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Raab H, Moyer J, Afrin S, Garcia-Menendez F, Ward-Caviness CK. Prescribed fires, smoke exposure, and hospital utilization among heart failure patients. Environ Health 2023; 22:86. [PMID: 38087300 PMCID: PMC10717133 DOI: 10.1186/s12940-023-01032-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients' hospital utilization. METHODS We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients' primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). RESULTS Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. CONCLUSIONS Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.
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Affiliation(s)
- Henry Raab
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Joshua Moyer
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Sadia Afrin
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Present address: MIT Laboratory for Aviation and the Environment, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Fernando Garcia-Menendez
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA.
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Bae S, Lim YH, Oh J, Kwon HJ. Mediation of daily ambient ozone concentration on association between daily mean temperature and mortality in 7 metropolitan cities of Korea. ENVIRONMENT INTERNATIONAL 2023; 178:108078. [PMID: 37413930 DOI: 10.1016/j.envint.2023.108078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Climate change is suspected to cause adverse health effects, and increased ozone concentration is one of the proposed pathways. We examined the mediation of ozone on the association between temperature and daily mortality and estimated excess mortality due to climate change. METHODS Daily mean temperature, 8-hour maximum ozone concentration, and daily number of non-accidental deaths from 7 metropolitan cities in Korea (Seoul, Busan, Daegu, Incheon, Daejeon, Gwangju, and Ulsan) between January 1, 2006 and December 31, 2019 were analyzed. A mediation analysis using a linear regression model for temperature and ozone and a Poisson regression model for temperature and mortality adjusting for ozone was conducted on days with temperature higher than or lower than city specific minimum mortality temperature. We calculated excess mortality due to direct and indirect effects of daily temperature exceeding average daily temperature from 1960 to 1990. RESULTS The daily mean temperature from 2006 to the end of 2019 was 1.15 ± 2.94 °C higher than the average daily temperature from 1960 to 1990. The pooled relative risk (for a 1 °C increment) of indirect effects through increased ozone were 1.0002 [95% confidence interval (CI): 0.9999, 1.0004] and 1.0003 (95% CI: 1.0002, 1.0005) in days with higher than or lower than minimum mortality temperature, respectively. The numbers of excess deaths during the study period were 2072.5 (95% CI: 1957.1, 2186.5) due to direct effects in days with higher than minimal mortality temperature, and 94.6 (95% CI: 84.3, 101.7) and 268.5 (95% CI: 258.4, 289.1) due to indirect effects in days with higher than and lower than minimal mortality temperature, respectively. CONCLUSION We observed a mediating effect of ozone between temperature and daily mortality. There has been excess deaths due direct effect of temperature and indirect effects through ozone.
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Affiliation(s)
- Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Environmental Health Center, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Youn-Hee Lim
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jongmin Oh
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Human Systems Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
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Jia Y, Lin Z, He Z, Li C, Zhang Y, Wang J, Liu F, Li J, Huang K, Cao J, Gong X, Lu X, Chen S. Effect of Air Pollution on Heart Failure: Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:76001. [PMID: 37399145 PMCID: PMC10317211 DOI: 10.1289/ehp11506] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/15/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. OBJECTIVES We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences. METHODS Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, O 3 ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results. RESULTS Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk ( RR ) = 1.018 , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (RR = 1.016 , 95% CI: 1.011, 1.020) per 10 - μ g / m 3 increment of PM 2.5 and PM 10 , respectively. HF was also significantly associated with NO 2 , SO 2 , and CO, but not O 3 . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per 10 - μ g / m 3 increment in PM 2.5 , 1.212 (1.010, 1.454) per 10 - μ g / m 3 increment in PM 10 , and 1.204 (1.069, 1.356) per 10 -ppb increment in NO 2 , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results. DISCUSSION Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
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Affiliation(s)
- Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhennan Lin
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Chenyang Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Youjing Zhang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jingyu Wang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Xinyuan Gong
- Department of Science and Education, Tianjin First Central Hospital, Tianjin, China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
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Zhang D, Chen W, Cheng C, Huang H, Li X, Qin P, Chen C, Luo X, Zhang M, Li J, Sun X, Liu Y, Hu D. Air pollution exposure and heart failure: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 872:162191. [PMID: 36781139 DOI: 10.1016/j.scitotenv.2023.162191] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
While the literature strongly supports a positive association between particulate matter with diameter ≤ 2.5 μm (PM2.5) exposure and heart failure (HF), there is uncertainty regarding the other pollutants and the dose and duration of exposure that triggers an adverse response. To comprehensively assess and quantify the association of air pollution exposure with HF incidence and mortality, we performed separate meta-analyses according to pollutant types [PM2.5, PM10, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and exposure duration (short- and long-term). We systematically searched PubMed, EMBASE, and Web of Science for relevant articles with publication dates up to July 12, 2022, identifying 35 eligible studies. Random-effects models were used to summarize the pooled odds ratios (ORs) and 95 % confidence intervals (95 % CIs). For long-term exposure, the growing risk of HF was significantly associated with each 10 μg/m3 increase in PM2.5 (OR = 1.196, 95 % CI: 1.079-1.326; I2 = 76.8 %), PM10 (1.190, 1.045-1.356; I2 = 76.2 %), and NO2 (1.072, 1.028-1.118; I2 = 78.3 %). For short-term exposure, PM2.5, PM10, NO2, and O3 (per 10 μg/m3 increment) increased the risk of HF, with estimated ORs of 1.019 (1.008-1.030; I2 = 39.9 %), 1.012 (1.007-1.017; I2 = 28.3 %), 1.016 (1.005-1.026; I2 = 53.7 %), and 1.006 (1.002-1.010; I2 = 0.0 %), respectively. No significant effects of SO2 and CO exposure on the risk of HF were observed. In summary, our study powerfully highlights the deleterious impact of PM2.5, PM10, and NO2 exposure (either short- or long-term) on HF risk. Serious efforts should be made to improve air quality through legislation and interdisciplinary cooperation.
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Affiliation(s)
- Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Weiling Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Cheng Cheng
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xi Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Pei Qin
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Chuanqi Chen
- Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xinping Luo
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Xizhuo Sun
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong, People's Republic of China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China.
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Yang YS, Pei YH, Gu YY, Zhu JF, Yu P, Chen XH. Association between short-term exposure to ambient air pollution and heart failure: An updated systematic review and meta-analysis of more than 7 million participants. Front Public Health 2023; 10:948765. [PMID: 36755739 PMCID: PMC9900180 DOI: 10.3389/fpubh.2022.948765] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Exposure to air pollution has been linked to the mortality of heart failure. In this study, we sought to update the existing systematic review and meta-analysis, published in 2013, to further assess the association between air pollution and acute decompensated heart failure, including hospitalization and heart failure mortality. Methods PubMed, Web of Science, EMBASE, and OVID databases were systematically searched till April 2022. We enrolled the studies regarding air pollution exposure and heart failure and extracted the original data to combine and obtain an overall risk estimate for each pollutant. Results We analyzed 51 studies and 7,555,442 patients. Our results indicated that heart failure hospitalization or death was associated with increases in carbon monoxide (3.46% per 1 part per million; 95% CI 1.0233-1.046, P < 0.001), sulfur dioxide (2.20% per 10 parts per billion; 95% CI 1.0106-1.0335, P < 0.001), nitrogen dioxide (2.07% per 10 parts per billion; 95% CI 1.0106-1.0335, P < 0.001), and ozone (0.95% per 10 parts per billion; 95% CI 1.0024-1.0166, P < 0.001) concentrations. Increases in particulate matter concentration were related to heart failure hospitalization or death (PM2.5 1.29% per 10 μg/m3, 95% CI 1.0093-1.0165, P < 0.001; PM10 1.30% per 10 μg/m3, 95% CI 1.0102-1.0157, P < 0.001). Conclusion The increase in the concentration of all pollutants, including gases (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone) and particulate matter [(PM2.5), (PM10)], is positively correlated with hospitalization rates and mortality of heart failure. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021256241.
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Affiliation(s)
- Yu-shan Yang
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China,Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ying-hao Pei
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan-yuan Gu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China,Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jun-feng Zhu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China,Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Peng Yu
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,*Correspondence: Peng Yu ✉
| | - Xiao-hu Chen
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,Xiao-hu Chen ✉
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Atmospheric Pollution and Hospitalization for Cardiovascular and Respiratory Diseases in the City of Manaus from 2008 to 2012. ScientificWorldJournal 2020; 2020:8458359. [PMID: 32308570 PMCID: PMC7152981 DOI: 10.1155/2020/8458359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 11/30/2022] Open
Abstract
Objective To relate the levels of air pollution and hospital admissions for cardiovascular and respiratory diseases in the city of Manaus in Brazil from 2008 to 2012. Method This is an ecological time-series study among children (under 5 years of age) and elderly (above 60 years of age). Data on the daily number of hospitalizations for cardiovascular and respiratory diseases, pollutants (PM2.5), temperature, and humidity were used. Poisson generalized additive models were used to estimate the association between variables. Increases in hospitalizations for cardiovascular and respiratory diseases were estimated for the interquartile range (IQR) daily mean level of each variable studied, with a confidence interval of 95%. Results Respiratory diseases and children: −0.40% (95% CI: −1.11, 0.30), 0.59% (95% CI: −0.35, 1.52), and 0.47% (95% CI: −3.28, 4.21) for PM2.5, temperature, and humidity, respectively. Respiratory diseases and elderly: 0.19% (95% CI: −0.93, 1.31), −0.10% (95% CI: −1.85, 1.65), and −6.17% (95% CI: −13.08, 0.74) for PM2.5, temperature, and humidity, respectively. Cardiovascular diseases and elderly: −0.18% (95% CI: −0.86, 0.50), −0.04% (95% CI: −1.10, 1.03), and −3.37% (95% CI: −7.59, 0.85) for PM2.5, temperature, and humidity, respectively. Conclusions The time-series study found no significant association between PM2.5, temperature, humidity, and hospitalization, unlike the evidences provided by the present academic literature. Since there is no air quality monitoring network in Manaus and the option available in the present study was to reproduce some information obtained from remote sensing, there is a need for implementation of ground monitoring stations for health and environmental studies in the region.
