Particulate air pollution and daily mortality in Steubenville, Ohio

A Long Way from Steubenville: Environmental Epidemiology in a Rapidly Changing World

This commentary focuses on research that has long been at the core of environmental epidemiology: studies of the health effects of air pollution. It highlights publications in the American Journal of Epidemiology going back more than 50 years that have contributed to the debate about the validity of this research and its meaning for public policy. Technological advances have greatly expanded the toolbox of environmental epidemiologists in terms of measuring and analyzing complex exposures in large populations. Yet, discussions about biases in estimating air pollution health effects have always been and remain intense. Epidemiologists have brought new methodologies and concepts to this research, alleviating some but not all concerns. Here, the focus is on seminal epidemiologic work that established valid links between air pollution exposures and health outcomes and generated data for environmental policies and prevention. With this commentary, I hope to inspire epidemiologists to address many more of the burning environmental health questions-wildfires included-with a similar scientific doggedness. The rapidly changing conditions of our planet are challenging us to innovate and offer solutions, albeit perhaps a little bit faster this time around.

Synergy of Biostatistics and Epidemiology in Air Pollution Health Effects Studies

The extraordinary advances in quantifying the health effects of ambient air pollution over the last five decades have led to dramatic improvement in air quality in the United States. This work has been possible through innovative epidemiologic study designs coupled with advanced statistical analytic methods. This paper presents a historical perspective on the coordinated developments of epidemiologic designs and statistical methods for air pollution health effects studies at the Harvard School of Public Health.

Realistic operation of two residential cordwood-fired outdoor hydronic heater appliances-Part 3: Optical properties of black and brown carbon emissions

Residential biomass combustion is a source of carbonaceous aerosol. Inefficient combustion, particularly of solid fuels produces large quantities of black and brown carbon (BC and BrC). These particle types are important as they have noted effects on climate forcing and human health. One method of measuring these quantities is by measurement of aerosol light-absorption and scattering, which can be performed using an aethalometer and nephelometer, respectively. These instruments are widely deployed in the study of ambient air and are frequently used in air quality modeling and source apportionment studies. In this study, we will describe (1) a method for measuring primary BC and BrC emissions from two residential log-fired wood hydronic heaters and (2) the BC and BrC emission from these devices over a wide range of operating conditions, such as cold-starts, warm-starts, four different levels of output ranging from 15% to 100% maximum rated output, and periods of repeated cycling. The range in flue-gas BC concentrations, measured using an aethalometer at the 880 nanometer (nm) wavelength, were between 5.09 × 10² and 2.24 × 10⁴ micrograms per cubic meter (µg/m³) while the scattering coefficient of the flue-gas, measured by a nephelometer at 880 nm, ranged between 2.20 × 10³ and 8.56 × 10⁵ inverse megameters (Mm^-1). The BrC concentrations, measured using the 370 nm wavelength of an aethalometer, were between 9.10 × 10¹ and 3.56 × 10⁴ µg/m³. The calculated Angstrom Absorption Exponent (AAE) of the flue-gas aerosol ranged between 1.54 and 3.63. Performing a comparison between the measured BC concentration and an external particulate matter (PM) concentration showed that overall BC makes up roughly a quarter of the PM emitted by either of the two appliances. Further for both appliances, the cold-start and the test phase immediately following it had the highest BC and BrC concentrations, the highest measured scattering coefficient, as well as a low AAE.Implications: In this work we provide information on the black and brown carbon emissions from outdoor cordwood-fired hydronic heaters. Aethalometer based black carbon measurements are common in atmospheric science, but are uncommonly used in laboratory studies. This work helps to bridge that gap. This data helps to inform the work of modelers and policy makers interested in hydronic heaters and source apportioning biomass combustion emissions.

Fifty years of EPA science for air quality management and control

Research and development has been a key part of the foundation for improvements in US air quality since the establishment of the Environmental Protection Agency (EPA) 50 years ago. Although the scientific accomplishments and advances over the course of EPA's history are often overshadowed by policy debates, much of the air pollution science and engineering we now consider to be routine did not exist when EPA was established. Many of the advances in air pollutant measurement, monitoring, modeling, and control were developed by EPA researchers or supported by EPA programs. The technical foundation built during EPA's early years has since given the Agency the scientific ability to respond quickly and effectively to unexpected and emerging issues. Equally important, EPA also developed approaches to conducting and presenting science in policy settings to ensure that the science was as objective and complete as possible and was communicated effectively. A look back at some of the accomplishments of EPA scientists and engineers provides a reminder that the cumulative effect of continual, incremental advances can result in large and lasting benefits to society.

