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Li Q, Wang X, Yip BHK, Wong SYS, Yang X. The impact of solid fuel use on major depression and the buffering effect of outdoor time in the UK adults: A 12-year cohort study. J Affect Disord 2024:S0165-0327(24)01534-9. [PMID: 39271066 DOI: 10.1016/j.jad.2024.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 07/17/2024] [Accepted: 09/08/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND This study aims to investigate age- and gender-specific effects of household solid fuels for heating on major depression and buffering effects of outdoor time in a high-income country. METHODS Data were obtained from the UK Biobank. Participants with complete information on our studied variables and no prior diagnosis of major depression at baseline were included. Cox proportional hazards regression models were used to examine the effects of household solid fuels for heating on major depression. Subgroup analyses were conducted to investigate the buffering effects of outdoor time in summer and winter. Sensitivity analyses were performed to test the robustness of the main findings. RESULTS Of 255,505 participants (50.2 % women), the 12-year cumulative incidence of major depression was 4.4 %. Household solid fuels for heating increased the risk of major depression only in women aged <45 years (HR (95%CI) = 1.30 (1.04, 1.63)). In this group, the solid fuel effect was moderated by outdoor time spending both in summer (HR (95%CI), ≤2 h/day: 1.61 (1.13, 2.28); >2 h/day: 1.13 (0.84, 1.52)) and winter (≤1 h/day: 1.35 (1.01, 1.08); >1 h/day: 1.24 (0.86, 1.77)). LIMITATIONS Self-reported measures might lead to recall bias and some potential confounders, such as ventilation efficiency, were not measured and controlled in data analyses. CONCLUSIONS Younger women are more vulnerable to the impact of domestic air pollution on major depression. Promoting outdoor activities is a cost-effective and efficient approach to mitigating the risk of major depression caused by household solid fuels.
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Affiliation(s)
- Qian Li
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Benjamin Hon-Kei Yip
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Yeung-Shan Wong
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Xue Yang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
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Demoury C, Aerts R, Berete F, Lefebvre W, Pauwels A, Vanpoucke C, Van der Heyden J, De Clercq EM. Impact of short-term exposure to air pollution on natural mortality and vulnerable populations: a multi-city case-crossover analysis in Belgium. Environ Health 2024; 23:11. [PMID: 38267996 PMCID: PMC10809644 DOI: 10.1186/s12940-024-01050-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The adverse effect of air pollution on mortality is well documented worldwide but the identification of more vulnerable populations at higher risk of death is still limited. The aim of this study was to evaluate the association between natural mortality (overall and cause-specific) and short-term exposure to five air pollutants (PM2.5, PM10, NO2, O3 and black carbon) and identify potential vulnerable populations in Belgium. METHODS We used a time-stratified case-crossover design with conditional logistic regressions to assess the relationship between mortality and air pollution in the nine largest Belgian agglomerations. Then, we performed a random-effect meta-analysis of the pooled results and described the global air pollution-mortality association. We carried out stratified analyses by individual characteristics (sex, age, employment, hospitalization days and chronic preexisting health conditions), living environment (levels of population density, built-up areas) and season of death to identify effect modifiers of the association. RESULTS The study included 304,754 natural deaths registered between 2010 and 2015. We found percentage increases for overall natural mortality associated with 10 μg/m3 increases of air pollution levels of 0.6% (95% CI: 0.2%, 1.0%) for PM2.5, 0.4% (0.1%, 0.8%) for PM10, 0.5% (-0.2%, 1.1%) for O3, 1.0% (0.3%, 1.7%) for NO2 and 7.1% (-0.1%, 14.8%) for black carbon. There was also evidence for increases of cardiovascular and respiratory mortality. We did not find effect modification by individual characteristics (sex, age, employment, hospitalization days). However, this study suggested differences in risk of death for people with preexisting conditions (thrombosis, cardiovascular diseases, asthma, diabetes and thyroid affections), season of death (May-September vs October-April) and levels of built-up area in the neighborhood (for NO2). CONCLUSIONS This work provided evidence for the adverse health effects of air pollution and contributed to the identification of specific population groups. These findings can help to better define public-health interventions and prevention strategies.
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Affiliation(s)
- Claire Demoury
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium.
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
- Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Louvain, Belgium
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | | | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Arno Pauwels
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
- Health Information, Sciensano, Brussels, Belgium
| | | | | | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
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3
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Yang J, Deng J, Ye L, Liu L, Hu X. Study on the impact of central environmental protection inspection on the health of the older adult population-A quasi-natural experiment in China. Front Public Health 2024; 12:1290192. [PMID: 38322126 PMCID: PMC10844512 DOI: 10.3389/fpubh.2024.1290192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
In 2015, the central government of China established the Central Environmental Protection Inspection (CEPI) system for oversight of local governments. It enhanced local government enforcement of environmental regulations, which had a considerable influence on the health of the local older adult population. This study quantifies the effects of local government regulation brought about by CEPI on the health of the older adult. It examines the impact mechanism using the DID model and panel data from the China Health and Retirement Longitudinal Study (CHARLS). The results show that (1) local governments' environmental protection regulations implemented by CEPI have a positive impact on the general health of the older adult. The results of the study passed the parallel trend test, PSM test, replacement variable test, and placebo test and remained significant; (2) in terms of the impact mechanism, CEPI has promoted local governments' environmental governance initiatives, which has reduced industrial wastewater emissions, industrial sulfur dioxide emissions, and industrial fumes emissions. This has improved air quality, thereby creating a good living environment for the older adult and improving their overall health; (3) according to heterogeneity research, the health of older adult living in the Yangtze River Basin, urban older adult, and older adult without chronic diseases is more significantly affected by the environmental protection regulations of the local governments brought about by CEPI.
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Affiliation(s)
- Jiayu Yang
- West China Hospital of Sichuan University/Innovation Center of Nursing Research/Sichuan Key Laboratory of Nursing, Chengdu, Sichuan, China
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Juqiu Deng
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Lianguang Ye
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Li Liu
- West China Hospital of Sichuan University/Innovation Center of Nursing Research/Sichuan Key Laboratory of Nursing, Chengdu, Sichuan, China
| | - Xiuying Hu
- West China Hospital of Sichuan University/Innovation Center of Nursing Research/Sichuan Key Laboratory of Nursing, Chengdu, Sichuan, China
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4
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Jung J, Wilkins JL, Schollaert CL, Masuda YJ, Flunker JC, Connolly RE, D'Evelyn SM, Bonillia E, Rappold AG, Haugo RD, Marlier ME, Spector JT. Advancing the community health vulnerability index for wildland fire smoke exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167834. [PMID: 37839481 DOI: 10.1016/j.scitotenv.2023.167834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023]
Abstract
Wildland fire smoke risks are not uniformly distributed across people and places, and the most vulnerable communities are often disproportionately impacted. This study develops a county level community health vulnerability index (CHVI) for the Contiguous United States (CONUS) using three major vulnerability components: adaptive capacity, sensitivity, and exposure at the national and regional level. We first calculated sensitivity and adaptive capacity sub-indices using nine sensitivity and twenty adaptive capacity variables. These sub-indices were then combined with an exposure sub-index, which is based on the Community Multiscale Air Quality data (2008-2018), to develop CHVI. Finally, we conducted several analyses with the derived indices to: 1) explore associations between the level of fine particulate matter from wildland fires (fire-PM2.5) and the sub-indices/CHVI; 2) measure the impact of fire-PM2.5 on the increase in the annual number of days with 12-35 μg/m3 (moderate) and >35 μg/m3 (at or above unhealthy for sensitive groups) based on the US EPA Air Quality Index categories, and 3) calculate population size in different deciles of the sub-indices/CHVI. This study has three main findings. First, we showed that the counties with higher daily fire-PM2.5 concentration tend to have lower adaptive capacity and higher sensitivity and vulnerability. Relatedly, the counties at high risk tended to experience a greater increase in the annual number of days with 12-35 μg/m3 and >35 μg/m3 than their counterparts. Second, we found that 16.1, 12.0, and 17.6 million people out of 332 million in CONUS reside in the counties in the lowest adaptive capacity decile, highest sensitivity decile, and highest vulnerability decile, respectively. Third, we identified that the US Northwest, California, and Southern regions tended to have higher vulnerability than others. Accurately identifying a community's vulnerability to wildfire smoke can help individuals, researchers, and policymakers better understand, prepare for, and respond to future wildland fire events.
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Affiliation(s)
- Jihoon Jung
- Department of City and Regional Planning, University of North Carolina, Chapel Hill, NC, USA.
| | - Joseph L Wilkins
- Interdisciplinary Studies Department, Howard University, Washington, DC, USA; School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA
| | - Claire L Schollaert
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Yuta J Masuda
- Partnerships and Programs, Vulcan LLC, Seattle, WA, USA
| | - John C Flunker
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Rachel E Connolly
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Savannah M D'Evelyn
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Eimy Bonillia
- Interdisciplinary Studies Department, Howard University, Washington, DC, USA
| | - Ana G Rappold
- United States Environmental Protection Agency, Office of Research and Development, Durham, NC, USA
| | | | - Miriam E Marlier
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - June T Spector
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
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5
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Hu J, Zhou R, Ding R, Ye DW, Su Y. Effect of PM 2.5 air pollution on the global burden of lower respiratory infections, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019. JOURNAL OF HAZARDOUS MATERIALS 2023; 459:132215. [PMID: 37557046 DOI: 10.1016/j.jhazmat.2023.132215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023]
Abstract
Particulate matter (PM) air pollution is closely related to lower respiratory infections (LRIs). However, the global LRI burden attributable to PM remains unclear. Here, we provide a comprehensive assessment of the PM2.5-attributable LRI burden using data from the Global Burden and Disease Study (GBD) 2019. We found that PM2.5 air pollution contributed to approximately 0.7 million deaths and 37.6 million disability-adjusted life years (DALYs) of LRIs in 2019. The LRI burden attributable to PM2.5 has decreased from 1990 to 2019, with a more pronounced decrease in household PM2.5 than in ambient PM2.5. Unlike the decreasing trend in LRI burden due to household PM2.5 worldwide, nearly one fifth of countries experienced an increase of LRI burden due to ambient PM2.5. The burden was unevenly distributed to less developed countries, mainly in Sub-Saharan Africa. All age groups experienced a decrease in the PM2.5-attributable burden, with the most significant decrease in children younger than 10 years. Notably, individuals aged 20-84 years experienced an increase in the LRI burden attributable to ambient PM2.5. Males had higher burden than females in the elder age and higher SDI regions. This study provided an evidence-based guidance for the prevention of LRIs and control of PM2.5 air pollution.
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Affiliation(s)
- Junjie Hu
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Runxuan Zhou
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Rong Ding
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Da-Wei Ye
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China.
| | - Yanbing Su
- Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China.
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Devaleenal Daniel B, Baskaran A, D B, Mercy H, C P. Addressing the challenges in implementing airborne infection control guidelines and embracing the policies. Indian J Tuberc 2023; 70:460-467. [PMID: 37968052 DOI: 10.1016/j.ijtb.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/29/2023] [Indexed: 11/17/2023]
Abstract
Airborne pathogens not only lead to epidemics and pandemics, but are associated with morbidity and mortality. Administrative or managerial control, environmental control and use of personal protective equipments are the three components in airborne infection control. National and international guidelines for ideal airborne infection control (AIC) practices are available for more than a decade; however the implementation of these need to be looked into, challenges identified and addressed for effective prevention of airborne disease transmission. Commitment of multiple stakeholders from policy makers to patients, budget allocation and adequate fund flow, functioning AIC committees at multiple levels with an inbuilt reporting and monitoring mechanism, adaptation of the AIC practices at various health care levels, supportive supervision, training and ongoing education for health care providers, behaviour change communication to patients to adapt the practices at health care facility level, by health care personnel and patients will facilitate health system preparedness for handling any emergencies, but will also help in reducing the burden of persisting airborne diseases such as tuberculosis. Operational research in this least focused area will also help to identify and address the challenges.
