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Review of Ground-Level Ozone Impact in Respiratory Health Deterioration for the Past Two Decades. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Ground-level ozone has been gaining notoriety with increasing evidence of its nefarious effects on health, especially respiratory diseases. Where do we stand on the solidity of this data and is there room for improvement? Objectives: Evaluate this evidence for incongruities or heterogeneity in this field of research. How is the exposure assessment conducted, where does Portugal stand in this field, and what can be improved? Health deterioration concerning asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) are analysed. Methods: A review of 1735 studies was conducted through PubMed and Google Scholar engines for the past two decades. We identified 59 eligible studies and included an array of variables, including O3 measurements, number of air-quality monitoring stations used, relative risks, odds ratios, hazard ratios, number of hospital admissions, visits, or mortality, and size of population dataset used. Results: Approximately 83% of data in this review presents significant correlations of ozone with asthma, COPD, and ARDS. Studies that report negative or not significant associations mention a lack of data or topographic differences as the main issue with these divergent results. Studies consistently report summer as a period of particular concern. Portuguese data in this field is lacking. Conclusions: This research field is growing in interest and there is evidence that ozone plays a non-negligible role in health deterioration. The few Portuguese studies in this field seem aligned with the literature reviewed but more research is needed. Suggested improvements are more and better data through denser air-quality networks to accurately depict personal exposure to ozone. Homogenization of the exposure assessment concerning averaging times of ozone to daily maximum 8 h averages whenever possible. Risk increments based on 10 ppb instead of interquartile ranges. Lastly, contrary to some studies in this review, the topographic effect on concentrations and health deterioration should not be underestimated and seasonality should always be checked.
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Huang J, Yang X, Fan F, Hu Y, Wang X, Zhu S, Ren G, Wang G. Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: a systematic review and meta-analysis. J Asthma 2021; 59:2322-2339. [PMID: 34809505 DOI: 10.1080/02770903.2021.2008429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: To synthesize evidence regarding the relationship between outdoor air pollution and risk of asthma exacerbations in single lag0 and lag1 exposure patterns.Methods: We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases. Articles published until August 1, 2020 and the reference lists of the relevant articles were reviewed. Two authors independently evaluated the eligible articles and performed structured extraction of the relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using random-effect models.Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with increased risk of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95% CI) (pollutants), 1.057(1.011, 1.103) (air quality index, AQI), 1.007 (1.005, 1.010) (particulate matter of diameter ≤ 2.5 μm, PM2.5), 1.009 (1.005, 1.012) (particulate matter of diameter, PM10), 1.010 (1.006, 1.014) (NO2), 1.030 (1.011, 1.048) (CO), 1.005 (1.002, 1.009) (O3); lag1:1.064(1.022, 1.106) (AQI), 1.005 (1.002, 1.008) (PM2.5), 1.007 (1.004, 1.011) (PM10), 1.008 (1.004, 1.012) (NO2), 1.025 (1.007, 1.042) (CO), 1.010 (1.006, 1.013) (O3)], except SO2 [lag0: RR (95% CI), 1.004 (1.000, 1.007); lag1: RR (95% CI), 1.003 (0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use).Conclusion: Outdoor air pollution increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.Trial registration: PROSPERO, CRD42020204097. https://www.crd.york.ac.uk/.Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2008429 .
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Affiliation(s)
- Junjun Huang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Yang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Hu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xi Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Guanhua Ren
- Department of Library, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Diao M, Holloway T, Choi S, O’Neill SM, Al-Hamdan MZ, van Donkelaar A, Martin RV, Jin X, Fiore AM, Henze DK, Lacey F, Kinney PL, Freedman F, Larkin NK, Zou Y, Kelly JT, Vaidyanathan A. Methods, availability, and applications of PM 2.5 exposure estimates derived from ground measurements, satellite, and atmospheric models. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2019; 69:1391-1414. [PMID: 31526242 PMCID: PMC7072999 DOI: 10.1080/10962247.2019.1668498] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/01/2019] [Accepted: 08/22/2019] [Indexed: 05/20/2023]
Abstract
Fine particulate matter (PM2.5) is a well-established risk factor for public health. To support both health risk assessment and epidemiological studies, data are needed on spatial and temporal patterns of PM2.5 exposures. This review article surveys publicly available exposure datasets for surface PM2.5 mass concentrations over the contiguous U.S., summarizes their applications and limitations, and provides suggestions on future research needs. The complex landscape of satellite instruments, model capabilities, monitor networks, and data synthesis methods offers opportunities for research development, but would benefit from guidance for new users. Guidance is provided to access publicly available PM2.5 datasets, to explain and compare different approaches for dataset generation, and to identify sources of uncertainties associated with various types of datasets. Three main sources used to create PM2.5 exposure data are ground-based measurements (especially regulatory monitoring), satellite retrievals (especially aerosol optical depth, AOD), and atmospheric chemistry models. We find inconsistencies among several publicly available PM2.5 estimates, highlighting uncertainties in the exposure datasets that are often overlooked in health effects analyses. Major differences among PM2.5 estimates emerge from the choice of data (ground-based, satellite, and/or model), the spatiotemporal resolutions, and the algorithms used to fuse data sources.Implications: Fine particulate matter (PM2.5) has large impacts on human morbidity and mortality. Even though the methods for generating the PM2.5 exposure estimates have been significantly improved in recent years, there is a lack of review articles that document PM2.5 exposure datasets that are publicly available and easily accessible by the health and air quality communities. In this article, we discuss the main methods that generate PM2.5 data, compare several publicly available datasets, and show the applications of various data fusion approaches. Guidance to access and critique these datasets are provided for stakeholders in public health sectors.
