Noise and air pollution as triggers of hypertension

Geospatial analysis for environmental noise mapping: A land use regression approach in a metropolitan city

Environmental noise can lead to adverse health outcomes. Understanding the spatial variability of environmental noise is crucial for mitigating potential health risks and developing influential urban strategies for reducing noise levels. This study aimed to measure noise levels and develop a land use regression (LUR) model to determine the spatial variability of environmental noise in Shiraz, Iran. A grid-based technique was used to establish 191 noise measurement sites (summer) across the city to generate the LUR model based on two noise metrics: Lden and Lnight. Leave-one-out cross-validation (LOOCV) and 38 additional measurement sites (winter) were used for the LUR model assessment. The mean values of Lden and Lnight during summer were 68.20 (±8.05) and 58.95 (±9.55), respectively, while during winter, the corresponding values were 69.46 (±5.46) and 58.81 (±6.79). The LUR models explained 67% and 65% of the spatial variability in Lden and Lnight, respectively. LOOCV analysis demonstrated R2 values of 0.64 and 0.61. Moreover, findings indicated mean absolute error (MAE) values of 3.96 dB(A) for Lden and 4.74 dB(A) for Lnight. Validation based on an additional set of 38 measurement sites revealed R2 values of 0.62 for both Lden and Lnight, with MAE of 2.78 and 3.31, respectively. In addition, the adjusted R2 values were 0.54 and 0.53. The results indicated no significant temporal variations between summer and winter. The results revealed that road-related variables significantly influenced noise levels. Moreover, the results indicated that Lden and Lnight levels were higher than the World Health Organization recommendations for exposure to road traffic noise. The results of our study showed that the LUR modeling approach based on geographical predictors is an effective tool for assessing changes in ambient noise levels in other cities in Iran and around the globe.

Exposure to ambient air pollution and metabolic dysfunction-associated fatty liver disease: Findings from over 2.7 million adults in Northwestern China

Ambient air pollutants exposures may lead to aggravated Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD). However, there is still a scarcity of empirical studies that have rigorously estimated this association, especially in regions where air pollution is severe. To fill in the literature gap, we conducted a cross-sectional study involving 2711,207 adults living in five regions of southern Xinjiang Uyghur Autonomous Region in 2021. Using a Space-Time Extra-Trees model, we assessed the four-year (2017-2020) average concentrations of particulate matter with aerodynamic diameter ≤1 µm (PM1), particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), particulate matter with aerodynamic diameter ≤10 µm (PM10), ozone (O3), sulfur dioxide (SO2), and carbon monoxide (CO), and then assigned these values to the participants. Generalized linear mixed models were employed to examine the relationships between air pollutants and the prevalence of MAFLD, with adjustment for multiple confounding factors. The odds ratios and 95% confidence intervals of MAFLD were 2.002 (1.826-2.195), 1.133 (1.108-1.157), 1.034 (1.027-1.040), 1.077 (1.023-1.134), 2.703 (2.322-3.146) and 1.033 (1.029-1.036) per 10 µg/m3 increase in the 4-year average PM1, PM2.5, PM10, O3, SO2 and CO exposures, respectively. The robustness of the findings was confirmed by a series of sensitivities. In summary, long-term exposure to ambient air pollutants was associated with increased odds of MAFLD, particularly in males and individuals with unhealthy lifestyles.

Exposome in ischaemic heart disease: beyond traditional risk factors

Ischaemic heart disease represents the leading cause of morbidity and mortality, typically induced by the detrimental effects of risk factors on the cardiovascular system. Although preventive interventions tackling conventional risk factors have helped to reduce the incidence of ischaemic heart disease, it remains a major cause of death worldwide. Thus, attention is now shifting to non-traditional risk factors in the built, natural, and social environments that collectively contribute substantially to the disease burden and perpetuate residual risk. Of importance, these complex factors interact non-linearly and in unpredictable ways to often enhance the detrimental effects attributable to a single or collection of these factors. For this reason, a new paradigm called the 'exposome' has recently been introduced by epidemiologists in order to define the totality of exposure to these new risk factors. The purpose of this review is to outline how these emerging risk factors may interact and contribute to the occurrence of ischaemic heart disease, with a particular attention on the impact of long-term exposure to different environmental pollutants, socioeconomic and psychological factors, along with infectious diseases such as influenza and COVID-19. Moreover, potential mitigation strategies for both individuals and communities will be discussed.

Identifying interactions among air pollutant emissions on diabetes prevalence in Northeast China using a complex network

BACKGROUND

Low air quality related to ambient air pollution is the largest environmental risk to health worldwide. Interactions between air pollution emissions may affect associations between air pollution exposure and chronic diseases. Therefore, this study aimed to quantify interactions among air pollution emissions and assess their effects on the association between air pollution and diabetes.