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Affiliation(s)
- Bella Devaleenal Daniel
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, 1, Mayor Satyamoorthy Road, Chetpet, Chennai, 600031, Tamil Nadu, India
| | - Abinaya Baskaran
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, 1, Mayor Satyamoorthy Road, Chetpet, Chennai, 600031, Tamil Nadu, India
| | - Baskaran D
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, 1, Mayor Satyamoorthy Road, Chetpet, Chennai, 600031, Tamil Nadu, India
| | - Hephzibah Mercy
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, 1, Mayor Satyamoorthy Road, Chetpet, Chennai, 600031, Tamil Nadu, India
| | - Padmapriyadarsini C
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, 1, Mayor Satyamoorthy Road, Chetpet, Chennai, 600031, Tamil Nadu, India.
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7
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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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8
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Zhu R, Chen J. Long-term effects of air pollution on hospital admissions and mortality for chronic obstructive pulmonary disease in Beijing, China. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:672-683. [PMID: 37392082 PMCID: PMC10363839 DOI: 10.1111/crj.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE We aimed to clarify the association between air pollution and hospital admissions for chronic obstructive pulmonary disease (COPD) and mortality in Beijing, China. METHODS In this retrospective study, we recruited 510 COPD patients from 1 January 2006 to 31 December 2009. The patient data were obtained from the electronic medical records of Peking University Third Hospital in Beijing. Air pollution and meteorological data were obtained from the Institute of Atmospheric Physics of the Chinese Academy of Sciences. Monthly COPD hospital admissions, mortality and air pollution data were analysed using Poisson regression in generalised additive models adjusted for mean temperature, pressure and relative humidity. RESULTS There were positive correlations between sulfur dioxide (SO2 ), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10 ) and COPD hospital admissions in the single-pollutant model. An increase of 10 μg/m3 in SO2 and PM10 were associated with an increase of 4.053% (95% CI: 1.470-5.179%) and 1.401% (95%CI: 0.6656-1.850%) in COPD hospital admissions. In the multiple-pollutant model [SO2 and nitrogen dioxide (NO2 ) combinations], there was only a positive correlation between SO2 and COPD hospital admissions. An increase of 10 μg/m3 in SO2 were associated with an increase of 1.916% (95% CI: 1.118-4.286%) in COPD hospital admissions. There was no correlation between three pollutant combinations and COPD hospital admissions. We did not find correlations between air pollution and COPD mortality in either single- or multiple-pollutant models. CONCLUSIONS SO2 and PM10 may be important factors for the increase in COPD hospital admissions in Beijing, China.
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Affiliation(s)
- Rui‐xia Zhu
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
| | - Jin Chen
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
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9
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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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10
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Henderson SB, McLean KE, Ding Y, Yao J, Turna NS, McVea D, Kosatsky T. Hot weather and death related to acute cocaine, opioid and amphetamine toxicity in British Columbia, Canada: a time-stratified case-crossover study. CMAJ Open 2023; 11:E569-E578. [PMID: 37369523 DOI: 10.9778/cmajo.20210291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Previous research has shown that cocaine-associated deaths occur more frequently in hot weather, which has not been described for other illicit drugs or combinations of drugs. The study objective was to evaluate the relation between temperature and risk of death related to cocaine, opioids and amphetamines in British Columbia, Canada. METHODS We extracted data on all deaths with cocaine, opioid or amphetamine toxicity recorded as an underlying or contributing cause from BC vital statistics for 1998-2017. We used a time-stratified case-crossover design to estimate the effect of temperature on the risk of death associated with acute drug toxicity during the warmer months (May through September). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each 10°C increase in the 2-day average maximum temperature at the residential location. RESULTS We included 4913 deaths in the analyses. A 10°C increase in the 2-day average maximum temperature was associated with an OR of 1.43 (95% CI 1.11-1.86) for deaths with only cocaine toxicity recorded (n = 561), an OR of 1.15 (95% CI 0.99-1.33) for deaths with opioids only (n = 1682) and an OR of 1.11 (95% CI 0.60-2.04) for deaths with amphetamines only (n = 133). There were also elevated effects when toxicity from multiple drugs was recorded. Sensitivity analyses showed differences in the ORs by sex, by climatic region, and when the location of death was used instead of the location of residence. INTERPRETATION Increasing temperatures were associated with higher odds of death due to drug toxicity, especially for cocaine alone and combined with other drugs. Targeted interventions are necessary to prevent death associated with toxic drug use during hot weather.
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Affiliation(s)
- Sarah B Henderson
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Kathleen E McLean
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Yue Ding
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Jiayun Yao
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Nikita Saha Turna
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - David McVea
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Tom Kosatsky
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
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11
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Huang M, Strickland MJ, Richards M, Warren JL, Chang HH, Darrow LA. Confounding by Conception Seasonality in Studies of Temperature and Preterm Birth: A Simulation Study. Epidemiology 2023; 34:439-449. [PMID: 36719763 PMCID: PMC10993929 DOI: 10.1097/ede.0000000000001588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Seasonal patterns of conception may confound acute associations between birth outcomes and seasonally varying exposures. We aim to evaluate four epidemiologic designs (time-stratified case-crossover, time-series, pair-matched case-control, and time-to-event) commonly used to study acute associations between ambient temperature and preterm births. METHODS We conducted simulations assuming no effect of temperature on preterm birth. We generated pseudo-birth data from the observed seasonal patterns of birth in the United States and analyzed them in relation to observed temperatures using design-specific seasonality adjustments. RESULTS Using the case-crossover approach (time-stratified by calendar month), we observed a bias (among 1,000 replicates) = 0.016 (Monte-Carlo standard error 95% CI: 0.015-0.018) in the regression coefficient for every 10°C increase in mean temperature in the warm season (May-September). Unbiased estimates obtained using the time-series approach required accounting for both the pregnancies-at-risk and their weighted probability of birth. Notably, adding the daily weighted probability of birth from the time-series models to the case-crossover models corrected the bias in the case-crossover approach. In the pair-matched case-control design, where the exposure period was matched on gestational window, we observed no bias. The time-to-event approach was also unbiased but was more computationally intensive than others. CONCLUSIONS Most designs can be implemented in a way that yields estimates unbiased by conception seasonality. The time-stratified case-crossover design exhibited a small positive bias, which could contribute to, but not fully explain, previously reported associations.
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Affiliation(s)
| | | | | | | | - Howard H. Chang
- Rollins School of Public Health, Emory University, Atlanta, GA
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12
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Święczkowski M, Dobrzycki S, Kuźma Ł. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085566. [PMID: 37107848 PMCID: PMC10139136 DOI: 10.3390/ijerph20085566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/11/2023]
Abstract
Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016-2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011-1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1-1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001-1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01-1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011-1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003-1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006-1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008-1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01-1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011-1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007-1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001-1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.
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13
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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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14
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Gaines B, Kloog I, Zucker I, Ifergane G, Novack V, Libruder C, Hershkovitz Y, Sheffield PE, Yitshak-Sade M. Particulate Air Pollution Exposure and Stroke among Adults in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1482. [PMID: 36674236 PMCID: PMC9860673 DOI: 10.3390/ijerph20021482] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 05/13/2023]
Abstract
Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM2.5) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel-an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014-2018. We obtained daily PM2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m3). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure-response curves were nonlinear. PM2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure-response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.
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Affiliation(s)
- Britney Gaines
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben Gurion University, Beer Sheva 8410501, Israel
| | | | - Gal Ifergane
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Neurology Department, Soroka University Medical Center, Beer Sheva 8410101, Israel
| | - Victor Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Clinical Research Center, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | | | | | - Perry E. Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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15
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Kalia V, Kulick ER, Vardarajan B, Gu Y, Manly JJ, Elkind MS, Kaufman JD, Jones DP, Baccarelli AA, Mayeux R, Kioumourtzoglou MA, Miller GW. Linking Air Pollution Exposure to Blood-Based Metabolic Features in a Community-Based Aging Cohort with and without Dementia. J Alzheimers Dis 2023; 96:1025-1040. [PMID: 37927256 PMCID: PMC10741333 DOI: 10.3233/jad-230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Long-term exposure to air pollution has been associated with changes in levels of metabolites measured in the peripheral blood. However, most research has been conducted in ethnically homogenous, young or middle-aged populations. OBJECTIVE To study the relationship between the plasma metabolome and long-term exposure to three air pollutants: particulate matter (PM) less than 2.5μm in aerodynamic diameter (PM2.5), PM less than 10μm in aerodynamic diameter (PM10), and nitrogen dioxide (NO2) in an ethnically diverse, older population. METHODS Plasma metabolomic profiles of 107 participants of the Washington Heights and Inwood Community Aging Project in New York City, collected from 1995-2015, including non-Hispanic white, Caribbean Hispanic, and non-Hispanic Black older adults were used. We estimated the association between each metabolic feature and predicted annual mean exposure to the air pollutants using three approaches: 1) A metabolome wide association study framework; 2) Feature selection using elastic net regression; and 3) A multivariate approach using partial-least squares discriminant analysis. RESULTS 79 features associated with exposure to PM2.5 but none associated with PM10 or NO2. PM2.5 exposure was associated with altered amino acid metabolism, energy production, and oxidative stress response, pathways also associated with Alzheimer's disease. Three metabolites were associated with PM2.5 exposure through all three approaches: cysteinylglycine disulfide, a diglyceride, and a dicarboxylic acid. The relationship between several features and PM2.5 exposure was modified by diet and metabolic diseases. CONCLUSIONS These relationships uncover the mechanisms through which PM2.5 exposure can lead to altered metabolic outcomes in an older population.
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Affiliation(s)
- Vrinda Kalia
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Erin R. Kulick
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA, USA
| | - Badri Vardarajan
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Yian Gu
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Mitchell S.V. Elkind
- The Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Joel D. Kaufman
- Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA
| | - Dean P. Jones
- Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, GA, USA
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | - Gary W. Miller
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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16
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Li X, Li Y, Yu B, Zhu H, Zhou Z, Yang Y, Liu S, Tian Y, Xiao J, Xing X, Yin L. Health and economic impacts of ambient air pollution on hospital admissions for overall and specific cardiovascular diseases in Panzhihua, Southwestern China. J Glob Health 2022; 12:11012. [PMID: 36538381 PMCID: PMC9805700 DOI: 10.7189/jogh.12.11012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background The associations of ambient air pollution with hospital admissions (HAs) for overall and specific causes of cardiovascular diseases (CVDs), as well as related morbidity and economic burdens remain understudied, especially in low-pollution areas of low- and middle-income countries (LMICs). We evaluated the short-term effects of exposure to PM2.5 (particles with an aerodynamic diameter ≤2.5 μm), PM10 (particles with an aerodynamic diameter ≤10 μm), and SO2 (sulfur dioxide) on HAs for CVDs in Panzhihua, China, during 2016-2020, and calculated corresponding attributable risks and economic burden. Methods We used a generalized additive model (GAM) while controlling for time trends, meteorological conditions, holidays, and days of the week to estimate the associations. The cost of illness (COI) method was adopted to further assess corresponding hospitalization costs and productivity losses. Results A total of 27 660 HAs for CVDs were included in this study. PM10 and SO2 were significantly associated with elevated risks of CVDs hospitalizations. Each 10 μg/m3 increase in PM10 and SO2 at lag06 corresponded to an increase of 2.48% (95% confidence interval (CI) = 0.92%-4.06%), and 5.50% (95% CI = 3.09%-7.97%) in risk of HAs for CVDs, respectively. The risk estimates of PM10 and SO2 on CVD hospitalizations were generally robust after adjustment for other pollutants in two-pollutant models. We found stronger associations between air pollution (PM10 and SO2) and CVDs in cool seasons than in warm seasons. For specific causes of CVDs, significant associations of PM10 and SO2 exposure with cerebrovascular disease and ischaemic heart disease were observed. Using 0 μg/m3 as the reference concentrations, 11.91% (95%CI = 4.64%-18.56%) and 15.71% (95%CI = 9.30%-21.60%) of HAs for CVDs could be attributable to PM10 and SO2, respectively. During the study period, PM10 and SO2 brought 144.34 million Yuan economic losses for overall CVDs, accounting for 0.028% of local GDP. Conclusions Our results suggest that PM10 and SO2 exposure might be an important trigger of HAs for CVDs and accounted for substantial morbidity and economic burden.