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Affiliation(s)
- Minghui Diao
- San Jose State University, Department of Meteorology and Climate Science, One Washington Square, San Jose, California, USA, 95192-0104
| | - Tracey Holloway
- University of Wisconsin-Madison, Nelson Institute Center for Sustainability and the Global Environment (SAGE) and Department of Atmospheric and Oceanic Sciences, 201A Enzyme Institute, 1710 University Ave., Madison, Wisconsin, USA, 53726
| | - Seohyun Choi
- University of Wisconsin-Madison, Nelson Institute Center for Sustainability and the Global Environment (SAGE) and Department of Atmospheric and Oceanic Sciences, 201A Enzyme Institute, 1710 University Ave., Madison, Wisconsin, USA, 53726
| | - Susan M. O’Neill
- United States Department of Agriculture Forest Service, Pacific Northwest Research Station, Seattle, WA, USA, 98103-8600
| | - Mohammad Z. Al-Hamdan
- Universities Space Research Association, NASA Marshall Space Flight Center, National Space Science and Technology Center, 320 Sparkman Dr., Huntsville, Alabama, USA, 35805
| | - Aaron van Donkelaar
- Dalhousie University, Department of Physics and Atmospheric Science, 6299 South St, Halifax, Nova Scotia, Canada, B3H 4R2
| | - Randall V. Martin
- Dalhousie University, Department of Physics and Atmospheric Science, 6299 South St, Halifax, Nova Scotia, Canada, B3H 4R2
- Smithsonian Astrophysical Observatory, Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA, 02138
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA, 63130
| | - Xiaomeng Jin
- Columbia University, Department of Earth and Environmental Sciences and Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, New York, USA, 10964
| | - Arlene M. Fiore
- Columbia University, Department of Earth and Environmental Sciences and Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, New York, USA, 10964
| | - Daven K. Henze
- University of Colorado, Mechanical Engineering Department, 1111 Engineering Drive UCB 427, Boulder, CO, USA, 80309
| | - Forrest Lacey
- University of Colorado, Mechanical Engineering Department, 1111 Engineering Drive UCB 427, Boulder, CO, USA, 80309
- National Center for Atmospheric Research, Atmospheric Chemistry Observations and Modeling, 3450 Mitchell Ln, Boulder, CO, USA, 80301
| | - Patrick L. Kinney
- Boston University School of Public Health, Department of Environmental Health, 715 Albany Street, Talbot 4W, Boston, Massachusetts, USA, 02118
| | - Frank Freedman
- San Jose State University, Department of Meteorology and Climate Science, One Washington Square, San Jose, California, USA, 95192-0104
| | - Narasimhan K. Larkin
- United States Department of Agriculture Forest Service, Pacific Northwest Research Station, Seattle, WA, USA, 98103-8600
| | - Yufei Zou
- University of Washington, School of Environmental and Forest Sciences, Anderson Hall, Seattle, WA, USA, 98195
| | - James T. Kelly
- Office of Air Quality Planning & Standards, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA 27711
| | - Ambarish Vaidyanathan
- Asthma and Community Health Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop E-19, Atlanta, Georgia, USA, 30333
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Osgood RS, Kasahara DI, Tashiro H, Cho Y, Shore SA. Androgens augment pulmonary responses to ozone in mice. Physiol Rep 2019; 7:e14214. [PMID: 31544355 PMCID: PMC6755142 DOI: 10.14814/phy2.14214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/28/2022] Open
Abstract
Ozone causes airway hyperresponsiveness, a defining feature of asthma, and is an asthma trigger. In mice, ozone-induced airway hyperresponsiveness is greater in males than in females, suggesting a role for sex hormones in the response to ozone. To examine the role of androgens in these sex differences, we castrated 4-week-old mice. Controls underwent sham surgery. At 8 weeks of age, mice were exposed to ozone (2ppm, 3 h) or room air. Twenty-four hours later, mice were anesthetized and measurements of airway responsiveness to inhaled aerosolized methacholine were made. Mice were then euthanized and bronchoalveolar lavage was performed. Castration attenuated ozone-induced airway hyperresponsiveness and reduced bronchoalveolar lavage cells. In intact males, flutamide, an androgen receptor inhibitor, had similar effects to castration. Bronchoalveolar lavage concentrations of several cytokines were reduced by either castration or flutamide treatment, but only IL-1α was reduced by both castration and flutamide. Furthermore, an anti-IL-1α antibody reduced bronchoalveolar lavage neutrophils in intact males, although it did not alter ozone-induced airway hyperresponsiveness. Our data indicate that androgens augment pulmonary responses to ozone and that IL-1α may contribute to the effects of androgens on ozone-induced cellular inflammation but not airway hyperresponsiveness.
