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Xu J, Shi Y, He G, Guo Y, Ruan Y, Hu J, Zhu Q, Chen Z, Liang S, Zheng Y, Huang Z, Yu S, Zhu R, Dong X, Wu F, Ma W, Liu T. Effects of Long-Term Exposure to Ambient Formaldehyde on Hypertension and Angina Pectoris Symptoms: Evidence From the WHO SAGE Cohort Study. J Am Heart Assoc 2024; 13:e035341. [PMID: 39291508 DOI: 10.1161/jaha.124.035341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/13/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND We aimed to investigate the associations of long-term exposure to ambient formaldehyde with hypertension and angina pectoris symptoms in Chinese adults. METHODS AND RESULTS Participants' information was obtained from the WHO SAGE (World Health Organization Study on Global Aging and Adult Health) study. The Cox proportional hazards regression model was applied to estimate the associations of formaldehyde with hypertension and angina pectoris symptoms. Mediating effect analysis was used to investigate the mediating effect of hypertension between formaldehyde exposure and angina pectoris symptoms. Long-term exposure to formaldehyde was positively associated with the risk of angina pectoris symptoms (hazard ratio [HR], 1.66 [95% CI, 1.29-2.13], per interquartile range [IQR], 3.33, 1015 molecules/cm2) and hypertension (HR, 1.17 [95% CI, 1.02-1.34], per IQR, 3.34, 1015 molecules/cm2). The associations between formaldehyde and angina pectoris symptoms were greater in participants aged ≥65 years (HR, 1.90 [95% CI, 1.29-2.80]) and in rural areas (HR, 2.71 [95% CI, 1.54-4.77]), whereas the associations of formaldehyde with hypertension were stronger in men (HR, 1.27 [95% CI, 1.02-1.58]), rural areas (HR, 1.22 [95% CI, 0.94-1.59]), and in ever smokers (HR, 1.33 [95% CI, 1.02-1.72]). The mediation effect analysis indicated that 18.44% (95% CI, 2.17-37.65) of the association between formaldehyde exposure and angina pectoris symptoms was mediated by hypertension. CONCLUSIONS Long-term exposure to ambient formaldehyde was positively associated with hypertension and angina pectoris symptoms. The effects of formaldehyde may be modified by age, sex, urbanicity, and smoking status. Hypertension might play a mediating effect in formaldehyde-induced angina pectoris symptoms.
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Affiliation(s)
- Jiahong Xu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yan Shi
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yanfei Guo
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Ye Ruan
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Shuru Liang
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yuan Zheng
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Zhongguo Huang
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Ruotong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Fan Wu
- Department of Epidemiology, School of Public Health Fudan University Shanghai China
- Shanghai Institute of Infectious Disease and Biosecurity Fudan University Shanghai China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control(Jinan University) Ministry of Education Guangzhou China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control(Jinan University) Ministry of Education Guangzhou China
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Lee EY, Park S, Kim YB, Lee M, Lim H, Ross-White A, Janssen I, Spence JC, Tremblay MS. Exploring the Interplay Between Climate Change, 24-Hour Movement Behavior, and Health: A Systematic Review. J Phys Act Health 2024:1-19. [PMID: 39187251 DOI: 10.1123/jpah.2023-0637] [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: 10/23/2023] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Given the emergence of climate change and health risks, this review examined potential relationships between varying indicators of climate change, movement behaviors (ie, physical activity [PA], sedentary behavior, and sleep), and health. METHODS Seven databases were searched in March 2020, April 2023, and April 2024. To be included, studies must have examined indicators of climate change and at least one of the movement behaviors as either an exposure or a third variable (ie, mediator/moderator), and a measure of health as outcome. Evidence was summarized by the role (mediator/moderator) that either climate change or movement behavior(s) has with health measures. Relationships and directionality of each association, as well as the strength and certainty of evidence were synthesized. RESULTS A total of 79 studies were eligible, representing 6,671,791 participants and 3137 counties from 25 countries (40% low- and middle-income countries). Of 98 observations from 17 studies that examined PA as a mediator, 34.7% indicated that PA mediated the relationship between climate change and health measure such that indicators of adverse climate change were associated with lower PA, and worse health outcome. Of 274 observations made from 46 studies, 28% showed that PA favorably modified the negative association between climate change and health outcome. Evidence was largely lacking and inconclusive for sedentary behavior and sleep, as well as climate change indicators as an intermediatory variable. CONCLUSIONS PA may mitigate the adverse impact of climate change on health. Further evidence is needed to integrate PA into climate change mitigation, adaptation, and resilience strategies.
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Affiliation(s)
- Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Department of Gender Studies, Queen's University, Kingston, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa,ON, Canada
- Institute of Sport Science, Seoul National University, Seoul, South Korea
| | - Seiyeong Park
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Institute of Sport Science, Seoul National University, Seoul, South Korea
| | - Yeong-Bae Kim
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Mikyung Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Heejun Lim
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Bracken Health Sciences Library, Queen's University, Kingston, ON, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Department of Health Sciences, Queen's University, Kingston, ON, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa,ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Xu H, He X, Zhang B, Li M, Zhu Y, Wang T, Liu S, Shu M, Ding D, Wang Y, Zhao Q, Li J, Song X, Huang W. Low-level ambient ozone exposure associated with neutrophil extracellular traps and pro-atherothrombotic biomarkers in healthy adults. Atherosclerosis 2024; 395:117509. [PMID: 38523002 DOI: 10.1016/j.atherosclerosis.2024.117509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/31/2024] [Accepted: 03/05/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND AND AIMS Uncertainty of the causality determinations for ambient ozone (O3) on cardiovascular events is heightened by the limited understanding of the mechanisms involved in humans. We aimed to examine the pro-atherothrombotic impacts of O3 exposure and to explore the potential mediating roles of dysfunctional neutrophils, focusing on neutrophil extracellular traps (NETs). METHODS A longitudinal panel study of 152 healthy adults was conducted in the cool to cold months with relatively low levels of O3 between September 2019 and January 2020 in Beijing, China. Four repeated measurements of indicators reflecting atherothrombotic balance and NETs were performed for each participant. RESULTS Daily average exposure levels of ambient O3 were 16.6 μg/m3 throughout the study period. Per interquartile range increase in average concentrations of O3 exposure at prior up to 7 days, we observed elevations of 200.1-276.3% in D-dimer, 27.2-36.8% in thrombin-antithrombin complex, 10.8-60.3% in plasminogen activator inhibitor 1, 13.9-21.8% in soluble P-selectin, 16.5-45.1% in matrix metalloproteinase-8, and 2.4-12.4% in lipoprotein-associated phospholipase A2. These pro-atherothrombotic changes were accompanied by endothelial activation, lung injury, and immune inflammation. O3 exposure was also positively associated with circulating NETs indicators, including citrullinated histone H3, neutrophil elastase, myeloperoxidase, and double-stranded DNA. Mediation analyses indicated that NETs could mediate O3-associated pro-atherothrombotic responses. The observational associations remained significant and robust after controlling for other pollutants, and were generally greater in participants with low levels of physical activity. CONCLUSIONS Ambient O3 exposure was associated with significant increases in NETs and pro-atherothrombotic potential, even at exposure levels well below current air quality guidelines of the World Health Organization.
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Affiliation(s)
- Hongbing Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Xinghou He
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Bin Zhang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Mengyao Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Yutong Zhu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Shengcong Liu
- Division of Cardiology, Peking University First Hospital, Beijing, China
| | - Mushui Shu
- Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, China
| | - Ding Ding
- Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, China
| | - Yu Wang
- Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, China
| | - Qian Zhao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Jianping Li
- Division of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
| | - Wei Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
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Wu P, Guo Q, Zhao Y, Bian M, Cao S, Zhang J(J, Duan X. Emerging concern on air pollution and health: Trade-off between air pollution exposure and physical activity. ECO-ENVIRONMENT & HEALTH 2024; 3:202-207. [PMID: 38655004 PMCID: PMC11035044 DOI: 10.1016/j.eehl.2024.01.012] [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: 09/03/2023] [Revised: 12/31/2023] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
Air pollution is a major contributor to the global disease burden, especially affecting respiratory and cardiovascular health. However, physical activity is associated with improved lung function, a slower decline in lung function, and lower mortality. The public is more likely to be exposed to air pollution during outdoor physical activity. However, studies on how long-term and short-term exposure to air pollution interacts with physical activity yield inconsistent results, and the thresholds for air pollution and physical activity remain unclear. Thus, more studies are needed to provide sufficient evidence to guide the public to safely engage in outdoor physical activity when exposed to air pollution.
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Affiliation(s)
- Pengpeng Wu
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Qian Guo
- China North Artificial Intelligence & Innovation Research Institute, Beiing 100072, China
- Collective Intelligence & Collaboration Laboratory, Beijing 100072, China
| | - Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA
- Duke Kunshan University, Kunshan 215316, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
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5
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Song J, Wang BH, Gao Y, Chen Y, Sun X, Zhang Z, Wu IXY, Dai W. Interaction of physical activity and low-level air pollution on cardiovascular disease: a prospective cohort study in UK Biobank. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:188. [PMID: 38696021 DOI: 10.1007/s10653-024-01922-7] [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: 12/20/2023] [Accepted: 02/19/2024] [Indexed: 06/17/2024]
Abstract
To investigate the associations of physical activity (PA), low-level air pollution, and interaction on cardiovascular diseases (CVD) incidence based on the UK Biobank. PA was measured by the International Physical Activity Questionnaire and five air pollutants were estimated using Land Use Regression. All association estimates were based on Cox regression. Dose-response relationship was explored by restricted cubic spline, while multiplicative and additive interaction were examined by Pinteraction and relative excess risk due to interaction (RERI). As deviating proportional hazards assumption, we analyzed data as follow-up < 4 years and ≥ 4 years, separately. PA with 1000-4000 Metabolic Equivalent Task (MET) min/week showed the strongest protective impact on CVD incidence, while only low-level nitrogen dioxides (NO2) showed negative impact among five air pollutants and was considered for further analysis. Multiplicative interaction between PA and NO2 was observed during ≥ 4 years follow-up (Pinteraction = 0.049) while not during < 4 years (Pinteraction = 0.290). Positive additive interactions were found for high PA and low NO2 (< 20 μg/m3) group (RERI: 0.07, 95% confidence intervals: 0.02-0.11) during < 4 years, and for moderate PA with NO2 at 40- μg/m3 (0.07, 0.02-0.13) and < 20 μg/m3 (0.07, 0.02-0.12), while high PA showed similar results with NO2 at 40-, 20- and < 20 μg/m3 during ≥ 4 years. PA about 1000-4000 METs min/week showed the lowest CVD risk. Possibility of interaction with PA and NO2 is more likely to present with the increase in follow-up duration. We call for the optimal thresholds of PA, and exploring interaction thoroughly by considering types of PA.
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Affiliation(s)
- Jinlu Song
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Zixuan Zhang
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, Hunan, China.