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Affiliation(s)
- Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
| | - Yajie Li
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University – Hong Kong Polytechnic University, Chengdu, China
| | - Hongwei Zhu
- Department of dermatology, Panzhihua Central Hospital, Panzhihua, China
| | - Zonglei Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yan Yang
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China,Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, China
| | - Shunjin Liu
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
| | - Yunyun Tian
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
| | - Junjie Xiao
- Department of Medical Records and Statistics, Panzhihua Central Hospital, Panzhihua, China
| | - Xiangyi Xing
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China,Department of Pharmacy, Panzhihua Central Hospital, Panzhihua, China
| | - Li Yin
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
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17
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Kim H, Samet JM, Bell ML. Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:117006. [PMID: 36367781 PMCID: PMC9651183 DOI: 10.1289/ehp10836] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35 μg/m3); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7 μg/m3 or 70 parts per billion). An interquartile range (IQR) increase (5.2 μg/m3) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2 μg/m3) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. https://doi.org/10.1289/EHP10836.
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Affiliation(s)
- Honghyok Kim
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
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Nicolaou L, Underhill L, Hossen S, Simkovich S, Thangavel G, Rosa G, McCracken JP, Davila-Roman V, Fuentes LDL, Quinn AK, Clark M, Diaz A, Pillarisetti A, Steenland K, Waller LA, Jabbarzadeh S, Peel JL, Checkley W. Cross-sectional analysis of the association between personal exposure to household air pollution and blood pressure in adult women: Evidence from the multi-country Household Air Pollution Intervention Network (HAPIN) trial. ENVIRONMENTAL RESEARCH 2022; 214:114121. [PMID: 36029836 PMCID: PMC9492861 DOI: 10.1016/j.envres.2022.114121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 08/13/2022] [Indexed: 06/18/2023]
Abstract
Elevated blood pressure (BP) is a leading risk factor for the global burden of disease. Household air pollution (HAP), resulting from the burning of biomass fuels, may be an important cause of elevated BP in resource-poor communities. We examined the exposure-response relationship of personal exposures to HAP -fine particulate matter (PM2.5), carbon monoxide (CO), and black carbon (BC) - with BP measures in women aged 40-79 years across four resource-poor settings in Guatemala, Peru, India and Rwanda. BP was obtained within a day of 24-h personal exposure measurements at baseline, when participants were using biomass for cooking. We used generalized additive models to characterize the shape of the association between BP and HAP, accounting for the interaction of personal exposures and age and adjusting for a priori identified confounders. A total of 418 women (mean age 52.2 ± 7.9 years) were included in this analysis. The interquartile range of exposures to PM2.5 was 42.9-139.5 μg/m3, BC was 6.4-16.1 μg/m3, and CO was 0.5-2.9 ppm. Both SBP and PP were positively associated with PM2.5 exposure in older aged women, achieving statistical significance around 60 years of age. The exact threshold varied by BP measure and PM2.5 exposures being compared. For example, SBP of women aged 65 years was on average 10.8 mm Hg (95% CI 1.0-20.6) higher at 232 μg/m3 of PM2.5 exposure (90th percentile) when compared to that of women of the same age with personal exposures of 10 μg/m3. PP in women aged 65 years was higher for exposures ≥90 μg/m3, with mean differences of 6.1 mm Hg (95% CI 1.8-10.5) and 9.2 mm Hg (95% CI 3.3-15.1) at 139 (75th percentile) and 232 μg/m3 (90th percentile) respectively, when compared to that of women of the same age with PM2.5 exposures of 10 μg/m3. Our findings suggest that reducing HAP exposures may help to reduce BP, particularly among older women.
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Affiliation(s)
- Laura Nicolaou
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA; Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA
| | - Lindsay Underhill
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA; Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA
| | - Shakir Hossen
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA; Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA
| | - Suzanne Simkovich
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA; Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA; Division of Healthcare Delivery Research, MedStar Health Research Institute, Hyattsville, USA; Division of Pulmonary and Critical Care Medicine, Georgetown University School of Medicine, Washington, USA
| | - Gurusamy Thangavel
- Sri Ramachandra Institute for Higher Education and Research, Chennai, India
| | - Ghislaine Rosa
- Faculty of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, UK
| | - John P McCracken
- Center for Health Studies, Universidad Del Valle de Guatemala, Guatemala City, Guatemala; Global Health Institute, Epidemiology and Biostatistics Department, University of Georgia, Athens, GA, USA
| | | | | | - Ashlinn K Quinn
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Maggie Clark
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Anaite Diaz
- Center for Health Studies, Universidad Del Valle de Guatemala, Guatemala City, Guatemala
| | - Ajay Pillarisetti
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shirin Jabbarzadeh
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer L Peel
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA; Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA; Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
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Safiri S, Carson-Chahhoud K, Noori M, Nejadghaderi SA, Sullman MJM, Ahmadian Heris J, Ansarin K, Mansournia MA, Collins GS, Kolahi AA, Kaufman JS. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ 2022; 378:e069679. [PMID: 35896191 PMCID: PMC9326843 DOI: 10.1136/bmj-2021-069679] [Citation(s) in RCA: 194] [Impact Index Per Article: 97.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To report the global, regional, and national burden of chronic obstructive pulmonary disease (COPD) and its attributable risk factors between 1990 and 2019, by age, sex, and sociodemographic index. DESIGN Systematic analysis. DATA SOURCE Global Burden of Disease Study 2019. MAIN OUTCOME MEASURES Data on the prevalence, deaths, and disability adjusted life years (DALYs) of COPD, and its attributable risk factors, were retrieved from the Global Burden of Disease 2019 project for 204 countries and territories, between 1990 and 2019. The counts and rates per 100 000 population, along with 95% uncertainty intervals, were presented for each estimate. RESULTS In 2019, 212.3 million prevalent cases of COPD were reported globally, with COPD accounting for 3.3 million deaths and 74.4 million DALYs. The global age standardised point prevalence, death, and DALY rates for COPD were 2638.2 (95% uncertainty intervals 2492.2 to 2796.1), 42.5 (37.6 to 46.3), and 926.1 (848.8 to 997.7) per 100 000 population, which were 8.7%, 41.7%, and 39.8% lower than in 1990, respectively. In 2019, Denmark (4299.5), Myanmar (3963.7), and Belgium (3927.7) had the highest age standardised point prevalence of COPD. Egypt (62.0%), Georgia (54.9%), and Nicaragua (51.6%) showed the largest increases in age standardised point prevalence across the study period. In 2019, Nepal (182.5) and Japan (7.4) had the highest and lowest age standardised death rates per 100 000, respectively, and Nepal (3318.4) and Barbados (177.7) had the highest and lowest age standardised DALY rates per 100 000, respectively. In men, the global DALY rate of COPD increased up to age 85-89 years and then decreased with advancing age, whereas for women the rate increased up to the oldest age group (≥95 years). Regionally, an overall reversed V shaped association was found between sociodemographic index and the age standardised DALY rate of COPD. Factors contributing most to the DALYs rates for COPD were smoking (46.0%), pollution from ambient particulate matter (20.7%), and occupational exposure to particulate matter, gases, and fumes (15.6%). CONCLUSIONS Despite the decreasing burden of COPD, this disease remains a major public health problem, especially in countries with a low sociodemographic index. Preventive programmes should focus on smoking cessation, improving air quality, and reducing occupational exposures to further reduce the burden of COPD.
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Affiliation(s)
- Saeid Safiri
- Tuberculosis and Lung Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, University of South Australia, South Australia, Australia
- School of Medicine, University of Adelaide, South Australia, Australia
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- Research Centre for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Javad Ahmadian Heris
- Department of Allergy and Clinical Immunology, Paediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Ansarin
- Rahat Breath and Sleep Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Busenkell E, Collins CM, Moy ML, Hart JE, Grady ST, Coull BA, Schwartz JD, Koutrakis P, Garshick E. Modification of associations between indoor particulate matter and systemic inflammation in individuals with COPD. ENVIRONMENTAL RESEARCH 2022; 209:112802. [PMID: 35101396 PMCID: PMC9159533 DOI: 10.1016/j.envres.2022.112802] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 06/03/2023]
Abstract
RATIONALE Little is known about personal characteristics and systemic responses to particulate pollution in patients with COPD. OBJECTIVES Assess whether diabetes, obesity, statins and non-steroidal anti-inflammatory medications (NSAIDs) modify associations between indoor black carbon (BC) and fine particulate matter ≤2.5 μm in diameter (PM2.5) on systemic inflammation and endothelial activation. METHODS 144 individuals with COPD without current smoking and without major in-home combustion sources were recruited at Veterans Affairs Boston Healthcare System. PM2.5 and BC were measured in each participant's home seasonally for a week (up to 4 times; 482 observations) and plasma biomarkers of systemic inflammation [C-reactive protein (CRP); interleukin-6 (IL-6)] and endothelial activation [soluble vascular adhesion molecule-1 (sVCAM-1)] measured. Linear mixed effects regression with a random intercept was used, and effect modification assessed with multiplicative interaction terms and stratum specific estimates. RESULTS Median (25%ile, 75%ile) indoor BC and PM2.5 were 0.6 (0.5,0.7) μg/m3 and 6.8 (4.8,10.4) μg/m3, respectively. Although p-values for effect modification were not statistically significant, there were positive associations (%-increase/interquartile range; 95% CI) between CRP and BC greater among non-statin (18.8%; 3.6-36.3) than statin users (11.1%; 2.1-20.9). There were also positive associations greater among non-statin users between PM2.5 and CRP. For IL-6, associations with BC and PM2.5 were also greater among non-statin users. Associations between CRP and BC were greater (20.3%; 4.5-38.5) in persons with diabetes than without diabetes (10.3%; 0.92-20.6) with similar effects of PM2.5. There were no consistent associations that differed based on obesity. Effect modification was not observed for NSAID use, or with any factor considered with sVCAM-1. CONCLUSIONS Associations between indoor BC and PM2.5 and CRP were greater in patients with diabetes and those not taking statins, and with IL-6 if not taking statins. These results suggest that these characteristics may modify the systemic response to indoor BC and PM2.5 in persons with COPD.
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Affiliation(s)
- Emma Busenkell
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - Christina M Collins
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jaime E Hart
- Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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21
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Montinari MR, Minelli P, Russo A, Gianicolo E. Patterns of coronary heart disease mortality in Italy from 1931 to 2015 and a focus on a region with highly industrialized areas. Int J Cardiol 2022; 354:56-62. [DOI: 10.1016/j.ijcard.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022]
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22
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Filigrana P, Milando C, Batterman S, Levy JI, Mukherjee B, Pedde M, Szpiro AA, Adar SD. Exposure to Primary Air Pollutants Generated by Highway Traffic and Daily Mortality Risk in Near-Road Communities: A Case-Crossover Study. Am J Epidemiol 2022; 191:63-74. [PMID: 34347034 DOI: 10.1093/aje/kwab215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Most epidemiologic studies fail to capture the impact of spatiotemporal fluctuations in traffic on exposure to traffic-related air pollutants in the near-road population. Using a case-crossover design and the Research LINE source (R-LINE) dispersion model with spatiotemporally resolved highway traffic data, we quantified associations between primary pollutants generated by highway traffic-particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5), oxides of nitrogen (NOx), and black carbon (BC)-and daily nonaccidental, respiratory, cardiovascular, and cerebrovascular mortality among persons who had resided within 1 km (0.6 mile) of major highways in the Puget Sound area of Washington State between 2009 and 2013. We estimated these associations using conditional logistic regression, adjusting for time-varying covariates. Although highly resolved modeled concentrations of PM2.5, NOx, and BC from highway traffic in the hours before death were used, we found no evidence of an association between mortality and the preceding 24-hour average PM2.5 exposure (odds ratio = 0.99, 95% confidence interval: 0.96, 1.02) or exposure during shorter averaging periods. This work did not support the hypothesis that mortality risk was meaningfully higher with greater exposures to PM2.5, NOx, and BC from highways in near-road populations, though we did incorporate a novel approach to estimate exposure to traffic-generated air pollution based on detailed traffic congestion data.