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Neisi A, Borsi SH, Dastoorpoor M, Kiasat N, Goudarzi G, AlizadehAttar G, Angali KA, AlizadehAttar S. Relationship between environmental Fungi and changes in lung function indices of new referral allergic patients in Ahvaz city under normal and dust conditions. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2019; 17:961-967. [PMID: 32030166 PMCID: PMC6985357 DOI: 10.1007/s40201-019-00411-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Aim of this study was to determine whether any specific fungal spores could be responsible for changes observed in lung function indices. MATERIALS AND METHODS 1042 new allergic patients were selected from July 2017 to May 2018 in Ahvaz City, Iran. Fungal samples were collected in normal and dusty condition within 5 and 2 min, respectively. Sampling was repeated once every 6 days and also in the dusty days. RESULTS Average numbers of fungi colony were 639.86 and 836.44 CFU m-3 under normal and dusty conditions, respectively. Most common fungi in Ahwaz City air were Cladosporium sp., Penicillium sp., Aspergillus Niger, Aspergillus Flavus and Alternaria sp.. Highest fungal mean concentrations, 392 and 480 CFU m-3, were related to Cladosporium sp. under normal and dust conditions, respectively. Average total numbers of colony fungal were 614, 483, 1082, 424 CFU m-3 and 856, 701, 1418, 418 CFU m-3 during the spring, summer, autumn, and winter under normal and dusty conditions, respectively. Patients were evaluated by measured lung function parameters of FEV1 (L), FEV1 (%pred), FVC (L), FVC (%pred), and FEV1/FVC ratio with mean values of 1.85, 58.32, 2.63, 68.18, and 69.43, respectively. CONCLUSION Increases in mean total spores of fungi in spring were accompanied by decreases in FEV1/FVC ratio. Enhanced spores of Cladosporium sp. in spring led to reduced FEV1/FVC ratio. Increase the spores of Curvularia sp. in summer decreased by FEF25-75%. The augmented spores of Drechslera sp. in summer were associated with declined FEV1 and FEV1/FVC ratio. Enhanced fungal spores of Rhizopus sp. in spring resulted in lowered FEV1, FEV1/FVC ratio, and FEF25-75%.
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Affiliation(s)
- Abdolkazem Neisi
- Environmental Health Department, Public Health Faculty, Air Pollution and Respiratory Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed-Hamid Borsi
- Air Pollution and Respiratory Diseases Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Biostatistics and Epidemiology Department, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Neda Kiasat
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Environmental Health Department, Public Health Faculty, Air Pollution and Respiratory Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza AlizadehAttar
- Air Pollution and Respiratory Diseases Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Somayeh AlizadehAttar
- Environmental Health Department, Public Health Faculty, Air Pollution and Respiratory Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Madureira J, Brancher EA, Costa C, Aurino de Pinho R, Teixeira JP. Cardio-respiratory health effects of exposure to traffic-related air pollutants while exercising outdoors: A systematic review. ENVIRONMENTAL RESEARCH 2019; 178:108647. [PMID: 31450147 DOI: 10.1016/j.envres.2019.108647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
Despite physical exercise provides numerous health benefits, outdoor exercisers are frequently exposed to traffic-related air pollutants (TRAP) known to be associated with respiratory and cardiovascular diseases. The aim of this systematic review was to investigate the effects of TRAP exposure, specifically particulate matter and nitrogen dioxide (NO2), during outdoor exercise on cardio-respiratory health effects. Systematic database searches of PubMed, Web of Science, Scopus and Medline were performed by two researchers to identify peer-reviewed studies from 2000 to 2018. Combinations of keywords related to cardio-respiratory health effects, physical exercise and ambient air pollution were used. Thirteen studies were included, originating predominantly from European countries but also the American. They suggested that exercising in an environment with high TRAP exposure increases markers of respiratory and systemic inflammation, as well as, impairs the vascular function and increases artery pressure, when compared with an environment with low-TRAP exposure. In addition, the smaller particles appear to have the most severe health consequences compared with the larger coarse particles and NO2. This study also provides evidence that specific groups of the population have enhanced susceptibility to adverse effects from particulate matter exposure while exercising. There is a need for more studies focused on the relationship between air pollution, physical exercise and health, as large societal benefits can be obtained from healthy environments that can promote outdoor physical exercise.
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Affiliation(s)
- Joana Madureira
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - Emerson Antonio Brancher
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE), Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina, Brazil; Departamento de Educação Física, Universidade Regional de Blumenau, Blumenau, Santa Catarina, Brazil
| | - Carla Costa
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - Ricardo Aurino de Pinho
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - João Paulo Teixeira
- National Institute of Health, Environmental Health Department, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Air pollutants and outpatient visits for cardiovascular disease in a severe haze-fog city: Shijiazhuang, China. BMC Public Health 2019; 19:1366. [PMID: 31651288 PMCID: PMC6814061 DOI: 10.1186/s12889-019-7690-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/25/2019] [Indexed: 12/27/2022] Open
Abstract
Background Many studies have reported the impact of air pollution on cardiovascular disease (CVD), but few of these studies were conducted in severe haze-fog areas. The present study focuses on the impact of different air pollutant concentrations on daily CVD outpatient visits in a severe haze-fog city. Methods Data regarding daily air pollutants and outpatient visits for CVD in 2013 were collected, and the association between six pollutants and CVD outpatient visits was explored using the least squares mean (LSmeans) and logistic regression. Adjustments were made for days of the week, months, air temperature and relative humidity. Results The daily CVD outpatient visits for particulate matter (PM10 and PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) in the 90th-quantile group were increased by 30.01, 29.42, 17.68, 14.98, 29.34%, and − 19.87%, respectively, compared to those in the <10th-quantile group. Odds ratios (ORs) and 95% confidence intervals (CIs) for the increase in daily CVD outpatient visits in PM10 300- and 500-μg/m3, PM2.5 100- and 300-μg/m3 and CO 3-mg/m3 groups were 2.538 (1.070–6.020), 7.781 (1.681–36.024), 3.298 (1.559–6.976), 8.72 (1.523–49.934), and 5.808 (1.016–33.217), respectively, and their corresponding attributable risk percentages (AR%) were 60.6, 87.15, 69.68, 88.53 and 82.78%, respectively. The strongest associations for PM10, PM2.5 and CO were found only in lag 0 and lag 1. The ORs for the increase in CVD outpatient visits per increase in different units of the six pollutants were also analysed. Conclusions All five air pollutants except O3 were positively associated with the increase in daily CVD outpatient visits in lag 0. The high concentrations of PM10, PM2.5 and CO heightened not only the percentage but also the risk of increased daily CVD outpatient visits. PM10, PM2.5 and CO may be the main factors of CVD outpatient visits.
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10
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Aghababaeian H, Dastoorpoor M, Ghasemi A, Kiarsi M, Khanjani N, Araghi Ahvazi L. Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran. J Cardiovasc Thorac Res 2019; 11:264-271. [PMID: 31824607 PMCID: PMC6891034 DOI: 10.15171/jcvtr.2019.44] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 09/15/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS).
Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days.
Results: In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions.
Conclusion: Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.
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Affiliation(s)
- Hamidreza Aghababaeian
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran.,Department of Health in Emergencies and Disaster, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Afsaneh Ghasemi
- Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Kiarsi
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ladan Araghi Ahvazi
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran
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11
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Kopel J, Brower GL. Impact of fossil fuel emissions and particulate matter on pulmonary health. Proc (Bayl Univ Med Cent) 2019; 32:636-638. [PMID: 31656449 DOI: 10.1080/08998280.2019.1641367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 01/23/2023] Open
Abstract
In recent decades, several national and international legislative efforts have aimed to improve air quality standards and limit major pollutants, such as carbon monoxide, sulfur dioxide, and nitrogen dioxide, linked to several public health problems. In recent years, particulate matter sources have become an important cause of several pulmonary and systemic diseases. Specifically, several studies examining cigarette smoke particulates have discovered the important contribution that mast cells play in the pathogenesis and progression of smoking-related lung disease and other particulate matter-related lung injury. By understanding the mechanisms of activation and signaling cascades involved in cigarette smoke and mast cell activation, novel pharmacological therapies for particulate matter-induced lung diseases could be developed.
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Affiliation(s)
- Jonathan Kopel
- School of Medicine, Texas Tech University Health Sciences CenterLubbockTexas
| | - Gregory L Brower
- Department of Medical Education, Texas Tech University Health Sciences CenterLubbockTexas
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12
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Abstract
The conference "Climate change, air pollution and health" was held at the Pontifical Academy of Sciences. The data presented highlighted that air pollution is a major, under-recognized and modifiable risk factor for stroke and heart disease. Air pollution causes 7.6% of all deaths making it the fifth cause of death globally, and this figure is expected to increase by 50% by 2050. Particulate matter causes endothelial dysfunction and induces thrombosis by altering reactive oxygen species, nitric oxide, insulin resistance, and lipid levels. Thirty-three articles published since 2002 were reviewed to assess the relation between air pollution and stroke with age, geographical location, particulate and gaseous matter type, duration of exposure, previous stroke, and comorbidities. It remains to be defined if air pollution has pathophysiological effects that preferentially predispose individuals to ischemic or hemorrhagic stroke. There is ample evidence showing an association between acute and chronic exposure to PM2.5 or gaseous pollutants with stroke. This potentially avoidable scenario and its dramatic consequences are heavily under-recognized by health professionals and the wider public. Preventive measures in people at high vascular risk are warranted. Procrastination in implementing efforts to stop the current worldwide course of worsening air pollution is the seed of a potential global health catastrophe.