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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Abstract
Ubiquitous environmental exposures increase cardiovascular disease risk via diverse mechanisms. This review examines personal strategies to minimize this risk. With regard to fine particulate air pollution exposure, evidence exists to recommend the use of portable air cleaners and avoidance of outdoor activity during periods of poor air quality. Other evidence may support physical activity, dietary modification, omega-3 fatty acid supplementation, and indoor and in-vehicle air conditioning as viable strategies to minimize adverse health effects. There is currently insufficient data to recommend specific personal approaches to reduce the adverse cardiovascular effects of noise pollution. Public health advisories for periods of extreme heat or cold should be observed, with limited evidence supporting a warm ambient home temperature and physical activity as strategies to limit the cardiovascular harms of temperature extremes. Perfluoroalkyl and polyfluoroalkyl substance exposure can be reduced by avoiding contact with perfluoroalkyl and polyfluoroalkyl substance-containing materials; blood or plasma donation and cholestyramine may reduce total body stores of perfluoroalkyl and polyfluoroalkyl substances. However, the cardiovascular impact of these interventions has not been examined. Limited utilization of pesticides and safe handling during use should be encouraged. Finally, vasculotoxic metal exposure can be decreased by using portable air cleaners, home water filtration, and awareness of potential contaminants in ground spices. Chelation therapy reduces physiological stores of vasculotoxic metals and may be effective for the secondary prevention of cardiovascular disease.
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Affiliation(s)
- Luke J Bonanni
- Grossman School of Medicine (L.J.B.), NYU Langone Health, New York, NY
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Thakrar SK. Time to Review Air Quality Activity Guidelines. JAMA Netw Open 2024; 7:e245259. [PMID: 38587848 DOI: 10.1001/jamanetworkopen.2024.5259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Affiliation(s)
- Sumil K Thakrar
- Department of Applied Economics, University of Minnesota, St Paul
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8
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Liu S, Lv Y, Zhang Y, Suo H, Wang F, Gao S. Global trends and burden of stroke attributable to particulate matter pollution from 1990 to 2019. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 274:116205. [PMID: 38503105 DOI: 10.1016/j.ecoenv.2024.116205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To investigate the association between particulate matter and the incidence, disability, and mortality of stroke, we reported the burden of stroke attributable to particulate matter (PM2.5) pollution, including ambient particulate matter pollution (APMP) and household air pollution from solid fuels (HAP), from 1990 to 2019. METHODS We retrieved the detailed data on the burden of stroke attributable to PM2.5 from the Global Burden of Disease (GBD) 2019. The number of disability-adjusted life-years (DALYs) and deaths, age-standardized death rates (ASMR), and age-standardized disability-adjusted life-years rates (ASDR) attributable to PM2.5 were estimated by age, sex, geographical location, socio-demographic index (SDI), and stroke subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage). The estimated annual percentage change (EAPC) was calculated to assess the trends in ASDR and ASMR during the period 1990-2019. RESULTS Regarding stroke subtypes, the proportion of ischemic stroke burden is increasing, while intracerebral hemorrhage carries the heaviest burden. Both APMP and HAP contributed the most to stroke-related deaths and DALYs of stroke among the elderly populations and males. The highest ASDR and ASMR of stroke attributable to APMP were in the middle SDI regions, especially in East Asia. For HAP, the highest ASDR and ASMR were in the low SDI regions, mainly in Oceania. From 1990-2019, in terms of the EAPC results, APMP caused an increased burden of stroke, whereas the impact of HAP significantly fell. The most pronounced increase in ASDR and ASMR for strokes attributed to APMP were in the low-middle SDI and low SDI regions, particularly among the 25-35 age group. CONCLUSIONS Stroke attributed to PM2.5 is a global health problem, and the patterns and trends were heterogeneous across APMP and HAP. Targeted interventions should be formulated for APMP and HAP.
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Affiliation(s)
- Siqi Liu
- Department of Toxicology, School of Public Health, Harbin Medical University, Heilongjiang Province, China
| | - Yanming Lv
- Department of Toxicology, School of Public Health, Harbin Medical University, Heilongjiang Province, China
| | - Ya Zhang
- Department of Toxicology, School of Public Health, Harbin Medical University, Heilongjiang Province, China
| | - Huimin Suo
- Department of Toxicology, School of Public Health, Harbin Medical University, Heilongjiang Province, China
| | - Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Heilongjiang Province, China
| | - Shuying Gao
- Department of Toxicology, School of Public Health, Harbin Medical University, Heilongjiang Province, China.
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9
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Hu X, Knibbs LD, Zhou Y, Ou Y, Dong GH, Dong H. The role of lifestyle in the association between long-term ambient air pollution exposure and cardiovascular disease: a national cohort study in China. BMC Med 2024; 22:93. [PMID: 38439026 PMCID: PMC10913402 DOI: 10.1186/s12916-024-03316-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) caused by air pollution poses a considerable burden on public health. We aim to examine whether lifestyle factors mediate the associations of air pollutant exposure with the risk of CVD and the extent of the interaction between lifestyles and air pollutant exposure regarding CVD outcomes. METHODS We included 7000 participants in 2011-2012 and followed up until 2018. The lifestyle evaluation consists of six factors as proxies, including blood pressure, blood glucose, blood lipids, body mass index, tobacco exposure, and physical activity, and the participants were categorized into three lifestyle groups according to the number of ideal factors (unfavorable, 0-1; intermediate, 2-4; and favorable, 5-6). Satellite-based spatiotemporal models were used to estimate exposure to ambient air pollutants (including particles with diameters ≤ 1.0 μm [PM1], ≤ 2.5 μm [PM2.5], ≤ 10 μm [PM10], nitrogen dioxide [NO2], and ozone [O3]). Cox regression models were used to examine the associations between air pollutant exposure, lifestyles and the risk of CVD. The mediation and modification effects of lifestyle categories on the association between air pollutant exposure and CVD were analyzed. RESULTS After adjusting for covariates, per 10 μg/m3 increase in exposure to PM1 (HR: 1.09, 95% CI: 1.05-1.14), PM2.5 (HR: 1.04, 95% CI: 1.00-1.08), PM10 (HR: 1.05, 95% CI: 1.03-1.08), and NO2 (HR: 1.11, 95% CI: 1.05-1.18) was associated with an increased risk of CVD. Adherence to a healthy lifestyle was associated with a reduced risk of CVD compared to an unfavorable lifestyle (HR: 0.65, 95% CI: 0.56-0.76 for intermediate lifestyle and HR: 0.41, 95% CI: 0.32-0.53 for favorable lifestyle). Lifestyle played a significant partial mediating role in the contribution of air pollutant exposure to CVD, with the mediation proportion ranging from 7.4% for PM10 to 14.3% for PM2.5. Compared to an unfavorable lifestyle, the relative excess risk due to interaction for a healthier lifestyle to reduce the effect on CVD risk was - 0.98 (- 1.52 to - 0.44) for PM1, - 0.60 (- 1.05 to - 0.14) for PM2.5, - 1.84 (- 2.59 to - 1.09) for PM10, - 1.44 (- 2.10 to - 0.79) for NO2, and - 0.60 (- 1.08, - 0.12) for O3. CONCLUSIONS Lifestyle partially mediated the association of air pollution with CVD, and adherence to a healthy lifestyle could protect middle-aged and elderly people from the adverse effects of air pollution regarding CVD.
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Affiliation(s)
- Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Yanqiu Ou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
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Wang R, Gao K, Wang L, Gong X, Wu Y, Zheng L, Han S, Li L, Xue M. A cross-sectional study exploring the relationship between oxidative balance score and 10-year atherosclerotic cardiovascular disease risk based on the National Health and Nutrition Examination Survey (2011-2020). Diab Vasc Dis Res 2024; 21:14791641241244658. [PMID: 38597578 PMCID: PMC11008352 DOI: 10.1177/14791641241244658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The intricate interaction between oxidative stress and atherosclerotic cardiovascular disease (ASCVD) is an essential area of research because of the potential role of oxidative homeostasis in regulating ASCVD risk. This study aimed to investigate the relationship between the oxidative balance score (OBS) and the 10-years risk of ASCVD to gain insight into how oxidative balance affects cardiovascular health. METHODS This cross-sectional study analyzed National Health and Nutrition Examination Survey (NHANES) 2011-2020 data (40-79 age group), exploring OBS's link to 10-years ASCVD risk. OBS categorized dietary and lifestyle factors. Multivariate logistic regression controlled for age, sex, race, and demographics. A restricted cubic spline examined linear relationships; robustness was ensured through subgroup analyses. RESULTS Analysis of 4955 participants reveals a negative association between OBS and 10-years ASCVD risk. Continuous OBS adjusted OR: 0.97 (95% CI: 0.95∼0.99, p < .001). Quartile analysis shows reduced risk in Q2 0.88 (95% CI: 0.63∼1.22, p = .43), Q3 0.92 (95% CI: 0.66∼1.28, p = .614), and Q4 0.59 (95% CI: 0.42∼0.83, p = .002) compare Q1. Quartile analysis indicated decreasing risk in higher OBS quartiles. Lifestyle OBS and Dietary OBS demonstrated similar trends. Stratified analyses highlight race and hypertension as effect modifiers (p < .05). CONCLUSION Our study suggests an association between higher OBS and a reduced 10-years ASCVD risk. However, causation should not be inferred, and in the future, more extensive clinical and fundamental research is required to delve deeper into this association.
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Affiliation(s)
- Rumeng Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kun Gao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lianhua Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao Gong
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanyan Wu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liying Zheng
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Senfu Han
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lizhi Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mei Xue
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Jung J, Kim G, Kang SW, Jeong S, Kang Y, Lee JY, Myung W, Kim H, Lee H. Short-term exposure to ambient air pollution and injuries due to external causes according to intentions and mechanisms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169202. [PMID: 38097073 DOI: 10.1016/j.scitotenv.2023.169202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023]
Abstract
Although injuries are a leading cause of death and affect the life expectancy of individuals who live with disabilities globally, the potential role of air pollution exposure on injuries due to external causes has received little scientific attention, especially compared with that given to the association of air pollution and non-external causes of morbidity and mortality. We investigated the association between emergency department visits for externally caused injuries and short-term exposure to major ambient air pollutants, with focus on the intentions and mechanisms of injuries. We identified 2,049,855 injured patients in Seoul, South Korea between 2008 and 2016 using the National Emergency Database. Daily short-term exposure to air pollution including particles <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) was estimated based on hourly concentrations. We employed a time-stratified case-crossover study design using a conditional Poisson regression model adjusted for meteorological variables, influenza epidemics, and holidays. Immediate exposure (lag 0) to most pollutants significantly increased the risk of total injuries (PM2.5, 0.42 %; NO2, 0.68 %; SO2, 1.05 %; CO, 0.57 %; O3, 1.86 % per interquartile range increment), and the associations differed according to the intention and mechanism of injury. Unintentional and assault injuries were significantly associated with air pollution exposure, whereas self-harm injuries showed no association. In mechanism-specific analyses, injuries caused by falls, blunt objects, penetration, traffic accidents, machinery, and slips were associated with specific air pollutants, even in the co-pollutant models. The associations were stronger in injured patients aged <15 years, and in males than in their counterparts. Our results suggest that short-term air pollution exposure might play a role in the risk of externally caused injuries and the association may differ depending on the intention and mechanism of injury, which provide important evidence for injury prevention and air quality strategies.