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Disparities in COPD Hospitalizations: A Spatial Analysis of Proximity to Toxics Release Inventory Facilities in Illinois. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413128. [PMID: 34948739 PMCID: PMC8702175 DOI: 10.3390/ijerph182413128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
Abstract
Disproportionate distribution of air pollution is a major burden on the health of people living in proximity to toxic facilities. There are over 1000 Toxics Release Inventory (TRI) facilities distributed across the state of Illinois. This study investigates and spatially analyzes the relationship between chronic obstructive pulmonary disease (COPD) hospitalizations and toxic emissions from TRI facilities. In addition, this study investigates the connection between COPD hospitalizations and socioeconomic variables. Accounting for dispersion of air pollution beyond the TRI facilities source was attained using the inverse distance weighting interpolation approach. Multiple statistical methods were used including principal components analysis, linear regression, and bivariate local indicators of spatial association (BiLISA). The results from the linear regression model and BiLISA clustering maps show there is a strong connection between COPD hospitalizations and socioeconomic status along with race. TRI emissions were not statistically significant, but there are three major clusters of high COPD hospitalizations with high TRI emissions. Rural areas also seem to carry a higher burden of pollution-emitting facilities and respiratory hospitalizations.
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Acute Effects of Particulate Matter on All-Cause Mortality in Urban, Rural, and Suburban Areas, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412895. [PMID: 34948503 PMCID: PMC8701500 DOI: 10.3390/ijerph182412895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022]
Abstract
Background: Short-term exposure to particulate matter (PM) has been related to mortality worldwide. Most evidence comes from studies conducted in major cities, while little is known on the effects of low concentrations of PM and in less urbanized areas. We aim to investigate the relationship between PM and all-cause mortality at national level in Italy. Methods: Daily numbers of all-cause mortality were collected for all 8092 municipalities of Italy, from 2006 to 2015. A satellite-based spatiotemporal model was developed to estimate daily PM10 (inhalable particles) and PM2.5 (fine particles) concentrations at 1-km resolution. Multivariate Poisson regression models were fit to estimate the association between daily PM and mortality at province level, and then, results were pooled with a random-effects meta-analysis. Associations were estimated by combination of age and sex and degree of urbanization of the municipalities. Flexible functions were estimated to explore the shape of the associations at low PM concentrations. Results: We analyzed 5,884,900 deaths (40% among subjects older than 85 years, 60% occurring outside the main urban areas). National daily mean (interquartile range) PM10 and PM2.5 concentrations were 23 (14) μg/m3 and 15 (11) μg/m3, respectively. Relative increases of mortality per 10 μg/m3 variation in lag 0–5 (average of last six days since death) PM10 and PM2.5 were 1.47% (95% Confidence Intervals (CI): 1.15%, 1.79%) and 1.96% (1.33%, 2.59%), respectively. Associations were highest among elderly and women for PM10 only, similar between rural and urbanized areas, and were present even at low concentrations, e.g., below WHO guidelines. Conclusions: Air pollution was robustly associated with peaks in daily all-cause mortality in Italy, both in large cities and in less urbanized areas of Italy. Current WHO Air Quality Guidelines (2021) for PM10 and PM2.5 are not sufficient to protect public health.
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Yang X, Zhang T, Zhang Y, Chen H, Sang S. Global burden of COPD attributable to ambient PM2.5 in 204 countries and territories, 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 796:148819. [PMID: 34265615 DOI: 10.1016/j.scitotenv.2021.148819] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
The global spatiotemporal pattern of the COPD burden attributable to ambient PM2.5 is unknown in the context of the continuing increase in exposure to ambient PM2.5. Data on COPD burden attributable to ambient PM2.5 from 1990 to 2019 were retrieved from the Global Burden of Disease Study 2019. Cases and age-standardized rates of COPD mortality (ASMR) and disability-adjusted life years (ASDR) were estimated by age, sex, region, and country. The estimated annual percentage change (EAPC) was calculated to quantify the secular trends of ASMR and ASDR from 1990 to 2019. Globally, the number of COPD deaths and DALYs attributable to ambient PM2.5 both increased by over 90% from 1990 to 2019, but ASMR and ASDR both slightly decreased, with EAPC of -0.58 (95% CI: -0.72, -0.44) and -0.40 (95% CI: -0.51, -0.29), respectively. Most COPD deaths and DALYs attributable to PM2.5 occurred in the middle sociodemographic index (SDI) region, but the fastest growth of ASMR and ASDR occurred in the low SDI region, with EAPCs of 2.41 (95% CI: 2.23, 2.59) and 2.34 (95% CI: 2.16, 2.52), respectively. East Asia and South Asia were the high-risk areas of COPD deaths and DALYs attributable to PM2.5, among which China and India were the countries with the heaviest burden. COPD deaths and DALYs attributable to PM2.5 mainly occurred in individuals 70-89 years old and 60-84 years old, respectively. The age-specific rates of mortality and DALYs had a rapid increase in low and low-middle SDI regions from 1990 to 2019. The ASMR or ASDR had a reverse V-shaped relationship with SDI. In summary, the ambient PM2.5-attributable COPD burden is socioeconomic- and age-dependent, and it mediates the heterogeneity of spatial and temporal distribution. Low- and middle-income countries endure the highest ambient PM2.5-attributable COPD burden due to the high exposure to PM2.5 and poor availability and affordability of medicines and diagnostic tests.
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Affiliation(s)
- Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China; Clinical Research Center of Shandong University, Jinan, Shandong, People's Republic of China
| | - Tongchao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yuan Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China; Clinical Research Center of Shandong University, Jinan, Shandong, People's Republic of China
| | - Hao Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China; Clinical Research Center of Shandong University, Jinan, Shandong, People's Republic of China
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China; Clinical Research Center of Shandong University, Jinan, Shandong, People's Republic of China; Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.
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Dominski FH, Lorenzetti Branco JH, Buonanno G, Stabile L, Gameiro da Silva M, Andrade A. Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses. ENVIRONMENTAL RESEARCH 2021; 201:111487. [PMID: 34116013 DOI: 10.1016/j.envres.2021.111487] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/15/2021] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 μm (PM2.5) and 10 μm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.
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Affiliation(s)
- Fábio Hech Dominski
- Laboratory of Sport and Exercise Psychology (Lape) - College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Joaquim Henrique Lorenzetti Branco
- Laboratory of Sport and Exercise Psychology (Lape) - College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Giorgio Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, FR, Italy
| | - Luca Stabile
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, FR, Italy
| | | | - Alexandro Andrade
- Laboratory of Sport and Exercise Psychology (Lape) - College of Health and Sport Science of the Santa Catarina State University (UDESC), Florianópolis, SC, Brazil.
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27
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Chen X, Que C, Yao Y, Han Y, Zhang H, Li X, Lu X, Chen W, Hu X, Wu Y, Wang T, Zhang L, Zheng M, Qiu X, Zhu T. Susceptibility of individuals with lung dysfunction to systemic inflammation associated with ambient fine particle exposure: A panel study in Beijing. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 788:147760. [PMID: 34020092 DOI: 10.1016/j.scitotenv.2021.147760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/02/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The underlying mechanism on the susceptibility of chronic obstructive pulmonary disease (COPD) patients to air pollution has yet to be clarified. OBJECTIVES Based on the COPD in Beijing (COPDB) study, we examined whether lung dysfunction contributed to pollutant-associated systemic inflammation in COPD patients. METHODS Proinflammatory biomarkers including interleukin-8 (IL-8) and tumor necrosis factor α (TNFα) were measured in serum samples collected from 53 COPD and 82 healthy participants. Concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), carbonaceous components in PM2.5, and PM size distribution were continuously monitored. Linear mixed effects models were used to examine the associations of biomarker differences with particle exposure, between COPD and healthy participants, and across subgroups with different levels of lung dysfunction. RESULTS COPD patients showed higher differences in IL-8 and TNFα levels associated with exposure to measured pollutants, comparing to healthy controls. In advanced analysis, particle-associated differences in IL-8 and TNFα levels were higher in participants with poorer lung ventilation and diffusion capacity, and higher ratio of residual volume. For example, an interquartile range increase in average PM2.5 concentration 2 weeks before visits was associated with a 15.7% difference in IL-8 level in participants with the lowest ratio of measured value to predicted value of forced expiratory volume in 1 s (FEV1%pred) (65.2%), and the association decreased monotonically with increasing FEV1%pred. Associations between differences in TNFα level and average ultrafine particle concentration 1 week before visits increased gradually with increasing ratio of measured value to predicted value of residual volume/total lung capacity. CONCLUSIONS COPD patients, especially those with poorer lung function, are more susceptible to systemic inflammation associated with fine particle exposure.
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Affiliation(s)
- Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; GRiC, Shenzhen Institute of Building Research Co., Ltd., Xiong'an 071700, China.
| | - Chengli Que
- Peking University First Hospital, Peking University, Beijing 100034, China.
| | - Yuan Yao
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Department of Epidemiology and Biostatistics, MRC Centre for Environmental and Health, Imperial College London, SW7 2AZ, UK.
| | - Hanxiyue Zhang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Xiaoying Li
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Xinchen Lu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Xinyan Hu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Yusheng Wu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Lina Zhang
- Beijing Xicheng District Shichahai Community Health Center, Beijing 100000, China.
| | - Mei Zheng
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
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Lim YH, Oh J, Han C, Bae HJ, Kim S, Jang Y, Ha E, Hong YC. Long-term exposure to moderate fine particulate matter concentrations and cause-specific mortality in an ageing society. Int J Epidemiol 2021; 49:1792-1801. [PMID: 33079997 DOI: 10.1093/ije/dyaa146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Long-term exposure to particulate matter <2.5 μm in size (PM2.5) is considered a risk factor for premature death. However, only a few studies have been conducted in areas with moderate PM2.5 concentrations. Moreover, an ageing society may be more susceptible to environmental exposure and future burden of mortality due to PM2.5. METHODS This study estimates hazard ratios (HRs) for all-cause and cause-specific mortality from long-term exposure to moderate PM2.5 concentrations in the elderly populations of seven cities in South Korea. We also projected nationwide elderly mortality caused by long-term exposure to PM2.5, accounting for population ageing until 2045. Mortality in 1 720 230 elderly adults aged ≥65 years in 2008 was monitored across 2009-16 and linked to modelled PM2.5 concentrations. RESULTS A total of 421 100 deaths occurred in 2009-16, and the mean of annual PM2.5 concentration ranged between 21.1 and 31.9 μg/m3 in most regions. The overall HR for a 10 μg/m3 increase in a 36-month PM2.5 moving average was 1.024 (95% confidence intervals: 1.009, 1.039). We estimated that 11 833 all-cause nationwide elderly deaths were attributable to PM2.5 exposure. Annual death tolls may increase to 17 948 by 2045. However, if PM2.5 is reduced to 5 μg/m3 by 2045, the tolls may show a lower increase to 3646. CONCLUSIONS Long-term exposure to moderately high levels of PM2.5 was associated with increased mortality risk among the elderly. Thus, PM2.5 reduction in response to the projected ageing-associated mortality in South Korea is critical.