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Affiliation(s)
- Ross S. Osgood
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - David I. Kasahara
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - Hiroki Tashiro
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - Youngji Cho
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusetts
| | - Stephanie A. Shore
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMassachusetts
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Luong LMT, Phung D, Dang TN, Sly PD, Morawska L, Thai PK. Seasonal association between ambient ozone and hospital admission for respiratory diseases in Hanoi, Vietnam. PLoS One 2018; 13:e0203751. [PMID: 30248114 PMCID: PMC6152873 DOI: 10.1371/journal.pone.0203751] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/01/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Many studies have indicated the detrimental effect of ambient ozone to respiratory health in different countries. The levels of ozone in Hanoi, Vietnam are frequently above the WHO guideline but very few studies on the effects of ambient ozone on human health have been conducted in this location. This study aimed to examine the effects of ozone on hospital admission for respiratory diseases in Hanoi, by diseases, ages and seasons. METHODS Hospital admissions, air pollutants and meteorological data were collected from January 2010 to June 2014. We used generalized linear models and distributed lag linear model to assess the association. In addition to full year analysis, we conducted restricted analysis of the data for two summer (from June-August) and winter (from December-February) seasons and grouped hospital admissions by diseases and ages (all ages, children 0 to 5 years and elderly >65 years). The delayed effect of ozone was assessed using lags of up to 5 days. RESULTS Ozone has a stronger effect on the risk of hospital admission for respiratory diseases and wheeze-associated disorders in the winter. For respiratory diseases, children were affected by ozone more than other age groups in both winter and summer. Each increase of 10 μg/m3 of ozone is associated with an increase of 6.2% risk of admission for respiratory disease among children in the winter and 1.2% in the summer. For wheeze-associated disorders, the elderly group seemed to be more affected by ozone in full year and winter but no significant association was found between ozone and admission for wheeze-associated diseases in any age group. CONCLUSIONS Ozone is a risk factor for respiratory admission, especially amongst children under 5 years old in Hanoi, and ozone has a stronger effect in the winter than in the summer in this city.
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Affiliation(s)
- Ly M. T. Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia
| | - Tran Ngoc Dang
- The Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Peter D. Sly
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
| | - Phong K. Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
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Witonsky J, Abraham R, Toh J, Desai T, Shum M, Rosenstreich D, Jariwala SP. The association of environmental, meteorological, and pollen count variables with asthma-related emergency department visits and hospitalizations in the Bronx. J Asthma 2018; 56:927-937. [PMID: 30207818 DOI: 10.1080/02770903.2018.1514627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To better understand how meteorological variables, air quality variables, and pollen counts collectively contribute to asthma-related emergency department visits (AREDV) and asthma-related hospitalizations (ARH) among pediatric and adult patients in the New York City borough of the Bronx. Methods: The numbers of daily adult and pediatric AREDV and ARH from 2001 to 2008 were obtained from three Bronx hospitals. After removing outliers, interpolating missing data, and standardizing variable values by scaling the data using z-scores, data were analyzed using Spearman rank tests and linear regression models for the full year and each season. Results: There were a total of 42,065 AREDV and 1,664 ARH at both Bronx hospitals. With the exception of a spring peak in AREDVs, AREDVs and ARHs follow a cyclical pattern, climbing in the fall, plateauing in the winter, dropping in the spring, and reaching a low in the summer. Among the 11 air quality, meteorological, and pollen count variables, temperature and tree pollen made the greatest contribution to AREDV with scaled coefficients of -0.337 and 0.311 respectively; equating to an additional AREDV for every 5.0-unit decrease in temperature and an additional AREDV for every 186.0-unit increase in tree pollen. These two variables were confirmed to have independent associations with AREDV prior to the data interpolation. Grass pollen was also found to have a relatively large contribution to AREDV during the summer with a scaled coefficient of 0.314, equating to an additional AREDV for every 2.3-unit increase in grass pollen. Conclusion: There are distinct peaks of increased AREDVs that are closely associated with increased tree pollen counts in the spring and decreasing temperatures in the fall. Early anticipation of these air quality, meteorological, and pollen factor changes based on ongoing surveillance could potentially guide clinical practice and minimize AREDVs in the Bronx.
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Affiliation(s)
- Jonathan Witonsky
- a Department of Pediatrics, University of California , San Francisco , CA , USA ; Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ryan Abraham
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Jennifer Toh
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Tulsi Desai
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Mili Shum
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - David Rosenstreich
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Sunit P Jariwala
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
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Nnoli NC, Linder SH, Smith MA, Gemeinhardt GL, Zhang K. The combined effect of ambient ozone exposure and toxic air releases on hospitalization for asthma among children in Harris County, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:358-378. [PMID: 29962221 DOI: 10.1080/09603123.2018.1479515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/16/2018] [Indexed: 06/08/2023]
Abstract
This study represents an analysis of the effect of exposure to ambient ozone and toxic air releases on hospitalization for asthma among children in Harris County, Texas. Our study identified temporal and spatial variations in asthma hospitalization across the study region and explored the combined effect of exposure to ambient ozone and air toxics on asthma hospitalization. Asthma hospitalization hot spots and clusters were mostly not located on zip codes with reported high quantities of total air releases of chemical pollutants. There was no significant interaction between ambient ozone exposure and toxic air releases relative to asthma hospitalization. The major predictor of asthma hospitalization was season, with hospitalization rate per 10,000 people for asthma being highest in winter period when ozone levels are usually lowest.