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Affiliation(s)
- Conrado J Estol
- Stroke Unit, Sanatorio Guemes, Francisco Acuña de Figueroa 1240, C1180, CABA, Argentina
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13
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Bae S, Kwon HJ. Current State of Research on the Risk of Morbidity and Mortality Associated with Air Pollution in Korea. Yonsei Med J 2019; 60:243-256. [PMID: 30799587 PMCID: PMC6391524 DOI: 10.3349/ymj.2019.60.3.243] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The effects of air pollution on health can vary regionally. Our goal was to comprehensively review previous epidemiological studies on air pollution and health conducted in Korea to identify future areas of potential study. MATERIALS AND METHODS We systematically searched all published epidemiologic studies examining the association between air pollution and occurrence of death, diseases, or symptoms in Korea. After classifying health outcomes into mortality, morbidity, and health impact, we summarized the relationship between individual air pollutants and health outcomes. RESULTS We analyzed a total of 27 studies that provided 104 estimates of the quantitative association between risk of mortality and exposure to air pollutants, including particulate matter with aerodynamic diameter less than 10 μm, particulate matter with aerodynamic diameter less than 2.5 μm, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide in Korea between January 1999 and July 2018. Regarding the association with morbidity, there were 38 studies, with 98 estimates, conducted during the same period. Most studies examined the short-term effects of air pollution using a time series or case-crossover study design; only three cohort studies that examined long-term effects were found. There were four health impact studies that calculated the attributable number of deaths or disability-adjusted life years due to air pollution. CONCLUSION There have been many epidemiologic studies in Korea regarding air pollution and health. However, the present review shows that additional studies, especially cohort and experimental studies, are needed to provide more robust and accurate evidence that can be used to promote evidence-based policymaking.
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Affiliation(s)
- Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
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14
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Warburton DER, Bredin SSD, Shellington EM, Cole C, de Faye A, Harris J, Kim DD, Abelsohn A. A Systematic Review of the Short-Term Health Effects of Air Pollution in Persons Living with Coronary Heart Disease. J Clin Med 2019; 8:E274. [PMID: 30813506 PMCID: PMC6406357 DOI: 10.3390/jcm8020274] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/13/2019] [Accepted: 02/21/2019] [Indexed: 01/27/2023] Open
Abstract
Persons living with chronic medical conditions (such as coronary artery disease (CAD)) are thought to be at increased risk when exposed to air pollution. This systematic review critically evaluated the short-term health effects of air pollution in persons living with CAD. Original research articles were retrieved systematically through searching electronic databases (e.g., Medical Literature Analysis and Retrieval System Online (MEDLINE)), cross-referencing, and the authors' knowledge. From 2884 individual citations, 26 eligible articles were identified. The majority of the investigations (18 of 22 (82%)) revealed a negative relationship between air pollutants and cardiac function or overall health. Heart rate variability (HRV) was the primary cardiovascular outcome measure, with 10 out of 13 studies reporting at least one index of HRV being significantly affected by air pollutants. However, there was some inconsistency in the relationship between HRV and air pollutants, mediated (at least in part) by the confounding effects of beta-blocker medications. In conclusion, there is strong evidence that air pollution can have adverse effects on cardiovascular function in persons living with CAD. All persons living with CAD should be educated on how to monitor air quality, should recognize the potential risks of excessive exposure to air pollution, and be aware of strategies to mitigate these risks. Persons living with CAD should minimize their exposure to air pollution by limiting outdoor physical activity participation when the forecast air quality health index indicates increased air pollution (i.e., an increased risk).
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Affiliation(s)
- Darren E R Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Shannon S D Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Erin M Shellington
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Christie Cole
- Department of Heart Wise Exercise, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Amanda de Faye
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Jennifer Harris
- Department of Heart Wise Exercise, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - David D Kim
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Alan Abelsohn
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
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15
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Tian Y, Xiang X, Wu Y, Cao Y, Song J, Sun K, Liu H, Hu Y. Fine Particulate Air Pollution and First Hospital Admissions for Ischemic Stroke in Beijing, China. Sci Rep 2017; 7:3897. [PMID: 28634403 PMCID: PMC5478610 DOI: 10.1038/s41598-017-04312-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/15/2017] [Indexed: 12/26/2022] Open
Abstract
The primary objective of this study was to assess the association between short-term changes in ambient fine particulate matter (PM2.5) and first hospital admissions for ischemic stroke. We identified 63,956 first hospital admissions for ischemic stroke from the Beijing Medical Claim Data for Employees from January 1, 2010, through June 30, 2012. A generalized additive Poisson model was applied to explore the association between PM2.5 and admissions for ischemic stroke. We also explore the effect modification of risk by age and gender. The exposure-response relationship between PM2.5 and admissions for ischemic stroke was approximately linear, with a relatively stable response at lower concentrations (<100 μg/m3) and a steeper response at higher concentrations. A 10 μg/m3 increase in the same-day PM2.5 concentration was associated with 0.31% (95% CI, 0.17-0.45%, P < 1.57 × 10-5) increase in the daily admissions for ischemic stroke. The association was also statistically significant at lag 1, 2, 3, 0-2 and 0-4 days. Subgroup analyses showed that the association was not different between patients ≥65 years and <65 years old or between males and females. In conclusion, short-term exposure to PM2.5 was positively associated with first hospital admissions for ischemic stroke in Beijing, China.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Kexin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
- Medical Informatics Center, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China.
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16
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Pintaric S, Jelavic MM, Nesek V, Babic Z, Vrsalovic M, Knezovic M, Bielen J, Zeljkovic I, Pintaric H. The influence of air pollutants on appearance of acute myocardial infarction in the region with humid continental climate. Am J Emerg Med 2016; 34:1679-82. [DOI: 10.1016/j.ajem.2016.04.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 04/29/2016] [Accepted: 04/30/2016] [Indexed: 01/06/2023] Open
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17
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Kang HJ, Kwon S. Regional Disparity of Cardiovascular Mortality and Its Determinants. HEALTH POLICY AND MANAGEMENT 2016. [DOI: 10.4332/kjhpa.2016.26.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Luyts K, Smulders S, Napierska D, Van Kerckhoven S, Poels K, Scheers H, Hemmeryckx B, Nemery B, Hoylaerts MF, Hoet PHM. Pulmonary and hemostatic toxicity of multi-walled carbon nanotubes and zinc oxide nanoparticles after pulmonary exposure in Bmal1 knockout mice. Part Fibre Toxicol 2014; 11:61. [PMID: 25394423 PMCID: PMC4234845 DOI: 10.1186/s12989-014-0061-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/29/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Pulmonary exposure to nanoparticles (NPs) may affect, in addition to pulmonary toxicity, the cardiovascular system such as procoagulant effects, vascular dysfunction and progression of atherosclerosis. However, only few studies have investigated hemostatic effects after pulmonary exposure. METHODS We used Bmal1 (brain and muscle ARNT-like protein-1) knockout (Bmal1(-/-)) mice which have a disturbed circadian rhythm and procoagulant phenotype, to study the pulmonary and hemostatic toxicity of multi-walled carbon nanotubes (MWCNTs) and zinc oxide (ZnO) NPs after subacute pulmonary exposure. Bmal1(-/-) and wild-type (Bmal1(+/+)) mice were exposed via oropharyngeal aspiration, once a week, during 5 consecutive weeks, to a cumulative dose of 32 or 128 μg MWCNTs or 32 or 64 μg ZnO NPs. RESULTS MWCNTs caused a pronounced inflammatory response in the lung with increased cell counts in the broncho-alveolar lavage and increased secretion of interleukin-1β and cytokine-induced neutrophil chemo-attractant (KC), oxidative stress (increased ratio of oxidized versus reduced glutathione and decreased total glutathione) as well as anemic and procoagulant effects as evidenced by a decreased prothrombin time with increased fibrinogen concentrations and coagulation factor (F)VII. In contrast, the ZnO NPs seemed to suppress the inflammatory (decreased neutrophils in Bmal1(-/-) mice) and oxidative response (increased total glutathione in Bmal1(-/-) mice), but were also procoagulant with a significant increase of FVIII. The procoagulant effects, as well as the significant correlations between the pulmonary endpoints (inflammation and oxidative stress) and hemostasis parameters were more pronounced in Bmal1(-/-) mice than in Bmal1(+/+) mice. CONCLUSIONS The Bmal1(-/-) mouse is a sensitive animal model to study the procoagulant effects of engineered NPs. The MWCNTs and ZnO NPs showed different pulmonary toxicity but both NPs induced procoagulant effects, suggesting different mechanisms of affecting hemostasis. However, the correlation analysis suggests a causal association between the observed pulmonary and procoagulant effects.
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MESH Headings
- ARNTL Transcription Factors/genetics
- ARNTL Transcription Factors/metabolism
- Air Pollutants/chemistry
- Air Pollutants/toxicity
- Anemia, Hemolytic/chemically induced
- Anemia, Hemolytic/immunology
- Anemia, Hemolytic/metabolism
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/chemistry
- Anti-Inflammatory Agents, Non-Steroidal/toxicity
- Coagulants/administration & dosage
- Coagulants/chemistry
- Coagulants/toxicity
- Dose-Response Relationship, Drug
- Hemolysis/drug effects
- Inflammation Mediators/agonists
- Inflammation Mediators/metabolism
- Inhalation Exposure/adverse effects
- Lung/drug effects
- Lung/immunology
- Lung/metabolism
- Metal Nanoparticles/administration & dosage
- Metal Nanoparticles/chemistry
- Metal Nanoparticles/toxicity
- Mice, Inbred C57BL
- Mice, Knockout
- Nanotubes, Carbon/chemistry
- Nanotubes, Carbon/toxicity
- Oxidative Stress/drug effects
- Pneumonia/chemically induced
- Pneumonia/immunology
- Pneumonia/metabolism
- Respiratory Mucosa/drug effects
- Respiratory Mucosa/immunology
- Respiratory Mucosa/metabolism
- Thrombophilia/chemically induced
- Thrombophilia/immunology
- Thrombophilia/metabolism
- Toxicity Tests, Subacute
- Zinc Oxide/administration & dosage
- Zinc Oxide/chemistry
- Zinc Oxide/toxicity
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Affiliation(s)
- Katrien Luyts
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
| | - Stijn Smulders
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
| | - Dorota Napierska
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
| | - Soetkin Van Kerckhoven
- Department of Cardiovascular sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.
| | - Katrien Poels
- Department of Public Health and Primary Care, Laboratory for Occupational and Environmental Hygiene, KU Leuven, Leuven, Belgium.
| | - Hans Scheers
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
| | - Bianca Hemmeryckx
- Department of Cardiovascular sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.
| | - Ben Nemery
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
| | - Marc F Hoylaerts
- Department of Cardiovascular sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium.
| | - Peter H M Hoet
- Department of Public Health and Primary Care, Occupational and Environmental Toxicology, KU Leuven, Leuven, Belgium.