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Affiliation(s)
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jongmin Oh
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Changwoo Han
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Joo Bae
- Korea Environment Institute, Sejong, Republic of Korea
| | - Soontae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, Republic of Korea
| | - Yoonyoung Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Moon J. The effect of the heatwave on the morbidity and mortality of diabetes patients; a meta-analysis for the era of the climate crisis. ENVIRONMENTAL RESEARCH 2021; 195:110762. [PMID: 33515577 DOI: 10.1016/j.envres.2021.110762] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 01/06/2021] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION From the perspective of public health, the climate crisis is also causing many health problems worldwide. In contrast with the cardiovascular, respiratory, and urinary system, the adverse effects of heatwaves on the endocrine system, particularly in people with diabetes mellitus (DM), are not well established to date. In this study, the author investigated the morbidity and mortality changes of DM patients during heatwave periods, using the meta-analysis method. METHODS The author searched MEDLINE, EMBASE, and the Cochrane Library until March 12, 2020. The quality of each included study was assessed using the National Institutes of Health (NIH) Quality Assessment tools. The meta-analysis was conducted using the studies with a relative risk (RR) estimate and odds ratio (OR) estimate. The subgroup analysis and the meta-ANOVA analysis were conducted using various covariates, including lag days considered. RESULTS Only 36 articles were included in the meta-analysis. The pooled RR of mortality and of morbidity for diabetics under the heatwave were 1.18 (95% CI 1.13-1.25) and 1.10 (95% CI 1.06-1.14). For mortality studies, whether or not the lag days considered were 10 days or more was only a significant covariate for the meta-ANOVA analysis (Q = 3.17, p = 0.075). For morbidity studies, the definition of the heatwave (Q = 65.94, p < 0.0001), whether or not the maximum temperature was 40 °C or more (Q = 4.78, p = 0.0288), and the type of morbidity (Q = 60.23, p < 0.0001) were significant covariates for the analysis. DISCUSSION The mortality and morbidity risks of diabetes patients under the heatwave were mildly increased by about 18 percent for mortality and 10 percent for overall morbidity. The mortality risk of diabetics can increase more when lag days of 10 days or more are considered than when lag days of less than 10 days are considered. These valuable findings can be used in developing public health strategies to cope with heatwaves in the current era of aggravating global warming and climate crisis.
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Affiliation(s)
- Jinyoung Moon
- Seoul National University Graduate School of Public Health, Department of Environmental Health Science, Gwanak-ro 1, Gwanak-gu, Seoul, 08826, Republic of Korea; Department of Occupational and Environmental Medicine, Seoul Saint Mary's Hospital, Republic of Korea.
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Ye X, Shin BC, Baldauf C, Ganguly A, Ghosh S, Devaskar SU. Developing Brain Glucose Transporters, Serotonin, Serotonin Transporter, and Oxytocin Receptor Expression in Response to Early-Life Hypocaloric and Hypercaloric Dietary, and Air Pollutant Exposures. Dev Neurosci 2021; 43:27-42. [PMID: 33774619 DOI: 10.1159/000514709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/20/2021] [Indexed: 12/18/2022] Open
Abstract
Perturbed maternal diet and prenatal exposure to air pollution (AP) affect the fetal brain, predisposing to postnatal neurobehavioral disorders. Glucose transporters (GLUTs) are key in fueling neurotransmission; deficiency of the neuronal isoform GLUT3 culminates in autism spectrum disorders. Along with the different neurotransmitters, serotonin (5-HT) and oxytocin (OXT) are critical for the development of neural connectivity. Serotonin transporter (SERT) modulates synaptic 5-HT levels, while the OXT receptor (OXTR) mediates OXT action. We hypothesized that perturbed brain GLUT1/GLUT3 regulated 5-HT-SERT imbalance, which serves as a contributing factor to postnatal neuropsychiatric phenotypes, with OXT/OXTR providing a counterbalance. Employing maternal diet restriction (intrauterine growth restriction [IUGR]), high-fat (HF) dietary modifications, and prenatal exposure to simulated AP, fetal (E19) murine brain 5-HT was assessed by ELISA with SERT and OXTR being localized by immunohistochemistry and measured by quantitative Western blot analysis. IUGR with lower head weights led to a 48% reduction in male and female fetal brain GLUT3 with no change in GLUT1, when compared to age- and sex-matched controls, with no significant change in OXTR. In addition, a ∼50% (p = 0.005) decrease in 5-HT and SERT concentrations was displayed in fetal IUGR brains. In contrast, despite emergence of microcephaly, exposure to a maternal HF diet or AP caused no significant changes. We conclude that in the IUGR during fetal brain development, reduced GLUT3 is associated with an imbalanced 5-HT-SERT axis. We speculate that these early changes may set the stage for altering the 5HT-SERT neural axis with postnatal emergence of associated neurodevelopmental disorders.
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Affiliation(s)
- Xin Ye
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Bo-Chul Shin
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Claire Baldauf
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Amit Ganguly
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Shubhamoy Ghosh
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Sherin U Devaskar
- Department of Pediatrics, Division of Neonatology & Developmental Biology and the Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Yan Y, She L, Guo Y, Zhao Y, Zhang P, Xiang B, Zeng J, Yang M, Wang L. Association between ambient air pollution and mortality from chronic obstructive pulmonary disease in Wuhan, China: a population-based time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-13180-6. [PMID: 33650052 PMCID: PMC7920403 DOI: 10.1007/s11356-021-13180-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/22/2021] [Indexed: 06/02/2023]
Abstract
Evidence on the short-term effects of ambient air pollution on chronic obstructive pulmonary disease (COPD) mortality is still not conclusive. The aim of this study was to investigate the relationships between them in Wuhan China. Daily death numbers, concentrations of air pollutants (PM2.5, PM10, SO2, NO2, and O3), and meteorological characteristics in Wuhan from January 1, 2014, to December 31, 2019, were collected. Time-series analysis using generalized additive model was applied. The results showed that a total of 16,150 deaths (7.37 deaths per day) from COPD were observed. The daily average concentrations of PM2.5, PM10, SO2, NO2, and O3 were 59.03, 90.48, 12.91, 48.84, and 91.77 μg/m3, respectively. In single pollutant model, for every increase of 10 μg/m3 in PM10, SO2, and NO2 levels, COPD mortality increased by 0.583% (95% CI: 0.055-1.113%), 4.299% (95% CI: 0.978-7.729%), and 1.816% (95% CI: 0.515-3.313%) at lag03, respectively. No significant associations were found for PM2.5 and O3. Subgroup analysis demonstrated that females were more susceptible to PM2.5, PM10, SO2, and NO2. The concentrations of PM10, SO2, and NO2 were significantly associated with COPD mortality for older adults. The effects of PM2.5 and O3 on COPD mortality were higher in warm period. In two-pollutant models, the significantly positive associations between SO2 and NO2 and COPD mortality remained after adjusting for PM2.5 or O3. In conclusions, short-term exposure to PM10, SO2, and NO2 are significantly associated with a higher risk of COPD mortality. Female or elderly are more susceptible to air pollution. It is urgent to implement the environmental protection policy.
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Affiliation(s)
- Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Lu She
- School of Medicine, Wuhan University of Science and Technology, No.947 Heping Road, Wuhan, China
- Research Center for Health Promotion in Women, Youth and Children, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Yuanyuan Zhao
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China
| | - Pei Zhang
- School of Medicine, Wuhan University of Science and Technology, No.947 Heping Road, Wuhan, China
- Research Center for Health Promotion in Women, Youth and Children, Wuhan University of Science and Technology, Wuhan, China
| | - Bing Xiang
- School of Medicine, Wuhan University of Science and Technology, No.947 Heping Road, Wuhan, China
- Research Center for Health Promotion in Women, Youth and Children, Wuhan University of Science and Technology, Wuhan, China
| | - Jing Zeng
- School of Medicine, Wuhan University of Science and Technology, No.947 Heping Road, Wuhan, China
- Research Center for Health Promotion in Women, Youth and Children, Wuhan University of Science and Technology, Wuhan, China
| | - Mei Yang
- School of Medicine, Wuhan University of Science and Technology, No.947 Heping Road, Wuhan, China.
- Research Center for Health Promotion in Women, Youth and Children, Wuhan University of Science and Technology, Wuhan, China.
| | - Liang Wang
- Wuhan Centers for Disease Control and Prevention, No.288 Machang Road, Wuhan, China.
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32
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Reames TG, Daley DM, Pierce JC. Exploring the Nexus of Energy Burden, Social Capital, and Environmental Quality in Shaping Health in US Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E620. [PMID: 33450890 PMCID: PMC7828329 DOI: 10.3390/ijerph18020620] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/04/2022]
Abstract
The United States spends more on health care than any other OECD country, yet the nation's health is declining. Recent research has identified multiple sources for this decline, including one's position in social and economic structures, environmental quality, and individual and collective social capital. This paper assesses the primary hypotheses that the health effects of household energy burden, social capital and environmental quality on aggregated community health levels remain while controlling for other determinants. The analysis moves beyond prior research by integrating multiple secondary data sources to assess those effects across US counties. Three indicators of public health are analyzed (premature mortality, self-reported health, and life expectancy). The county-level energy burden is measured by the percent of household income spent on housing energy bills for low- and moderate-income households. In addition to energy burden, social capital, environmental quality and other determinants are included in the analysis. The results produced by multivariate regression models support the primary hypotheses, even while a number of control variables also have a significant effect on health. The paper concludes that public health is associated with a complex nexus of factors, including environmental quality and social capital, and that energy burden needs to be among the considerations.
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Affiliation(s)
- Tony G. Reames
- School for Environment & Sustainability, University of Michigan, 440 Church St., Ann Arbor, MI 48109, USA
| | - Dorothy M. Daley
- School of Public Affairs & Administration and Environmental Studies Program, University of Kansas, Lawrence, KS 66045, USA;
| | - John C. Pierce
- School of Public Affairs & Administration, University of Kansas, Lawrence, KS 66045, USA;
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Wang B, Liu J, Li Y, Fu S, Xu X, Li L, Zhou J, Liu X, He X, Yan J, Shi Y, Niu J, Yang Y, Li Y, Luo B, Zhang K. Airborne particulate matter, population mobility and COVID-19: a multi-city study in China. BMC Public Health 2020; 20:1585. [PMID: 33087097 PMCID: PMC7576551 DOI: 10.1186/s12889-020-09669-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/09/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an emerging infectious disease, which has caused numerous deaths and health problems worldwide. This study aims to examine the effects of airborne particulate matter (PM) pollution and population mobility on COVID-19 across China. METHODS We obtained daily confirmed cases of COVID-19, air particulate matter (PM2.5, PM10), weather parameters such as ambient temperature (AT) and absolute humidity (AH), and population mobility scale index (MSI) in 63 cities of China on a daily basis (excluding Wuhan) from January 01 to March 02, 2020. Then, the Generalized additive models (GAM) with a quasi-Poisson distribution were fitted to estimate the effects of PM10, PM2.5 and MSI on daily confirmed COVID-19 cases. RESULTS We found each 1 unit increase in daily MSI was significantly positively associated with daily confirmed cases of COVID-19 in all lag days and the strongest estimated RR (1.21, 95% CIs:1.14 ~ 1.28) was observed at lag 014. In PM analysis, we found each 10 μg/m3 increase in the concentration of PM10 and PM2.5 was positively associated with the confirmed cases of COVID-19, and the estimated strongest RRs (both at lag 7) were 1.05 (95% CIs: 1.04, 1.07) and 1.06 (95% CIs: 1.04, 1.07), respectively. A similar trend was also found in all cumulative lag periods (from lag 01 to lag 014). The strongest effects for both PM10 and PM2.5 were at lag 014, and the RRs of each 10 μg/m3 increase were 1.18 (95% CIs:1.14, 1.22) and 1.23 (95% CIs:1.18, 1.29), respectively. CONCLUSIONS Population mobility and airborne particulate matter may be associated with an increased risk of COVID-19 transmission.