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Affiliation(s)
- Jiyun Jung
- Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang, South Korea; Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, South Korea
| | - Gyeongchan Kim
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Sun-Woo Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Subin Jeong
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Yoonjung Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho Kim
- Department of Public Health Science, School of Public Health, Seoul National University, Seoul, South Korea
| | - Hyewon Lee
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea; Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, South Korea; Department of Software Convergence, Soonchunhyang University Graduate School, Asan, South Korea.
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12
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Kim K, Jeong S, Choi S, Chang J, Choi D, Lee G, Kim SR, Park SM. Cardiovascular Benefit of Statin Use Against Air Pollutant Exposure in Older Adults. Eur J Prev Cardiol 2024:zwae061. [PMID: 38365315 DOI: 10.1093/eurjpc/zwae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND AND AIMS Little is known about the cardiovascular benefit of statin use against ambient air pollution among older adults who are at higher risk of cardiovascular disease (CVD) potentially owing to age-related declines in cardiovascular functions along with other risk factors. METHODS AND RESULTS This retrospective, population-based cohort study consisted of adults aged 60 years and older free of CVD at baseline identified from the National Health Insurance Service (NHIS) database linked to the National Ambient Air Monitoring Information System (NAMIS) for average daily exposure to PM10 and PM2.5 in 2015 in the major metropolitan areas in the Republic of Korea. Follow-up period began on January 1, 2016 and lasted until December 31, 2021. Cox proportional hazards model was used to evaluate association of cardiovascular benefit with statin use against different levels of air pollutant exposure. Of 1,229,444 participants aged 60 years and older (mean age, 67.4; 37.7% male), 377,076 (30.7%) were identified as statin-users. During 11,963,322 person-years (PY) of follow-up, a total of 86,018 incident stroke events occurred (719.0 events per 100,000 PYs). Compared to statin non-user exposed to high level of PM10 (>50 µg/m3) and PM2.5 (>25 µg/m3), statin users had 20% (adjusted hazard ratio [HR], 0.80; 95% confidence intervals [CI], 0.75 to 0.85) and 17% (adjusted HR, 0.80; 95% CI, 0.80 to 0.86) lower adjusted risk of incident stroke for PM10 and PM2.5, respectively. Similar risk reduction for incident CVD was also found among statin-users exposed to low or moderate level of PM10 (≤50 µg/m3) and PM2.5 (≤25 µg/m3) exposure. CONCLUSION Among adults aged 60 years and older with high and low or moderate levels of exposure to PM10 and PM2.5, statin use was associated with a significantly lower risk of stroke.
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Affiliation(s)
- Kyuwoong Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seulggie Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Daein Choi
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York, USA
| | - Gyeongsil Lee
- KS Health Link Institute and Life Clinic, Seoul, Republic of Korea
| | - Seong Rae Kim
- Department of Dermatology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Min Park
- XAIMED Co. Ltd, Seoul, Republic of Korea
- Department of Dermatology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea 9Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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13
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Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH, De Smet S. Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 2024; 37:12448. [PMID: 38414660 PMCID: PMC10898592 DOI: 10.3389/ti.2024.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.
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Affiliation(s)
- Dimitri Stylemans
- Department of Respiratory Diseases, Pulmonary Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Marieke Vandecruys
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Leunis
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Engelborghs
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Davide Gargioli
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
- Transplantoux Foundation, Leuven, Belgium
| | - Véronique Cornelissen
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Amaryllis H. Van Craenenbroeck
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Nephrology and Kidney Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Stefan De Smet
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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14
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De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F, Covino M. The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases. J Clin Med 2024; 13:759. [PMID: 38337453 PMCID: PMC10856578 DOI: 10.3390/jcm13030759] [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: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.
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Affiliation(s)
- Antonio De Vita
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Antonietta Belmusto
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Federico Di Perna
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Saverio Tremamunno
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Giuseppe De Matteis
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Francesco Franceschi
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
| | - Marcello Covino
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
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15
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Lee HH, Lee H, Bhatt DL, Kang D, Youn JC, Shin DW, Cho J, Kim HC. Changes in physical activity and incident cardiovascular events in cancer survivors. Eur Heart J 2023; 44:4997-5000. [PMID: 37847791 DOI: 10.1093/eurheartj/ehad677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine,Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine,Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, NewYork, NY, USA
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Wook Shin
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine,Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
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16
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Tao J, Zhang Y, Li Z, Yang M, Huang C, Hossain MZ, Xu Y, Wei X, Su H, Cheng J, Zhang W. Daytime and nighttime high temperatures differentially increased the risk of cardiovascular disease: A nationwide hospital-based study in China. ENVIRONMENTAL RESEARCH 2023; 236:116740. [PMID: 37495061 DOI: 10.1016/j.envres.2023.116740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/01/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023]
Abstract
Short-term exposure to ambient high temperature (heat) could increase the risk of cardiovascular disease (CVD). However, available evidence on the burden of daytime and nighttime heat on CVD is limited and vulnerable populations remain unknown so far. We aimed to examine and differentiate the impact of daytime and nighttime heat on CVD in China. Data on daily outpatient visits for CVD were collected from 15 Chinese cities spanning multiple geographical regions, climates, and socio-economic conditions. The population-weighted temperature was used to calculate excess heat exposure in warm seasons (June-September) from 2011 to 2015. Hot day excess (HDE) and hot night excess (HNE), the sum of temperature above the heat threshold during daytime and nighttime respectively, were used to represent daytime and nighttime excess heat. A distributed lag non-linear model was employed to estimate the city-level association between HDE/HNE and daily CVD cases. The city-level association was then pooled by multivariate meta-analysis. We further estimated the disease burden of CVD attributable to HDE and HNE by geographical regions, gender, and age. A total of 729,409 cases of CVD were included in this study. Both HDE and HNE were associated with an increased risk of CVD, with greater effects from nighttime heat (relative risk (RR): 1.38; 95% confidence interval (CI): 1.18-1.61) than daytime heat (RR: 1.10; 95% CI: 1.05-1.15). The proportion of CVD cases attributable to HNE was 15.7%, which was almost three times as high as HDE (4.6%, p for difference <0.05). Males, people living in northern cities, and those aged less than 45 years were more vulnerable to HNE. Our findings for the first time revealed an intra-day difference in the heat effect on CVD, with a greater impact from nighttime heat exposure, which should be considered to protect vulnerable populations on hot days.
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Affiliation(s)
- Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Zhiwei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Min Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xianyu Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
| | - Wenyi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Chinese PLA Center for Disease Control and Prevention, Beijing, China.
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17
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Qi W, Mei Z, Sun Z, Lin C, Lin J, Li J, Ji JS, Zheng Y. Exposure to Multiple Air Pollutants and the Risk of Fractures: A Large Prospective Population-Based Study. J Bone Miner Res 2023; 38:1549-1559. [PMID: 37341992 DOI: 10.1002/jbmr.4872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023]
Abstract
Atmospheric chemistry studies suggest air pollution impedes ultraviolet B photons and thus reduces cutaneous vitamin D3 synthesis. Biological evidence shows that inhaled pollutants disrupt circulating 25-hydroxyvitamin D (25[OH]D) metabolism and ultimately impact bone health. The hypothesis is that higher air pollution concentrations are associated with a higher risk of fractures, mediated by lower circulating 25(OH)D. The study included participants of the UK Biobank who were free of fracture history at enrollment (2006 to 2010) and analyzed their environmental exposure data (2007 to 2010). Air pollution measurements included the annual averages of air particulate matter (PM2.5 , PM2.5-10 , and PM10 ), nitrogen oxides (NO2 and NOx ), and a composite air pollution score. Multivariable Cox proportional hazard models were used to assess the associations of the individual pollutants and the score with fracture risks. Mediation analyses were conducted to assess the underlying role of serum 25(OH)D in such associations. Among 446,395 participants with a median of 8-year follow-up, 12,288 incident fractures were documented. Participants living in places with the highest quintile of air pollution score had a 15.3% increased risk of fractures (hazard ratio [95%CI]: 1.15[1.09,1.22]) compared to those in the lowest, and 5.49% of this association was mediated through serum 25(OH)D (pmediation < 0.05). Pollutant-specific hazard of top-to-bottom quintiles was 16% for PM2.5 , 4% for PM2.5-10 , 5% for PM10 , 20% for NO2 , and 17% for NOx , with a 4% to 6% mediation effect of serum 25(OH)D concentrations. The associations of the air pollution score with fracture risks were weaker among female participants, those who drank less alcohol, and consumed more fresh fruit than their counterparts (pinteraction < 0.05). © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Wenhao Qi
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhendong Mei
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Chenhao Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jinran Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jialin Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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Kvandová M, Rajlic S, Stamm P, Schmal I, Mihaliková D, Kuntic M, Bayo Jimenez MT, Hahad O, Kollárová M, Ubbens H, Strohm L, Frenis K, Duerr GD, Foretz M, Viollet B, Ruan Y, Jiang S, Tang Q, Kleinert H, Rapp S, Gericke A, Schulz E, Oelze M, Keaney JF, Daiber A, Kröller-Schön S, Jansen T, Münzel T. Mitigation of aircraft noise-induced vascular dysfunction and oxidative stress by exercise, fasting, and pharmacological α1AMPK activation: molecular proof of a protective key role of endothelial α1AMPK against environmental noise exposure. Eur J Prev Cardiol 2023; 30:1554-1568. [PMID: 37185661 DOI: 10.1093/eurjpc/zwad075] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/22/2023] [Accepted: 03/11/2023] [Indexed: 05/17/2023]
Abstract
AIMS Environmental stressors such as traffic noise represent a global threat, accounting for 1.6 million healthy life years lost annually in Western Europe. Therefore, the noise-associated health side effects must be effectively prevented or mitigated. Non-pharmacological interventions such as physical activity or a balanced healthy diet are effective due to the activation of the adenosine monophosphate-activated protein kinase (α1AMPK). Here, we investigated for the first time in a murine model of aircraft noise-induced vascular dysfunction the potential protective role of α1AMPK activated via exercise, intermittent fasting, and pharmacological treatment. METHODS AND RESULTS Wild-type (B6.Cg-Tg(Cdh5-cre)7Mlia/J) mice were exposed to aircraft noise [maximum sound pressure level of 85 dB(A), average sound pressure level of 72 dB(A)] for the last 4 days. The α1AMPK was stimulated by different protocols, including 5-aminoimidazole-4-carboxamide riboside application, voluntary exercise, and intermittent fasting. Four days of aircraft noise exposure produced significant endothelial dysfunction in wild-type mice aorta, mesenteric arteries, and retinal arterioles. This was associated with increased vascular oxidative stress and asymmetric dimethylarginine formation. The α1AMPK activation with all three approaches prevented endothelial dysfunction and vascular oxidative stress development, which was supported by RNA sequencing data. Endothelium-specific α1AMPK knockout markedly aggravated noise-induced vascular damage and caused a loss of mitigation effects by exercise or intermittent fasting. CONCLUSION Our results demonstrate that endothelial-specific α1AMPK activation by pharmacological stimulation, exercise, and intermittent fasting effectively mitigates noise-induced cardiovascular damage. Future population-based studies need to clinically prove the concept of exercise/fasting-mediated mitigation of transportation noise-associated disease.