METHODS

After constructing long-term emission networks for six air pollutants based on data collected from routine monitoring stations in Northeast China, a mutual information network was used to quantify interactions among air pollution emissions. Multiple linear regression analysis was then used to explore the influence of emission interactions on the association between air pollution exposure and the prevalence of diabetes based on data reported from the Northeast Natural Cohort Study in China.

RESULTS

Complex network analysis detected three major emission sources in Northeast China located in Shenyang and Changchun. The effects of particulate matter (PM2.5 and PM10) and ground-level ozone (O3) emissions were limited to certain communities but could spread to other communities through emissions in Inner Mongolia. Emissions of sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) significantly influenced other communities. These results indicated that air pollutants in different geographic areas can interact directly or indirectly. Adjusting for interactions between emissions changed associations between air pollution emissions and diabetes prevalence, especially for PM2.5, NO2, and CO.

CONCLUSIONS

Complex network analysis is suitable for quantifying interactions among air pollution emissions and suggests that the effects of PM2.5 and NO2 emissions on health outcomes may have been overestimated in previous population studies while those of CO may have been underestimated. Further studies examining associations between air pollution and chronic diseases should consider controlling for the effects of interactions among pollution emissions.

Air pollution, cardiovascular disease, and urban greening: an ecological blueprint

A number of studies and systematic reviews indicate that exposure to greenness reduces of all-cause, non accidental mortality, particularly from cardiopulmonary and cancer causes. There is also some evidence that green space residence may be associated with improved pregnancy and birth outcomes, and with better school performances in children. Furthermore, because at least one third of the premature deaths are globally attributable to exposure to air pollution due household agents, particularly in fragile populations living in low-income countries (i.e., children, older and deprived people, pregnant women), that houseplants are an effective and economic mean for cleaning indoor air and thus reducing volatile organic compounds such as formaldehyde, benzene, toluene and others. On the whole more prospective studies are needed to further elucidate the mechanisms linking air pollution, greenness and health outcomes, although the multiple and interacting mechanisms depicted in this article are all biologically plausible.

Pollution from fine particulate matter and atherosclerosis: A narrative review

According to the WHO, the entire global population is exposed to air pollution levels higher than recommended for health preservation. Air pollution is a complex mixture of nano- to micro-sized particles and gaseous components that poses a major global threat to public health. Among the most important air pollutants, causal associations have been established between particulate matter (PM), mainly < 2.5 μm, and cardiovascular diseases (CVD), i.e., hypertension, coronary artery disease, ischemic stroke, congestive heart failure, arrhythmias as well as total cardiovascular mortality. Aim of this narrative review is to describe and critically discuss the proatherogenic effects of PM_2.5 that have been attributed to many direct or indirect effects comprising endothelial dysfunction, a chronic low-grade inflammatory state, increased production of reactive oxygen species, mitochondrial dysfunction and activation of metalloproteases, all leading to unstable arterial plaques. Higher concentrations of air pollutants are associated with the presence of vulnerable plaques and plaque ruptures witnessing coronary artery instability. Air pollution is often disregarded as a CVD risk factor, in spite of the fact that it is one of the main modifiable factors relevant for prevention and management of CVD. Thus, not only structural actions should be taken in order to mitigate emissions, but health professionals should also take care to counsel patients on the risks of air pollution.

Long-term effects of PM2.5 components on hypertension: A national analysis in China

BACKGROUND

Evidence is less about the associations between fine particulate matter (PM_2.5) components and hypertension. We aimed to examine the long-term effects of PM_2.5 components on prevalence of hypertension, diastolic blood pressure (DBP) and systolic blood pressure (SBP).

METHODS

We included participants between March 1, and July 31, 2021, from 13 provinces in China. Geocoded residential address was used for exposure assignment. Mixed-effect regression was used to assess 3-year average concentrations of PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) on prevalence of hypertension, DBP and SBP with covariate-adjusted. SHapley Additive exPlanation was used to compare the contribution of PM_2.5 components to hypertension, DBP, and SBP. Sex and age subgroup were also analyzed.