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Affiliation(s)
- Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jiangtao Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Shihua Fu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Xiaocheng Xu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Lanyu Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, 200030, People's Republic of China
| | - Xingrong Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Xiaotao He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jun Yan
- Department of General Surgery, the First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yanjun Shi
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yong Yang
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, 38152, USA
| | - Yiyao Li
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China. .,Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, 200030, People's Republic of China. .,Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, 200030, China.
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.,Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
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Li X, Cai H, Ren X, He J, Tang J, Xie P, Wang N, Nie F, Lei L, Wang C, Li W, Ma J. Sandstorm weather is a risk factor for mortality in ischemic heart disease patients in the Hexi Corridor, northwestern China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:34099-34106. [PMID: 32557065 DOI: 10.1007/s11356-020-09616-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
Ischemic heart disease (IHD) is one of the leading causes of mortality worldwide. Moreover, the effects of air pollution have been associated with several cardiovascular diseases (CVDs). The relationship between sandstorm weather and IHD is unknown. The Hexi Corridor is located in northwestern China and is a typical desert region comprising a large area of desert with a high incidence of sandstorms. This study aimed to explore the association between sandstorm weather and IHD-related mortality in this area. We acquired meteorological data of sandstorm weather from 2006 to 2015 from the Gansu Meteorological Bureau, and data regarding deaths due to IHD in five cities within the Hexi Corridor were collected from the death registration system of the Center for Disease Control of Gansu during the same period. Two other cities with few sandstorm events were selected as control regions. The time series method of the generalized additive model (GAM) was used to assess the association between sandstorm weather and IHD-related mortality in the Hexi Corridor. The results showed that the frequency of sandstorms in the Hexi Corridor was higher than that in the control regions (5.48% vs 1.64%, P < 0.01), and IHD-related mortality was correspondingly higher than that in the control regions (56.42/100,000 vs 45.62/100,000, P < 0.01). After stratification by gender, age, and urban/rural residence, a significant difference in IHD-related mortality was also noted (P < 0.05). Significant associations were found between sandstorm weather and IHD-related mortality, and the relative risk (RR) increased with an increasing number of days of sandstorm weather. According to the monthly and annual analyses, the mortality rate corresponded to sandstorm frequency. Our data suggest a positive association between sandstorm weather and IHD-related mortality in the Hexi Corridor of Gansu Province. The underlying mechanism requires further study.
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Affiliation(s)
- Xinghui Li
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Hui Cai
- Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Xiaolan Ren
- Department of Prevention and Control of Chronic Non-communicable Diseases, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, China
| | - Jin He
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jia Tang
- Department of Infectious Diseases, Huashan Hospital of Fudan University, Shanghai, 200041, China
| | - Ping Xie
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Nan Wang
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Fangfei Nie
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Linfeng Lei
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Chenchen Wang
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Wenli Li
- Central Meteorological Station of Gansu Meteorological Bureau, Lanzhou, 730000, China
| | - Jing Ma
- Department of Endocrinology, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, 730000, Gansu, China.
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Woo SHL, Liu JC, Yue X, Mickley LJ, Bell ML. Air pollution from wildfires and human health vulnerability in Alaskan communities under climate change. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:094019. [PMID: 34413900 PMCID: PMC8372693 DOI: 10.1088/1748-9326/ab9270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Alaskan wildfires are becoming more frequent and severe, but very little is known regarding exposure to wildfire smoke, a risk factor for respiratory and cardiovascular illnesses. We estimated long-term, present-day and future exposure to wildfire-related fine particulate matter (PM2.5) across Alaska for the general population and subpopulations to assess vulnerability using observed data for the present day (1997-2010), modelled estimates for the present day (1997-2001), and modelled estimates for the future (2047-2051). First, we assessed wildfire-PM2.5 exposure by estimating monthly-average wildfire-specific PM2.5 levels across 1997-2010 for 158 Alaskan census tracts, using atmospheric transport modelling based on observed area-burned data. Second, we estimated changes in future (2047-2051) wildfire-PM2.5 exposure compared to the present-day (1997-2001) by estimating the monthly-average wildfire-specific PM2.5 levels for 29 boroughs/census areas (county-equivalent areas), under the Intergovernmental Panel on Climate Change (IPCC) A1B scenario from an ensemble of 13 climate models. Subpopulation risks for present and future exposure levels were estimated by summing area-weighted exposure levels utilizing the 2000 Census and State of Alaska's population projections. We assessed vulnerability by several subpopulation characteristics (e.g. race/ethnicity, urbanicity). Wildfire-PM2.5 exposure levels during 1997-2010 were highest in interior Alaska during July. Among subpopulations, average summer (June-August) exposure levels for urban dwellers and African-American/Blacks were highest at 9.1 μg m-3 and 10 μg m-3, respectively. Estimated wildfire-PM2.5 varied by Native American tribe, ranging from average summer levels of 2.4 μg m-3 to 13 μg m-3 for Tlingit-Haida and Alaskan Athabascan tribes, respectively. Estimates indicate that by the mid-21st century, under climate change, almost all of Alaska could be exposed to increases of 100% or more in levels of wildfire-specific PM2.5 levels. Exposure to wildfire-PM2.5 likely presents a substantial public health burden in the present day for Alaska communities, with different impacts by subpopulation. Under climate change, wildfire smoke could pose an even greater public health risks for most Alaskans.
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Affiliation(s)
- Seung Hyun Lucia Woo
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
| | - Jia Coco Liu
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Xu Yue
- Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Loretta J Mickley
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
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White PF, Conway RP, Byrne DG, O'Riordan DMR, Silke BM. Air pollution and comorbidity burden influencing acute hospital mortality outcomes in a large academic teaching hospital in Dublin, Ireland: a semi-ecologic analysis. Public Health 2020; 186:164-169. [PMID: 32836006 DOI: 10.1016/j.puhe.2020.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the extent to which air pollution interacts with comorbidity in determining mortality outcomes of emergency medical admissions. STUDY DESIGN Routinely collected data were used to study all emergency medical admissions to an academic teaching hospital in Dublin, Ireland, from 2002 to 2018. Air pollution was measured by particulate matter with aerodynamic diameter ≤10 μm (PM10) and sulphur dioxide (SO2) levels on the day of admission. Comorbidity Score was measured using a previously derived score. METHODS A multivariable logistic regression model was used to relate air pollutant levels, Comorbidity Scores, and their interaction to 30-day in-hospital mortality. RESULTS There were 102,483 admissions in 58,127 patients over 17 years. Both air pollutant levels and Comorbidity Score were associated with 30-day in-hospital mortality. On admission days with PM10 levels above the median, mortality was higher (Odds ratio [OR] 1.09; 95% confidence interval [CI] 1.06, 1.18) at 11.2% (95% CI 10.5, 12) compared with 10.4% (95% CI 10, 10.7) on days when PM10 levels were below the median. On admission days with SO2 levels above the median, mortality was higher (OR 1.13; 95% CI 1.10, 1.16) at 12.2% (95% CI 11.4, 13) compared with 10.7% (95% CI 10.3, 11.1) on days when SO2 levels were below the median. Comorbidity Score was strongly associated with mortality (mortality rate of 8.9% for those with a 6-point score vs mortality rate of 30.3% for those with a 16-point score). There was limited interaction between air pollutant levels and Comorbidity Score. CONCLUSION Both air pollution levels on the day of admission and Comorbidity Score were associated with 30-day in-hospital mortality. However, there was limited interaction between these two factors.
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Affiliation(s)
- P F White
- Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
| | - R P Conway
- Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland
| | - D G Byrne
- Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland
| | - D M R O'Riordan
- Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland
| | - B M Silke
- Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland
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Chen X, Wang T, Qiu X, Que C, Zhang H, Zhang L, Zhu T. Susceptibility of individuals with chronic obstructive pulmonary disease to air pollution exposure in Beijing, China: A case-control panel study (COPDB). THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 717:137285. [PMID: 32092811 DOI: 10.1016/j.scitotenv.2020.137285] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Exposure to air pollution is one of the major risk factors contributing to the occurrence and development of chronic obstructive pulmonary disease (COPD). However, few studies have investigated the susceptibility of patients with COPD to air pollution. Here, we provided a study protocol. A panel study of a total of 480 samples to compare the response to air pollution exposure between 60 patients with COPD and 60 healthy control subjects has been performed in Beijing (the COPDB study) since May 2016. The health assessment and exposure evaluation methods used in this COPDB study are summarized here. Throat, exhaled breath and condensate, urine, serum, plasma, and blood samples, as well as cardiopulmonary function indexes were repeatedly collected over four visits. Indicators of inflammation, oxidative stress, infection, metabolic changes, and genetic differences were then analyzed. Personal and ambient levels of fine particles and their components, as well as gaseous pollutants were monitored during the follow-up period. Linear mixed-effects models were used to evaluate the associations between changes in biomarkers and exposure to air pollution in both patients with COPD and healthy control subjects. Based on the COPDB study, the susceptibility of COPD patients and underlying mechanisms, involving difference in inflammatory, infection, metabolic, and genetic response to different air pollutants, were investigated. Our preliminary result shows that air pollution-associated changes in heart rate were higher in COPD patients than the healthy controls. More investigations of the underlying mechanisms of the susceptibility are ongoing. This study has been registered in ChiCTR with the number of ChiCTR1900023692.
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Affiliation(s)
- Xi Chen
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China; The Beijing Innovation Center for Engineering Science and Advanced Technology, College of Environmental Sciences and Engineering, Peking University, Beijing, China; GRiC, Shenzhen Institute of Building Research Co., Ltd., Shenzhen, China.
| | - Teng Wang
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China; The Beijing Innovation Center for Engineering Science and Advanced Technology, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
| | - Xinghua Qiu
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
| | - Chengli Que
- Peking University First Hospital, Peking University, Beijing, China.
| | - Hanxiyue Zhang
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
| | - Lina Zhang
- Beijing Xicheng District Shichahai Community Health Center, Beijing, China.
| | - Tong Zhu
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China; The Beijing Innovation Center for Engineering Science and Advanced Technology, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
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Cohen G, Steinberg DM, Keinan-Boker L, Yuval, Levy I, Chen S, Shafran-Nathan R, Levin N, Shimony T, Witberg G, Bental T, Shohat T, Broday DM, Kornowski R, Gerber Y. Preexisting coronary heart disease and susceptibility to long-term effects of traffic-related air pollution: A matched cohort analysis. Eur J Prev Cardiol 2020; 28:2047487320921987. [PMID: 32389024 DOI: 10.1177/2047487320921987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with coronary heart disease are considered susceptible to traffic-related air pollution exposure. Yet, cohort-based evidence on whether preexisting coronary heart disease modifies the association of traffic-related air pollution with health outcomes is lacking. AIM Using data of four Israeli cohorts, we compared associations of traffic-related air pollution with mortality and cancer between coronary heart disease patients and matched controls from the general population. METHODS Subjects hospitalized with acute coronary syndrome from two patient cohorts (inception years: 1992-1993 and 2006-2014) were age- and sex-matched to coronary heart disease-free participants of two cycles of the Israeli National Health and Nutrition Surveys (inception years: 1999-2001 and 2005-2006). Ambient concentrations of nitrogen oxides at the residential place served as a proxy for traffic-related air pollution exposure across all cohorts, based on a high-resolution national land use regression model (50 m). Data on all-cause mortality (last update: 2018) and cancer incidence (last update: 2016) were retrieved from national registries. Cox-derived stratum-specific hazard ratios with 95% confidence intervals were calculated, adjusted for harmonized covariates across cohorts, including age, sex, ethnicity, neighborhood socioeconomic status, smoking, diabetes, hypertension, prior stroke and prior malignancy (the latter only in the mortality analysis). Effect-modification was examined by testing nitrogen oxides-by-coronary heart disease interaction term in the entire matched cohort. RESULTS The cohort (mean (standard deviation) age 61.5 (14) years; 44% women) included 2393 matched pairs, among them 2040 were cancer-free at baseline. During a median (25th-75th percentiles) follow-up of 13 (10-19) and 11 (7-17) years, 1458 deaths and 536 new cancer cases were identified, respectively. In multivariable-adjusted models, a 10-parts per billion nitrogen oxides increment was positively associated with all-cause mortality among coronary heart disease patients (hazard ratio = 1.13, 95% confidence interval 1.05-1.22), but not among controls (hazard ratio = 1.00, 0.93-1.08) (pinteraction = 0.003). A similar pattern was seen for all-cancer incidence (hazard ratioCHD = 1.19 (1.03-1.37), hazard ratioCHD-Free = 0.93 (0.84-1.04) (pinteraction = 0.01)). Associations were robust to multiple sensitivity analyses. CONCLUSIONS Coronary heart disease patients might be at increased risk for traffic-related air pollution-associated mortality and cancer, irrespective of their age and sex. Patients and clinicians should be more aware of the adverse health effects on coronary heart disease patients of chronic exposure to vehicle emissions.
