Association Between Short-term Exposure to Ultrafine Particles and Mortality in Eight European Urban Areas:

Predicting within-city spatiotemporal variations in daily median outdoor ultrafine particle number concentrations and size in Montreal and Toronto, Canada

Background

Epidemiological evidence suggests that long-term exposure to outdoor ultrafine particles (UFPs, <0.1 μm) may have important human health impacts. However, less is known about the acute health impacts of these pollutants as few models are available to estimate daily within-city spatiotemporal variations in outdoor UFPs.

Methods

Several machine learning approaches (i.e., generalized additive models, random forest models, and extreme gradient boosting) were used to predict daily spatiotemporal variations in outdoor UFPs (number concentration and size) across Montreal and Toronto, Canada using a large database of mobile monitoring measurements. Separate models were developed for each city and all models were evaluated using a 10-fold cross-validation procedure.

Results

In total, our models were based on measurements from 12,705 road segments in Montreal and 10,929 road segments in Toronto. Daily median outdoor UFP number concentrations varied substantially across both cities with 1st-99th percentiles ranging from 1389 to 181,672 in Montreal and 2472 to 118,544 in Toronto. Outdoor UFP size tended to be smaller in Montreal (mean [SD]: 34 nm [15]) than in Toronto (mean [SD]: 44 nm [25]). Extreme gradient boosting models performed best and explained the majority of spatiotemporal variations in outdoor UFP number concentrations (Montreal, R 2: 0.727; Toronto, R 2: 0.723) and UFP size (Montreal, R 2: 0.823; Toronto, R 2: 0.898) with slopes close to one and intercepts close to zero for relationships between measured and predicted values.

Conclusion

These new models will be applied in future epidemiological studies examining the acute health impacts of outdoor UFPs in Canada's two largest cities.

Evaluating the adverse effects and mechanisms of nanomaterial exposure on longevity of C. elegans: A literature meta-analysis and bioinformatics analysis of multi-transcriptome data

Exposure to large-size particulate air pollution (PM2.5 or PM10) has been reported to increase risks of aging-related diseases and human death, indicating the potential pro-aging effects of airborne nanomaterials with ultra-fine particle size (which have been widely applied in various fields). However, this hypothesis remains inconclusive. Here, a meta-analysis of 99 published literatures collected from electronic databases (PubMed, EMBASE and Cochrane Library; from inception to June 2023) was performed to confirm the effects of nanomaterial exposure on aging-related indicators and molecular mechanisms in model animal C. elegans. The pooled analysis by Stata software showed that compared with the control, nanomaterial exposure significantly shortened the mean lifespan [standardized mean difference (SMD) = -2.30], reduced the survival rate (SMD = -4.57) and increased the death risk (hazard ratio = 1.36) accompanied by upregulation of ced-3, ced-4 and cep-1, while downregulation of ctl-2, ape-1, aak-2 and pmk-1. Furthermore, multi-transcriptome data associated with nanomaterial exposure were retrieved from Gene Expression Omnibus (GSE32521, GSE41486, GSE24847, GSE59470, GSE70509, GSE14932, GSE93187, GSE114881, and GSE122728) and bioinformatics analyses showed that pseudogene prg-2, mRNAs of abu, car-1, gipc-1, gsp-3, kat-1, pod-2, acdh-8, hsp-60 and egrh-2 were downregulated, while R04A9.7 was upregulated after exposure to at least two types of nanomaterials. Resveratrol (abu, hsp-60, pod-2, egrh-2, acdh-8, gsp-3, car-1, kat-1, gipc-1), naringenin (kat-1, egrh-2), coumestrol (egrh-2) or swainsonine/niacin/ferulic acid (R04A9.7) exerted therapeutic effects by reversing the expression levels of target genes. In conclusion, our study demonstrates the necessity to use phytomedicines that target hub genes to delay aging for populations with nanomaterial exposure.