RESULTS

We enrolled a total of 113,159 participants aged ≥18 years. Long-term exposure to PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) had associations with prevalence of hypertension, with the Odds Ratios and 95% confidence interval (CI) of 1.06 (95%CI: 1.03-1.09), 1.07 (95%CI: 1.04-1.09), 1.07 (95%CI: 1.04-1.10), 1.05 (95%CI: 1.01-1.08), 1.03 (95%CI: 1.00-1.06), and 1.03 (95%CI: 1.00-1.04), respectively. Effects of that except for black carbon on DBP with per interquartile upticks of concentration were 0.23 (95%CI: 0.11-0.35), 0.17 (95%CI: 0.04-0.29), 0.35 (95%CI: 0.21-0.48), 0.40 (95%CI: 0.28-0.52), and 0.25 (95%CI: 0.13-0.26), respectively. Ammonium was associated with SBP, corresponding to an increase of 0.18 (95%CI: 0.01-0.35). Males had higher risks of DBP (Z = 2.54-6.08, P < 0.001). Older people were substantially more affected by PM_2.5 and its components. Nitrate showed the highest contribution to hypertension, DBP and SBP compared with other components.

CONCLUSIONS

Long-term exposure to PM_2.5 and its components had adverse consequences on prevalence of hypertension, DBP and SBP, especially for males and older people. Nitrate contributed the highest to hypertension, DBP and SBP. Findings may have implications for pollution and hypertension control.

Road Traffic Noise and Incidence of Primary Hypertension: A Prospective Analysis in UK Biobank

Background

The quality of evidence regarding the associations between road traffic noise and hypertension is low due to the limitations of cross-sectional study design, and the role of air pollution remains to be further clarified.

Objectives

The purpose of this study was to evaluate the associations of long-term road traffic noise exposure with incident primary hypertension; we conducted a prospective population-based analysis in UK Biobank.

Methods

Road traffic noise was estimated at baseline residential address using the common noise assessment method model. Incident hypertension was ascertained through linkage with medical records. Cox proportional hazard models were used to estimate hazard ratios (HRs) for association in an analytical sample size of over 240,000 participants free of hypertension at baseline, adjusting for covariates determined via directed acyclic graph.

Results

During a median of 8.1 years follow-up, 21,140 incident primary hypertension (International Classification of Diseases-10th Revision [ICD-10]: I10) were ascertained. The HR for a 10 dB[A] increment in mean weighted average 24-hour road traffic noise level (L den ) exposure was 1.07 (95% CI: 1.02-1.13). A dose-response relationship was found, with HR of 1.13 (95% CI: 1.03-1.25) for L den >65 dB[A] vs ≤55 dB[A] (P for trend <0.05). The associations were all robust to adjustment for fine particles (PM2.5) and nitrogen dioxide (NO2). Furthermore, high exposure to both road traffic noise and air pollution was associated with the highest hypertension risk.

Conclusions

Long-term exposure to road traffic noise was associated with increased incidence of primary hypertension, and the effect estimates were stronger in presence of higher air pollution.

Association between polycyclic aromatic hydrocarbon exposure and hypertension among the U.S. adults in the NHANES 2003-2016: A cross-sectional study

The global burden of hypertension, the major cause of cardiovascular disease (CVD) globally, remains unresolved. Exposure to PM2.5 has been linked to hypertension (HTN) in adults and the elderly globally according to previous studies. Nonetheless, evidence on the association of polycyclic aromatic hydrocarbon (PAH) exposure and HTN risk in the general adult population in the United States was limited. To investigate the relationship between PAH exposure and HTN in adults in the United States, cross-sectional data during 2003 and 2016 from the National Health and Nutrition Examination Survey (NHANES) on a stratified multistage random sample of the civilian non-institutionalized population were utilized. After eliminating individuals with incomplete information of interest, the final analysis contained 8951 subjects aged ≥20. In the multivariate logistic regression model, 1-hydroxynaphthalene and 2-hydroxyfluorene were found positively associated with increased risk of HTN among overall participants after adjusting for the covariates. 1-hydroxynaphthalene and 2-hydroxynaphthalene showed positive associations with HTN risk among overweight participants. In the Bayesian kernel machine regression (BKMR) model, 1-hydroxynaphthalene and 2-hydroxyfluorene presented great importance to HTN risk among overall individuals. In the male subgroup analyses by BKMR, 2-hydroxyfluorene presented a positive effect on HTN risk when the remaining OH-PAHs were set at their 25th, 50th, and 75th percentile. Our findings highlight the complexities of estimating the risk of HTN associated with mixed PAH exposure, and additional longitudinal studies are required to determine the exact link between PAH exposure and HTN risk, as well as the underlying mechanisms.

Effects of ambient particulate exposure on blood lipid levels in hypertension inpatients

Background

With modernization development, multiple studies of atmospheric particulate matter exposure conducted in China have confirmed adverse cardiovascular health effects. However, there are few studies on the effect of particulate matter on blood lipid levels in patients with cardiovascular disease, especially in southern China. The purpose of this study was to investigate the association between short- and long-term exposure to ambient particulate matter and the levels of blood lipid markers in hypertension inpatients in Ganzhou, China.