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Affiliation(s)
- Gali Cohen
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
- Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Israel
| | - David M Steinberg
- Department of Statistics and Operations Research, Tel Aviv University, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Israel
- School of Public Health, University of Haifa, Israel
| | - Yuval
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Ilan Levy
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Shimon Chen
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Rakefet Shafran-Nathan
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Noam Levin
- Department of Geography, Hebrew University of Jerusalem, Israel
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Israel
| | - Guy Witberg
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
- Department of Cardiology, Rabin Medical Center (Beilinson and Hasharon Hospitals), Israel
| | - Tamir Bental
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
| | - Tamar Shohat
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
| | - David M Broday
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Ran Kornowski
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
- Deptartment of Cardiovascular Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
- Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Israel
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Yang J, Zhou M, Zhang F, Yin P, Wang B, Guo Y, Tong S, Wang H, Zhang C, Sun Q, Song X, Liu Q. Diabetes mortality burden attributable to short-term effect of PM 10 in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:18784-18792. [PMID: 32207004 DOI: 10.1007/s11356-020-08376-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/09/2020] [Indexed: 05/06/2023]
Abstract
Ambient air pollution may be associated with diabetes mellitus. However, evidence from developing countries is limited although the concentrations of air pollution are disproportionably higher in these countries. We collected daily data on diabetes mortality, air pollution, and weather conditions from 16 Chinese provincial cities during 2007-2013. A quasi-Poisson regression combined with a distributed lag model was used to quantify the city-specific mortality risk of PM10 (particulate matter with aerodynamic diameter < 10 μm). Then, a random-effect meta-analysis was conducted to pool effect estimates from 16 cities. We also calculated the attributable fraction and attributable number of diabetes mortality due to PM10. Effects of PM10 were found to be acute and limited to 3 days. Harvesting effect of PM10 was found during lag 4-10 days on diabetes mortality. An increase of 0.17% (95%CI: 0.01-0.34), 0.48% (95%CI: 0.22-0.73), and 0.53% (95%CI: 0.27-0.80) in diabetes mortality was associated with per 10 μg/m3 increase in PM10 at lag 0, 0-4 and 0-10 days, respectively. Totally, 5.76% (95%CI: 2.59-8.00%) and 5878 (95%CI: 2639-8163) deaths due to diabetes could be attributable to PM10. If the concentration of PM10 attained the Chinese government and WHO targets, the reduction in number of PM2.5-attributed diabetes deaths was 2016 and 5528, respectively. Higher effect estimates of PM10 were observed among females and those aged 0-64 years old at lag 0 day, while greater cumulative effects of PM10 were among males, the elderly aged 75 or over, and the illiterate at lag 0-10 days. However, the between-group differences were not statistically significant. It is one of the few studies on examining the attributable burden of diabetes mortality caused by particulate matter. Our findings indicated that effective efforts on controlling air pollution could reduce a prominent number of air pollution-related diabetes deaths.
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Affiliation(s)
- Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China.
- Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Fengying Zhang
- China National Environmental Monitoring Centre, Beijing, 100012, China
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
- Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Hao Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
- Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Chunlin Zhang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
- Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Xiuping Song
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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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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Xu M, Sbihi H, Pan X, Brauer M. Modifiers of the effect of short-term variation in PM 2.5 on mortality in Beijing, China. ENVIRONMENTAL RESEARCH 2020; 183:109066. [PMID: 32058147 DOI: 10.1016/j.envres.2019.109066] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Epidemiologic studies have reported associations between short-term exposure to particulate matter <2.5 μm in aerodynamic diameter (PM2.5) and mortality, but the role of modifiers remains unclear with studies reporting inconsistent results. We evaluated the impact of individual (age, gender and education) and township (geographic area, socioeconomic status, background air pollution and road density) level factors on the relationship between short-term variation in PM2.5 with cause-specific mortality in Beijing (population: 21.7 million in 2016), China. METHODS Daily PM2.5 concentrations in each township (n = 327; township population: 2000-359,400; township area: 1-392 km2) within Beijing were estimated by kriging with external drift using measurements from 35 air quality monitoring stations and geographic variables. Time-stratified case-crossover analysis with township-level mortality data from Oct. 1st, 2012 to Dec. 31st, 2013 was then used to examine associations between PM2.5 exposure estimates and cause-specific mortality, stratified by the potential effect modifiers. RESULTS A 10-μg/m3 increase in PM2.5 concentration was associated with a 0.17% [95% confidence interval (CI): 0.05%-0.29%] and 0.27% (95%CI:0.01%-0.52%) increase in non-accidental and stroke mortality with no lag, a 0.81% (95%CI:0.39%-1.23%) and 0.96% (95%CI:0.35%-1.57%) increase in respiratory disease (RD) and chronic obstructive pulmonary disease (COPD) mortality at a lag of two-day moving average. For individual-level effect modifiers, the elderly showed higher effects for all the specific causes of mortality; those with lower education level showed higher effects for non-accidental, cardiovascular disease and stroke mortality; females showed higher effects for non-accidental and cause-specific cardiovascular diseases. For township-level effect modifiers, effect estimates tended to be larger for suburban areas, areas of lower road density, lower PM2.5 and lower socioeconomic status. CONCLUSIONS Short-term exposure to township-level ambient PM2.5 was associated with increased mortality in Beijing, with indications of effect modification by both individual and township-level factors.
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Affiliation(s)
- Meimei Xu
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Hind Sbihi
- BC Children's Hospital Research Institute, Vancouver, BC, V6H 3N1, Canada; School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
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Sharma E, Deo RC, Prasad R, Parisi AV. A hybrid air quality early-warning framework: An hourly forecasting model with online sequential extreme learning machines and empirical mode decomposition algorithms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 709:135934. [PMID: 31869708 DOI: 10.1016/j.scitotenv.2019.135934] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
Modelling air quality with a practical tool that produces real-time forecasts to mitigate risk to public health continues to face significant challenges considering the chaotic, non-linear and high dimensional nature of air quality predictor variables. The novelty of this research is to propose a hybrid early-warning artificial intelligence (AI) framework that can emulate hourly air quality variables (i.e., Particulate Matter 2.5, PM2.5; Particulate Matter 10, PM10 and lower atmospheric visibility, VIS), the atmospheric variables associated with increased respiratory induced mortality and recurrent health-care cost. Firstly, hourly air quality data series (January-2015 to December-2017) are demarcated into their respective intrinsic mode functions (IMFs) and a residual sub-series that reveal patterns and resolve data complexity characteristics, followed by partial autocorrelation function applied to each IMF and residual sub-series to unveil historical changes in air quality. To design the prescribed hybrid model, the data is partitioned into training (70%), validation (15%) and testing (15%) sub-sets. The online sequential-extreme learning machine (OS-ELM) algorithm integrated with improved complete ensemble empirical mode decomposition with adaptive noise (ICEEMDAN) is designed as a data pre-processing system to robustly extract predictive patterns and fine-tune the model generalization to a near-optimal global solution, which represents modelled air quality at hourly forecast horizons. The resulting early warning AI-based framework denoted as ICEEMDAN-OS-ELM model, is individually constructed by forecasting each IMF and residual sub-series, with hourly PM2.5, PM10, and VIS obtained by the aggregated sum of forecasted IMFs and residual sub-series. The results are benchmarked with many competing predictive approaches; e.g., hybrid ICEEMDAN-multiple-linear regression (MLR), ICEEMDAN-M5 model tree and standalone versions: OS-ELM, MLR, M5 model tree. Statistical metrics including the root-mean-square error (RMSE), mean absolute error (MAE), Willmott's Index (WI), Legates & McCabe's Index (ELM) and Nash-Sutcliffe coefficients (ENS) are used to evaluate the model's accuracy. Both visual and statistical results show that the proposed ICEEMDAN-OS-ELM model registers superior results, outperforming alternative comparison approaches. For instance, for PM2.5,ELM values ranged from 0.65-0.82 vs. 0.59-0.77 for ICEEMDAN-M5 tree, 0.59-0.74 for ICEEMDAN-MLR, 0.28-0.54 for OS-ELM, 0.27-0.54 for M5 tree and 0.25-0.53 for the MLR model. For remaining air quality variables (i.e., PM10 & VIS), the objective model (ICEEMDAN-OS-ELM) outperformed the comparative models. In particular, ICEEMDAN-OS-ELM registered relatively low RMSE/MAE, ranging from approximately 0.7-1.03 μg/m3(MAE), 1.01-1.47 μg/m3(RMSE) for PM2.5 whereas for PM10, these metrics registered a value of 1.29-3.84 μg/m3(MAE), 3.01-7.04 μg/m3(RMSE) and for Visibility, they were 0.01-3.72 μg/m3 (MAE (Mm-1)), 0.04-5.98 μg/m3 (RMSE (Mm-1)). Visual analysis of forecasted and observed air quality through a Taylor diagram illustrates the objective model's preciseness, confirming the versatility of early warning AI-model in generating air quality forecasts. The excellent performance ascertains the hybrid model's potential utility for air quality monitoring and subsequent public health risk mitigation.
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Affiliation(s)
- Ekta Sharma
- Advanced Data Analytics: Environmental Modelling and Simulation Group, School of Sciences, University of Southern Queensland, Springfield, QLD 4300, Australia.
| | - Ravinesh C Deo
- Advanced Data Analytics: Environmental Modelling and Simulation Group, School of Sciences, University of Southern Queensland, Springfield, QLD 4300, Australia.
| | - Ramendra Prasad
- Department of Science, School of Science and Technology, The University of Fiji, Fiji
| | - Alfio V Parisi
- Advanced Data Analytics: Environmental Modelling and Simulation Group, School of Sciences, University of Southern Queensland, Springfield, QLD 4300, Australia.