Influence of Meteorological Conditions and Aerosol Properties on the COVID-19 Contamination of the Population in Coastal and Continental Areas in France: Study of Offshore and Onshore Winds

Human behaviors probably represent the most important causes of the SARS-Cov-2 virus propagation. However, the role of virus transport by aerosols—and therefore the influence of atmospheric conditions (temperature, humidity, type and concentration of aerosols)—on the spread of the epidemic remains an open and still debated question. This work aims to study whether or not the meteorological conditions related to the different aerosol properties in continental and coastal urbanized areas might influence the atmospheric transport of the SARS-Cov-2 virus. Our analysis focuses on the lockdown period to reduce the differences in the social behavior and highlight those of the weather conditions. As an example, we investigated the contamination cases during March 2020 in two specific French areas located in both continental and coastal areas with regard to the meteorological conditions and the corresponding aerosol properties, the optical depth (AOD) and the Angstrom exponent provided by the AERONET network. The results show that the analysis of aerosol ground-based data can be of interest to assess a virus survey. We found that moderate to strong onshore winds occurring in coastal regions and inducing humid environment and large sea-spray production episodes coincides with smaller COVID-19 contamination rates. We assume that the coagulation of SARS-Cov-2 viral particles with hygroscopic salty sea-spray aerosols might tend to inhibit its viral infectivity via possible reaction with NaCl, especially in high relative humidity environments typical of maritime sites.

Does environment quality and public spending on environment promote life expectancy in China? Evidence from a nonlinear autoregressive distributed lag approach

Environmental quality has become a growing concern for Chinese society since the last 2 decades in China. The large contribution of different pollutants severely affected the environmental quality that untimely affects life expectancy in the country. In this backdrop, the present study investigates the impact of environmental quality and public spending on the environment for life expectancy in China using the period 1999Q1-2017Q4. We employ nonlinear autoregressive distributed lag model (ARDL) approach for the empirical assessment. The outcomes of the study reveal the existence of a long-run relationship between environmental quality, public spending on the environment and life expectancy in China. The empirical finding reported that life expectancy reacts differently in response to positive and negative shocks of environmental quality both in the long- and short-run. Environmental quality and spending on the environment increase the life expectancy, furthermore, population has a positive and significant association with life expectancy only in short run while in long run it does not affect. Hence, the government needs to roll out policies to enhance environmental quality and ensure adequate funding for environmental preservation, to achieve both longevity of society and sustainability of the eco-system.

The effects of "Fangcang, Huoshenshan, and Leishenshan" hospitals and environmental factors on the mortality of COVID-19

Background

In December 2019, a novel coronavirus disease (COVID-19) broke out in Wuhan, China; however, the factors affecting the mortality of COVID-19 remain unclear.

Methods

Thirty-two days of data (the growth rate/mortality of COVID-19 cases) that were shared by Chinese National Health Commission and Chinese Weather Net were collected by two authors independently. Student’s t-test or Mann-Whitney U test was used to test the difference in the mortality of confirmed/severe cases before and after the use of “Fangcang, Huoshenshan, and Leishenshan” makeshift hospitals (MSHs). We also studied whether the above outcomes of COVID-19 cases were related to air temperature (AT), relative humidity (RH), or air quality index (AQI) by performing Pearson’s analysis or Spearman’s analysis.

Results

Eight days after the use of MSHs, the mortality of confirmed cases was significantly decreased both in Wuhan (t = 4.5, P < 0.001) and Hubei (U = 0, P < 0.001), (t and U are the test statistic used to test the significance of the difference). In contrast, the mortality of confirmed cases remained unchanged in non-Hubei regions (U = 76, P = 0.106). While on day 12 and day 16 after the use of MSHs, the reduce in mortality was still significant both in Wuhan and Hubei; but in non-Hubei regions, the reduce also became significant this time (U = 123, P = 0.036; U = 171, P = 0.015, respectively). Mortality of confirmed cases was found to be negatively correlated with AT both in Wuhan (r =  − 0.441, P = 0.012) and Hubei (r =  − 0.440, P = 0.012). Also, both the growth rate and the mortality of COVID-19 cases were found to be significantly correlated with AQI in Wuhan and Hubei. However, no significant correlation between RH and the growth rate/mortality of COVID-19 cases was found in our study.

Conclusions

Our findings indicated that both the use of MSHs, the rise of AT, and the improvement of air quality were beneficial to the survival of COVID-19 patients.

Does Air Pollution Influence COVID-19 Outbreaks?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [...]

A Systematic Review of the Time Series Studies Addressing the Endemic Risk of Acute Gastroenteritis According to Drinking Water Operation Conditions in Urban Areas of Developed Countries

Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to drinking water operation conditions in urban areas of developed countries. Eighteen studies were included, covering 17 urban sites (seven in North-America and 10 in Europe) with study populations ranging from 50,000 to 9 million people. Most studies used general practitioner consultations or visits to hospitals for acute gastroenteritis (AGE) as health outcomes. In 11 of the 17 sites, a significant and plausible association was found between turbidity (or particle count) in finished water and the AGE indicator. When provided and significant, the interquartile excess of relative risk estimates ranged from 3–13%. When examined, water temperature, river flow, and produced flow were strongly associated with the AGE indicator. The potential of TSS for the study of the health risk from fecal pathogens in tap water is limited by the lack of specificity of turbidity and its site-sensitive value as an exposure proxy. Nevertheless, at the DWS level, TSS could help water operators to identify operational conditions most at risk, almost if considering other water operation indicators, in addition to turbidity, as possible relevant proxies for exposure.