Harnessing AI to unmask Copenhagen's invisible air pollutants: A study on three ultrafine particle metrics

Ultrafine particles (UFPs) are airborne particles with a diameter of less than 100 nm. They are emitted from various sources, such as traffic, combustion, and industrial processes, and can have adverse effects on human health. Long-term mean ambient average particle size (APS) in the UFP range varies over space within cities, with locations near UFP sources having typically smaller APS. Spatial models for lung deposited surface area (LDSA) within urban areas are limited and currently there is no model for APS in any European city. We collected particle number concentration (PNC), LDSA, and APS data over one-year monitoring campaign from May 2021 to May 2022 across 27 locations and estimated annual mean in Copenhagen, Denmark, and obtained additionally annual mean PNC data from 6 state-owned continuous monitors. We developed 94 predictor variables, and machine learning models (random forest and bagged tree) were developed for PNC, LDSA, and APS. The annual mean PNC, LDSA, and APS were, respectively, 5523 pt/cm3, 12.0 μm2/cm3, and 46.1 nm. The final R2 values by random forest (RF) model were 0.93 for PNC, 0.88 for LDSA, and 0.85 for APS. The 10-fold, repeated 10-times cross-validation R2 values were 0.65, 0.67, and 0.60 for PNC, LDSA, and APS, respectively. The root mean square error for final RF models were 296 pt/cm3, 0.48 μm2/cm3, and 1.60 nm for PNC, LDSA, and APS, respectively. Traffic-related variables, such as length of major roads within buffers 100-150 m and distance to streets with various speed limits were amongst the highly-ranked predictors for our models. Overall, our ML models achieved high R2 values and low errors, providing insights into UFP exposure in a European city where average PNC is quite low. These hyperlocal predictions can be used to study health effects of UFPs in the Danish Capital.

Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis

Previous epidemiological studies have linked short-term exposure to particulate matter with outpatient visits for respiratory diseases. However, evidence on ultrafine particle (UFP) is still scarce in China. To investigate the association between short-term UFP exposure and outpatient visits for respiratory diseases as well as the corresponding lag patterns, information on outpatient visits for main respiratory diseases during January 1, 2017, to December 31, 2019 was collected from electronic medical records of two large tertiary hospitals in Shanghai, China. Generalized additive models employing a Quasi-Poisson distribution were employed to investigate the relationships between UFP and respiratory diseases. We computed the percentage change and its corresponding 95% confidence interval (CI) for outpatient visits related to respiratory diseases per interquartile range (IQR) increase in UFP concentrations. Based on a total of 1,034,394 hospital visits for respiratory diseases in Shanghai, China, we found that the strongest associations of total UFP with acute upper respiratory tract infection (AURTI), bronchitis, chronic obstructive pulmonary disease (COPD), and pneumonia occurred at lag 03, 03, 0, and 03 days, respectively. Each IQR increase in the total UFP concentrations was associated with increments of 9.02% (95% CI: 8.64-9.40%), 3.94% (95% CI: 2.84-5.06%), 4.10% (95% CI: 3.01-5.20%), and 10.15% (95% CI: 9.32-10.99%) for AURTI, bronchitis, COPD, and pneumonia, respectively. Almost linear concentration-response relationship curves without apparent thresholds were observed between total UFP and outpatient-department visits for four respiratory diseases. Stratified analyses illustrated significantly stronger associations of total UFP with AURTI, bronchitis, and pneumonia among female patients, while that with COPD was stronger among male patients. After adjustment of criteria air pollutants, these associations all remained robust. This time-series study indicates that short-term exposure to UFP was associated with increased risk of hospital visits for respiratory diseases, underscoring the importance of reducing ambient UFP concentrations for respiratory diseases control and prevention.