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19
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Yoon SJ, Oh IH, Seo HY, Kim EJ. Measuring the burden of disease due to climate change and developing a forecast model in South Korea. Public Health 2014; 128:725-33. [PMID: 25132390 DOI: 10.1016/j.puhe.2014.06.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 05/28/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Climate change influences human health in various ways, and quantitative assessments of the effect of climate change on health at national level are becoming essential for environmental health management. STUDY DESIGN This study quantified the burden of disease attributable to climate change in Korea using disability-adjusted life years (DALY), and projected how this would change over time. METHODS Diseases related to climate change in Korea were selected, and meteorological data for each risk factor of climate change were collected. Mortality was calculated, and a database of incidence and prevalence was established. After measuring the burden of each disease, the total burden of disease related to climate change was assessed by multiplying population-attributable fractions. Finally, an estimation model for the burden of disease was built based on Korean climate data. RESULTS The total burden of disease related to climate change in Korea was 6.85 DALY/1000 population in 2008. Cerebrovascular diseases induced by heat waves accounted for 72.1% of the total burden of disease (hypertensive disease 1.82 DALY/1000 population, ischaemic heart disease 1.56 DALY/1000 population, cerebrovascular disease 1.56 DALY/1000 population). According to the estimation model, the total burden of disease will be 11.48 DALY/1000 population in 2100, which is twice the total burden of disease in 2008. CONCLUSIONS This study quantified the burden of disease caused by climate change in Korea, and provides valuable information for determining the priorities of environmental health policy in East Asian countries with similar climates.
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Affiliation(s)
- S-J Yoon
- Department of Preventive Medicine, Korea University, Seoul, Republic of Korea
| | - I-H Oh
- Department of Preventive Medicine, Kyunghee University, Seoul, Republic of Korea
| | - H-Y Seo
- Department of Public Health, Graduate School of Korea University, Seoul, Republic of Korea
| | - E-J Kim
- Community-based Primary Care Project Team, Ministry of Health & Welfare, Seoul, Republic of Korea.
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20
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Bell ML, Zanobetti A, Dominici F. Who is more affected by ozone pollution? A systematic review and meta-analysis. Am J Epidemiol 2014; 180:15-28. [PMID: 24872350 DOI: 10.1093/aje/kwu115] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ozone is associated with adverse health; however, less is known about vulnerable/sensitive populations, which we refer to as sensitive populations. We systematically reviewed epidemiologic evidence (1988-2013) regarding sensitivity to mortality or hospital admission from short-term ozone exposure. We performed meta-analysis for overall associations by age and sex; assessed publication bias; and qualitatively assessed sensitivity to socioeconomic indicators, race/ethnicity, and air conditioning. The search identified 2,091 unique papers, with 167 meeting inclusion criteria (73 on mortality and 96 on hospitalizations and emergency department visits, including 2 examining both mortality and hospitalizations). The strongest evidence for ozone sensitivity was for age. Per 10-parts per billion increase in daily 8-hour ozone concentration, mortality risk for younger persons, at 0.60% (95% confidence interval (CI): 0.40, 0.80), was statistically lower than that for older persons, at 1.27% (95% CI: 0.76, 1.78). Findings adjusted for publication bias were similar. Limited/suggestive evidence was found for higher associations among women; mortality risks were 0.39% (95% CI: -0.22, 1.00) higher than those for men. We identified strong evidence for higher associations with unemployment or lower occupational status and weak evidence of sensitivity for racial/ethnic minorities and persons with low education, in poverty, or without central air conditioning. Findings show that some populations, especially the elderly, are particularly sensitive to short-term ozone exposure.
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21
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Hsieh YL, Tsai SS, Yang CY. Fine particulate air pollution and hospital admissions for congestive heart failure: a case-crossover study in Taipei. Inhal Toxicol 2014; 25:455-60. [PMID: 23876070 DOI: 10.3109/08958378.2013.804609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was undertaken to determine whether there was an association between fine particles (PM₂.₅) levels and hospital admissions for congestive heart failure (CHF) in Taipei, Taiwan. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased CHF admissions were significantly associated with PM₂.₅ both on warm days (>23 °C) and cool days (<23 °C), with an interquartile range increase associated with a 13% (95% CI = 9-17%) and 3% (95% CI = 0-7%) increase in CHF admissions, respectively. In the two-pollutant models, PM₂.₅ remained significant after the inclusion of SO₂ or O₃ both on warm and cool days. This study provides evidence that higher levels of PM₂.₅ increase the risk of hospital admissions for CHF.
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Affiliation(s)
- Ya-Lun Hsieh
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Teng THK, Williams TA, Bremner A, Tohira H, Franklin P, Tonkin A, Jacobs I, Finn J. A systematic review of air pollution and incidence of out-of-hospital cardiac arrest. J Epidemiol Community Health 2013; 68:37-43. [DOI: 10.1136/jech-2013-203116] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Goldberg MS, Burnett RT, Stieb DM, Brophy JM, Daskalopoulou SS, Valois MF, Brook JR. Associations between ambient air pollution and daily mortality among elderly persons in Montreal, Quebec. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 463-464:931-42. [PMID: 23872247 DOI: 10.1016/j.scitotenv.2013.06.095] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 06/12/2013] [Accepted: 06/24/2013] [Indexed: 05/22/2023]
Abstract
BACKGROUND Persons with underlying health conditions may be at higher risk for the short-term effects of air pollution. We have extended our original mortality time series study in Montreal, Quebec, among persons 65 years of age and older, for an additional 10 years (1990-2003) to assess whether these associations persisted and to investigate new health conditions. METHODS AND RESULTS We created subgroups of subjects diagnosed with major health conditions one year before death using billing and prescription data from the Quebec Health Insurance Plan. We used parametric log-linear Poisson models within the distributed lag non-linear models framework, that were adjusted for long-term temporal trends and daily maximum temperature, for which we assessed associations with NO2, O3, CO, SO2, and particles with aerodynamic diameters 2.5 μm in diameter or less (PM2.5). We found positive associations between daily non-accidental mortality and all air pollutants but O3 (e.g., for a cumulative effect over a 3-day lag, with a mean percent change (MPC) in daily mortality of 1.90% [95% confidence interval: 0.73, 3.08%] for an increase of the interquartile range (17.56 μg m(-3)) of NO2). Positive associations were found amongst persons having cardiovascular disease (cumulative MPC for an increase equal to the interquartile range of NO2=2.67%), congestive heart failure (MPC=3.46%), atrial fibrillation (MPC=4.21%), diabetes (MPC=3.45%), and diabetes and cardiovascular disease (MPC=3.50%). Associations in the warm season were also found for acute and chronic coronary artery disease, hypertension, and cancer. There was no persuasive evidence to conclude that there were seasonal associations for cerebrovascular disease, acute lower respiratory disease (defined within 2 months of death), airways disease, and diabetes and airways disease. CONCLUSIONS These data indicate that individuals with certain health conditions, especially those with diabetes and cardiovascular disease, hypertension, atrial fibrillation, and cancer, may be susceptible to the short-term effects of air pollution.
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Affiliation(s)
- Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W., R4.29, Montreal, Quebec H3A 1A1, Canada.
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Shah ASV, Langrish JP, Nair H, McAllister DA, Hunter AL, Donaldson K, Newby DE, Mills NL. Global association of air pollution and heart failure: a systematic review and meta-analysis. Lancet 2013; 382:1039-48. [PMID: 23849322 PMCID: PMC3809511 DOI: 10.1016/s0140-6736(13)60898-3] [Citation(s) in RCA: 732] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Acute exposure to air pollution has been linked to myocardial infarction, but its effect on heart failure is uncertain. We did a systematic review and meta-analysis to assess the association between air pollution and acute decompensated heart failure including hospitalisation and heart failure mortality. METHODS Five databases were searched for studies investigating the association between daily increases in gaseous (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate (diameter <2·5 μm [PM2·5] or <10 μm [PM10]) air pollutants, and heart failure hospitalisations or heart failure mortality. We used a random-effects model to derive overall risk estimates per pollutant. FINDINGS Of 1146 identified articles, 195 were reviewed in-depth with 35 satisfying inclusion criteria. Heart failure hospitalisation or death was associated with increases in carbon monoxide (3·52% per 1 part per million; 95% CI 2·52-4·54), sulphur dioxide (2·36% per 10 parts per billion; 1·35-3·38), and nitrogen dioxide (1·70% per 10 parts per billion; 1·25-2·16), but not ozone (0·46% per 10 parts per billion; -0·10 to 1·02) concentrations. Increases in particulate matter concentration were associated with heart failure hospitalisation or death (PM2·5 2·12% per 10 μg/m(3), 95% CI 1·42-2·82; PM10 1·63% per 10 μg/m(3), 95% CI 1·20-2·07). Strongest associations were seen on the day of exposure, with more persistent effects for PM2·5. In the USA, we estimate that a mean reduction in PM2·5 of 3·9 μg/m(3) would prevent 7978 heart failure hospitalisations and save a third of a billion US dollars a year. INTERPRETATION Air pollution has a close temporal association with heart failure hospitalisation and heart failure mortality. Although more studies from developing nations are required, air pollution is a pervasive public health issue with major cardiovascular and health economic consequences, and it should remain a key target for global health policy. FUNDING British Heart Foundation.