A Vision for Health in Our New Century

Our vision of good health is changing. Extraordinary progress was made over the course of the 20th century—life expectancy at birth increased by nearly 30 years and scientific insights revealed that our health fates are determined by interacting factors within each of the five major health domains. As life expectancies extend far beyond customary notions of old age, attention shifts from survival and toward improving the quality of life. Our beliefs about what makes for a healthy life are reorienting around a vision of new possibilities, in which we take full advantage of what we know about getting each child off to the right start; providing all the opportunity for lifelong vitality borne of healthy lifestyles; designing safe and nurturing physical environments for our communities; assuring that all have access to the kind of medical care they need; protecting the isolated or estranged from the illness or injury that often accompanies their condition; and providing comfort and choices for all at the end of life.

How relevant is environmental quality to per capita health expenditures? Empirical evidence from panel of developing countries

BACKGROUND

Developing countries have witnessed economic growth as their GDP keeps increasing steadily over the years. The growth led to higher energy consumption which eventually leads to increase in air pollutions that pose a danger to human health. People's healthcare demand, in turn, increase due to the changes in the socioeconomic life and improvement in the health technology. This study is an attempt to investigate the impact of environmental quality on per capital health expenditure in 125 developing countries within a panel cointegration framework from 1995 to 2012.

RESULTS

We found out that a long-run relationship exists between per capita health expenditure and all explanatory variables as they were panel cointegrated. The explanatory variables were found to be statistically significant in explaining the per capita health expenditure. The result further revealed that CO2 has the highest explanatory power on the per capita health expenditure. The impact of the explanatory power of the variables is greater in the long-run compared to the short-run. Based on this result, we conclude that environmental quality is a powerful determinant of health expenditure in developing countries.

CONCLUSION

Therefore, developing countries should as a matter of health care policy give provision of healthy air a priority via effective policy implementation on environmental management and control measures to lessen the pressure on health care expenditure. Moreover more environmental proxies with alternative methods should be considered in the future research.

Association between Ambient Air Pollution and Asthma Prevalence in Different Population Groups Residing in Eastern Texas, USA

Air pollution has been an on-going research focus due to its detrimental impact on human health. However, its specific effects on asthma prevalence in different age groups, genders and races are not well understood. Thus, the present study was designed to examine the association between selected air pollutants and asthma prevalence in different population groups during 2010 in the eastern part of Texas, USA.The pollutants considered were particulate matter (PM2.5 with an aerodynamic diameter less than 2.5 micrometers) and surface ozone. The population groups were categorized based on age, gender, and race. County-wise asthma hospital discharge data for different age, gender, and racial groups were obtained from Texas Asthma Control Program, Office of Surveillance, Evaluation and Research, Texas Department of State Health Services. The annual means of the air pollutants were obtained from the United States Environmental Protection Agency (U.S. EPA)'s air quality system data mart program. Pearson correlation analyzes were conducted to examine the relationship between the annual mean concentrations of pollutants and asthma discharge rates (ADR) for different age groups, genders, and races. The results reveal that there is no significant association or relationship between ADR and exposure of air pollutants (PM2.5, and O₃). The study results showed a positive correlation between PM2.5 and ADR and a negative correlation between ADR and ozone in most of the cases. These correlations were not statistically significant, and can be better explained by considering the local weather conditions. The research findings facilitate identification of hotspots for controlling the most affected populations from further environmental exposure to air pollution, and for preventing or reducing the health impacts.

Commuter exposure to inhalable, thoracic and alveolic particles in various transportation modes in Delhi

A public health concern is to understand the linkages between specific pollution sources and adverse health impacts. Commuting can be viewed as one of the significant-exposure activity in high-vehicle density areas. This paper investigates the commuter exposure to inhalable, thoracic and alveolic particles in various transportation modes in Delhi, India. Air pollution levels are significantly contributed by automobile exhaust and also in-vehicle exposure can be higher sometime than ambient levels. Motorcycle, auto rickshaw, car and bus were selected to study particles concentration along two routes in Delhi between Kashmere Gate and Dwarka. The bus and auto rickshaw were running on compressed natural gas (CNG) while the car and motorcycle were operated on gasoline fuel. Aerosol spectrometer was employed to measure inhalable, thoracic and alveolic particles during morning and evening rush hours for five weekdays. From the study, we observed that the concentration levels of these particles were greatly influenced by transportation modes. Concentrations of inhalable particles were found higher during morning in auto rickshaw (332.81 ± 90.97 μg/m(3)) while the commuter of bus exhibited higher exposure of thoracic particles (292.23 ± 110.45 μg/m(3)) and car commuters were exposed to maximum concentrations of alveolic particles (222.37 ± 26.56 μg/m(3)). We observed that in evening car commuters experienced maximum concentrations of all sizes of particles among the four commuting modes. Interestingly, motorcycle commuters were exposed to lower levels of inhalable and thoracic particles during morning and evening hours as compared to other modes of transport. The mean values were found greater than the median values for all the modes of transport suggesting that positive skewed distributions are characteristics of naturally occurring phenomenon.