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Affiliation(s)
- Nnamdi C Nnoli
- a Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Stephen H Linder
- b Department of Management Policy and Community Health, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
- c Institute of Health Policy, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Mary A Smith
- a Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Gretchen L Gemeinhardt
- b Department of Management Policy and Community Health, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Kai Zhang
- a Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health , The University of Texas Health Science Center at Houston , Houston , Texas , USA
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Castner J, Guo L, Yin Y. Ambient air pollution and emergency department visits for asthma in Erie County, New York 2007-2012. Int Arch Occup Environ Health 2017; 91:205-214. [PMID: 29043427 DOI: 10.1007/s00420-017-1270-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 10/05/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE 8% of the US population has asthma. Air pollution is linked to exacerbation in susceptible individuals. The objective was to identify air pollutants that increased the risk of asthma emergency department visits during a time wherein a polluting factory was criminally convicted, changing local air pollutant levels. METHODS An ecological time-series design used a daily count of asthma emergency visits from 2007 to 2012 as the dependent variable. Independent variables air pollutants (NO2, PM2.5 CO, and O3), controlling for meteorological conditions, were analyzed using time-series and Poisson GLM models. RESULTS 76,651 emergency asthma visits were included with an average of 35 visits per day (SD = 9.2, range 11-80) in a stationary time series. Increased visit volume in fall and spring had no associations to the air pollutants. Associations between individual air pollutants occurred in otherwise low-volume months for asthma emergency visits. The strongest relationship was an 11.6% increase in the asthma emergency visit rate during the month of June. In monthly groupings that removed most of the autumn and spring months, O3, PM2.5, CO, and NO2 were associated with 5, 4, 2, and 2% increases in asthma emergency visits, respectively. CO was the only pollutant with a negative association with asthma emergency visits, occurring in the month of April. CONCLUSIONS Pollutants NO2, PM2.5 CO, and O3 were associated with increased emergency asthma visits in some, but not all months of the year. Air pollution's impact on asthma emergencies may be masked by other, more influential seasonal triggers, such as infections or allergies.
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Affiliation(s)
- Jessica Castner
- University at Buffalo, Buffalo, NY, USA. .,Heilbrunn Family Center for Research Nursing Scholar, Rockefeller University, New York, NY, USA.
| | | | - Yong Yin
- Department of Economics, College of Arts and Sciences, University at Buffalo, Buffalo, NY, USA
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Weber SA, Insaf TZ, Hall ES, Talbot TO, Huff AK. Assessing the impact of fine particulate matter (PM 2.5) on respiratory-cardiovascular chronic diseases in the New York City Metropolitan area using Hierarchical Bayesian Model estimates. ENVIRONMENTAL RESEARCH 2016; 151:399-409. [PMID: 27543787 DOI: 10.1016/j.envres.2016.07.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
An enhanced research paradigm is presented to address the spatial and temporal gaps in fine particulate matter (PM2.5) measurements and generate realistic and representative concentration fields for use in epidemiological studies of human exposure to ambient air particulate concentrations. The general approach for research designed to analyze health impacts of exposure to PM2.5 is to use concentration data from the nearest ground-based air quality monitor(s), which typically have missing data on the temporal and spatial scales due to filter sampling schedules and monitor placement, respectively. To circumvent these data gaps, this research project uses a Hierarchical Bayesian Model (HBM) to generate estimates of PM2.5 in areas with and without air quality monitors by combining PM2.5 concentrations measured by monitors, PM2.5 concentration estimates derived from satellite aerosol optical depth (AOD) data, and Community-Multiscale Air Quality (CMAQ) model predictions of PM2.5 concentrations. This methodology represents a substantial step forward in the approach for developing representative PM2.5 concentration datasets to correlate with inpatient hospitalizations and emergency room visits data for asthma and inpatient hospitalizations for myocardial infarction (MI) and heart failure (HF) using case-crossover analysis. There were two key objective of this current study. First was to show that the inputs to the HBM could be expanded to include AOD data in addition to data from PM2.5 monitors and predictions from CMAQ. The second objective was to determine if inclusion of AOD surfaces in HBM model algorithms results in PM2.5 air pollutant concentration surfaces which more accurately predict hospital admittance and emergency room visits for MI, asthma, and HF. This study focuses on the New York City, NY metropolitan and surrounding areas during the 2004-2006 time period, in order to compare the health outcome impacts with those from previous studies and focus on any benefits derived from the changes in the HBM model surfaces. Consistent with previous studies, the results show high PM2.5 exposure is associated with increased risk of asthma, myocardial infarction and heart failure. The estimates derived from concentration surfaces that incorporate AOD had a similar model fit and estimate of risk as compared to those derived from combining monitor and CMAQ data alone. Thus, this study demonstrates that estimates of PM2.5 concentrations from satellite data can be used to supplement PM2.5 monitor data in the estimates of risk associated with three common health outcomes. Results from this study were inconclusive regarding the potential benefits derived from adding AOD data to the HBM, as the addition of the satellite data did not significantly increase model performance. However, this study was limited to one metropolitan area over a short two-year time period. The use of next-generation, high temporal and spatial resolution satellite AOD data from geostationary and polar-orbiting satellites is expected to improve predictions in epidemiological studies in areas with fewer pollutant monitors or over wider geographic areas.