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Affiliation(s)
- Miroslava Kvandová
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Institute of Normal and Pathological Physiology, Center of Experimental Medicine, Slovak Academy of Sciences, Sienkiewiczova 1813 71 Bratislava, Slovak Republic
| | - Sanela Rajlic
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiovascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Paul Stamm
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Isabella Schmal
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Dominika Mihaliková
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marin Kuntic
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Maria Teresa Bayo Jimenez
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marta Kollárová
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Institute of Physiology, Faculty of Medicine, Comenius University Bratislava, Sasinkova 2, 811 08 Bratislava, Slovakia
| | - Henning Ubbens
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Lea Strohm
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Katie Frenis
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Georg Daniel Duerr
- Department of Cardiovascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Marc Foretz
- Université Paris Cité, CNRS, INSERM, Institut Cochin, F-75014 Paris, France
| | - Benoit Viollet
- Université Paris Cité, CNRS, INSERM, Institut Cochin, F-75014 Paris, France
| | - Yue Ruan
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Subao Jiang
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Qi Tang
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Hartmut Kleinert
- Department of Pharmacology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Steffen Rapp
- Department of Cardiology, Preventive Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | | | - Matthias Oelze
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - John F Keaney
- Division of Cardiovascular Medicine, UMass Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Andreas Daiber
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Swenja Kröller-Schön
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Thomas Jansen
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Cardiology, KVB Hospital Königstein, 61462 Königstein, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I-Laboratory of Molecular Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131 Mainz, Germany
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Zhang J, Chen G, Xia H, Wang X, Wang C, Cai M, Gao Y, Lip GYH, Lin H. Associations of Life's Essential 8 and fine particulate matter pollution with the incidence of atrial fibrillation. JOURNAL OF HAZARDOUS MATERIALS 2023; 459:132114. [PMID: 37494795 DOI: 10.1016/j.jhazmat.2023.132114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 07/28/2023]
Abstract
Both unhealthy lifestyle factors and ambient air pollution have been closely linked with the risk of atrial fibrillation (AF). We retrieved 250,898 participants without AF at baseline from UK Biobank. LE8 was determined by 8 metrics, and was characterized as low, moderate and high cardiovascular health (CVH). Exposure to PM2.5 was estimated at the geocoded residential address of each participant. During a median follow-up of 12.46 years, we identified 14,743 (5.9%) incident AF cases. Participants with moderate and high CVH showed a decreased risk of incident AF compared to those with low CVH. Of the LE8 metrics, ideal body mass index (BMI) and blood pressure (BP) were associated with a decrease of 11.57% and 11.46% AF cases. High PM2.5 exposure was associated with an 8% increased risk of AF as compared to low PM2.5 exposure. Compared with those who had low CVH and high PM2.5 exposure, participants with a high CVH and low PM2.5 exposure had the lower AF incidence. Our study found higher CVH is protective, while higher PM2.5 might be one risk factor of AF. Adherence to the LE8 guidelines may help reduce the incidence of AF, especially in those with lower PM2.5 exposure.
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Affiliation(s)
- Junguo Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ge Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hui Xia
- Center for Health Care, Longhua District, Shenzhen, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - ChongJian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yanhui Gao
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China; Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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20
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Liu Y, Yan M. Association of physical activity and PM2.5-attributable cardiovascular disease mortality in the United States. Front Public Health 2023; 11:1224338. [PMID: 37841709 PMCID: PMC10568068 DOI: 10.3389/fpubh.2023.1224338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Objective The study aimed to explore the association between physical activity (PA) and PM2. 5-attributable cardiovascular disease (CVD) mortality trends across the United States (US) at the state level. Methods We conducted a cross-sectional study using data from the Global Burden of Disease 2019 study for PM2.5-attributable CVD mortality and the Behavioral Risk Factor Surveillance System for PA prevalence. The study covered all 50 US states and the District of Columbia from 2001 to 2019. We utilized Joinpoint Regression to calculate AAPC from 2011 to 2019 and Pearson correlation coefficients to assess state-level associations between PA and PM2.5-attributable CVD mortality AAPC. Results During 2011-2019, a total of 244,318 PM2.5-attributable CVD deaths were recorded. The age-adjusted mortality rates (AAMR) of PM2.5-attributable CVD declined substantially from 2011 to 2019 across all US states, with the most pronounced reductions observed in industrialized states such as West Virginia (51% decline), Kentucky (32%), and Ohio (22%). AAMR ratios for the US states varied substantially, ranging from 0.1 in Hawaii to 1.7 in Arkansas. The AAPC ranged from -9.4% (West Virginia) to -1.7% (New Mexico) in the majority of states, while a few states such as Alaska, Wyoming, and Washington saw slight positive AAPCs from 0.9 to 2.9%. A significant correlation was found between PA and PM2.5-attributable CVD mortality trends (r = 0.454, p = 0.001), with similar results in subgroup analyses. Conclusion Our findings suggest a correlation between increased physical activity (PA) and increased PM2.5-attributable CVD mortality, highlighting the potential need to consider PM2.5 exposure when engaging in PA to mitigate adverse cardiovascular health impacts. However, further research is warranted to establish causality and underlying mechanisms in the relationship between PA and PM2.5-attributable CVD mortality. Potential limitations include reliance on self-reported PA data.
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Affiliation(s)
- Yingying Liu
- Department of Health Management and Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Mengmeng Yan
- School of Healthcare and Technology, Chengdu Neusoft University, Chengdu, China
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21
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Park H, Yang PS, Sung JH, Jin MN, Jang E, Yu HT, Kim TH, Pak HN, Lee MH, Joung B. Association Between the Combined Effects of Physical Activity Intensity and Particulate Matter and All-Cause Mortality in Older Adults. Mayo Clin Proc 2023; 98:1153-1163. [PMID: 37422738 DOI: 10.1016/j.mayocp.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/18/2023] [Accepted: 04/12/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE To investigate the association between the combined effects of physical activity (PA) intensity and particulate matter ≤10 μm in diameter (PM10) and mortality in older adults. METHODS This nationwide cohort study included older adults without chronic heart or lung disease who engaged in regular PA. Physical activity was assessed by a standardized, self-reported questionnaire that asked the usual frequency of PA sessions with low (LPA), moderate (MPA), or vigorous intensity (VPA). Each participant's annual average cumulative PM10 was categorized as low to moderate and high PM10 on the basis of a cutoff value of 90th percentile. RESULTS A total of 81,326 participants (median follow-up, 45 months) were included. For participants engaged in MPA or VPA sessions, every 10% increase in the proportion of VPA to total PA sessions resulted in a 4.9% (95% CI, 1.0% to 9.0%; P=.014) increased and 2.8% (95% CI, -5.0% to -0.5%; P=.018) decreased risk of mortality for those exposed to high and low to moderate PM10, respectively (Pinteraction, <.001). For participants engaged only in LPA or MPA sessions, every 10% increase in the proportion of MPA to total PA sessions resulted in a 4.8% (95% CI, -8.9% to -0.4%; P=.031) and 2.3% (95% CI, -4.2% to -0.3%; P=.023) decreased risk of mortality for those exposed to high and low to moderate PM10, respectively (Pinteraction, .096). CONCLUSION We found that for the same level of total PA, MPA was associated with delayed mortality whereas VPA was associated with hastened mortality of older adults in high levels of PM10.
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Affiliation(s)
- Hanjin Park
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Pil-Sung Yang
- Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jung-Hoon Sung
- Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Moo-Nyun Jin
- Division of Cardiology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Eunsun Jang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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22
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Crea F. Focus on ischaemic heart disease: from mechanisms to prevention and treatment. Eur Heart J 2023; 44:2351-2354. [PMID: 37418309 DOI: 10.1093/eurheartj/ehad422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023] Open
Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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23
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Xu Z, Han Z, Wang J, Jin R, Li Z, Wu Z, Zhao Z, Lv S, Zhao X, Liu Y, Guo X, Tao L. Association Between Long-Term Exposure to Fine Particulate Matter Constituents and Progression of Cerebral Blood Flow Velocity in Beijing: Modifying Effect of Greenness. GEOHEALTH 2023; 7:e2023GH000796. [PMID: 37449300 PMCID: PMC10337285 DOI: 10.1029/2023gh000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
Few studies have explored the effects of fine particulate matter (PM2.5) and its constituents on the progression of cerebral blood flow velocity (BFV) and the potential modifying role of greenness. In this study, we investigated the association of PM2.5 and its constituents, including sulfate (SO4 2-), nitrate (NO3 -), ammonium (NH4 +), organic matter (OM), and black carbon (BC), with the progression of BFV in the middle cerebral artery. Participants from the Beijing Health Management Cohort who underwent at least two transcranial Doppler sonography examinations during 2015-2020 were recruited. BFV change and BFV change rate were used to define the progression of cerebral BFV. Linear mixed effects models were employed to analyze the data, and the weighted quantile sum regression assessed the contribution of PM2.5 constituents. Additionally, greenness was examined as a modifier. Among the examined constituents, OM exhibited the strongest association with BFV progression. An interquartile range increase in PM2.5 and OM exposure concentrations was associated with a decrease of -16.519 cm/s (95% CI: -17.837, -15.201) and -15.403 cm/s (95% CI: -16.681, -14.126) in BFV change, and -10.369 cm/s/year (95% CI: -11.387, -9.352) and -9.615 cm/s/year (95% CI: -10.599, -8.632) in BFV change rate, respectively. Furthermore, stronger associations between PM2.5 and BFV progression were observed in individuals working in areas with lower greenness, those aged under 45 years, and females. In conclusion, reducing PM2.5 levels in the air, particularly the OM constituent, and enhancing greenness could potentially contribute to the protection of cerebrovascular health.