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Affiliation(s)
- Anoop SV Shah
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Jeremy P Langrish
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Harish Nair
- Centre of Population Health Sciences, University of Edinburgh, UK
- Public Health Foundation of India, New Delhi, India
| | | | - Amanda L Hunter
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Ken Donaldson
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
| | - David E Newby
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Nicholas L Mills
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, UK
- Correspondence to: Dr Nicholas L Mills, BHF/University Centre for Cardiovascular Science, University of Edinburgh Chancellor's Building, Edinburgh, EH16 4SB, UK
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Seasonal effects of PM10 concentrations on mortality in Tianjin, China: a time-series analysis. J Public Health (Oxf) 2012. [DOI: 10.1007/s10389-012-0529-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Madsen C, Rosland P, Hoff DA, Nystad W, Nafstad P, Naess OE. The short-term effect of 24-h average and peak air pollution on mortality in Oslo, Norway. Eur J Epidemiol 2012; 27:717-27. [PMID: 22836233 DOI: 10.1007/s10654-012-9719-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 07/10/2012] [Indexed: 11/26/2022]
Abstract
Numerous epidemiological studies have shown associations between increases in outdoor air pollution and all-cause mortality as well as cardiovascular and respiratory related mortality. The majority of studies has used the routine monitoring network and thus has not been able to characterize the small-scale variation in daily averages and peak concentrations within urban settings. To address possible short term impact on mortally by air pollution we used a time-stratified case-crossover design to estimate associations of traffic-related air pollution and wood burning and daily mortality during a period of 10 years among residents above 50 years of age in Oslo, Norway. A dispersion model was used to assess short-term air pollution for daily (24-h) averages and peak concentrations of nitrogen dioxide (NO(2)) from exhaust and particulate matter with a diameter of 2.5 μm or less (PM(2.5)) from exhaust and wood-burning at residential neighbourhood level for each individual. We found an overall increased risk from exposure at the lag of 0-5 days before the day of death for both pollutants. The excess risk was highest for PM(2.5) with a 2.8 % (95 % confidence interval: 1.2-4.4) increase per 10 μg per cubic meter change in daily exposure. Short-term traffic-related air pollution was associated with increased risk for mortality among individuals above 50 years of age, especially for circulatory outcomes.
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Affiliation(s)
- Christian Madsen
- Division of Epidemiology, Norwegian Institute of Public Health, Nydalen, Oslo, Norway.
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Wold LE, Ying Z, Hutchinson KR, Velten M, Gorr MW, Velten C, Youtz DJ, Wang A, Lucchesi PA, Sun Q, Rajagopalan S. Cardiovascular remodeling in response to long-term exposure to fine particulate matter air pollution. Circ Heart Fail 2012; 5:452-61. [PMID: 22661498 DOI: 10.1161/circheartfailure.112.966580] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Air pollution is a pervasive environmental health hazard that occurs over a lifetime of exposure in individuals from many industrialized societies. However, studies have focused primarily on exposure durations that correspond to only a portion of the lifespan. We therefore tested the hypothesis that exposure over a considerable portion of the lifespan would induce maladaptive cardiovascular responses. METHODS AND RESULTS C57BL/6 male mice were exposed to concentrated ambient particles <2.5 µm (particulate matter, PM or PM(2.5)) or filtered air (FA), 6 h/d, 5 d/wk, for 9 months. Assessment of cardiac contractile function, coronary arterial flow reserve, isolated cardiomyocyte function, expression of hypertrophic markers, calcium handling proteins, and cardiac fibrosis were then performed. Mean daily concentrations of PM(2.5) in the exposure chamber versus ambient daily PM(2.5) concentration at the study site were 85.3 versus 10.6 µg/m(3) (7.8-fold concentration), respectively. PM(2.5) exposure resulted in increased hypertrophic markers leading to adverse ventricular remodeling characterized by myosin heavy chain (MHC) isoform switch and fibrosis, decreased fractional shortening (39.8 ± 1.4 FA versus 27.9 ± 1.3 PM, FS%), and mitral inflow patterns consistent with diastolic dysfunction (1.95 ± 0.05 FA versus 1.52 ± 0.07 PM, E/A ratio). Contractile reserve to dobutamine was depressed (62.3 ± 0.9 FA versus 49.2 ± 1.5 PM, FS%) in response to PM(2.5) without significant alterations in maximal vasodilator flow reserve. In vitro cardiomyocyte function revealed depressed peak shortening (8.7 ± 0.6 FA versus 7.0 ± 0.4 PM, %PS) and increased time-to-90% shortening (72.5 ± 3.2 FA versus 82.8 ± 3.2 PM, ms) and re-lengthening (253.1 ± 7.9 FA versus 282.8 ± 9.3 PM, ms), which were associated with upregulation of profibrotic markers and decreased total antioxidant capacity. Whole-heart SERCA2a levels and the ratio of α/β-MHC were both significantly decreased (P<0.05) in PM(2.5)-exposed animals, suggesting a switch to fetal programming. CONCLUSIONS Long-term exposure to environmentally relevant concentrations of PM(2.5) resulted in a cardiac phenotype consistent with incipient heart failure.
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Affiliation(s)
- Loren E Wold
- Center for Cardiovascular and Pulmonary Research, The Research Institute at Nationwide Children's Hospital, Department of Pediatrics/Physiology and Cell Biology, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA.
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Particulate Air Pollution and Hospital Admissions for Cardiac Diseases in Potentially Sensitive Subgroups. Epidemiology 2012; 23:473-81. [DOI: 10.1097/ede.0b013e31824d5a85] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tsai SS, Chen PS, Yang YH, Liou SH, Wu TN, Sung FC, Yang CY. Air pollution and hospital admissions for myocardial infarction: are there potentially sensitive groups? JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:242-51. [PMID: 22352332 DOI: 10.1080/15287394.2012.641202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Recent studies showed that air pollution is a risk factor for hospitalization for myocardial infarction (MI). However, there is limited evidence to suggest which subpopulations are at higher risk for MI arising from air pollution. This study was undertaken to examine the modifying effects of specific secondary cardiovascular diagnosis (including hypertension, diabetes, congestive heart failure, and arrhythmias) on the relationship between hospital admissions for MI and exposure to ambient air pollutants. Hospital admissions for MI and ambient air pollution data for Taipei were obtained for the period 1999-2009. The relative risk of hospital admissions for MI was estimated using a case-crossover approach. None of the secondary diagnosis examined showed significant evidence of effect modification. It would appear that the correlation between air pollutant exposure and MI occurrence is not affected by predisposing factors present in other cardiovascular diseases.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
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Shannahan JH, Schladweiler MC, Thomas RF, Ward WO, Ghio AJ, Gavett SH, Kodavanti UP. Vascular and thrombogenic effects of pulmonary exposure to Libby amphibole. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:213-231. [PMID: 22352330 DOI: 10.1080/15287394.2012.652055] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Exposure to Libby amphibole (LA) asbestos is associated with increased incidences of human autoimmune disease and mortality related to cardiovascular diseases. However, the systemic and vascular impacts are less well examined because of the dominance of pulmonary disease. It was postulated that regardless of the type of exposure scenario, LA exposure might produce systemic and vascular inflammogenic and thrombotic alterations in healthy and cardiovascular compromised rat models. Samples from three independent studies were examined. In the first study, male Wistar Kyoto (WKY), spontaneously hypertensive (SH), and SH heart failure (SHHF) rats were intratracheally instilled once with 0 (vehicle), 0.25, or 1 mg/rat of LA. In the second study, F344 rats were instilled with vehicle or LA at 0.5, 1.5, or 5 mg/rat. In the third study, F344 rats were instilled with the same mass concentrations of LA delivered by biweekly multiple instillations over 3 mo to simulate an episodic subchronic exposure. Complete blood count, platelet aggregation, serum cytokines, and biomarkers of systemic and aortic effects were examined. LA reduced adenosine diphosphate (ADP)-induced platelet aggregation and decreased circulating platelets in WKY (1 mg/rat) and F344 (5 mg/rat) at the 3-mo time point but did not do so in SH or SHHF rats. A decline in circulating lymphocytes with age appeared to be exacerbated by LA exposure in F344 rats but the differences were not significant. Aorta mRNA expression for biomarkers of oxidative stress (HO-1, LOX-1), inflammation (MIP-2), and thrombosis (tPA, PAI-1, vWf) were increased at baseline in SH and SHHF relative to WKY. LA exposure upregulated several of these biomarkers and also those involved in aortic contractility of WKY rats at 3 mo, suggesting thrombogenic, vasocontractile, and oxidative stress-mediated impairments. The aorta changes in F344 rats were less remarkable than changes noted in WKY following LA exposure. In conclusion, exposure to LA decreased circulating platelets and platelet coagulability while increasing the expression of oxidative stress, thrombosis, and vasoconstriction biomarkers in the aorta of healthy rats. These changes were similar to those noted at baseline in SH and SHHF rats, suggesting that LA-induced pulmonary injury might increase the risk of developing cardiovascular disease in healthy individuals.