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Affiliation(s)
| | - Tabassum Z Insaf
- New York State Department of Health, Albany, NY, United States; School of Public Health, University at Albany, SUNY, Rensselaer, NY, United States
| | - Eric S Hall
- US Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Thomas O Talbot
- New York State Department of Health, Albany, NY, United States; School of Public Health, University at Albany, SUNY, Rensselaer, NY, United States
| | - Amy K Huff
- Pennsylvania State University, University Park, PA, United States
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Fan J, Li S, Fan C, Bai Z, Yang K. The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:843-50. [PMID: 26347419 DOI: 10.1007/s11356-015-5321-x] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/25/2015] [Indexed: 05/20/2023]
Abstract
Although the relationship between asthma and exposure to fine particulate matter (PM2.5) has been frequently measured, reported conclusions have not been consistent. As emergency department (ED) visits are an effective way to estimate health outcomes for people with asthma and short-term exposure to PM2.5, this review systematically searched five databases without language or geographical restrictions from inception to January 13, 2015 to study the impact of PM2.5 on asthma ED visits. A random-effects model was used to calculate the pooled risk ratio (RR) and 95% confidence intervals (CI). With respect to short-term effects, asthma ED visits increased at higher PM2.5 concentrations (RR 1.5% per 10 μg/m(3); 95% CI 1.2-1.7%), and children were more susceptible (3.6% per 10 μg/m(3); 95% CI 1.8, 5.3%) than adults (1.7, 95% CI 0.7%, 2.8%) to increased PM2.5; the ED visits increased during the warm season by 3.7% (95% CI 0.5, 6.9%) per 10 μg/m(3) increase in PM2.5, which was higher than the corresponding increase during the cold season (2.6, 95% CI 0.7-4.6%). This demonstrates that ambient PM2.5 has an adverse impact on asthma ED visits after short-term exposure and that children are a high-risk population when PM2.5 concentrations are high, particularly in warm seasons, during which measures should be taken to prevent PM2.5.
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Affiliation(s)
- Jingchun Fan
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou, Gansu, 730000, China.
- First Clinical Medical College, Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China.
| | - Shulan Li
- Department of Ultrasound, People's Hospital of Gansu Province, No. 204 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China.
| | - Chunling Fan
- Department of Clinical Pharmacy, Gansu Provincial Cancer Hospital, No. 2 Xiaoxihu East Street, Qilihe District, Lanzhou, Gansu, 730050, China.
| | - Zhenggang Bai
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou, Gansu, 730000, China.
| | - Kehu Yang
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou, Gansu, 730000, China.
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Zheng XY, Ding H, Jiang LN, Chen SW, Zheng JP, Qiu M, Zhou YX, Chen Q, Guan WJ. Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138146. [PMID: 26382947 PMCID: PMC4575194 DOI: 10.1371/journal.pone.0138146] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 08/25/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined. OBJECTIVE We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations. METHODS Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed. RESULTS After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater. CONCLUSION Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.
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Affiliation(s)
- Xue-yan Zheng
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Hong Ding
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Li-na Jiang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Shao-wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Jin-ping Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Min Qiu
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Ying-xue Zhou
- Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Wei-jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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12
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Castner J, Gittere S, Seo JY. Criteria Air Pollutants and Emergency Nursing. J Emerg Nurs 2015; 41:186-92. [DOI: 10.1016/j.jen.2014.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 08/14/2014] [Accepted: 08/17/2014] [Indexed: 11/26/2022]
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13
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Kearney GD, Namulanda G, Qualters JR, Talbott EO. A decade of environmental public health tracking (2002-2012): progress and challenges. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2015; 21 Suppl 2:S23-35. [PMID: 25621442 PMCID: PMC5667361 DOI: 10.1097/phh.0000000000000181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The creation of the Centers for Disease Control and Prevention Environmental Public Health Tracking Program spawned an invigorating and challenging approach toward implementing the nation's first population-based, environmental disease tracking surveillance system. More than 10 years have passed since its creation and an abundance of peer-reviewed articles have been published spanning a broad variety of public health topics related primarily to the goal of reducing diseases of environmental origin. OBJECTIVE To evaluate peer-reviewed literature related to Environmental Public Health Tracking during 2002-2012, recognize major milestones and challenges, and offer recommendations. DESIGN A narrative overview was conducted using titles and abstracts of peer-reviewed articles, key word searches, and science-based search engine databases. MAIN OUTCOMES Eighty published articles related to "health tracking" were identified and categorized according to 4 crossed-central themes. The Science and Research theme accounted for the majority of published articles, followed by Policy and Practice, Collaborations Among Health and Environmental Programs, and Network Development. CONCLUSIONS Overall, progress was reported in the areas of data linkage, data sharing, surveillance methods, and network development. Ongoing challenges included formulating better ways to establish the connections between health and the environment, such as using biomonitoring, public water systems, and private well water data. Recommendations for future efforts include use of data to inform policy and practice and use of electronic health records data for environmental health surveillance.