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Affiliation(s)
- Zongkai Xu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Rui Jin
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Center of Precision HealthSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupWAAustralia
| | - Zemeng Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Shiyun Lv
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaoyu Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Yueruijing Liu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
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Chen S, Lin X, Du Z, Zhang Y, Zheng L, Ju X, Guo T, Wang X, Chen L, Jiang J, Hu W, Zhang W, Hao Y. Potential causal links between long-term ambient particulate matter exposure and cerebrovascular mortality: Insights from a large cohort in southern China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 328:121336. [PMID: 36822305 DOI: 10.1016/j.envpol.2023.121336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 05/09/2023]
Abstract
Cohort studies conducted in North America and Europe have linked cerebrovascular mortality to long-term exposure to particulate matter (PM). However, limited evidence from large cohorts in high-exposure areas and the traditional approach of association assessment may cause residual confounding issues. In this study, we aimed to investigate the causal links between cerebrovascular mortality and long-term exposure to PM2.5, PM10, and PM2.5-10 in an ongoing cohort study with 580,757 participants in southern China. Using satellite-based estimates of PM concentration at a 1-km2 spatial resolution, we assigned exposure levels to each participant and used the marginal structural Cox model to assess the association between PM exposure and cerebrovascular mortality while accounting for time-varying covariates. We also explored the potential modification effects of sociodemographic and behavioral factors on the PM-health associations. Adjusted hazard ratios (HR) for overall cerebrovascular mortality were 1.041 (95% confidence interval (CI): 1.034-1.049) and 1.032 (95% CI: 1.026-1.038) for each 1 μg/m3 increase in PM2.5, and PM10, respectively. Similar trends were observed in the mortality risk from stroke and ischemic stroke, with HRs ranging from 1.040 to 1.069 and 1.025 to 1.052, respectively, across 2 p.m. exposures. The impact of PM exposure was generally more apparent among women, participants with primary school diplomas and below, and the subgroup under low-exposure. Multiple sensitivity analyses confirmed the robustness of the results. In conclusion, this sizable prospective cohort study hypothesizes causal links between long-term PM exposure and cerebrovascular mortality, particularly among vulnerable participants, supporting the rationale for reducing PM concentration in China to reduce cerebrovascular mortality.
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Affiliation(s)
- Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lingling Zheng
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xu Ju
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Tong Guo
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xinran Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lichang Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jie Jiang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China.
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25
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Lv S, Shi Y, Xue Y, Hu Y, Hu M, Li S, Xie W, Li Y, Ouyang Y, Li Z, Liu M, Wei J, Guo X, Liu X. Long-term effects of particulate matter on incident cardiovascular diseases in middle-aged and elder adults: The CHARLS cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115181. [PMID: 37393817 DOI: 10.1016/j.ecoenv.2023.115181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/07/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Although there is evidence of long-term effects of particulate matter (PM) on cardiovascular diseases (CVD), researches about long-term effects of PM1 on CVD are limited. We aimed to examine the long-term effects and magnitude of PM, especially PM1, on incident CVD in China. METHODS We included 6016 participants aged ≥ 45 years without CVD at baseline in 2011 from the China Health and Retirement Longitudinal Study. Personal PM (PM1, PM2.5, and PM10) concentrations were estimated using geocoded residential address. Generalized linear mixed models and SHapley Additive exPlanation were utilized to calculate the impacts and contributions of PM on CVD. Sensitivity analyses were used to check the robustness. RESULTS After a follow up of 4-year, 481 (7.99 %) participants developed CVD. Per 10 μg/m3 uptick in 1-year average concentrations of PM1, PM2.5 and PM10 was associated with a 1.20 [95 % confidence interval (CI): 1.05-1.37], 1.13 (95 % CI: 1.11-1.15), and 1.10 (95 % CI: 1.06-1.13) fold risk of incident CVD, respectively. The 2-year average concentrations of PM1, PM2.5 and PM10 were associated with incident CVD, corresponding to a 1.03 (95 % CI: 0.96-1.10), 1.11 (95 % CI: 1.02-1.21), and 1.09 (95 % CI: 1.03-1.15) fold risk, respectively. The SHapley Additive exPlanation values of PM1, PM2.5, and PM10 were 0.170, 0.153, and 0.053, respectively, corresponding to the first, second, and fifth among all air pollutants. Effects of PM1, PM2.5 and PM10 on CVD remained statistically significant in two-pollutant models. The elderly, males, smokers and alcohol drinkers tended to have slightly higher effects, while the differences were not statistically significant (all P-values > 0.05) between subgroups. CONCLUSION Long-term exposure to PM1, PM2.5, and PM10 was associated with an increased incidence of CVD. The smaller the particle size, the more important it was for incident CVD indicating that emphasis should be placed on small size of PM.
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Affiliation(s)
- Shiyun Lv
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yadi Shi
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yongxi Xue
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yaoyu Hu
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Meiling Hu
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Shuting Li
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Wenhan Xie
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yuan Li
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yixin Ouyang
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Mengmeng Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, USA
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China.
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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Crea F. The saga of non-traditional risk factors continues with proteomics, microbiome, ozone, ketone bodies, and depression: let us rethink prevention. Eur Heart J 2023; 44:1579-1582. [PMID: 37149288 DOI: 10.1093/eurheartj/ehad233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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Święczkowski M, Dobrzycki S, Kuźma Ł. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085566. [PMID: 37107848 PMCID: PMC10139136 DOI: 10.3390/ijerph20085566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/11/2023]
Abstract
Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016-2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011-1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1-1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001-1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01-1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011-1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003-1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006-1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008-1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01-1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011-1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007-1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001-1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.
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Hahad O, Daiber A, Münzel T. Physical activity in polluted air: an urgent call to study the health risks. Lancet Planet Health 2023; 7:e266-e267. [PMID: 37019566 DOI: 10.1016/s2542-5196(23)00055-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Affiliation(s)
- Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz 55131, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz 55131, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz 55131, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
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29
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Jia R, Wei M, Lei J, Meng X, Du R, Yang M, Lu X, Jiang Y, Cao R, Wang L, Song L. PM 2.5 induce myocardial injury in hyperlipidemic mice through ROS-pyroptosis signaling pathway. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 254:114699. [PMID: 36889212 DOI: 10.1016/j.ecoenv.2023.114699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/07/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Exposure to particulate matters with diameters below 2.5 µm (PM2.5) is considered a major risk factor for cardiovascular diseases (CVDs). The closest associations between PM2.5 and CVDs have been observed in hyperbetalipoproteinemia cases, although the detailed underpinning mechanism remains undefined. In this work, hyperlipidemic mice and H9C2 cells were used to examine the effects of PM2.5 on myocardial injury and their underlying mechanisms. The results revealed that PM2.5 exposure caused severe myocardial damage in the high-fat mouse model. Oxidative stress and pyroptosis were also observed along with myocardial injury. After inhibiting pyroptosis with disulfiram (DSF), the level of pyroptosis was effectively reduced as well as myocardial injury, suggesting that PM2.5 induced the pyroptosis pathway and further caused myocardial injury and cell death. Afterwards, by suppressing PM2.5-induced oxidative stress with N-acetyl-L-cysteine (NAC), myocardial injury was markedly ameliorated, and the upregulation of pyroptosis markers was reversed, which indicated that PM2.5-pyroptosis was also improved. Taken together, this study revealed that PM2.5 induce myocardial injury through the ROS-pyroptosis signaling pathway in hyperlipidemia mice models, providing a potential approach for clinical interventions.
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Affiliation(s)
- Ruxue Jia
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China; Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Min Wei
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Jinrong Lei
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Xianzong Meng
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China; Department of Cognitive Neuroscience, Centre for Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Rui Du
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Mengxin Yang
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Xinjun Lu
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116000, People's Republic of China
| | - Yizhu Jiang
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Ran Cao
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Lili Wang
- Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China.
| | - Laiyu Song
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China.
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Feng Y, Dang Y, Wang J, An Y. A novel grey projection incidence model for assessing the relationships between cardiovascular diseases and air pollutants. ISA TRANSACTIONS 2023; 135:398-409. [PMID: 36167593 DOI: 10.1016/j.isatra.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The accurate assessment of the relationships between cardiovascular diseases and various air pollutants is essential for population health protection, especially in low- and middle-income countries or regions with poor air quality and dense populations. In view of this situation, we propose a novel grey incidence model, namely, the grey projection incidence model based on Gaussian function, by integrating the advantages of geometric projection and Gaussian function. Firstly, the basic principles of the proposed model are elaborated. Then, a framework including six steps to evaluate the relationships between CVDs and air pollutants is illustrated. Finally, a case study is utilized to validate the effectiveness of the proposed model. Experimental results show that the proposed model outperforms other grey incidence models in terms of reliability and stability of the relational rank.
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Affiliation(s)
- Yu Feng
- College of Economics and Management, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 211106, China
| | - Yaoguo Dang
- College of Economics and Management, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 211106, China
| | - Junjie Wang
- College of Economics and Management, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 211106, China.
| | - Yimeng An
- College of Economics and Management, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 211106, China
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Sun D, Liu C, Ding Y, Yu C, Guo Y, Sun D, Pang Y, Pei P, Du H, Yang L, Chen Y, Meng X, Liu Y, Liu J, Sohoni R, Sansome G, Chen J, Chen Z, Lv J, Kan H, Li L. Long-term exposure to ambient PM 2·5, active commuting, and farming activity and cardiovascular disease risk in adults in China: a prospective cohort study. Lancet Planet Health 2023; 7:e304-e312. [PMID: 37019571 PMCID: PMC10104773 DOI: 10.1016/s2542-5196(23)00047-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Increased physical activity is associated with a reduced risk of cardiovascular disease, but outdoor physical activity can be accompanied by increased inhalation of fine particulate matter (PM2·5). The extent to which long-term exposure to PM2·5 can offset the cardiovascular benefits of physical activity is unknown. We aimed to evaluate whether the associations between active commuting or farming activity and incident risks of cerebrovascular disease and ischaemic heart disease were consistent between populations with different ambient PM2·5 exposures. METHODS We did a prospective cohort study using data from people aged 30-79 years without cardiovascular disease at baseline from the China Kadoorie Biobank (CKB). Active commuting and farming activity were assessed at baseline using questionnaires. A high-resolution (1 × 1 km) satellite-based model was used to estimate annual average PM2·5 exposure during the study period. Participants were stratified according to PM2·5 exposure (54 μg/m3 or greater vs less than 54 μg/m3). Hazard ratios (HRs) and 95% CIs for incident cerebrovascular disease and ischaemic heart disease by active commuting and farming activity were estimated using Cox proportional hazard models. Effect modifications by PM2·5 exposure were tested by likelihood ratio tests. Analyses were restricted to the period from Jan 1, 2005, to Dec 31, 2017. FINDINGS Between June 25, 2004, and July 15, 2008, 512 725 people were enrolled in the CKB cohort. 322 399 eligible participants completed the baseline survey and were included in the analysis of active commuting (118 274 non-farmers and 204 125 farmers). Among 204 125 farmers, 2985 reported no farming time and 201 140 were included in the farming activity analysis. During a median follow-up of 11 years, 39 514 cerebrovascular disease cases and 22 313 ischaemic heart disease cases were newly identified. Among non-farmers with exposure to annual average PM2·5 concentrations of less than 54 μg/m3, increased active commuting was associated with lower risks of cerebrovascular disease (highest active commuting vs lowest active commuting HR 0·70, 95% CI 0·65-0·76) and ischaemic heart disease (0·60, 0·54-0·66). However, among non-farmers with exposure to annual average PM2·5 concentrations of 54 μg/m3 or greater, there was no association between active commuting and cerebrovascular disease or ischaemic heart disease. Among farmers with exposure to annual average PM2·5 concentrations of less than 54 μg/m3, increased active commuting (highest active commuting vs lowest active commuting HR 0·77, 95% CI 0·63-0·93) and increased farming activity (highest activity vs lowest activity HR 0·85, 95% CI 0·79-0·92) were both associated with a lower cerebrovascular disease risk. However, among farmers with exposure to annual average PM2·5 concentrations of 54 μg/m3 or greater, increases in active commuting (highest active commuting vs lowest active commuting HR 1·12, 95% CI 1·05-1·19) and farming activity (highest activity vs lowest activity HR 1·18, 95% CI 1·09-1·28) were associated with an elevated cerebrovascular disease risk. The above associations differed significantly between PM2·5 strata (all interaction p values <0·0001). INTERPRETATION For participants with long-term exposure to higher ambient PM2·5 concentrations, the cardiovascular benefits of active commuting and farming activity were significantly attenuated. Higher levels of active commuting and farming activity even increased the cerebrovascular disease risk among farmers with exposure to annual average PM2·5 concentrations of 54 μg/m3 or greater. FUNDING National Natural Science Foundation of China, National Key Research and Development Program of China, Kadoorie Charitable Foundation, UK Wellcome Trust.