Short-term exposure to ultrafine particles and mortality and hospital admissions due to respiratory and cardiovascular diseases in Copenhagen, Denmark

Ultrafine particles (UFP; particulate matter <0.1 μm in diameter) may be more harmful to human health than larger particles, but epidemiological evidence on their health effects is still limited. In this study, we examined the association between short-term exposure to UFP and mortality and hospital admissions in Copenhagen, Denmark. Daily concentrations of UFP (measured as particle number concentration in a size range 11-700 nm) and meteorological variables were monitored at an urban background station in central Copenhagen during 2002-2018. Daily counts of deaths from all non-accidental causes, as well as deaths and hospital admissions from cardiovascular and respiratory diseases were obtained from Danish registers. Mortality and hospital admissions associated with an interquartile range (IQR) increase in UFP exposure on a concurrent day and up to six preceding days prior to the death or admission were examined in a case-crossover study design. Odds ratios (OR) with 95% confidence intervals (CI) per one IQR increase in UFP were estimated after adjusting for temperature and relative humidity. We observed 140,079 deaths in total, 236,003 respiratory and 342,074 cardiovascular hospital admissions between 2002 and 2018. Hospital admissions due to respiratory and cardiovascular diseases were significantly positively associated with one IQR increase in UFP (OR: 1.04 [95% CI: 1.01, 1.07], lag 0-4, and 1.02 [1.00, 1.04], lag 0-1, respectively). Among the specific causes, the strongest associations were found for chronic obstructive pulmonary disease (COPD) mortality and asthma hospital admissions and two-day means (lag 0-1) of UFP (OR: 1.13 [1.01, 1.26] and 1.08 [1.00, 1.16], respectively, per one IQR increase in UFP). Based on 17 years of UFP monitoring data, we present novel findings showing that short-term exposure to UFP can trigger respiratory and cardiovascular diseases mortality and morbidity in Copenhagen, Denmark. The strongest associations with UFP were observed with COPD mortality and asthma hospital admissions.

Effect of air pollutants on ambulatory blood pressure

BACKGROUND AND METHODOLOGY

Air pollutants have a significant impact on public health. The aim of the study was to find out the relationship between ambulatory blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM) and the atmospheric pollutants that are measured regularly (PM10, PM2.5, NO2 and SO2). An observational study of temporal and geographic measurements of individual patients (case-time series design) was carried out in Primary Care Centres and Hypertension Units in the Barcelona metropolitan area. We included 2888 hypertensive patients≥18 years old, untreated, with a first valid ABPM performed between 2005 and 2014 and with at least one air pollution station within a radius of <3km.

RESULTS AND CONCLUSIONS

The mean age was 54.3 (SD 14.6) years. 50.1% were women and 16.9% of the sample were smokers. Mean 24-h blood pressure (BP) was 128.0 (12.7)/77.4 (9.7) mmHg. After adjusting for mean ambient temperature and different risk factors, a significant association was found between ambulatory diastolic BP (DBP) and PM10 concentrations the day before ABPM. For each increase of 10μg/m3 of PM10, an increase of 1.37mmHg 24-h DBP and 1.48mmHg daytime DBP was observed. No relationship was found between PM2.5, NO2 and SO2 and ambulatory BP, nor between any pollutant and clinical BP. The concentration of PM10 the day before the ABPM is significantly associated with an increase in 24-h DBP and daytime DBP.

Impact of Ambient Ultrafine Particles on Cause-Specific Mortality in Three German Cities