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Affiliation(s)
- Gregory D Kearney
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville North Carolina (Dr Kearney); Division of Environmental Hazards & Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Namulanda and Dr Qualters); and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Talbott)
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14
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Pride KR, Peel JL, Robinson BF, Busacker A, Grandpre J, Bisgard KM, Yip FY, Murphy TD. Association of short-term exposure to ground-level ozone and respiratory outpatient clinic visits in a rural location - Sublette County, Wyoming, 2008-2011. ENVIRONMENTAL RESEARCH 2015; 137:1-7. [PMID: 25483412 DOI: 10.1016/j.envres.2014.10.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 09/30/2014] [Accepted: 10/15/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008-2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. METHODS Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008-December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0-3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. RESULTS The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47 ± 8 ppb. The unconstrained distributed lag of 0-3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990-1.012); results for lags 0, 2, and 3 days were consistent with the null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994-1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. CONCLUSIONS The results demonstrate an association of increasing ground-level ozone with an increase in clinic visits for adverse respiratory-related effects in the following day (lag day 1) in Sublette County; the magnitude was strongest during the winter months; this association during the winter months in a rural location warrants further investigation.
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Affiliation(s)
- Kerry R Pride
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002, USA.
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Byron F Robinson
- Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, E-92, Atlanta, GA 30333, USA
| | - Ashley Busacker
- Field Support Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002, USA
| | - Joseph Grandpre
- Chronic Disease Epidemiologist, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002, USA
| | - Kristine M Bisgard
- Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 600 Clifton Road, NE, E-92, Atlanta, GA 30333, USA
| | - Fuyuen Y Yip
- Air Pollution and Respiratory Disease Branch, Centers for Disease Control and Prevention, 600 Clifton Rd, NE, E-92, Atlanta, GA 30333, USA
| | - Tracy D Murphy
- Wyoming Department of Health, 101 Yellowstone Road, Suite 510, Cheyenne, WY 82002, USA
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15
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Vinikoor-Imler LC, Owens EO, Nichols JL, Ross M, Brown JS, Sacks JD. Evaluating potential response-modifying factors for associations between ozone and health outcomes: a weight-of-evidence approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:1166-76. [PMID: 24927060 PMCID: PMC4216162 DOI: 10.1289/ehp.1307541] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 06/11/2014] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiologic and experimental studies have reported a variety of health effects in response to ozone (O3) exposure, and some have indicated that certain populations may be at increased or decreased risk of O3-related health effects. OBJECTIVES We sought to identify potential response-modifying factors to determine whether specific groups of the population or life stages are at increased or decreased risk of O3-related health effects using a weight-of-evidence approach. METHODS Epidemiologic, experimental, and exposure science studies of potential factors that may modify the relationship between O3 and health effects were identified in U.S. Environmental Protection Agency's 2013 Integrated Science Assessment for Ozone and Related Photochemical Oxidants. Scientific evidence from studies that examined factors that may influence risk were integrated across disciplines to evaluate consistency, coherence, and biological plausibility of effects. The factors identified were then classified using a weight-of-evidence approach to conclude whether a specific factor modified the response of a population or life stage, resulting in an increased or decreased risk of O3-related health effects. DISCUSSION We found "adequate" evidence that populations with certain genotypes, preexisting asthma, or reduced intake of certain nutrients, as well as different life stages or outdoor workers, are at increased risk of O3-related health effects. In addition, we identified other factors (i.e., sex, socioeconomic status, and obesity) for which there was "suggestive" evidence that they may increase the risk of O3-related health effects. CONCLUSIONS Using a weight-of-evidence approach, we identified a diverse group of factors that should be considered when characterizing the overall risk of health effects associated with exposures to ambient O3.
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Affiliation(s)
- Lisa C Vinikoor-Imler
- National Center for Environmental Assessment (NCEA), U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
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Strosnider H, Zhou Y, Balluz L, Qualters J. Engaging academia to advance the science and practice of environmental public health tracking. ENVIRONMENTAL RESEARCH 2014; 134:474-81. [PMID: 25038624 PMCID: PMC4909327 DOI: 10.1016/j.envres.2014.04.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/25/2014] [Accepted: 04/29/2014] [Indexed: 05/27/2023]
Abstract
Public health agencies at the federal, state, and local level are responsible for implementing actions and policies that address health problems related to environmental hazards. These actions and policies can be informed by integrating or linking data on health, exposure, hazards, and population. The mission of the Centers for Disease Control and Prevention׳s National Environmental Public Health Tracking Program (Tracking Program) is to provide information from a nationwide network of integrated health, environmental hazard, and exposure data that drives actions to improve the health of communities. The Tracking Program and federal, state, and local partners collect, integrate, analyze, and disseminate data and information to inform environmental public health actions. However, many challenges exist regarding the availability and quality of data, the application of appropriate methods and tools to link data, and the state of the science needed to link and analyze health and environmental data. The Tracking Program has collaborated with academia to address key challenges in these areas. The collaboration has improved our understanding of the uses and limitations of available data and methods, expanded the use of existing data and methods, and increased our knowledge about the connections between health and environment. Valuable working relationships have been forged in this process, and together we have identified opportunities and improvements for future collaborations to further advance the science and practice of environmental public health tracking.