Beirut Air Pollution and Health Effects - BAPHE study protocol and objectives

Background

Recent studies investigating the health effects of air pollution have proven an existing impact around and below international air quality guidelines and standards. These studies were based on accessible data from official registers managed by public authorities. The protocol followed in BAPHE project is described; its benefits and disadvantages are presented and discussed in this paper.

Methods

Based on the review of several international studies we developed a custom made approach in BAPHE (Beirut Air Pollution and Health Effects) project in order to analyze the short term health effects of air pollution taking into consideration the lack of data availability from official sources.

Results

PM_2.5 and PM₁₀ concentrations were measured in Beirut for the period starting from the 1^st of January 2012 to the 31^st of December 2012. The annual average concentrations of PM₁₀ and PM_2.5 exceeded WHO’s annual average limits by 150 % and 200 %, respectively. Health data for 11,567 individuals were collected over 12 months. A variation of hospital admission causes was observed by age categories and gender.

Conclusions

This article presents a simple protocol and the descriptive results of its application in the frame of an eco-epidemiological study in Lebanon. We believe that this work is not only important on a local scale, but it could be helpful for environmental epidemiological studies in other countries.

Understanding the characteristics of the microenvironments in urban street canyons through analysis of pollution measured using a novel pervasive sensor array

This paper presents results of comprehensive analyses of data from the first 122 commercially available wireless environmental pervasive sensors (motes), developed by Newcastle University and deployed in England. Measurements of pollution, meteorology and traffic are used to investigate the complexity of the physical and chemical processes governing the levels of traffic-related pollution in urban areas. Following a brief introduction on health impacts associated with air quality, description of the mote technology is given. Cluster analysis statistics to investigate the relationship between different pollutant types and traffic data demonstrated that traffic flow regimes alone cannot be used to estimate diurnal kerbside pollutant concentrations. Also, the absolute levels, whilst dependent on meteorological conditions and static parameters are only partially governed by the pollutant dispersion. The research clearly illustrates the benefits and added value of pervasive concentration measurement in urban micro environments with potential to effectively evaluate human exposure to transport-related emissions.

Aerosols from biomass burning and respiratory diseases in children, Manaus, Northern Brazil

OBJECTIVE

To investigate the effects of fine particulate matter emitted through biomass burning on hospitalizations for respiratory diseases in children living in Manaus, Northern Brazil.

METHODS

Descriptive study with ecologic time series design carried out in Manaus from 2002 to 2009. Hospital admission data were obtained from the Unified Health System database. PM2.5 levels were estimated using aerosol remote sensing through the measurement of aerosol optical depth at a wavelength of 550 nm. Statistical methods were used in the data analysis, with Pearson correlation and multiple linear regression between variables, with a 95% confidence interval.

RESULTS

The region of Manaus showed low PM2.5 concentrations when compared to the Southern Amazonian region. Between August and November (dry period in the region), was when the highest mean levels of PM2.5, estimated between 18 to 23 µg/m3, and the largest number of fires were observed. For the rainy season, an average of 12 µg/m3, 66% lower than the dry season measurements (20.6 µg/m3) was observed. The highest rates of hospitalization were observed during the rainy season and April was the month with the highest levels at 2.51/1,000 children. A positive association between hospital admissions and relative humidity (R = 0.126; p-value = 0.005) was observed, while the association between admissions and PM2.5 was negative and statistically significant (R = -0.168; p-value = 0.003). The R 2 of the final model (Hospitalizations = 2.19*Humidity - 1.60*PM2.5 - 0.23*Precipitation) explained 84% of hospitalizations due to respiratory disease in children living in Manaus, considering the independent variables statistically significant (humidity, PM2.5, and precipitation).

CONCLUSIONS

Hospital admissions for respiratory diseases in children in Manaus, were more related to weather conditions and in particular relative humidity, than to exposure to aerosols emitted by biomass burning in the Amazonian region.

Long- and short-term exposure to PM2.5 and mortality: using novel exposure models

BACKGROUND

Many studies have reported associations between ambient particulate matter (PM) and adverse health effects, focused on either short-term (acute) or long-term (chronic) PM exposures. For chronic effects, the studied cohorts have rarely been representative of the population. We present a novel exposure model combining satellite aerosol optical depth and land-use data to investigate both the long- and short-term effects of PM2.5 exposures on population mortality in Massachusetts, United States, for the years 2000-2008.