Rationale: Exposure to ambient air pollution has been associated with adverse effects on morbidity and mortality. However, the evidence for ultrafine particles (UFPs; 10-100 nm) based on epidemiological studies remains scarce and inconsistent. Objectives: We examined associations between short-term exposures to UFPs and total particle number concentrations (PNCs; 10-800 nm) and cause-specific mortality in three German cities: Dresden, Leipzig, and Augsburg. Methods: We obtained daily counts of natural, cardiovascular, and respiratory mortality between 2010 and 2017. UFPs and PNCs were measured at six sites, and measurements of fine particulate matter (PM2.5; ⩽2.5 μm in aerodynamic diameter) and nitrogen dioxide were collected from routine monitoring. We applied station-specific confounder-adjusted Poisson regression models. We investigated air pollutant effects at aggregated lags (0-1, 2-4, 5-7, and 0-7 d after UFP exposure) and used a novel multilevel meta-analytical method to pool the results. Additionally, we assessed interdependencies between pollutants using two-pollutant models. Measurements and Main Results: For respiratory mortality, we found a delayed increase in relative risk of 4.46% (95% confidence interval, 1.52 to 7.48%) per 3,223-particles/cm3 increment 5-7 days after UFP exposure. Effects for PNCs showed smaller but comparable estimates consistent with the observation that the smallest UFP fractions showed the largest effects. No clear associations were found for cardiovascular or natural mortality. UFP effects were independent of PM2.5 in two-pollutant models. Conclusions: We found delayed effects for respiratory mortality within 1 week after exposure to UFPs and PNCs but no associations for natural or cardiovascular mortality. This finding adds to the evidence on the independent health effects of UFPs.

Estimating the economic value of ultrafine particle information: a contingent valuation method

Global concern regarding ultrafine particles (UFPs), which are particulate matter (PM) with a diameter of less than 100 nm, is increasing. These particles are difficult to measure using the current methods because their characteristics are different from those of other air pollutants. Therefore, a new monitoring system is required to obtain accurate UFP information, which will raise the financial burden of the government and people. In this study, we estimated the economic value of UFP information by evaluating the willingness-to-pay (WTP) for the UFP monitoring and reporting system. We used the contingent valuation method (CVM) and the one-and-one-half-bounded dichotomous choice (OOHBDC) spike model. We analyzed how the respondents' socio-economic variables, as well as their cognition level of PM, affected their WTP. Therefore, we collected WTP data of 1040 Korean respondents through an online survey. The estimated mean WTP for building a UFP monitoring and reporting system is KRW 6958.55-7222.55 (USD 6.22-6.45) per household per year. We found that people satisfied with the current air pollutant information, and generally possessing relatively greater knowledge of UFPs, have higher WTP for a UFP monitoring and reporting system. We found that people are willing to pay more than the actual installation and operating costs of current air pollution monitoring systems. If the collected UFP data is disclosed in an easily accessible manner, as is current air pollutant data, it will be possible to secure more public acceptance for expanding the UFP monitoring and reporting system nationwide.

Hourly Ultrafine Particle Exposure and Acute Myocardial Infarction Onset: An Individual-Level Case-Crossover Study in Shanghai, China, 2015-2020

Associations between ultrafine particles (UFPs) and hourly onset of acute myocardial infarction (AMI) have rarely been investigated. We aimed to evaluate the impacts of UFPs on AMI onset and the lag patterns. A time-stratified case-crossover study was performed among 20,867 AMI patients from 46 hospitals in Shanghai, China, between January 2015 and December 2020. Hourly data of AMI onset and number concentrations of nanoparticles of multiple size ranges below 0.10 μm (0.01-0.10, UFP/PNC_0.01-0.10; 0.01-0.03, PNC_0.01-0.03; 0.03-0.05, PNC_0.03-0.05; and 0.05-0.10 μm, PNC_0.05-0.10) were collected. Conditional logistic regressions were applied. Transient exposures to these nanoparticles were significantly associated with AMI onset, with almost linear exposure-response curves. These associations occurred immediately after exposure, lasted for approximately 6 h, and attenuated to be null thereafter. Each interquartile range increase in concentrations of total UFPs, PNC_0.01-0.03, PNC_0.03-0.05, and PNC_0.05-0.10 during the preceding 0-6 h was associated with increments of 3.29, 2.08, 2.47, and 2.93% in AMI onset risk, respectively. The associations were stronger during warm season and at high temperatures and were robust after adjusting for criteria air pollutants. Our findings provide novel evidence that hourly UFP exposure is associated with immediate increase in AMI onset risk.