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Affiliation(s)
- J H Shannahan
- Curriculum in Toxicology, UNC School of Medicine, Chapel Hill, North Carolina, USA
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32
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Wang T, Lang GD, Moreno-Vinasco L, Huang Y, Goonewardena SN, Peng YJ, Svensson EC, Natarajan V, Lang RM, Linares JD, Breysse PN, Geyh AS, Samet JM, Lussier YA, Dudley S, Prabhakar NR, Garcia JGN. Particulate matter induces cardiac arrhythmias via dysregulation of carotid body sensitivity and cardiac sodium channels. Am J Respir Cell Mol Biol 2011; 46:524-31. [PMID: 22108299 DOI: 10.1165/rcmb.2011-0213oc] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The mechanistic links between exposure to airborne particulate matter (PM) pollution and the associated increases in cardiovascular morbidity and mortality, particularly in people with congestive heart failure (CHF), have not been identified. To advance understanding of this issue, genetically engineered mice (CREB(A133)) exhibiting severe dilated cardiomyopathic changes were exposed to ambient PM collected in Baltimore. CREB(A133) mice, which display aberrant cardiac physiology and anatomy reminiscent of human CHF, displayed evidence of basal autonomic aberrancies (compared with wild-type mice) with PM exposure via aspiration, producing significantly reduced heart rate variability, respiratory dysynchrony, and increased ventricular arrhythmias. Carotid body afferent nerve responses to hypoxia and hyperoxia-induced respiratory depression were pronounced in PM-challenged CREB(A133) mice, and denervation of the carotid bodies significantly reduced PM-mediated cardiac arrhythmias. Genome-wide expression analyses of CREB(A133) left ventricular tissues demonstrated prominent Na(+) and K(+) channel pathway gene dysregulation. Subsequent PM challenge increased tyrosine phosphorylation and nitration of the voltage-gated type V cardiac muscle α-subunit of the Na(+) channel encoded by SCN5A. Ranolazine, a Na(+) channel modulator that reduces late cardiac Na(+) channel currents, attenuated PM-mediated cardiac arrhythmias and shortened PM-elongated QT intervals in vivo. These observations provide mechanistic insights into the epidemiologic findings in susceptibility of human CHF populations to PM exposure. Our results suggest a multiorgan pathobiology inherent to the CHF phenotype that is exaggerated by PM exposure via heightened carotid body sensitivity and cardiac Na(+) channel dysfunction.
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Affiliation(s)
- Ting Wang
- Section of Pulmonary, Critical Care, Sleep & Allergy, Department of Medicine, University of Illinois at Chicago, Illinois, USA
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Mills NL, Miller MR, Lucking AJ, Beveridge J, Flint L, Boere AJF, Fokkens PH, Boon NA, Sandstrom T, Blomberg A, Duffin R, Donaldson K, Hadoke PWF, Cassee FR, Newby DE. Combustion-derived nanoparticulate induces the adverse vascular effects of diesel exhaust inhalation. Eur Heart J 2011; 32:2660-71. [PMID: 21753226 PMCID: PMC3205591 DOI: 10.1093/eurheartj/ehr195] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim Exposure to road traffic and air pollution may be a trigger of acute myocardial infarction, but the individual pollutants responsible for this effect have not been established. We assess the role of combustion-derived-nanoparticles in mediating the adverse cardiovascular effects of air pollution. Methods and results To determine the in vivo effects of inhalation of diesel exhaust components, 16 healthy volunteers were exposed to (i) dilute diesel exhaust, (ii) pure carbon nanoparticulate, (iii) filtered diesel exhaust, or (iv) filtered air, in a randomized double blind cross-over study. Following each exposure, forearm blood flow was measured during intra-brachial bradykinin, acetylcholine, sodium nitroprusside, and verapamil infusions. Compared with filtered air, inhalation of diesel exhaust increased systolic blood pressure (145 ± 4 vs. 133 ± 3 mmHg, P< 0.05) and attenuated vasodilatation to bradykinin (P= 0.005), acetylcholine (P= 0.008), and sodium nitroprusside (P< 0.001). Exposure to pure carbon nanoparticulate or filtered exhaust had no effect on endothelium-dependent or -independent vasodilatation. To determine the direct vascular effects of nanoparticulate, isolated rat aortic rings (n= 6–9 per group) were assessed in vitro by wire myography and exposed to diesel exhaust particulate, pure carbon nanoparticulate and vehicle. Compared with vehicle, diesel exhaust particulate (but not pure carbon nanoparticulate) attenuated both acetylcholine (P< 0.001) and sodium-nitroprusside (P= 0.019)-induced vasorelaxation. These effects were partially attributable to both soluble and insoluble components of the particulate. Conclusion Combustion-derived nanoparticulate appears to predominately mediate the adverse vascular effects of diesel exhaust inhalation. This provides a rationale for testing environmental health interventions targeted at reducing traffic-derived particulate emissions.
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Affiliation(s)
- Nicholas L Mills
- The BHF/University Centre for Cardiovascular Science, Edinburgh University, The Queens Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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Vencloviene J, Grazuleviciene R, Babarskiene R, Dedele A, Grazulevicius T. Short-term nitrogen dioxide exposure and geomagnetic activity interaction: contribution to emergency hospitalization for acute coronary syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:149-160. [PMID: 21506035 DOI: 10.1080/09603123.2010.515671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We investigated whether extremely geomagnetic activity may modify the association between short-term nitrogen dioxide (NO₂) exposure and emergency hospitalization for acute coronary syndrome (ACS). A case-crossover study design was used to analyze ACS in 6,594 hospitalized patients at the Clinic of Kaunas, Lithuania. We evaluated the associations between NO₂, geomagnetic activity and the rate of emergency admissions for ACS by logistic regression controlling for seasonal variation, weekdays and meteorological factors. Ambient NO₂ pollution interquartile range increase (IQR) on the day of admission and previous day (lag 0-1) in patients below 65 years of age increase the risk of ACS equal to 24% (95% CI 0.96-1.60). Evidence of effect modification by combined NO₂ and geomagnetic activity was observed in relation to ACS, adjusted OR was 1.61; 95% CI 1.03-2.53. In conclusion, these findings suggest that geomagnetic activity variations may increase the traffic-related air pollution effect on ACS, and highlight environmental factors associated with ischemic heart disease course.
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Su TC, Chen SY, Chan CC. Progress of Ambient Air Pollution and Cardiovascular Disease Research in Asia. Prog Cardiovasc Dis 2011; 53:369-78. [PMID: 21414472 DOI: 10.1016/j.pcad.2010.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ta-Chen Su
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Carracedo-Martínez E, Taracido M, Tobias A, Saez M, Figueiras A. Case-crossover analysis of air pollution health effects: a systematic review of methodology and application. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1173-82. [PMID: 20356818 PMCID: PMC2920078 DOI: 10.1289/ehp.0901485] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 03/31/2010] [Indexed: 04/14/2023]
Abstract
BACKGROUND Case-crossover is one of the most used designs for analyzing the health-related effects of air pollution. Nevertheless, no one has reviewed its application and methodology in this context. OBJECTIVE We conducted a systematic review of case-crossover (CCO) designs used to study the relationship between air pollution and morbidity and mortality, from the standpoint of methodology and application. DATA SOURCES AND EXTRACTION A search was made of the MEDLINE and EMBASE databases.Reports were classified as methodologic or applied. From the latter, the following information was extracted: author, study location, year, type of population (general or patients), dependent variable(s), independent variable(s), type of CCO design, and whether effect modification was analyzed for variables at the individual level. DATA SYNTHESIS The review covered 105 reports that fulfilled the inclusion criteria. Of these, 24 addressed methodological aspects, and the remainder involved the design's application. In the methodological reports, the designs that yielded the best results in simulation were symmetric bidirectional CCO and time-stratified CCO. Furthermore, we observed an increase across time in the use of certain CCO designs, mainly symmetric bidirectional and time-stratified CCO. The dependent variables most frequently analyzed were those relating to hospital morbidity; the pollutants most often studied were those linked to particulate matter. Among the CCO-application reports, 13.6% studied effect modification for variables at the individual level. CONCLUSIONS The use of CCO designs has undergone considerable growth; the most widely used designs were those that yielded better results in simulation studies: symmetric bidirectional and time-stratified CCO. However, the advantages of CCO as a method of analysis of variables at the individual level are put to little use.
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Affiliation(s)
- Eduardo Carracedo-Martínez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Santiago of Compostela Health Area, Galician Health Service [Servizo Galego de Saúde (SERGAS)], Santiago de Compostela, Spain
| | - Margarita Taracido
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health [CIBER en Epidemiología y Salud Pública (CIBERESP)], Spain
| | - Aurelio Tobias
- Institute of Environmental Analysis and Water Research [Instituto de Diagnóstico Ambiental y Estudios del Agua (IDAEA)], Spanish Scientific Research Council [Consejo Superior de Investigaciones Científicas (CSIC)], Barcelona, Spain
| | - Marc Saez
- Consortium for Biomedical Research in Epidemiology and Public Health [CIBER en Epidemiología y Salud Pública (CIBERESP)], Spain
- Research Group on Statistics, Applied Economics and Health [Grup de Recerca en Estadística, Economia Aplicada i Salut (GRECS)], University of Girona, Girona, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health [CIBER en Epidemiología y Salud Pública (CIBERESP)], Spain
- Address correspondence to A. Figueiras, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, c/San Francisco s/n, 15786 Santiago de Compostela (A Coruña), Spain. Telephone: 34-981-581-237/34-981-951-192. Fax: 34-981-572-282. E-mail:
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Cheng MF, Tsai SS, Chiu HF, Sung FC, Wu TN, Yang CY. Air pollution and hospital admissions for pneumonia: are there potentially sensitive groups? Inhal Toxicol 2010; 21:1092-8. [PMID: 19852550 DOI: 10.3109/08958370902744855] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recent studies have shown that air pollution is a risk factor for hospitalization for pneumonia. However, there is limited evidence to suggest what subpopulations are at greater risk from air pollution. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, asthma, and upper respiratory infections) on the relationship between hospital admissions for pneumonia and ambient air pollutants. Hospital admissions for pneumonia and ambient air pollution data for Kaohsiung were obtained for the period 1996-2006. The relative risk of hospital admission was estimated using a case-crossover approach. We found that an interquartile range (IQR) increase in PM(10), NO(2), and CO on warm days was associated with a 28% (95% confidence interval [CI], 11-48%), 40% (95% CI, 20-63%), and 31% (95% CI, 19-45%), respectively, increase in admissions for pneumonia with upper respiratory infections (URI), but only 23% (95% CI, 18-28%), 30% (95% CI, 25-36%), and 24% (95% CI, 21-28%), respectively, increase for persons without URI. An IQR increase in PM(10), SO(2), and CO on cool days was associated with a 70% (95% CI, 50-92%), 30% (95% CI, 15-47%), and 64% (95% CI, 47-83%), respectively, increase in admissions in persons with URI, and an increase of 64% (95% CI, 57-70%), 18% (95% CI, 14-22%), and 55% (95% CI, 50-60%), respectively, in admissions in persons without URI. Our findings provide evidence that patients with comorbid URI may increase the risk of hospital admissions for pneumonia, in relation to air pollutant levels.