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Affiliation(s)
- Heather Strosnider
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Ying Zhou
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Lina Balluz
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch, 1600 Clifton Road, MS-F60, Atlanta, GA 30333, USA.
| | - Judith Qualters
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Office of the Director, 1600 Clifton Road, MS-F60, Atlanta, GA, 30333, USA.
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Raun LH, Ensor KB, Persse D. Using community level strategies to reduce asthma attacks triggered by outdoor air pollution: a case crossover analysis. Environ Health 2014; 13:58. [PMID: 25012280 PMCID: PMC4108967 DOI: 10.1186/1476-069x-13-58] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 07/02/2014] [Indexed: 05/05/2023]
Abstract
BACKGROUND Evidence indicates that asthma attacks can be triggered by exposure to ambient air pollutants, however, detailed pollution information is missing from asthma action plans. Asthma is commonly associated with four criteria pollutants with standards derived by the United States Environmental Protection Agency. Since multiple pollutants trigger attacks and risks depend upon city-specific mixtures of pollutants, there is lack of specific guidance to reduce exposure. Until multi-pollutant statistical modeling fully addresses this gap, some guidance on pollutant attack risk is required. This study examines the risks from exposure to the asthma-related pollutants in a large metropolitan city and defines the city-specific association between attacks and pollutant mixtures. Our goal is that city-specific pollution risks be incorporated into individual asthma action plans as additional guidance to prevent attacks. METHODS Case-crossover analysis and conditional logistic regression were used to measure the association between ozone, fine particulate matter, nitrogen dioxide, sulfur dioxide and carbon monoxide pollution and 11,754 emergency medical service ambulance treated asthma attacks in Houston, Texas from 2004-2011. Both single and multi-pollutant models are presented. RESULTS In Houston, ozone and nitrogen dioxide are important triggers (RR = 1.05; 95% CI: 1.00, 1.09), (RR = 1.10; 95% CI: 1.05, 1.15) with 20 and 8 ppb increase in ozone and nitrogen dioxide, respectively, in a multi-pollutant model. Both pollutants are simultaneously high at certain times of the year. The risk attributed to these pollutants differs when they are considered together, especially as concentrations increase. Cumulative exposure for ozone (0-2 day lag) is of concern, whereas for nitrogen dioxide the concern is with single day exposure. Persons at highest risk are aged 46-66, African Americans, and males. CONCLUSIONS Accounting for cumulative and concomitant outdoor pollutant exposure is important to effectively attribute risk for triggering of an asthma attack, especially as concentrations increase. Improved asthma action plans for Houston individuals should warn of these pollutants, their trends, correlation and cumulative effects. Our Houston based study identifies nitrogen dioxide levels and the three-day exposure to ozone to be of concern whereas current single pollutant based national standards do not.
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Affiliation(s)
- Loren H Raun
- Department of Statistics, Rice University, 6100 Main Street, Houston, TX 77005, USA
- City of Houston Health and Human Services Bureau of Pollution Control and Prevention, 7411 Park Place Blvd, Houston, TX 77087, USA
| | - Katherine B Ensor
- Department of Statistics, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - David Persse
- City of Houston Emergency Medical Services, 600 Jefferson Suite 800, Houston, TX 77002, USA
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza Houston, Houston, TX 77030, USA
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Bell ML, Zanobetti A, Dominici F. Who is more affected by ozone pollution? A systematic review and meta-analysis. Am J Epidemiol 2014; 180:15-28. [PMID: 24872350 DOI: 10.1093/aje/kwu115] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ozone is associated with adverse health; however, less is known about vulnerable/sensitive populations, which we refer to as sensitive populations. We systematically reviewed epidemiologic evidence (1988-2013) regarding sensitivity to mortality or hospital admission from short-term ozone exposure. We performed meta-analysis for overall associations by age and sex; assessed publication bias; and qualitatively assessed sensitivity to socioeconomic indicators, race/ethnicity, and air conditioning. The search identified 2,091 unique papers, with 167 meeting inclusion criteria (73 on mortality and 96 on hospitalizations and emergency department visits, including 2 examining both mortality and hospitalizations). The strongest evidence for ozone sensitivity was for age. Per 10-parts per billion increase in daily 8-hour ozone concentration, mortality risk for younger persons, at 0.60% (95% confidence interval (CI): 0.40, 0.80), was statistically lower than that for older persons, at 1.27% (95% CI: 0.76, 1.78). Findings adjusted for publication bias were similar. Limited/suggestive evidence was found for higher associations among women; mortality risks were 0.39% (95% CI: -0.22, 1.00) higher than those for men. We identified strong evidence for higher associations with unemployment or lower occupational status and weak evidence of sensitivity for racial/ethnic minorities and persons with low education, in poverty, or without central air conditioning. Findings show that some populations, especially the elderly, are particularly sensitive to short-term ozone exposure.