METHODS

All deaths were geocoded. We performed two separate analyses: a time-series analysis (for short-term exposure) where counts in each geographic grid cell were regressed against cell-specific short-term PM2.5 exposure, temperature, socioeconomic data, lung cancer rates (as a surrogate for smoking), and a spline of time (to control for season and trends). In addition, for long-term exposure, we performed a relative incidence analysis using two long-term exposure metrics: regional 10 × 10 km PM2.5 predictions and local deviations from the cell average based on land use within 50 m of the residence. We tested whether these predicted the proportion of deaths from PM-related causes (cardiovascular and respiratory diseases).

RESULTS

For short-term exposure, we found that for every 10-µg/m increase in PM 2.5 exposure there was a 2.8% increase in PM-related mortality (95% confidence interval [CI] = 2.0-3.5). For the long-term exposure at the grid cell level, we found an odds ratio (OR) for every 10-µg/m increase in long-term PM2.5 exposure of 1.6 (CI = 1.5-1.8) for particle-related diseases. Local PM2.5 had an OR of 1.4 (CI = 1.3-1.5), which was independent of and additive to the grid cell effect.

CONCLUSIONS

We have developed a novel PM2.5 exposure model based on remote sensing data to assess both short- and long-term human exposures. Our approach allows us to gain spatial resolution in acute effects and an assessment of long-term effects in the entire population rather than a selective sample from urban locations.

Application of GIS and modelling in health risk assessment for urban road mobility

Transport is an essential sector in modern societies. It connects economic sectors and industries. Next to its contribution to economic development and social interconnection, it also causes adverse impacts on the environment and results in health hazards. Transport is a major source of ground air pollution, especially in urban areas, and therefore contributes to the health problems, such as cardiovascular and respiratory diseases, cancer and physical injuries. This paper presents the results of a health risk assessment that quantifies the mortality and the diseases associated with particulate matter pollution resulting from urban road transport in Haiphong City, Vietnam. The focus is on the integration of modelling and geographic information system approaches in the exposure analysis to increase the accuracy of the assessment and to produce timely and consistent assessment results. The modelling was done to estimate traffic conditions and concentrations of particulate matters based on geo-referenced data. The study shows that health burdens due to particulate matter in Haiphong include 1,200 extra deaths for the situation in 2007. This figure can double by 2020 as the result of the fast economic development the city pursues. In addition, 51,000 extra hospital admissions and more than 850,000 restricted activity days are expected by 2020.

Effect of air pollution control on life expectancy in the United States: an analysis of 545 U.S. counties for the period from 2000 to 2007

BACKGROUND

In recent years (2000-2007), ambient levels of fine particulate matter (PM2.5) have continued to decline as a result of interventions, but the decline has been at a slower rate than previous years (1980-2000). Whether these more recent and slower declines of PM2.5 levels continue to improve life expectancy and whether they benefit all populations equally is unknown.

METHODS

We assembled a data set for 545 U.S. counties consisting of yearly county-specific average PM2.5, yearly county-specific life expectancy, and several potentially confounding variables measuring socioeconomic status, smoking prevalence, and demographic characteristics for the years 2000 and 2007. We used regression models to estimate the association between reductions in PM2.5 and changes in life expectancy for the period from 2000 to 2007.

RESULTS

A decrease of 10 μg/m in the concentration of PM2.5 was associated with an increase in mean life expectancy of 0.35 years (SD = 0.16 years, P = 0.033). This association was stronger in more urban and densely populated counties.

CONCLUSIONS

Reductions in PM2.5 were associated with improvements in life expectancy for the period from 2000 to 2007. Air pollution control in the last decade has continued to have a positive impact on public health.

Distributed lag associations between respiratory illnesses and mortality with suspended particle concentration in Tula, a highly polluted industrial region in Central Mexico

PURPOSE

We aimed to evaluate the association between changes in airborne particulate matter concentration (PM) with changes in cases of mortality, acute respiratory infections (ARI) and asthma over 2004-2008 in an industrialized and polluted region in central Mexico.

METHODS

A generalized linear model with a Poisson distribution and a negative binomial analysis was used to evaluate the influence of PM and temperature on all-cause mortality (All-cause-M), cause-specific mortality (Cause-specific-M), ARI and asthma, using cubic spline functions and distributed lags of PM. Estimated changes in relative risk were calculated for an exposure corresponding to each increase of 10 μg/m(3) in PM level.

RESULTS

Associations between PM and mortality and morbidity were statistically most consistent for total suspended particulate (TSP) than for particulate matter <10 μM aerodynamic diameter (PM10). The greatest effects in mortality were observed with a 3-week lag, and effects were greater for Cause-specific-M. We also found a displacement effect up to 4-week lag for Cause-specific-M and TSP. The greatest effects in morbidity were observed at 0-week lag, yet they were statistically marginal and were greater for asthma. We found a displacement effect at 4-5-6-week lag for asthma and TSP. All associations of mortality and morbidity, expressed as change in relative risk, were greater with PM10; however, all of them were statistically marginal.