Particle surface area, ultrafine particle number concentration, and cardiovascular hospitalizations

While the health impacts of larger particulate matter, such as PM₁₀ and PM_2.5, have been studied extensively, research regarding ultrafine particles (UFPs or PM_0.1) and particle surface area concentration (PSC) is lacking. This case-crossover study assessed the associations between exposure to PSC and UFP number concentration (UFPnc) and hospital admissions for cardiovascular diseases (CVDs) in New York State (NYS), 2013-2018. We used a time-stratified case-crossover design to compare the PSC and UFPnc levels between hospitalization days and control days (similar days without admissions) for each CVD case. We utilized NYS hospital discharge data to identify all CVD cases who resided in NYS. UFP simulation data from GEOS-Chem-APM, a state-of-the-art chemical transport model, was used to define PSC and UFPnc. Using a multi-pollutant model and conditional logistic regression, we assessed excess risk (ER)% per inter-quartile change of PSC and UFPnc after controlling for meteorological factors, co-pollutants, and time-varying variables. We found immediate and lasting associations between PSC and overall CVDs (lag0-lag0-6: ERs% (95% CI%) ranges: 0.4 (0.1,0.7) - 0.9 (0.7-1.2), and delayed and prolonged ERs%: 0.1-0.3 (95% CIs: 0.1-0.5) between UFPnc and CVDs (lag0-3-lag0-6). Exposure to larger PSC was associated with immediate ER increases in stroke, hypertension, and ischemic heart diseases (1.1%, 0.7%, 0.8%, respectively, all p < 0.05). The adverse effects of PSC on CVDs were highest among children (5-17 years old), in the fall and winter, and during cold temperatures. In conclusion, we found an immediate, lasting effects of PSC on overall CVDs and a delayed, prolonged impact of UFPnc. PSC was a more sensitive indicator than UFPnc. The PSC effects were higher among certain CVD subtypes, in children, in certain seasons, and during cold days. Further studies are needed to validate our findings and evaluate the long-term effects.

Associations between short-term ambient ozone exposure and cause-specific mortality in rural and urban areas of Jiangsu, China

Most previous studies on the acute health effects of ozone are limited to urban areas, largely due to the paucity of air pollutant measurements in rural areas. We here estimated the county-specific daily maximum 8-h average ozone concentration in Jiangsu Province, China during 2015-2018, using a recently developed spatiotemporal machine learning model at a spatial resolution of 0.1° × 0.1° (∼11 × 11 km). Counties were equally divided into urban and rural groups based on the median of the percentage of urban residents across Jiangsu counties obtained from the National Population Census in 2010. We first conducted time-series analyses to estimate the county-specific effect of ozone using generalized linear models, then pooled the effect estimates by random-effects modeling. A 10 μg/m³ increase in the 4-day moving average (lag 0-3) of ambient ozone exposure was associated with increases of 0.66% (95% confidence interval [CI] 0.36%-0.95%) in daily nonaccidental mortality in rural areas and 0.42% in urban areas (95% CI, 0.27%-0.56%). Short-term ambient ozone exposure was associated with an increased risk of mortality caused by chronic obstructive pulmonary disease, hypertension, ischemic heart disease, and stroke. Our finding suggests that both urban and rural residents suffer adverse health effects from short-term ozone exposure.