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Affiliation(s)
- Dong Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC 12 Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and 13 Governance on Weather or Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yinqi Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC 12 Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and 13 Governance on Weather or Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jiben Liu
- Prevention and Health Department, Yongqinglu Community Health Service, Qingdao, China
| | - Rajani Sohoni
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gary Sansome
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC 12 Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and 13 Governance on Weather or Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China.
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Bo YC, Yu T, Guo C, Lin CC, Yang HT, Chang LYY, Thomas GN, Tam T, Lau AKH, Lao XQ. Cardiovascular Mortality, Habitual Exercise, and Particulate Matter 2.5 Exposure: A Longitudinal Cohort Study. Am J Prev Med 2023; 64:250-258. [PMID: 36272861 DOI: 10.1016/j.amepre.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Habitual exercise may amplify the respiratory uptake of air pollutants in the lung, exacerbating the adverse effects of air pollution. However, it is unclear whether this can reduce the health benefits of habitual exercise (referred to as leisure-time exercise). Thus, the combined effects of habitual exercise and chronic exposure to ambient fine particulate matter 2.5 on cardiovascular mortality were examined among adults in Taiwan. METHODS A total of 384,128 adults were recruited between 2001 and 2016 and followed up to May 31, 2019. Participants' vital status was obtained by matching their unique identification numbers with records of cardiovascular death in the National Death Registry of Taiwan. A time-varying Cox regression model was used to analyze the data. Analyses were conducted in 2021. RESULTS Cardiovascular death risks were inversely associated with habitual exercise and positively associated with chronic exposure to particulate matter 2.5. The beneficial effects of habitual exercise on cardiovascular mortality were not modified by chronic exposure to particulate matter 2.5. Inactive participants with high particulate matter 2.5 exposure exhibited a 123% higher risk of cardiovascular death than high-exercise-group participants exposed to low levels of particulate matter 2.5 (95% CI=89, 163). CONCLUSIONS High level of habitual exercise combined with low exposure level of ambient particulate matter 2.5 is associated with the lowest risk of cardiovascular death. A higher level of habitual exercise is associated with a lower risk of cardiovascular death at all levels of particulate matter 2.5 exposure studied. The results indicate that habitual exercise is a safe health promotion strategy even for people residing in relatively polluted regions.
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Affiliation(s)
- Yacong C Bo
- School of Public Health, Zhengzhou University, Zhenghzou, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Cui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Changqing C Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | | | - G N Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong; Department of Biomedical Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong.
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Wu M, Pang Y, Chen M, Li L, Yan L, Ning J, Liu Q, Zhang Y, Jiang T, Kang A, Huang X, Hu W, Hu H, Geng Z, He L, Wang H, Wang M, Yang P, Chen J, Wu R, Shi B, Niu Y, Zhang R. Moderate physical activity against effects of short-term PM 2.5 exposure on BP via myokines-induced inflammation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158598. [PMID: 36108849 DOI: 10.1016/j.scitotenv.2022.158598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/24/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
Exposure to PM2.5 increases blood pressure (BP) and cardiovascular morbidity and mortality. We conducted a randomized controlled panel study in Shijiazhuang, China among 55 healthy college students randomly assigned to either the control (CON) or SPORTS group with intervention of 2000 m jogging in 20 min for 3 times in 4 days, and 3-round health examinations from November 15, 2020 to December 6, 2020. We aimed to evaluate whether moderate physical activity (PA) protected BP health against PM2.5 exposure and explore potential mechanisms through myokines and inflammation. Individual PM2.5 exposure was calculated based on outdoor and indoor PM2.5 concentration monitoring data as well as time-activity diary of each subject. In the CON group, the exposure-response curve for SBP was linear with a threshold concentration of approximately 31 μg/m3, while an increment of SBP level was 4.38 mm Hg (95%CI: 0.17 mm Hg, 8.59 mm Hg) at lag03 for each 10-μg/m3 increase in PM2.5, using linear mixed-effect models. For inflammatory indicators, PM2.5 exposure was associated with significant increases in eosinophil counts and proportion in CON group, but decreases in MCP-1 and TNF-α in SPORTS group. Meanwhile, higher myokines including CLU and IL-6 were observed in SPORTS group compared to the CON group. Further mediation analyses revealed that eosinophil counts mediated the elevated BP in CON group, whereas MCP-1 and TNF-α were also crucial mediating cytokines for the SPORTS group, as well as CLU and IL-6 acted as mediators on BP and inflammation indicators in SPORTS group. This study suggests that moderate PA could counteract the elevated BP induced by PM2.5 exposure via myokines-suppressed inflammation pathways.
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Affiliation(s)
- Mengqi Wu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Meiyu Chen
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Lipeng Li
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Lina Yan
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Jie Ning
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Qingping Liu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yaling Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Tao Jiang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Aijuan Kang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Xiaoyan Huang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Wentao Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Huaifang Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Zihan Geng
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Liyi He
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Hui Wang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Mengruo Wang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Peihao Yang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Jiawei Chen
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Ruiting Wu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Beibei Shi
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yujie Niu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China.
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Ju X, Yimaer W, Du Z, Wang X, Cai H, Chen S, Zhang Y, Wu G, Wu W, Lin X, Wang Y, Jiang J, Hu W, Zhang W, Hao Y. The impact of monthly air pollution exposure and its interaction with individual factors: Insight from a large cohort study of comprehensive hospitalizations in Guangzhou area. Front Public Health 2023; 11:1137196. [PMID: 37026147 PMCID: PMC10071997 DOI: 10.3389/fpubh.2023.1137196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/01/2023] [Indexed: 04/08/2023] Open
Abstract
Background Although the association between short-term air pollution exposure and certain hospitalizations has been well documented, evidence on the effect of longer-term (e. g., monthly) air pollution on a comprehensive set of outcomes is still limited. Method A total of 68,416 people in South China were enrolled and followed up during 2019-2020. Monthly air pollution level was estimated using a validated ordinary Kriging method and assigned to individuals. Time-dependent Cox models were developed to estimate the relationship between monthly PM10 and O3 exposures and the all-cause and cause-specific hospitalizations after adjusting for confounders. The interaction between air pollution and individual factors was also investigated. Results Overall, each 10 μg/m3 increase in PM10 concentration was associated with a 3.1% (95%CI: 1.3%-4.9%) increment in the risk of all-cause hospitalization. The estimate was even greater following O3 exposure (6.8%, 5.5%-8.2%). Furthermore, each 10 μg/m3 increase in PM10 was associated with a 2.3%-9.1% elevation in all the cause-specific hospitalizations except for those related to respiratory and digestive diseases. The same increment in O3 was relevant to a 4.7%-22.8% elevation in the risk except for respiratory diseases. Additionally, the older individuals tended to be more vulnerable to PM10 exposure (P interaction: 0.002), while the alcohol abused and those with an abnormal BMI were more vulnerable to the impact of O3 (P interaction: 0.052 and 0.011). However, the heavy smokers were less vulnerable to O3 exposure (P interaction: 0.032). Conclusion We provide comprehensive evidence on the hospitalization hazard of monthly PM10 and O3 exposure and their interaction with individual factors.
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Affiliation(s)
- Xu Ju
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wumitijiang Yimaer
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xinran Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Huanle Cai
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Gonghua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jie Jiang
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Wangjian Zhang
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking, China
- Yuantao Hao
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Jacobsen AP, Khiew YC, Duffy E, O'Connell J, Brown E, Auwaerter PG, Blumenthal RS, Schwartz BS, McEvoy JW. Climate change and the prevention of cardiovascular disease. Am J Prev Cardiol 2022; 12:100391. [PMID: 36164332 PMCID: PMC9508346 DOI: 10.1016/j.ajpc.2022.100391] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/27/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Abstract
Climate change is a worsening global crisis that will continue negatively impacting population health and well-being unless adaptation and mitigation interventions are rapidly implemented. Climate change-related cardiovascular disease is mediated by air pollution, increased ambient temperatures, vector-borne disease and mental health disorders. Climate change-related cardiovascular disease can be modulated by climate change adaptation; however, this process could result in significant health inequity because persons and populations of lower socioeconomic status have fewer adaptation options. Clear scientific evidence for climate change and its impact on human health have not yet resulted in the national and international impetus and policies necessary to slow climate change. As respected members of society who regularly communicate scientific evidence to patients, clinicians are well-positioned to advocate on the importance of addressing climate change. This narrative review summarizes the links between climate change and cardiovascular health, proposes actionable items clinicians and other healthcare providers can execute both in their personal life and as an advocate of climate policies, and encourages communication of the health impacts of climate change when counseling patients. Our aim is to inspire the reader to invest more time in communicating the most crucial public health issue of the 21st century to their patients.