CONCLUSIONS

Increased respiratory morbidity and mortality is associated with weekly changes of PM air pollution in the region. A reduction in air pollutants from industrial sources would benefit life quality and health of the exposed population.

Small (<2.5 micron) particulate matter concentration of ambient air and early death in Hungary

The small (<2.5 micron) particulate matter concentration of ambient air is constantly measured and estimated over Europe, based on the recommendations of the WHO and the Council of Europe. Concentration of small size particulate matter has been found to be very high in Central and Eastern Europe, including central and eastern regions of Hungary. Epidemiologic evidence indicates strong direct correlation between small size particulate matter pollution and incidences of cardiopulmonary disease and lung cancer. As compared to Slovakia or the Czech Republic and after correction for population size, Hungary has the highest number of years of life lost due to small size particulate matter pollution related cardiopulmonary disease and lung cancer. Orv. Hetil., 2012, 153, 285–288.

An Approach to the Estimation of Chronic Air Pollution Effects Using Spatio-Temporal Information

There is substantial observational evidence that long-term exposure to particulate air pollution is associated with premature death in urban populations. Estimates of the magnitude of these effects derive largely from cross-sectional comparisons of adjusted mortality rates among cities with varying pollution levels. Such estimates are potentially confounded by other differences among the populations correlated with air pollution, for example, socioeconomic factors. An alternative approach is to study covariation of particulate matter and mortality across time within a city, as has been done in investigations of short-term exposures. In either event, observational studies like these are subject to confounding by unmeasured variables. Therefore the ability to detect such confounding and to derive estimates less affected by confounding are a high priority. In this article, we describe and apply a method of decomposing the exposure variable into components with variation at distinct temporal, spatial, and time by space scales, here focusing on the components involving time. Starting from a proportional hazard model, we derive a Poisson regression model and estimate two regression coefficients: the "global" coefficient that measures the association between national trends in pollution and mortality; and the "local" coefficient, derived from space by time variation, that measures the association between location-specific trends in pollution and mortality adjusted by the national trends. Absent unmeasured confounders and given valid model assumptions, the scale-specific coefficients should be similar; substantial differences in these coefficients constitute a basis for questioning the model. We derive a backfitting algorithm to fit our model to very large spatio-temporal datasets. We apply our methods to the Medicare Cohort Air Pollution Study (MCAPS), which includes individual-level information on time of death and age on a population of 18.2 million for the period 2000-2006. Results based on the global coefficient indicate a large increase in the national life expectancy for reductions in the yearly national average of PM2.5. However, this coefficient based on national trends in PM2.5 and mortality is likely to be confounded by other variables trending on the national level. Confounding of the local coefficient by unmeasured factors is less likely, although it cannot be ruled out. Based on the local coefficient alone, we are not able to demonstrate any change in life expectancy for a reduction in PM2.5. We use additional survey data available for a subset of the data to investigate sensitivity of results to the inclusion of additional covariates, but both coefficients remain largely unchanged.

Health effects associated with passenger vehicles: monetary values of air pollution

Air pollution is regarded as one of the highest priorities in environmental protection in both developed and developing countries. High levels of air pollution have adverse effects on human health that might cause premature death. This study presents the monetary value estimates for the adverse human health effects resulted from ambient air pollution. It aids decision makers to set priorities in the public health relevance of pollution abatement. The main driver of policymaker is the need to reduce the avoidable cardiopulmonary morbidity and mortality from pollutant exposures. The monetary valuation involves 2 steps: (i) relate levels of pollutants to mortality and morbidity (concentration-response relationships) and (ii) apply unit economic values. Cost of air pollution associated with passenger vehicles running over a major traffic bridge (6th of October Elevated Highway) is presented as a case study to demonstrate the use of monetary value of air pollution. The study proves that the cost of air pollution is extremely high and should not be overlooked.

INDUSTRIAL POLLUTION AND ASTHMA: A MATHEMATICAL MODEL

In this paper, some nonlinear mathematical models are proposed and analyzed to study the spread of asthma due to inhaled pollutants from Industry. The following two types of demographics are considered here; (i) population with constant immigration, (ii) population with logistic growth. In each type of demography, the following three cases have been considered regarding the release of pollutant into the environment; (i) when emission of the pollutant into the environment is constant, (ii) when emission of the pollutant is population dependent, and (iii) when emission of the pollutant is periodic. Using stability theory of differential equations and computer simulation, it is shown that due to an increase in the air pollutant, the asthmatic (diseased) population increases in the region under consideration.