Investigation of Mask Efficiency for Loose-Fitting Masks against Ultrafine Particles and Effect on Airway Deposition Efficiency

Ultrafine particle (i.e., smaller than 100 nm) in the ambient air is a significant public health issue. The inhalation and deposition of ultrafine particles in the human airways can lead to various adverse health effects. Loose-fitting types of masks are commonly used by the general public in some developing countries for protecting against ultrafine particles in the ambient environment. This research conducted a series of laboratory chamber experiments using two sets of particle sizers and two mannequin heads to study the mask efficiency of selected loose-fitting masks. Results acquired demonstrated that the cloth mask showed a low mask efficiency against ultrafine particles with the mask efficiency generally less than 0.4. The KN95 presented a better mask efficiency among all tested masks with the mask efficiency overall larger than 0.5. In addition, the effect of mask-wearing on the change of ultrafine particle airway deposition efficiency was also investigated in this study. The ultrafine particle deposition efficiency in the airway section studied was found to decrease due to mask-wearing, and the decreases of the deposition efficiencies were similar among all loose-fitting masks tested.

Associations between sources of particle number and mortality in four European cities

BACKGROUND

The evidence on the association between ultrafine (UFP) particles and mortality is still inconsistent. Moreover, health effects of specific UFP sources have not been explored. We assessed the impact of UFP sources on daily mortality in Barcelona, Helsinki, London, and Zurich.

METHODS

UFP sources were previously identified and quantified for the four cities: daily contributions of photonucleation, two traffic sources (fresh traffic and urban, with size mode around 30 nm and 70 nm, respectively), and secondary aerosols were obtained from data from an urban background station. Different periods were investigated in each city: Barcelona 2013-2016, Helsinki 2009-2016, London 2010-2016, and Zurich 2011-2014. The associations between total particle number concentrations (PNC) and UFP sources and daily (natural, cardiovascular [CVD], and respiratory) mortality were investigated using city-specific generalized linear models (GLM) with quasi-Poisson regression.

RESULTS

We found inconsistent results across cities, sources, and lags for associations with natural, CVD, and respiratory mortality. Increased risk was observed for total PNC and natural mortality in Helsinki (lag 2; 1.3% [0.07%, 2.5%]), CVD mortality in Barcelona (lag 1; 3.7% [0.17%, 7.4%]) and Zurich (lag 0; 3.8% [0.31%, 7.4%]), and respiratory mortality in London (lag 3; 2.6% [0.84%, 4.45%]) and Zurich (lag 1; 9.4% [1.0%, 17.9%]). A similar pattern of associations between health outcomes and total PNC was followed by the fresh traffic source, for which we also found the same associations and lags as for total PNC. The urban source (mostly aged traffic) was associated with respiratory mortality in Zurich (lag 1; 12.5% [1.7%, 24.2%]) and London (lag 3; 2.4% [0.90%, 4.0%]) while the secondary source was associated with respiratory mortality in Zurich (lag 1: 12.0% [0.63%, 24.5%]) and Helsinki (4.7% [0.11%, 9.5%]). Reduced risk for the photonucleation source was observed for respiratory mortality in Barcelona (lag 2, -8.6% [-14.5%, -2.4%]) and for CVD mortality in Helsinki, as this source is present only in clean atmospheres (lag 1, -1.48 [-2.75, -0.21]).

CONCLUSIONS

We found inconsistent results across cities, sources and lags for associations with natural, CVD, and respiratory mortality.

Aerosol microphysics and chemistry reveal the COVID19 lockdown impact on urban air quality

Air quality in urban areas and megacities is dependent on emissions, physicochemical process and atmospheric conditions in a complex manner. The impact on air quality metrics of the COVID-19 lockdown measures was evaluated during two periods in Athens, Greece. The first period involved stoppage of educational and recreational activities and the second severe restrictions to all but necessary transport and workplace activities. Fresh traffic emissions and their aerosol products in terms of ultrafine nuclei particles and nitrates showed the most significant reduction especially during the 2nd period (40–50%). Carbonaceous aerosol both from fossil fuel emissions and biomass burning, as well as aging ultrafine and accumulation mode particles showed an increase of 10–20% of average before showing a decline (5 to 30%). It is found that removal of small nuclei and Aitken modes increased growth rates and migration of condensable species to larger particles maintaining aerosol volume.