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Affiliation(s)
- Ming-Fen Cheng
- Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Abstract
BACKGROUND Certain subgroups in the general population, such as persons with existing cardiovascular or respiratory disease, may be more likely to experience adverse health effects from air pollution. METHODS In this European multicenter study, 25,006 myocardial infarction (MI) survivors in 5 cities were recruited from 1992 to 2002 via registers, and daily mortality was followed for 6 to 12 years in relation to ambient particulate and gaseous air pollution exposure. Daily air pollution levels were obtained from central monitor sites, and particle number concentrations were measured in 2001 and estimated retrospectively based on measured pollutants and meteorology. City-specific effect estimates from time-series analyses with Poisson regression were pooled over all 5 cities. RESULTS Particle number concentrations and PM10 averaged over 2 days (lag 0-1) were associated with increased total nontrauma mortality for patients of age 35 to 74 (5.6% [95% confidence interval, 2.8%-8.5%] per 10,000/cm and 5.1% [1.6%-9.3%] per 10 microg/m, respectively). For longer averaging times (5 and 15 days), carbon monoxide and nitrogen dioxide were also associated with mortality. There were no clear associations with ozone or sulfur dioxide. CONCLUSION Exposure to traffic-related air pollution was associated with daily mortality in MI survivors. Point estimates suggest a stronger effect of air pollution in MI survivors than among the general population.
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Tracking associations between ambient ozone and asthma-related emergency department visits using case-crossover analysis. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 14:581-91. [PMID: 18849779 DOI: 10.1097/01.phh.0000338371.53242.0e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Traditional environmental public health surveillance consists of separately measuring hazards, exposures, and health outcomes. The Environmental Public Health Tracking (EPHT) Network seeks to accrue additional information by linking hazard or exposure data to health outcomes data. A natural progression is to consider tracking the "link" itself, that is, to track the association between an environmental hazard and a health outcome. The Maine EPHT Program conducted a case-crossover analysis to measure associations between daily estimated ambient ozone and particulate matter (PM2.5) and asthma-related emergency department (ED) visits for 2000-2003. We found an overall association of 7 percent (95% confidence interval, 4-11) excess asthma-related ED visits per 10-ppb increase in ozone averaged over 4 days (lag 0-3). The association was positive in the first 3 years and negative in the last. The excess risk was concentrated among females aged 15 to 34 and males younger than 15. The methodology for tracking associations between ambient air quality and acute morbidity is not generalizable to most other EPHT topic areas, but there are ample reasons to pursue this activity. The analysis can potentially help evaluate the effectiveness of regulatory and intervention programs, as well as inform us about trends, sensitive subpopulations, and changing potency of air constituents.
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Goldberg MS, Giannetti N, Burnett RT, Mayo NE, Valois MF, Brophy JM. Shortness of breath at night and health status in congestive heart failure: effects of environmental conditions and health-related and dietary factors. ENVIRONMENTAL RESEARCH 2009; 109:166-174. [PMID: 19131052 DOI: 10.1016/j.envres.2008.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 10/07/2008] [Accepted: 10/16/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Recent studies suggest that persons with congestive heart failure (CHF) may be at higher risk for the short-term effects of air pollution. We carried out this daily diary panel study in Montreal, Quebec, to determine whether indicators of self-reported health status and shortness of breath at night were associated with selected health-related and dietary factors, weather conditions, and air pollution. METHODS Thirty-one subjects with CHF participated in this study in 2002 and 2003. Over a 2-month period, they measured their oxygen saturation, pulse rate, weight, and temperature each morning and recorded these and other data in a daily diary. Every morning they recorded on visual analogue scales their assessments of their general health, shortness of breath, and weakness, their weight, temperature and other data in a daily diary. Air pollution and weather conditions were obtained from fixed-site monitoring stations. This paper deals only with the daily self-reported health outcomes of general health and shortness of breath. We made use of mixed regression models, adjusting for within-subject serial correlation and temporal trends, to determine the association between oxygen saturation and pulse rate and health-related, dietary and environmental variables. Depending on the model, we accounted for the effects of a variety of health-related and dietary variables as well as NO(2), ozone, maximum temperature and change in barometric pressure at 8:00AM from the previous day. RESULTS Of the many associations for self-reported general health and shortness of breath, we found only a few statistically significant predictors, although increases in many variables showed decrements in self-reported general health and shortness of breath. The statistically significant associations with general health were increases in daily pulse rate and body weight, higher maximum ambient air temperature, higher relative humidity, and ozone (on the concurrent day). Statistically significant predictors of worsened shortness of breath at night were increases in blood pressure, body weight, and higher maximum ambient air temperature (lag 0 and 1 days). We also found that there was little confounding between environmental variables and health and dietary factors. CONCLUSIONS The findings from the present investigation suggest that certain health-related indices and environmental conditions affect self-reported health and shortness of breath in CHF patients, although larger studies are needed to confirm these findings.
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Affiliation(s)
- Mark S Goldberg
- Department of Medicine, McGill University, 687 Pine Ave W., Montreal, Quebec, Canada H3A 1A1.
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Chiu HF, Cheng MH, Yang CY. Air Pollution and Hospital Admissions for Pneumonia in a Subtropical City: Taipei, Taiwan. Inhal Toxicol 2009; 21:32-7. [DOI: 10.1080/08958370802441198] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chiu HF, Yang CY. Air pollution and emergency room visits for arrhythmias: are there potentially sensitive groups? JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2009; 72:817-823. [PMID: 19557609 DOI: 10.1080/15287390902800405] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Recent studies showed that air pollution is a risk factor for hospitalization for arrhythmias. However, there is limited evidence to suggest which subpopulations are at higher risk for arrhythmia development due to increased air pollutant exposure. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, and congestive heart failure) on the relationship between frequency of emergency room (ER) visits for arrhythmias and ambient air pollutants concentrations. ER visits for arrhythmias and ambient air pollution data for Taipei were obtained for the period 2000-2006. The relative risk of ER visits was estimated using a case-crossover approach. Data showed an increased risk of ER visits for arrhythmias in relation to increased O(3) levels among individuals with a secondary diagnosis of hypertension and congestive heart failure.
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Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lee IM, Tsai SS, Ho CK, Chiu HF, Wu TN, Yang CY. Air pollution and hospital admissions for congestive heart failure: are there potentially sensitive groups? ENVIRONMENTAL RESEARCH 2008; 108:348-353. [PMID: 18786668 DOI: 10.1016/j.envres.2008.07.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2007] [Revised: 07/24/2008] [Accepted: 07/29/2008] [Indexed: 05/26/2023]
Abstract
Recent studies have shown that air pollution is a risk factor for hospitalization for congestive heart failure (CHF). However, there is limited evidence to suggest what subpopulations are at greater risk from air pollution. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, dysrhythmia, and chronic obstructive pulmonary disease) on the relationship between hospital admissions for CHF and ambient air pollutants. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period from 1996 to 2005. The relative risk of hospital admission was estimated using a case-crossover approach. None of the secondary diagnosis we examined (hypertension, diabetes, dysrhythmia, and chronic obstructive pulmonary disease (COPD)) showed much evidence of effect modification.
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Affiliation(s)
- I-Ming Lee
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Rich KE, Petkau J, Vedal S, Brauer M. A Case-Crossover Analysis of Particulate Air Pollution and Cardiac Arrhythmia in Patients with Implantable Cardioverter Defibrillators. Inhal Toxicol 2008; 16:363-72. [PMID: 15204752 DOI: 10.1080/08958370490439515] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We investigated the relationship between air pollution and incidence of cardiac arrhythmia in a study of patients with implantable cardioverter defibrillators (ICDs). Thirty-four patients (ages 15-85 yr, 80% male) with ICDs residing in the Vancouver, Canada, area were included in the analyses, representing all patients attending the 2 ICD clinics in the study region who had recorded at least 1 ICD discharge during the 14 February to 31 December 2000 study period. Air pollutant (PM(2.5), PM(10), SO(4)(2-), elemental carbon [EC], organic carbon [OC], O(3), SO(2), NO(2), and CO) concentrations on days for which ICD discharges were observed ("case days") were compared to concentrations on control days in case-crossover analyses. Control days were selected symmetrically, 7 days before and after each case day. ICD discharges occurring within 72 h of 1 another were grouped and considered as 1 discharge event. Temperature, relative humidity, barometric pressure, rainfall, and wind speed were included simultaneously as covariates. Sensitivity analyses examined the effect of grouping ICD discharges, of including meteorological variables, and of excluding discharges that were considered inappropriate by a cardiologist. As in previous studies, mean concentrations and interquartile ranges of air pollutants in Vancouver were low (e.g., PM(2.5) mean = 8.2 microg/m(3)). Although in general there were no statistically significant results, there were trends that might indicate associations between pollutants and ICD discharges. Odds ratios (OR) were consistently higher in summer than in winter (e.g., lag 0 per interquartile range increase in EC: 1.09 [0.86-1.37] vs. 0.61 [0.31-1.18]) and, in general, the highest ORs were observed for same-day effects. The one major exception was the observation of high ORs for ozone in winter (e.g., lag 1: 2.27 [0.67-7.66]). While an OR of 1.55 (0.51-4.70) was observed in summer at lag 0 for PM(10), no indications of positive associations were observed for PM(2.5) or SO(4)(2-). For indicators of local combustion-source pollution, EC, OC, CO, and SO(2), ORs were elevated at all lags (0-3 days) in summer. In summary, this study provides little evidence that specific components of PM affect risk of cardiac arrhythmias, although power limited the ability of the study to detect small effects.