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Affiliation(s)
- Alan P. Jacobsen
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yii Chun Khiew
- Division of Gastroenterology, Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Eamon Duffy
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - James O'Connell
- Department of Public Health, Health Service Executive West, Galway, Ireland
| | - Evans Brown
- Department of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Paul G. Auwaerter
- Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Brian S. Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - John William McEvoy
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, Ireland
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Liu Q, Huang K, Liang F, Yang X, Li J, Chen J, Liu X, Cao J, Shen C, Yu L, Zhao Y, Deng Y, Li Y, Hu D, Lu X, Liu Y, Gu D, Liu F, Huang J. Long-term exposure to fine particulate matter modifies the association between physical activity and hypertension incidence. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:708-715. [PMID: 35065296 PMCID: PMC9729921 DOI: 10.1016/j.jshs.2022.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/25/2021] [Accepted: 12/17/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND The trade-off between the benefits of regular physical activity (PA) and the potentially detrimental effects of augmented exposure to air pollution in highly polluted regions remains unclear. This study aimed to examine whether ambient fine particulate matter (PM2.5) exposure modified the impacts of PA volume and intensity on hypertension risk. METHODS We included 54,797 participants without hypertension at baseline in a nationwide cohort of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. PA volume and intensity were assessed by questionnaire, and high-resolution (1 km ×1 km) PM2.5 estimates were generated using a satellite-based model. RESULTS During 413,516 person-years of follow-up, 12,100 incident hypertension cases were identified. PM2.5 significantly modified the relationship between PA and hypertension incidence (pinteraction < 0.001). Increased PA volume was negatively associated with incident hypertension in the low PM2.5 stratum (<59.8 μg/m3, ptrend < 0.001), with a hazard ratio of 0.81 (95% confidence interval (95%CI): 0.74-0.88) when comparing the fourth with the first quartile of PA volume. However, the health benefits were not observed in the high PM2.5 stratum (≥59.8 μg/m3, ptrend = 0.370). Moreover, compared with light PA intensity, vigorous intensity was related to a 20% (95%CI: 9%-29%) decreased risk of hypertension for participants exposed to low PM2.5, but a 17% (95%CI: 4%-33%) increased risk for those with high PM2.5 levels. CONCLUSION PA was associated with a reduced risk of hypertension only among participants with low PM2.5 exposure. Our findings recommended regular PA to prevent hypertension in less polluted regions and reinforced the importance of air quality improvement.
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Affiliation(s)
- Qiong Liu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Keyong Huang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fengchao Liang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Jianxin Li
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jichun Chen
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Ying Deng
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Ying Li
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Xiangfeng Lu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
| | - Fangchao Liu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
| | - Jianfeng Huang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
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Zhang C, Liu X, Kang N, Hou X, Liao W, Yuchi Y, Ding Z, Baheti B, Chang G, Mao Z, Huo W, Hou J, Wang C. Physical activity attenuates the association between household air pollution and health-related quality of life in Chinese rural population: the Henan Rural Cohort Study. Qual Life Res 2022; 31:3165-3175. [PMID: 35933644 DOI: 10.1007/s11136-022-03195-y] [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] [Accepted: 07/02/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND AND PURPOSE Limited research focused on the association between household air pollution (HAP) and health-related quality of life (HRQoL). This study aimed to investigate the association of HAP with HRQoL and the effect modification of physical activity. METHOD A total of 16,761 eligible participants were derived from the Henan Rural Cohort Study. Based on structured questionnaires, HAP was assessed by fuel type, cooking duration and kitchen ventilation; HRQoL was measured with utility index and VAS score from the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L); physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear models and tobit regression models were utilized to explore the relationship of HAP with HRQoL. Further sensitivity analyses were conducted using structural equation models. RESULTS Compared with those who cooked with clean fuels, short-duration, or good kitchen ventilation, participants who cooked with solid fuels, long-duration, and poor ventilation had lower utility index and VAS score (All P < 0.001). The decrease in utility index for solid fuel users vs. clean fuel users were 0.06 [95%confidence interval (CI) 003, 0.08], 0.03 (95%CI 0.01, 0.04) and 0.02 (95%CI 0.01, 0.04) in low, moderate and high physical activity group, respectively, which decreased with physical activity levels (Pfor interaction < 0.05). Similar results were observed in associations of kitchen ventilation with utility index and VAS score. CONCLUSION HAP negatively associated with HRQoL in rural population, and potential intervention aimed at maintaining adequate physical activity. TRAIL REGISTRATION The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375 .
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Affiliation(s)
- Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Zhongao Ding
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Bota Baheti
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Gaohua Chang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
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Shamsa EH, Song Z, Kim H, Shamsa F, Hazlett LD, Zhang K. The links of fine airborne particulate matter exposure to occurrence of cardiovascular and metabolic diseases in Michigan, USA. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000707. [PMID: 36962575 PMCID: PMC10021276 DOI: 10.1371/journal.pgph.0000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022]
Abstract
Air pollutants, particularly airborne particulate matter with aerodynamic diameter < 2.5μm (PM2.5), have been linked to the increase in mortality and morbidity associated with cardiovascular and metabolic diseases. In this study, we investigated the dose-risk relationships between PM2.5 concentrations and occurrences of cardiovascular and metabolic diseases as well as the confounding socioeconomic factors in Michigan, USA, where PM2.5 levels are generally considered acceptable. Multivariate linear regression analyses were performed to investigate the relationship between health outcome and annual ground-level PM2.5 concentrations of 82 counties in Michigan. The analyses revelated significant linear dose-response associations between PM2.5 concentrations and cardiovascular disease (CVD) hospitalization. A 10 μg/m3 increase in PM2.5 exposure was found to be associated with a 3.0% increase in total CVD, 0.45% increase in Stroke, and a 0.3% increase in Hypertension hospitalization rates in Medicare beneficiaries. While the hospitalization rates of Total Stroke, Hemorrhagic Stroke, and Hypertension in urbanized counties were significantly higher than those of rural counties, the death rates of coronary heart disease and ischemic stroke in urbanized counties were significantly lower than those of rural counties. These results were correlated with the facts that PM2.5 levels in urbanized counties were significantly higher than that in rural counties and that the percentage of the population with health insurance and the median household income in rural counties were significantly lower. While obesity prevalence showed evidence of a weak positive correlation (ρ = 0.20, p-value = 0.078) with PM2.5 levels, there was no significant dose-response association between county diabetes prevalence rates and PM2.5 exposure in Michigan. In summary, this study revealed strong dose-response associations between PM2.5 concentrations and CVD incidence in Michigan, USA. The socioeconomic factors, such as access to healthcare resources and median household income, represent important confounding factors that could override the impact of PM2.5 exposure on CVD mortality.
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Affiliation(s)
- El Hussain Shamsa
- Center for Molecular Medicine & Genetics, The Wayne State University School of Medicine, Detroit, MI, United States of America
| | - Zhenfeng Song
- Center for Molecular Medicine & Genetics, The Wayne State University School of Medicine, Detroit, MI, United States of America
| | - Hyunbae Kim
- Center for Molecular Medicine & Genetics, The Wayne State University School of Medicine, Detroit, MI, United States of America
| | - Falah Shamsa
- Cancer Coalition of Georgia, Atlanta, GA, United States of America
| | - Linda D. Hazlett
- Ophthalmology, Visual and Anatomical Sciences, The Wayne State University School of Medicine, Detroit, MI, United States of America
| | - Kezhong Zhang
- Center for Molecular Medicine & Genetics, The Wayne State University School of Medicine, Detroit, MI, United States of America
- Department of Immunology and Microbiology, The Wayne State University School of Medicine, Detroit, MI, United States of America
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Li Z, Liu M, Wu Z, Liu Y, Li W, Liu M, Lv S, Yu S, Jiang Y, Gao B, Wang X, Li X, Wang W, Lin H, Guo X, Liu X. Association between ambient air pollution and hospital admissions, length of hospital stay and hospital cost for patients with cardiovascular diseases and comorbid diabetes mellitus: Base on 1,969,755 cases in Beijing, China, 2014-2019. ENVIRONMENT INTERNATIONAL 2022; 165:107301. [PMID: 35598418 DOI: 10.1016/j.envint.2022.107301] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence on the effects of the air pollutants on the hospital admissions, hospital cost and length of stay (LOS) among patients with comorbidities remains limited in China, particularly for patients with cardiovascular diseases and comorbid diabetes mellitus (CVD-DM). METHODS We collected daily data on CVD-DM patients from 242 hospitals in Beijing between 2014 and 2019. Generalized additive model was employed to quantify the associations between admissions, LOS, and hospital cost for CVD-DM patients and air pollutants. We further evaluated the attributable risk posed by air pollutants to CVD-DM patients, using both Chinese and WHO air quality guidelines as reference. RESULTS Per 10 ug/m3 increase of particles with an aerodynamic diameter < 2.5 μm (PM2.5), particles with an aerodynamic diameter < 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbonic oxide (CO) and ozone (O3) corresponded to a 0.64% (95% CI: 0.57 to 0.71), 0.52% (95% CI: 0.46 to 0.57), 0.93% (95% CI: 0.67 to 1.20), 0.98% (95% CI: 0.81 to 1.16), 1.66% (95% CI: 1.18 to 2.14) and 0.53% (95% CI: 0.45 to 0.61) increment for CVD-DM patients' admissions. Among the six pollutants, particulate pollutants (PM2.5 and PM10) in most lag days exhibited adverse effects on LOS and hospital cost. For every 10 ug/m3 increase in PM2.5 and PM10, the absolute increase with LOS will increase 62.08 days (95% CI: 28.93 to 95.23) and 51.77 days (95% CI:22.88 to 80.66), respectively. The absolute increase with hospital cost will increase 105.04 Chinese Yuan (CNY) (95% CI: 49.27 to 160.81) and 81.76 CNY (95% CI: 42.01 to 121.51) in PM2.5 and PM10, respectively. Given WHO 2021 air quality guideline as the reference, PM2.5 had the maximum attributable fraction of 3.34% (95% CI: 2.94% to 3.75%), corresponding to an avoidable of 65,845 (95% CI: 57,953 to 73,812) patients with CVD-DM. CONCLUSION PM2.5 and PM10 are positively associated with hospital admissions, hospital cost and LOS for patients with CVD-DM. Policy changes to reduce air pollutants exposure may reduce CVD-DM admissions and substantial savings in health care spending and LOS.
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Affiliation(s)
- Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Mengyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China; Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Zhiyuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Weiming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Mengmeng Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shiyun Lv
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Siqi Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanshuang Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Bo Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne 3086, Australia
| | - Wei Wang
- School of Medical Sciences and Health, Edith Cowan University, WA6027 Perth, Australia
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China; School of Medical Sciences and Health, Edith Cowan University, WA6027 Perth, Australia; National Institute for Data Science in Health and Medicine, Capital Medical University, China.