Air quality interventions and spatial dynamics of air pollution in Delhi and its surroundings

The paper examines the spatial distribution of air pollution in response to recent air quality regulations in Delhi, India. Air pollution was monitored at 113 sites spread across Delhi and its surrounding areas from July-December 2003. From the analysis of these data three important findings emerge. First, air pollution levels in Delhi and its surroundings were significantly higher than that recommended by the World Health Organization (WHO). Second, air quality regulations in the city adversely affected the air quality of the areas surrounding Delhi. Third, industries and trucks were identified as the major contributors of both fine and coarse particles.

Health effects of particulate air pollution

In the 1980's it was generally felt that particulate air pollution concentrations in the United States were not a hazard to the public health. However, in the early 1990's the application of econometric time-series studies and prospective cohort studies suggested increased mortality associated with acute (daily) and chronic (decades) exposures to particulate air pollution commonly observed in the developed world. The epidemiologic evidence was not supported by evidence of causal associations from other disciplines. Nevertheless, the EPA moved to tighten controls on fine particulate air pollution. The debate over the science was played out in public hearings and the courts. The experience provides lessons on the use of epidemiologic data in setting public policy.

Association between daily mortality from respiratory and cardiovascular diseases and air pollution in Taiwan

BACKGROUND

Many studies have investigated the effects of air pollutants on disease and mortality. However, the results remain inconsistent and inconclusive. We thought that the impact of different seasons or ages of people may explain these differences.

METHODS

Measurement of the five pollutants (particulate matter <10 microm in aerodynamic diameter (PM(10)), SO(2), NO(2), O(3), and CO) was monitored by automated measuring units at five different stations. Monitoring stations were provided by the Taiwan Environmental Protection Agency (EPA) from 1997 to 1999. The subjects in the study were classified in two groups: those 65 years of age and older, and those of all ages (including the subjects in the > or =65 group). Data on daily mortality caused by respiratory disease, cardiovascular disease, and all other causes including the two aforementioned was collected by the Taiwan Department of Health (DOH). A time-series regression model was used to analyze the relative risk of respiratory and cardiovascular diseases due to air pollution in the summer and winter seasons.

RESULTS

Risk of death from all causes and mortality from cardiovascular diseases during winter was significantly positively correlated with levels of SO(2), CO, and NO(2) for both groups of subjects and additionally with PM(10) for the elderly (> or =65 years old) group. There were significant positive correlations with respiratory diseases and levels of O(3) for both groups. However, the only significant positive correlation was with O(3) (RR=1.283) for the elderly group during summer. No other parameters showed significance for either group.

CONCLUSION

Our findings contribute to the evidence of an association between SO(2), CO, NO(2), and PM(10) and mortality from respiratory and cardiovascular diseases, especially among elderly people during the winter season.

Use of health information in air pollution health research: past successes and emerging needs

In September 2006, the US Environmental Protection Agency and the US Centers for Disease Control (CDC) co-organized a symposium on "Air Pollution Exposure and Health." The main objective of this symposium was to identify opportunities for improving the use of exposure and health information in future studies of air pollution health effects. This paper deals with the health information needs of such studies. We begin with a selected review of different types of health data and how they were used in previous epidemiologic studies of health effects of ambient particulate matter (PM). We then examine the current and emerging information needs of the environmental health community, dealing with PM and other air pollutants of health concern. We conclude that the past use of routinely collected health data proved to be essential for activities to protect public health, including the identification and evaluation of health hazards by air pollution research, setting standards for criteria pollutants, surveillance of health outcomes to identify incidence trends, and the more recent CDC environmental public health tracking program. Unfortunately, access to vital statistics records that have informed such pivotal research has recently been curtailed sharply, threatening the continuation of the type of research necessary to support future standard setting and research on emerging exposure and health problems (e.g. asthma, multiple sclerosis, diabetes, and others), as well as our ability to evaluate the efficacy of regulatory and other prevention activities. A comprehensive devoted effort, perhaps new legislation, will be needed to address the standardization, centralization, and sharing of data sets, as well as to harmonize the interpretation of confidentiality and privacy protections across jurisdictions. These actions, combined with assuring researchers and public health practitioners appropriate access to data for evaluation of environmental risks, will be essential for the achievement of our environmental health protection goals.

Surgical smoke and ultrafine particles

Background

Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine (<100 nm) and accumulation mode particles (< 1 μm). Epidemiological and toxicological studies have shown that exposure to particulate air pollution is associated with adverse cardiovascular and respiratory health effects.

Methods

To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc.) was applied.

Results

Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm^-3) of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes.

Conclusion

Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

Air pollutants, oxidative stress and human health

Air pollutants have, and continue to be, major contributing factors to chronic diseases and mortality, subsequently impacting public health. Chronic diseases include: chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (CVD), asthma, and cancer. Byproducts of oxidative stress found in air pollutants are common initiators or promoters of the damage produced in such chronic diseases. Such air pollutants include: ozone, sulfur oxides, carbon monoxide, nitrogen oxides, and particulate matter. Interaction between oxidative stress byproducts and certain genes within our population may modulate the expression of specific chronic diseases. In this brief review we attempt to provide some insight into what we currently know about the health problems associated with various air pollutants and their relationship in promoting chronic diseases through changes in oxidative stress and modulation of gene expression. Such insight eventually may direct the means for effective public health prevention and treatment of diseases associated with air pollution and treatment of diseases associated with air pollution.