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Affiliation(s)
- Kira E Rich
- School of Occupational and Environmental Hygiene, University of British Columbia, Vancouver, British Columbia, Canada
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Lee IM, Tsai SS, Ho CK, Chiu HF, Yang CY. Air Pollution and Hospital Admissions for Congestive Heart Failure in a Tropical City: Kaohsiung, Taiwan. Inhal Toxicol 2008; 19:899-904. [PMID: 17687721 DOI: 10.1080/08958370701479406] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was undertaken to determine whether there was an association between air pollutant levels and hospital admissions for congestive heart failure (CHF) in Kaohsiung, Taiwan. Hospital admissions for CHF and ambient air pollution data for Kaohsiung were obtained for the period 1996-2004. The relative risk of hospital admission was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days (> 25 degrees C) statistically significant positive associations were found in all pollutants except sulfur dioxide (SO(2)). On cool days (< 25 degrees C), all pollutants were significantly associated with CHF admissions. For the two-pollutant model, CO and O(3) were significant in combination with each of the other four pollutants on warm days. On cool days, NO(2) remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient air pollutants increase the risk of hospital admissions for CHF and that the effects of air pollutants on hospital admissions for CHF were temperature dependent.
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Affiliation(s)
- I-Ming Lee
- College of Health Sciences, Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chen Y, Yang Q, Krewski D, Burnett RT, Shi Y, McGrail KM. The Effect of Coarse Ambient Particulate Matter on First, Second, and Overall Hospital Admissions for Respiratory Disease Among the Elderly. Inhal Toxicol 2008; 17:649-55. [PMID: 16087571 DOI: 10.1080/08958370500189420] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of this article is to examine differences in the effect of ambient particulate matter on first, second, and overall hospital admissions for respiratory disease among the elderly. We studied 8989 adults 65 yr of age or older living in the greater Vancouver area who were admitted to hospital for any acute respiratory disease (ICD-9 codes 460-519) between June 1, 1995, and March 31, 1999. Time-series analysis was used to evaluate the association between respiratory admissions and daily measures of particulate matter (PM10, PM2.5, and PM10 - 2.5) in urban air, after adjustment for gaseous copollutants (CO, O3, NO2, and SO2) and meteorological variables. Repeated admissions for respiratory disease were common among the elderly. Approximately 30% of the subjects were readmitted to hospital after the first admission; 9% had more than 2 admissions for respiratory disease during the 4-yr study period. PM10 - 2.5 was significantly associated with the second and overall admissions for respiratory disease, but not with the first admission. The adjusted relative risks for an increment of 4.2 microg/m(3) in -day average PM10 - 2.5 concentrations were 1.03 (95% confidence interval: 0.98-1.09) for the first admission, 1.22 (1.10-1.36) for the second admission, and 1.06 (1.02, 1.11) for overall admissions. There was no significant association between PM2.5 and hospital admissions for respiratory disease among the elderly. Our data suggest that (1) people with a history of respiratory admissions are at a higher risk of respiratory disease in relation to particulate air pollution in urban areas, (2) analyses based on overall rather than repeated hospital admissions lead to lower estimates of the risk of respiratory disease associated with particulate air pollution, and (3) PM10 - 2.5 has a larger effect on respiratory admissions than PM2.5.
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Affiliation(s)
- Yue Chen
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Vichit-Vadakan N, Vajanapoom N, Ostro B. The Public Health and Air Pollution in Asia (PAPA) Project: estimating the mortality effects of particulate matter in Bangkok, Thailand. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:1179-82. [PMID: 18795160 PMCID: PMC2535619 DOI: 10.1289/ehp.10849] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 06/26/2008] [Indexed: 05/23/2023]
Abstract
BACKGROUND Air pollution data in Bangkok, Thailand, indicate that levels of particulate matter with aerodynamic diameter < or = 10 microm (PM(10)) are significantly higher than in most cities in North America and Western Europe, where the health effects of PM(10) are well documented. However, the pollution mix, seasonality, and demographics are different from those in developed Western countries. It is important, therefore, to determine whether the large metropolitan area of Bangkok is subject to similar effects of PM(10). OBJECTIVES This study was designed to investigate the mortality risk from air pollution in Bangkok, Thailand. METHODS The study period extended from 1999 to 2003, for which the Ministry of Public Health provided the mortality data. Measures of air pollution were derived from air monitoring stations, and information on temperature and relative humidity was obtained from the weather station in central Bangkok. The statistical analysis followed the common protocol for the multicity PAPA (Public Health and Air Pollution Project in Asia) project in using a natural cubic spline model with smooths of time and weather. RESULTS The excess risk for non-accidental mortality was 1.3% [95% confidence interval (CI), 0.8-1.7] per 10 microg/m(3) of PM(10), with higher excess risks for cardiovascular and above age 65 mortality of 1.9% (95% CI, 0.8-3.0) and 1.5% (95% CI, 0.9-2.1), respectively. In addition, the effects from PM(10) appear to be consistent in multipollutant models. CONCLUSIONS The results suggest strong associations between several different mortality outcomes and PM(10). In many cases, the effect estimates were higher than those typically reported in Western industrialized nations.
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Affiliation(s)
- Nuntavarn Vichit-Vadakan
- Faculty of Public Health, Thammasat University, Rangsit Campus, Klongluang, Pathumthani, Thailand
| | - Nitaya Vajanapoom
- Faculty of Public Health, Thammasat University, Rangsit Campus, Klongluang, Pathumthani, Thailand
| | - Bart Ostro
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California, USA
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Forastiere F, Stafoggia M, Berti G, Bisanti L, Cernigliaro A, Chiusolo M, Mallone S, Miglio R, Pandolfi P, Rognoni M, Serinelli M, Tessari R, Vigotti M, Perucci CA. Particulate matter and daily mortality: a case-crossover analysis of individual effect modifiers. Epidemiology 2008; 19:571-80. [PMID: 18467959 DOI: 10.1097/ede.0b013e3181761f8a] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several time-series studies have established the relationship between particulate matter (PM10) and mortality. We adopted a case-crossover design to evaluate whether individual socio-demographic characteristics and chronic or acute medical conditions modify the PM10-mortality association. METHODS We selected all natural deaths (321,024 subjects) occurring among adult (aged 35+ years) residents of 9 Italian cities between 1997 and 2004. We had access to individual information on socio-demographic variables, location of death, and chronic conditions (hospital admissions in the preceding 2-year period). For in-hospital deaths, we collected information on treatment wards at time of death and acute medical conditions. In a case-crossover analysis we adjusted for time, population changes, and meteorological conditions. RESULTS PM10 was associated with mortality among subjects age 65 years and older (0.75% increase per 10 microg/m3 [95% confidence interval = 0.42% to 1.09%]), with a more pronounced effect among people age 85 and older. A weaker effect was found among the most affluent people. The effect was present for both out-of-hospital and in-hospital deaths, especially among those treated in general medicine and other less specialized wards. PM10 effects were stronger among people with diabetes (1.03% [0.28% to 1.79%]) and chronic obstructive pulmonary disease (0.84% [0.17% to 1.52%]). The acute conditions with the largest effect estimates were acute impairment of pulmonary circulation (4.56% [0.75% to 8.51%]) and heart failure (1.67% [0.30% to 3.04%]). CONCLUSIONS Several factors, including advanced age, type of hospital ward, and chronic and acute health conditions, modify the PM10-related risk of death. Altered pulmonary circulation and heart failure are important effect modifiers, suggesting that cardiac decompensation is a possible mechanism of the fatal PM10 effect.
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Counterpoint: Time-series studies of acute health events and environmental conditions are not confounded by personal risk factors. Regul Toxicol Pharmacol 2008; 51:141-7; discussion 148-50. [DOI: 10.1016/j.yrtph.2008.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 03/10/2008] [Accepted: 03/13/2008] [Indexed: 01/17/2023]
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Stafoggia M, Schwartz J, Forastiere F, Perucci CA. Does temperature modify the association between air pollution and mortality? A multicity case-crossover analysis in Italy. Am J Epidemiol 2008; 167:1476-85. [PMID: 18408228 DOI: 10.1093/aje/kwn074] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Adverse health effects of particulate matter <10 microm in aerodynamic diameter (PM(10)) and high temperatures are well known, but the extent of their interaction on mortality is less clear. This paper describes effect modification of temperature in the PM(10)-mortality association and tests the hypothesis that higher PM(10) effects in summer are due to enhanced exposure to particles. All deaths of residents of nine Italian cities between 1997 and 2004 were selected. The case-crossover approach was adopted to estimate the effect of PM(10) on mortality by season and temperature level. Three strata of temperature corresponding to low, medium, and high "ventilation" were identified, and the interaction between PM(10) and temperature within each stratum was examined. Season and temperature levels strongly modified the PM(10)-mortality association: for a 10-microg/m(3) variation in PM(10), a 2.54% increase in risk of death in summer (95% confidence interval: 1.31, 3.78) compared with 0.20% (95% confidence interval: -0.08, 0.49) in winter. Analysis of the interaction between PM(10) and temperature within temperature strata resulted in positive but, in most cases, nonstatistically significant coefficients. The authors found much higher PM(10) effects on mortality during warmer days. The hypothesis that such an effect is attributable to enhanced exposure to particles in summer could not be rejected.
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Affiliation(s)
- M Stafoggia
- Department of Epidemiology, Rome E Health Authority, Rome, Italy.
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