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Axelrad DA, Setzer RW, Bateson TF, DeVito M, Dzubow RC, Fitzpatrick JW, Frame AM, Hogan KA, Houck K, Stewart M. Methods for evaluating variability in human health dose-response characterization. HUMAN AND ECOLOGICAL RISK ASSESSMENT : HERA 2019; 25:1-24. [PMID: 31404325 PMCID: PMC6688638 DOI: 10.1080/10807039.2019.1615828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/03/2019] [Indexed: 05/21/2023]
Abstract
The Reference Dose (RfD) and Reference Concentration (RfC) are human health reference values (RfVs) representing exposure concentrations at or below which there is presumed to be little risk of adverse effects in the general human population. The 2009 National Research Council report Science and Decisions recommended redefining RfVs as "a risk-specific dose (for example, the dose associated with a 1 in 100,000 risk of a particular end point)." Distributions representing variability in human response to environmental contaminant exposures are critical for deriving risk-specific doses. Existing distributions estimating the extent of human toxicokinetic and toxicodynamic variability are based largely on controlled human exposure studies of pharmaceuticals. New data and methods have been developed that are designed to improve estimation of the quantitative variability in human response to environmental chemical exposures. Categories of research with potential to provide new database useful for developing updated human variability distributions include controlled human experiments, human epidemiology, animal models of genetic variability, in vitro estimates of toxicodynamic variability, and in vitro-based models of toxicokinetic variability. In vitro approaches, with further development including studies of different cell types and endpoints, and approaches to incorporate non-genetic sources of variability, appear to provide the greatest opportunity for substantial near-term advances.
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Affiliation(s)
- Daniel A. Axelrad
- Office of Policy, U.S. Environmental Protection Agency, Washington, DC, USA
| | - R. Woodrow Setzer
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Thomas F. Bateson
- Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Michael DeVito
- National Institute of Environmental Health Sciences, National Toxicology Program, Research Triangle Park, NC, USA
| | - Rebecca C. Dzubow
- Office of Children’s Health Protection, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Julie W. Fitzpatrick
- Office of the Science Advisor, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Alicia M. Frame
- Office of Land and Emergency Management, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Karen A. Hogan
- Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Keith Houck
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Michael Stewart
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
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Mokoena KK, Ethan CJ, Yu Y, Shale K, Fan Y, Liu F, Rong J. The effect of ambient air pollution on circulatory mortality: a short-term exposure assessment in Xi'an, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:22512-22521. [PMID: 31161547 DOI: 10.1007/s11356-019-05463-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/14/2019] [Indexed: 05/27/2023]
Abstract
Various studies have illustrated that exposure to ambient air pollution has negative impacts on health. However, little evidence exists on the effects of ambient air pollution on circulatory mortality in Xi'an, China. This study aims to investigate and ascertain the association between short-term exposure to ambient air pollutants and circulatory mortality in Xi'an, China. Daily average concentrations of PM2.5, SO2, and O3, meteorological data (temperature and relative humidity) and daily counts of circulatory mortality were obtained between January 2014 and June 2016. Mortality was stratified by gender and age group (≤ 64 years and ≥ 65 years). A generalized additive model (GAM) with natural splines (NS) was constructed to analyze the relationship between ambient air pollutants and daily circulatory mortality. There were 57,570 cases of circulatory mortality, with cerebrovascular and ischemic heart diseases accounting for 48.5% and 43.5%, respectively. All ambient air pollutants displayed different seasonal patterns. In the single pollutant model, 10 μg/m3 increase in 2-day moving average concentrations of PM2.5, SO2, and O3 was associated with relative risk of 1.288(1.198, 1.388), 1.360(0.877, 2.331), and 1.324(1.059, 1.705) in circulatory mortality, respectively. After adjusting for collinearity in the multi-pollutant model, the effects remained statistically significant. The ≥ 65 years and female sub-groups were associated with a higher risk of circulatory mortality. Short-term exposure to ambient air pollutants plays a pivotal role in the genesis of circulatory mortality in Xi'an. Responses to ambient air pollutants exposure in relation to circulatory mortality are different when analyzed by sub-groups.
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Affiliation(s)
- Kingsley Katleho Mokoena
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
- Department of Life Sciences, Central University of Technology, Free State, Bloemfontein, Free State, South Africa
| | - Crystal Jane Ethan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Yan Yu
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China.
| | - Karabo Shale
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Yameng Fan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China.
| | - Jie Rong
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
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45
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Sheffield PE, Shmool JLC, Kinnee EJ, Clougherty JE. Violent crime and socioeconomic deprivation in shaping asthma-related pollution susceptibility: a case-crossover design. J Epidemiol Community Health 2019; 73:846-853. [PMID: 31289119 PMCID: PMC6820152 DOI: 10.1136/jech-2018-211816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/23/2019] [Accepted: 06/06/2019] [Indexed: 11/04/2022]
Abstract
Background The objective of this study was to quantify and compare the relative influence of community violent crime and socioeconomic deprivation in modifying associations between ozone and emergency department (ED) visits for asthma among children. Methods We used a spatiotemporal case-crossover analysis for all New York City EDs for the months May–September from 2005 to 2011 from a statewide administrative ED dataset. The data included 11 719 asthmatic children aged 5–18 years, and the main outcome measure was percentage of excess risk of asthma ED visit based on Cox regression analysis. Results Stronger ozone–asthma associations were observed for both elevated crime and deprivation (eg, on lag day 2, we found 20.0% (95% CI 10.2% to 30.6 %) and 21.0% (10.5% to 32.5%) increased risk per 10 ppb ozone, for communities in the highest vs lowest quartiles of violent crime and deprivation, respectively). However, in varied models accounting for both modifiers, only violence retained significance. Conclusions The results suggest stronger spatiotemporal ozone–asthma associations in communities of higher violent crime or deprivation. Notably, violence was the more consistent and significant modifier, potentially mediating a substantial portion of socioeconomic position–related susceptibility.
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Affiliation(s)
- Perry E Sheffield
- Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jessie L C Shmool
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Ellen J Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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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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47
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Lee S, Lee W, Kim D, Kim E, Myung W, Kim SY, Kim H. Short-term PM 2.5 exposure and emergency hospital admissions for mental disease. ENVIRONMENTAL RESEARCH 2019; 171:313-320. [PMID: 30711732 DOI: 10.1016/j.envres.2019.01.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 10/21/2018] [Accepted: 01/24/2019] [Indexed: 05/21/2023]
Abstract
Epidemiologic studies regarding the relationship between short-term exposure to particulate matter with a median aerodynamic diameter < 2.5 µm (PM2.5) and mental disease are limited. This study examined the effects of short-term exposure to PM2.5 on emergency admissions to the hospital for mental disease in Seoul, Korea. Data regarding 80,634 emergency admissions for mental diseases were collected from a nationally centralized healthcare claims database in Seoul during 2003-2013. Generalized linear models with climate variables were used to examine associations between short-term PM2.5 exposure and mental disease admissions. To comprehensively assess PM2.5 effects, we used single- and two-pollutant models, which considered other pollutants in combination with PM2.5. The relative risk (RR) of emergency admissions for mental disease was 1.008 (95% confidence interval, 1.001-1.015) for each 10 μg/m3 increase in 2-day average PM2.5 concentration. This effect persisted or became slightly stronger in the two-pollutant models that included carbon monoxide, nitrogen dioxide, ozone, or sulfur dioxide (RR, 1.01-1.021), but association appeared to be limited to individuals < 65 years of age. Significant association was estimated only during the warm season (RR, 1.021-1.023) in the two-pollutant models. The exposure-response curve was steeper at lower concentrations, suggesting that the risk of mental disease at lower concentrations of pm2.5 (0-30 µg/m3). PM2.5 was associated with increased admissions even when it was below the World Health Organization's Air Quality Guidelines (25 μg/m3), but the association was not statistically significant. Thus, based on the data from a large database, exposure to PM2.5 was associated with increases in emergency admissions for mental diseases, and this association was significant during the warm season. PM2.5 may even affect mental disease at levels below the current air quality guidelines. These results provide substantial insight regarding the effects of air pollutants and have important implications for policy makers.
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Affiliation(s)
- Suji Lee
- Institute of Health and Environment, Seoul National University, Gwanak-gu, Seoul 08826, Republic of korea.
| | - Whanhee Lee
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Dahye Kim
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea.
| | - Ejin Kim
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea.
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Republic of Korea.
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang Gyeonggi-do 10408, Republic of Korea.
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, Gwanak-gu, Seoul 08826, Republic of korea; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea.
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48
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Goudarzi G, Alavi N, Geravandi S, Yari AR, Aslanpour Alamdari F, Dobaradaran S, Farhadi M, Biglari H, Dastoorpour M, Hashemzadeh B, Mohammadi MJ. Ambient particulate matter concentration levels of Ahvaz, Iran, in 2017. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2019; 41:841-849. [PMID: 30191444 DOI: 10.1007/s10653-018-0182-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/29/2018] [Indexed: 06/08/2023]
Abstract
Dust storm in Khuzestan region is strongly influenced by transportation and influx of large amount of particulate matter from internal sources (Hawizeh Marshes and East Ahwaz) and external sources (the Arabian Desert in Saudi Arabia, Jordan, Syria and the Sahara Desert). Particulate matter is one of the main components of indoor and outdoor air quality that can be very dangerous for human. The principal objective of this study was the pinpoint of the source of airborne particulate matter by the NOAA HYSPLIT model in Ahvaz City, southwest of Iran. The investigation of dust storm and their origin was performed by the GFSG Meteorological Data (backward trajectories ending analysis of the NOAA HYSPLIT model) and collecting particulate samples with high-volume air samplers during the fall and winter seasons. The results showed the average ambient particulate matter concentration in the cold and warm seasons was 158 and 161 µg/m3, respectively. Moreover, the average particulate matter concentration in the cold season was significantly higher than the standard level as presented in the National Ambient Air Quality Standard. Consequently, it seems essential to develop green space, decrease particulate emission from source and make determined efforts to control dust at governmental and international scales.
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Affiliation(s)
- Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nadali Alavi
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Reza Yari
- Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran
| | | | - Sina Dobaradaran
- Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Majid Farhadi
- Nutrition Health Research Center, Department of Environmental Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamed Biglari
- Department of Environmental Health Engineering, School of Public Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Maryam Dastoorpour
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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49
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Huang G, Zhou W, Qian Y, Fisher B. Breathing the same air? Socioeconomic disparities in PM 2.5 exposure and the potential benefits from air filtration. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:619-626. [PMID: 30677928 DOI: 10.1016/j.scitotenv.2018.11.428] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/13/2018] [Accepted: 11/28/2018] [Indexed: 05/17/2023]
Abstract
Air pollution caused by particulate matter <2.5 μm in diameter (PM2.5) imposes a severe health burden to people worldwide. Across the globe, and even within cities, the health burden of air pollution is not equally shared by citizens. Despite being the region suffering from the most severe air pollution, studies examining the inequity of the burdens of air pollution in Asia are limited. We aim to fill in this gap by analyzing the relationship between PM2.5 pollution and residents' socioeconomic characteristics in Beijing, the icon city for PM2.5 pollution. Our results show that household income and education were negatively correlated with ambient air quality (r = -0.62; p < 0.05 and r = -0.73; p < 0.01 respectively) in 2014. We found in Beijing air quality is worse where residents have less income and lower education rates and are less capable to protect themselves from the potential health risk. To counter the effects of air pollution in Beijing, air filtration has been shown to be an effective means to reduce, at least, indoor PM2.5 levels. We illustrate through a simple scenario analysis that air filtration can reduce exposure (26-79%) to a similar extent as the structural mitigation programs (e.g. closing coal factories) achieved in recent years (53%). We argue government intervention is needed to convey the benefit of air filtration to the socioeconomically disadvantaged groups.
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Affiliation(s)
- Ganlin Huang
- Center for Human-Environment System Sustainability (CHESS), State Key Laboratory of Earth Surface Processes and Resource Ecology (ESPRE), Beijing Normal University, No 19 Xinjiekouwai Road, Beijing 100875, China; School of Natural Resources, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China.
| | - Weiqi Zhou
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-environmental Science, Chinese Academy of Sciences, No 18 Shuangqing Road, Beijing 100085, China
| | - Yuguo Qian
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-environmental Science, Chinese Academy of Sciences, No 18 Shuangqing Road, Beijing 100085, China
| | - Brendan Fisher
- Gund Institute/Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center, 81 Carrigan Drive, Burlington, VT 05405, USA
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50
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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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