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Glad JA, Brink LL, Talbott EO, Lee PC, Xu X, Saul M, Rager J. The relationship of ambient ozone and PM(2.5) levels and asthma emergency department visits: possible influence of gender and ethnicity. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2012; 67:103-8. [PMID: 22524651 DOI: 10.1080/19338244.2011.598888] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ABSTRACT An investigation of the relationship of air pollution and emergency department (ED) visits for asthma was an opportunity to assess environmental risks for asthma exacerbations in an urban population. A total of 6,979 individuals with a primary discharge diagnosis of asthma presented to 1 of 6 EDs in the Pittsburgh, Pennsylvania, area between 2002 and 2005. Using a case-crossover methodology, which controls for the effects of subject-specific covariates such as gender and race, a 2.5% increase was observed in asthma ED visits for each 10 ppb increase in the 1-hour maximum ozone level on day 2 (odds ratio [OR] = 1.025, p < .05). Particulate matter with an aerodynamic diameter ≤2.5 μm (PM(2.5)) had an effect both on the total population on day 1 after exposure (1.036, p < .05), and on African Americans on days 1, 2, and 3. PM(2.5) had no significant effect on Caucasian Americans alone. The disparity in risk estimates by race may reflect differences in residential characteristics, exposure to ambient air pollution, or a differential effect of pollution by race.
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Affiliation(s)
- Jo Ann Glad
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
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Ji M, Cohan DS, Bell ML. Meta-analysis of the Association between Short-Term Exposure to Ambient Ozone and Respiratory Hospital Admissions. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2011; 6:024006. [PMID: 21779304 PMCID: PMC3138529 DOI: 10.1088/1748-9326/6/2/024006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ozone is associated with health impacts including respiratory outcomes; however, results differ across studies. Meta-analysis is an increasingly important approach to synthesizing evidence across studies. We conducted meta-analysis of short-term ozone exposure and respiratory hospitalizations to evaluate variation across studies and explore some of the challenges in meta-analysis. We identified 136 estimates from 96 studies and investigated how estimates differed by age, ozone metric, season, lag, region, disease category, and hospitalization type. Overall results indicate associations between ozone and various types of respiratory hospitalizations; however, study characteristics affected risk estimates. Estimates were similar, but higher, for the elderly compared to all ages and for previous day exposure compared to same day exposure. Comparison across studies was hindered by variation in definitions of disease categories, as some (e.g., asthma) were identified through ≥3 different sets of ICD codes. Although not all analyses exhibited evidence of publication bias, adjustment for publication bias generally lowered overall estimates. Emergency hospitalizations for total respiratory disease increased 4.47% (95% interval 2.48, 6.50%) per 10ppb 24-hr ozone among the elderly without adjustment for publication bias and 2.97% (1.05, 4.94%) with adjustment. Comparison of multi-city study results and meta-analysis based on single-city studies further suggested publication bias.
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Affiliation(s)
- Meng Ji
- School of Forestry and Environmental Studies, School of Public Health, Yale University, New Haven, CT, U.S.A
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Talbot TO, Haley VB, Dimmick WF, Paulu C, Talbott EO, Rager J. Developing consistent data and methods to measure the public health impacts of ambient air quality for Environmental Public Health Tracking: progress to date and future directions. AIR QUALITY, ATMOSPHERE, & HEALTH 2009; 2:199-206. [PMID: 20098503 PMCID: PMC2805787 DOI: 10.1007/s11869-009-0043-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 05/11/2009] [Indexed: 05/28/2023]
Abstract
Environmental Public Health Tracking (EPHT) staff at the state and national levels are developing nationally consistent data and methods to estimate the impact of ozone and fine particulate matter on hospitalizations for asthma and myocardial infarction. Pilot projects have demonstrated the feasibility of pooling state hospitalization data and linking these data to The United States Environmental Protection Agency (EPA) statistically based ambient air estimates for ozone and fine particulates. Tools were developed to perform case-crossover analyses to estimate concentration-response (C-R) functions. A weakness of analyzing one state at a time is that the effects are relatively small compared to their confidence intervals. The EPHT program will explore ways to statistically combine the results of peer-reviewed analyses from across the country to provide more robust C-R functions and health impact estimates at the local level. One challenge will be to routinely share data for these types of analyses at fine geographic and temporal scales without disclosing confidential information. Another challenge will be to develop C-R estimates which take into account time, space, or other relevant effect modifiers.
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Affiliation(s)
- Thomas O. Talbot
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 547 River St. Room 200, Troy, NY 12180 USA
| | - Valerie B. Haley
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 547 River St. Room 200, Troy, NY 12180 USA
| | - W. Fred Dimmick
- National Exposure Research Laboratory, United States Environmental Protection Agency, Mail Code D205-03, Research Triangle Park, NC 27711 USA
| | - Chris Paulu
- Environmental and Occupational Health Programs, Maine Center for Disease Control and Prevention, 286 Water St., 11 State House Station, Augusta, ME 04333 USA
| | - Evelyn O. Talbott
- Department of Epidemiology, University of Pittsburgh, A526 Crabtree Hall, University of Pittsburgh, Pittsburgh, ME 15261 USA
| | - Judy Rager
- Department of Epidemiology, University of Pittsburgh, A526 Crabtree Hall, University of Pittsburgh, Pittsburgh, ME 15261 USA
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