay at 20 meters above street level was proposed and evaluated. The electrochemical sensors deployed during the canyon campaigns did not exhibit the degree of interunit precision necessary to detect vertical variations in gaseous pollutants, and these results were excluded from the study. We found that values of the median infiltration efficiencies (Finf) for both BC and PM2.5 were especially high during the cool season (91%). Finf values were somewhat lower during the warm season (81% and 88% for PM2.5 and BC, respectively), and we found a significant negative correlation between air conditioning use and Finf. The Finf for a mechanically ventilated office building was 45% and 40% during the cool and warm seasons, respectively. Dynamic exposure estimates were compared against home outdoor estimates. As expected, the addition of an indoor component decreased time-weighted exposure estimates, which were balanced out to some extent by the inclusion of transport microenvironments. Overall, mean time-weighted exposures for the full dynamic model were around 20% lower than home outdoor estimates. Higher levels of exposures were found with working adults and students than for those neither in work nor study. This was due to the increased mobility of people going to work or school. The exposures to PM2.5, BC, and NO2 were, respectively, 13%, 39%, and 14% higher for people who were under age 18, compared with people who were 65 or older. Exposure estimates for the female population were approximately 4% lower. The availability of an existing cohort data set of elderly Hong Kong residents (n = 66,820) facilitated the calculation and comparison of mortality risk estimates for the different exposure models. Overall, results indicated that the application of exposure estimates that incorporated infiltration, vertical, and to a lesser extent, dynamic components resulted in higher hazard ratios (HRs) than the standard street-level model and increased the number of significant associations with all-natural-cause, cardiovascular, and respiratory mortality outcomes. CONCLUSIONS The results from the study provided the first evidence that considering air pollution exposure in a dynamic 3D landscape would benefit epidemiological studies. Higher HRs and a greater number of significant associations were found between mortality and pollutant exposures that would not have been found had standard 2D exposure models been used. Dynamic models can also identify differential exposures between population subtypes (e.g., students and working adults; those neither in work nor study). Improved urban building design appears to be stimulating the dispersion of local TRAP in street canyons. Conversely, Finf values found in naturally ventilated buildings were high, and residences provided little protection from ambient air pollution. We have demonstrated that the creation of effective advanced exposure models is possible in Asian cities without an undue burden on resources. We recommend that vertical exposure patterns be incorporated in future epidemiological studies in high-rise cities where the floor of residence is recorded in health record data.
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Affiliation(s)
| | - M Lee
- University of British Columbia, Canada
| | - P Wong
- The University of Hong Kong, Hong Kong SAR
| | - R Tang
- The University of Hong Kong, Hong Kong SAR
| | - T H Tsui
- The University of Hong Kong, Hong Kong SAR
| | - W Cheng
- The University of Hong Kong, Hong Kong SAR
| | - Y Yang
- The University of Hong Kong, Hong Kong SAR
| | - P-C Lai
- The University of Hong Kong, Hong Kong SAR
| | - L Tian
- The University of Hong Kong, Hong Kong SAR
| | - T-Q Thach
- The University of Hong Kong, Hong Kong SAR
| | - R Allen
- Simon Fraser University, Canada
| | - M Brauer
- University of British Columbia, Canada
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Mamudu HM, Jones A, Paul T, Subedi P, Wang L, Alamian A, Alamin AE, Blackwell G, Budoff M. Geographic and Individual Correlates of Subclinical Atherosclerosis in an Asymptomatic Rural Appalachian Population. Am J Med Sci 2018; 355:140-148. [DOI: 10.1016/j.amjms.2017.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/26/2017] [Accepted: 08/18/2017] [Indexed: 01/13/2023]
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Human airway branch variation and chronic obstructive pulmonary disease. Proc Natl Acad Sci U S A 2018; 115:E974-E981. [PMID: 29339516 DOI: 10.1073/pnas.1715564115] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Susceptibility to chronic obstructive pulmonary disease (COPD) beyond cigarette smoking is incompletely understood, although several genetic variants associated with COPD are known to regulate airway branch development. We demonstrate that in vivo central airway branch variants are present in 26.5% of the general population, are unchanged over 10 y, and exhibit strong familial aggregation. The most common airway branch variant is associated with COPD in two cohorts (n = 5,054), with greater central airway bifurcation density, and with emphysema throughout the lung. The second most common airway branch variant is associated with COPD among smokers, with narrower airway lumens in all lobes, and with genetic polymorphisms within the FGF10 gene. We conclude that central airway branch variation, readily detected by computed tomography, is a biomarker of widely altered lung structure with a genetic basis and represents a COPD susceptibility factor.
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