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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Ao L, Zhou J, Han M, Li H, Li Y, Pan Y, Chen J, Xie X, Jiang Y, Wei J, Chen G, Li S, Guo Y, Hong F, Li Z, Xiao X, Zhao X. The joint effects of physical activity and air pollution on type 2 diabetes in older adults. BMC Geriatr 2022; 22:472. [PMID: 35650529 PMCID: PMC9158242 DOI: 10.1186/s12877-022-03139-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Older adults with type 2 diabetes are at higher risk of developing common geriatric syndromes and have a lower quality of life. To prevent type 2 diabetes in older adults, it's unclear whether the health benefits of physical activity (PA) will be influenced by the harms caused by increased exposure to air pollution during PA, especially in developing countries with severe air pollution problem. We aimed to investigate the joint effects of PA and long-term exposure to air pollution on the type 2 diabetes in older adults from China. METHODS This cross-sectional study was based on the China Multi-Ethnic cohort (CMEC) study. The metabolic equivalent of PA was calculated according to the PA scale during the CMEC baseline survey. High resolution air pollution datasets (PM10, PM2.5 and PM1) were collected from open products. The joint effects were assessed by the marginal structural mean model with generalized propensity score. RESULTS A total of 36,562 participants aged 50 to 79 years were included in the study. The prevalence of type 2 diabetes was 10.88%. The mean (SD) level of PA was 24.93 (18.60) MET-h/d, and the mean (SD) level of PM10, PM2.5, and PM1 were 70.00 (23.32) µg/m3, 40.45 (15.66) µg/m3 and 27.62 (6.51) µg/m3, respectively. With PM10 < 92 µg/m3, PM2.5 < 61 µg/m3, and PM1 < 36 µg/m3, the benefit effects of PA on type 2 diabetes was significantly greater than the harms due to PMs when PA levels were roughly below 80 MET-h/d. With PM10 ≥ 92 µg/m3, PM2.5 ≥ 61 µg/m3, and PM1 ≥ 36 µg/m3, the odds ratio (OR) first decreased and then rose rapidly with confidence intervals progressively greater than 1 and break-even points close to or even below 40 MET-h/d. CONCLUSIONS Our findings implied that for the prevention of type 2 diabetes in older adults, the PA health benefits outweighed the harms of air pollution except in extreme air pollution situations, and suggested that when the air quality of residence is severe, the PA levels should ideally not exceed 40 MET-h/d.
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Affiliation(s)
- Linjun Ao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Junmin Zhou
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Mingming Han
- grid.507966.bChengdu Center for Disease Control and Prevention, Sichuan, China
| | - Hong Li
- grid.508395.20000 0004 9404 8936Yunnan Center for Disease Control and Prevention, Yunnan, China
| | - Yajie Li
- Tibet Center for Disease Control and Prevention CN, Tibet, China
| | - Yongyue Pan
- grid.440680.e0000 0004 1808 3254Tibet University, Tibet, China
| | - Jiayi Chen
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Xiaofen Xie
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Ye Jiang
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Jing Wei
- grid.164295.d0000 0001 0941 7177Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD USA
| | - Gongbo Chen
- grid.12981.330000 0001 2360 039XGuangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Shanshan Li
- grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Feng Hong
- grid.413458.f0000 0000 9330 9891School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhifeng Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xiong Xiao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Xing Zhao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
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Hong J, McArthur DP, Sim J, Kim CH. Did air pollution continue to affect bike share usage in Seoul during the COVID-19 pandemic? JOURNAL OF TRANSPORT & HEALTH 2022; 24:101342. [PMID: 35198380 PMCID: PMC8853829 DOI: 10.1016/j.jth.2022.101342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The role of cycling has become more important in the urban transport system during the Covid-19 pandemic. As public transport passengers have tried to avoid crowded vehicles due to safety concerns, a rapid surge of cycling activities has been noted in many countries. This implies that more cyclists might be exposed to air pollution, potentially leading to health problems in cities like Seoul where the level of air pollution is high. METHODS We utilised three years of bike sharing programme (Ddareungi) data in Seoul and time series models to examine the changes in the relationship between particulate concentration (PM2.5) and total daily cycling duration before and during the pandemic. RESULTS We find that cyclists reacted less to the PM2.5 level during the pandemic, potentially due to the lack of covid-secure travel modes. Specifically, our results show significant negative associations between concentrations of PM2.5 and total daily cycling duration before the pandemic (year 2018 and 2019). However, this association became insignificant in 2020. CONCLUSIONS Building comprehensive cycling infrastructure that can reduce air pollution exposure of cyclists and improving air quality alert systems could help build a more resilient city for the future.
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Affiliation(s)
- Jinhyun Hong
- Department of Urban Studies, The University of Glasgow, Glasgow, United Kingdom
| | | | - Jaehun Sim
- Korea Rural Economic Institute, Naju-si, South Korea
| | - Chung Ho Kim
- Department of Urban Planning and Design, University of Seoul, Seoul, South Korea
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You Y, Wang D, Liu J, Chen Y, Ma X, Li W. Physical Exercise in the Context of Air Pollution: An Emerging Research Topic. Front Physiol 2022; 13:784705. [PMID: 35295574 PMCID: PMC8918627 DOI: 10.3389/fphys.2022.784705] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022] Open
Abstract
Physical exercise (PE) brings physiological benefits to human health; paradoxically, exposure to air pollution (AP) is harmful. Hence, the combined effects of AP and PE are interesting issues worth exploring. The objective of this study is to review literature involved in AP-PE fields to perform a knowledge-map analysis and explore the collaborations, current hotspots, physiological applications, and future perspectives. Herein, cluster, co-citation, and co-occurrence analysis were applied using CiteSpace and VOSviewer software. The results demonstrated that AP-PE domains have been springing up and in rapid growth since the 21st century. Subsequently, active countries and institutions were identified, and the productive institutions were mainly located in USA, China, UK, Spain, and Canada. Developed countries seemed to be the major promoters. Additionally, subject analysis found that environmental science, public health, and sports medicine were the core subjects, and multidimensional communications were forming. Thereafter, a holistic presentation of reference co-citation clusters was conducted to discover the research topics and trace the development focuses. Youth, elite athletes, and rural population were regarded as the noteworthy subjects. Commuter exposure and moderate aerobic exercise represented the common research context and exercise strategy, respectively. Simultaneously, the research hotspots and application fields were elaborated by keyword co-occurrence distribution. It was noted that physiological adaptations including respiratory, cardiovascular, metabolic, and mental health were the major themes; oxidative stress and inflammatory response were the mostly referred mechanisms. Finally, several challenges were proposed, which are beneficial to promote the development of the research field. Molecular mechanisms and specific pathways are still unknown and the equilibrium points and dose-effect relationships remain to be further explored. We are highly confident that this study provides a unique perspective to systematically and comprehensively review the pieces of AP-PE research and its related physiological mechanisms for future investigations.
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Affiliation(s)
- Yanwei You
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Dizhi Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Jianxiu Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xindong Ma
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- *Correspondence: Xindong Ma
| | - Wenkai Li
- China Table Tennis College, Shanghai University of Sport, Shanghai, China
- Wenkai Li
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43
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Ong GX, Ji JS. Is outdoor exercise in air polluted cities a major threat to global health? ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113146. [PMID: 34974363 DOI: 10.1016/j.ecoenv.2021.113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Gui Xian Ong
- Environmental Research Center, Duke Kunshan University, China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, China.
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Hahad O, Kuntic M, Frenis K, Chowdhury S, Lelieveld J, Lieb K, Daiber A, Münzel T. Physical Activity in Polluted Air-Net Benefit or Harm to Cardiovascular Health? A Comprehensive Review. Antioxidants (Basel) 2021; 10:1787. [PMID: 34829658 PMCID: PMC8614825 DOI: 10.3390/antiox10111787] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 12/15/2022] Open
Abstract
Both exposure to higher levels of polluted air and physical inactivity are crucial risk factors for the development and progression of major noncommunicable diseases and, in particular, of cardiovascular disease. In this context, the World Health Organization estimated 4.2 and 3.2 million global deaths per year in response to ambient air pollution and insufficient physical activity, respectively. While regular physical activity is well known to improve general health, it may also increase the uptake and deposit of air pollutants in the lungs/airways and circulation, due to increased breathing frequency and minute ventilation, thus increasing the risk of cardiovascular disease. Thus, determining the tradeoff between the health benefits of physical activity and the potential harmful effects of increased exposure to air pollution during physical activity has important public health consequences. In the present comprehensive review, we analyzed evidence from human and animal studies on the combined effects of physical activity and air pollution on cardiovascular and other health outcomes. We further report on pathophysiological mechanisms underlying air pollution exposure, as well as the protective effects of physical activity with a focus on oxidative stress and inflammation. Lastly, we provide mitigation strategies and practical recommendations for physical activity in areas with polluted air.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology—Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.H.); (M.K.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany;
| | - Marin Kuntic
- Department of Cardiology—Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.H.); (M.K.)
| | - Katie Frenis
- Department of Hematology/Oncology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA;
| | - Sourangsu Chowdhury
- Atmospheric Chemistry Department, Max Planck Institute for Chemistry, 55122 Mainz, Germany; (S.C.); (J.L.)
| | - Jos Lelieveld
- Atmospheric Chemistry Department, Max Planck Institute for Chemistry, 55122 Mainz, Germany; (S.C.); (J.L.)
- Climate and Atmosphere Research Center, The Cyprus Institute, Nicosia 2121, Cyprus
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany;
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology—Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.H.); (M.K.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology—Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.H.); (M.K.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
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45
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Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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46
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Kim SR, Choi S, Park SM. Potential effects of time-varying characteristics and discrepancies in covariates distribution upon interpreting the results from the association of air pollution and physical activity with cardiovascular disease among young adults. Eur Heart J 2021; 42:4193-4194. [PMID: 34480542 DOI: 10.1093/eurheartj/ehab615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Seong Rae Kim
- Department of Medicine, Seoul National University College of Medicine, 101, Daehak-ro, Jongro-gu, Seoul 03080, South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea
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47
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Affiliation(s)
- Yanguo Xin
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng district, Beijing 100050, China.,Laboratory of Heart Valve Disease, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu 610041, China
| | - Junli Li
- Laboratory of Heart Valve Disease, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu 610041, China
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48
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Münzel T, Hahad O, Sørensen M, Lelieveld J, Duerr GD, Nieuwenhuijsen M, Daiber A. Environmental risk factors and cardiovascular diseases: a comprehensive review. Cardiovasc Res 2021; 118:2880-2902. [PMID: 34609502 PMCID: PMC9648835 DOI: 10.1093/cvr/cvab316] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/30/2021] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality. The majority of these deaths are caused by cardiovascular disease. The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night and climate change, including heat extremes, desert storms and wildfires. In addition to the traditional risk factors for cardiovascular disease such as diabetes, arterial hypertension, smoking, hypercholesterolemia and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers. Furthermore, urbanization is associated with accumulation and intensification of these stressors. This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs. We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on cardiovascular disease.
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Affiliation(s)
- Thomas Münzel
- Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Germany
| | - Omar Hahad
- Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Germany
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Atmospheric Chemistry Department, Mainz, Germany
| | - Georg Daniel Duerr
- Department of Cardiac Surgery, University Medical Center Mainz, Johannes Gutenberg University, Germany
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Andreas Daiber
- Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Germany
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Crea F. The new SCORE2 risk prediction algorithms and the growing challenge of risk factors not captured by traditional risk scores. Eur Heart J 2021; 42:2403-2407. [PMID: 34198344 DOI: 10.1093/eurheartj/ehab369] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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50
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Münzel T, Hahad O, Daiber A. Running in polluted air is a two-edged sword - physical exercise in low air pollution areas is cardioprotective but detrimental for the heart in high air pollution areas. Eur Heart J 2021; 42:2498-2500. [PMID: 33963403 PMCID: PMC8248992 DOI: 10.1093/eurheartj/ehab227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
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