Ancillary human health benefits of improved air quality resulting from climate change mitigation

BACKGROUND

Greenhouse gas (GHG) mitigation policies can provide ancillary benefits in terms of short-term improvements in air quality and associated health benefits. Several studies have analyzed the ancillary impacts of GHG policies for a variety of locations, pollutants, and policies. In this paper we review the existing evidence on ancillary health benefits relating to air pollution from various GHG strategies and provide a framework for such analysis.

METHODS

We evaluate techniques used in different stages of such research for estimation of: (1) changes in air pollutant concentrations; (2) avoided adverse health endpoints; and (3) economic valuation of health consequences. The limitations and merits of various methods are examined. Finally, we conclude with recommendations for ancillary benefits analysis and related research gaps in the relevant disciplines.

RESULTS

We found that to date most assessments have focused their analysis more heavily on one aspect of the framework (e.g., economic analysis). While a wide range of methods was applied to various policies and regions, results from multiple studies provide strong evidence that the short-term public health and economic benefits of ancillary benefits related to GHG mitigation strategies are substantial. Further, results of these analyses are likely to be underestimates because there are a number of important unquantified health and economic endpoints.

CONCLUSION

Remaining challenges include integrating the understanding of the relative toxicity of particulate matter by components or sources, developing better estimates of public health and environmental impacts on selected sub-populations, and devising new methods for evaluating heretofore unquantified and non-monetized benefits.

The potential impact of climate change on annual and seasonal mortality for three cities in Québec, Canada

BACKGROUND

The impact of climate change and particularly increasing temperature on mortality has been examined for three cities in the province of Québec, Canada.

METHODS

Generalized linear Poisson regression has been fitted to the total daily mortality for each city. Smooth parametric cubic splines of temperature and humidity have been used to do nonlinear modeling of these parameters. The model, to control for day of the week and for non-temperature seasonal factors, used a smooth function of time, including delayed effects. The model was then used to assess variation in mortality for simulated future temperatures obtained from an atmospheric General Circulation Model coupled with downscaling regression techniques. Two CO2 emission scenarios are considered (scenarios A2 and B2). Projections are made for future periods around year 2020 (2010-2039), 2050 (2040-2069) and 2080 (2070-2099).

RESULTS

A significant association between mortality and current temperature has been found for the three cities. Under CO2 emission scenarios A2 and B2, the mortality model predicts a significant increase in mortality in the summertime, and a smaller, but significant decrease in the fall season. The slight variations in projected mortality for future winter and spring seasons were found to be not statistically significant. The variations in projected annual mortality are dominated by an increase in mortality in the summer, which is not balanced by the decrease in mortality in the fall and winter seasons. The summer increase and the annual mortality range respectively from about 2% and 0.5% for the 2020 period, to 10% and 3% for the years around 2080. The difference between the mortality variations projected with the A2 or B2 scenarios was not statistically significant.

CONCLUSION

For the three cities, the two CO2 emission scenarios considered led to an increase in annual mortality, which contrasts with most European countries, where the projected increase in summer mortality with respect to climate change is overbalanced by the decrease in winter mortality. This highlights the importance of place in such analyses. The method proposed here to establish these estimates is general and can also be applied to small cities, where mortality rates are relatively low (ex. two deaths/day).

Effects of residual oil fly ash (ROFA) in mice with chronic allergic pulmonary inflammation

Exposure to particulate matter (PM) air pollution is associated with increased asthma morbidity. Residual oil flash ash (ROFA) is rich in water-soluble transition metals, which are involved in the pathological effects of PM. The objective of this study was to investigate the effects of intranasal administration of ROFA on pulmonary inflammation, pulmonary responsiveness, and excess mucus production in a mouse model of chronic pulmonary allergic inflammation. BALB/c mice received intraperitoneal injections of ovalbumin (OVA) solution (days 1 and 14). OVA challenges were performed on days 22, 24, 26, and 28. After the challenge, mice were intranasally instilled with ROFA. After forty-eight hours, pulmonary responsiveness was performed. Mice were sacrificed, and lungs were removed for morphometric analysis. OVA-exposed mice presented eosinophilia in the bronchovascular space (p < .001), increased pulmonary responsiveness (p < .001), and epithelial remodeling (p = .003). ROFA instillation increased pulmonary responsiveness (p = .004) and decreased the area of ciliated cells in the airway epithelium (p = .006). The combined ROFA instillation and OVA exposure induced a further increase in values of pulmonary responsiveness (p = .043) and a decrease in the number of ciliated cells in the airway epithelium (p = .017). PM exposure results in pulmonary effects that are more intense in mice with chronic allergic pulmonary inflammation.