Methods

Data on admission lipid index testing for hypertension inpatients which were divided into those with and without arteriosclerosis disease were extracted from the hospital's big data center from January 1, 2016 to December 31, 2020, and air pollution and meteorology data were acquired from the China urban air quality real time release platform from January 1, 2015 to December 31, 2020 and climatic data center from January 1, 2016 to December 31, 2020, with data integrated according to patient admission dates. A semi-parametric generalized additive model (GAM) was established to calculate the association between ambient particulate matter and blood lipid markers in hypertension inpatients with different exposure time in 1 year.

Results

Long-term exposure to particulate matter was associated with increased Lp(a) in three kinds of people, and with increased TC and decreased HDL-C in total hypertension and hypertension with arteriosclerosis. But particulate matter was associated with increased HDL-C for hypertension inpatients without arteriosclerosis, at the time of exposure in the present study. It is speculated that hypertension inpatients without arteriosclerosis has better statement than hypertension inpatients with arteriosclerosis on human lipid metabolism.

Conclusion

Long-term exposure to ambient particulate matter is associated with adverse lipid profile changes in hypertension inpatients, especially those with arteriosclerosis. Ambient particulate matter may increase the risk of arteriosclerotic events in hypertensive patients.

Relationship between occupational noise exposure and hypertension: Cross-sectional evidence from real-world

Background

Occupational noise is one of the most common and prevalent occupational hazards worldwide and may induce adverse auditory and/or non-auditory health effects. However, the relationship between occupational noise exposure and hypertension is controversial and has long been debated.

Methods

Based on large sample cross-sectional data from all registered occupational health examination units from 2021 to 2022 (N = 101,605), this study aimed to analyze the prevalence of hearing loss and hypertension and to explore the influencing factors of hypertension of workers in Wuhan. Descriptive statistics, univariate analyses and multivariate analyses were used. Forest plot and nomograms were constructed for the visualization of predictive results. The ROC curve, AUC, C-index and calibration curves were used to assess the predictive accuracy and validity. DCA was performed to evaluate the net benefit that workers could receive.

Results

Higher rate of high-frequency hearing loss (25.3%), speech frequency hearing loss (8.8%), ECG abnormalities (31.9%) and hypertension (21.0%) were found in workers exposed to occupational noise in Wuhan. Occupational noise exposure (OR = 1.09, 95% CI: 1.01-1.18, p = 0.04), growth of age (OR: 1.07, 95% CI: 1.07-1.07, p < 0.001), overweight (OR: 1.82, 95% CI: 1.73-1.92, p < 0.001), obesity (OR: 3.62, 95% CI: 3.42-3.83, p < 0.001), hyperglycemia (OR: 1.84, 95% CI: 1.73-1.96, p < 0.001), hypercholesterolemia (OR = 1.34; 95% CI 1.22-1.48; p < 0.001), ECG abnormalities (OR = 1.11; 95% CI 1.07-1.15; p < 0.001) and family history of hypertension (OR = 1.69; 95% CI 1.58-1.81; p < 0.001) were risk factors of hypertension for workers. Male workers had a relatively higher hypertension risk than female workers (OR = 1.61; 95% CI 1.54-1.69; p < 0.001). Ear protective measures could not reduce the risk of hypertension in workers. Our nomogram has good predictive accuracy and validity. A dynamic nomogram to predict the workers' risk of hypertension was established publicly available online.

Conclusion

Occupational noise exposure may elevate workers' hypertension risk. More effective and relevant prevention measures should be taken. Our nomogram may help identify high-risk workers and facilitate timely interventions.

Relationship Between Occupational Noise and Hypertension in Modern Enterprise Workers: A Case–Control Study

Objective: The association between occupational noise exposure and hypertension is controversial. Thus, we aimed to assess the relationship between occupational noise exposure and hypertension.

Methods: This was a case‒control study, and 509 cases and 1,018 controls from an automobile company were included between July and October 2013. Occupational noise exposure was defined as exposure to noise level ≥80 dB(A) (Lex, 8 h) or cumulative noise exposure (CNE) ≥ 80 dB(A)-years. To assess the associations of noise level and CNE with hypertension, univariate and multivariate logistic regression were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The restricted cubic spline function was used to establish dose‒response curves.

Results: A noise level ≥80 dB (A) (Lex, 8 h) was significantly associated with hypertension (OR 2.48, 95% CI 1.89–3.24). CNE ≥80 dB (A)-years was significantly associated with hypertension (OR 1.53, 95% CI 1.18–2.00). Nonlinear relationships between noise level, CNE and hypertension were found (p- nonlinear<0.05).

Conclusion: Our study suggests that occupational noise exposure is a potential risk factor for hypertension in automobile company workers.