Continuous measurement of reactive oxygen species inside and outside of a residential house during summer

Reactive oxygen species (ROS) are an important contributor to adverse health effects associated with ambient air pollution. Despite infiltration of ROS from outdoors, and possible indoor sources (eg, combustion), there are limited data available on indoor ROS. In this study, part of the second phase of Air Composition and Reactivity from Outdoor aNd Indoor Mixing campaign (ACRONIM-2), we constructed and deployed an online, continuous, system to measure extracellular gas- and particle-phase ROS during summer in an unoccupied residence in St. Louis, MO, USA. Over a period of one week, we observed that the non-denuded outdoor ROS (representing particle-phase ROS and some gas-phase ROS) concentration ranged from 1 to 4 nmol/m³ (as H₂ O₂ ). Outdoor concentrations were highest in the afternoon, coincident with peak photochemistry periods. The indoor concentrations of particle-phase ROS were nearly equal to outdoor concentrations, regardless of window-opening status or air exchange rates. The indoor/outdoor ratio of non-denuded ROS (I/O_ROS ) was significantly less than 1 with windows open and even lower with windows closed. Combined, these observations suggest that gas-phase ROS are efficiently removed by interior building surfaces and that there may be an indoor source of particle-phase ROS.

How do ultrafine particles in urban air affect ambulatory blood pressure?

INTRODUCTION

Air in urban areas is usually contaminated with particle matter. High concentrations lead to a rise in the risk of cardiovascular and respiratory diseases. Some studies have reported that ultrafine particles (UFP) play a greater role in cardiovascular diseases than other particle matter, particularly regarding hypertensive crises and DBP, although in the latter such effects were described concerning clinical blood pressure (BP). In this study, we evaluate the relationship between 24-h ambulatory BP monitoring (ABPM) and atmospheric UFP concentrations in Barcelona.

METHODS

An observational study of individual patients' temporal and geographical characteristics attended in Primary Care Centres and Hypertensive Units during 2009-2014 was performed.

RESULTS

The participants were 521 hypertensive patients, mean age 56.8 years (SD 14.5), 52.4% were women. Mean BMI was 28.0 kg/m and the most prominent cardiovascular risk factors were diabetes (N = 66, 12.7%) and smoking (N = 79, 15.2%). We describe UFP effects at short-term and up to 1 week (from lag 0 to 7). For every 10 000 particle/cm UFP increase measured at an urban background site, a corresponding statistically significant increase of 2.7 mmHg [95% confidence interval = (0.5-4.8)] in 24-h DBP with ABPM for the following day was observed (lag 1).

CONCLUSION

We have observed that a rise in UFP concentrations during the day prior to ABPM is significantly associated with an increase in 24 h and diurnal DBP. It has been increasingly demonstrated that UFP play a key role in cardiovascular risk factors and, as we have demonstrated, in good BP control.

Influence of methodology on the estimation of the particle surface area dose received by a population in all-day activities

In everyday life, people are exposed to different concentrations of airborne particles depending on the microenvironment where they perform their different activities. Such exposure can lead to high sub-micron particle doses. The received dose depends on particle concentration to which people are exposed (typically expressed in terms of number or surface area), time spent in each activity or microenvironment (time activity pattern) and amount of air inhaled (inhalation rate). To estimate an actual value of the received dose, all these parameters should be measured under real-life conditions; in fact, the concentrations should be measured on a personal scale (i.e. through a direct exposure assessment), whereas time activity patterns and inhalation rates specific to the activity performed should be considered. The difficulties in obtaining direct measurements of these parameters usually lead to adopt time activity patterns and inhalation rates already available in scientific literature for typical populations, and local outdoor particle concentrations measured with fixed monitoring stations and extrapolated for all the other microenvironments. To overcome these limitations, we propose a full-field method for estimating the received dose of a population sample, in which all the parameters (concentration levels, time activity patterns and inhalation rates) are measured under real-life conditions (also including the inhalation rates, that were evaluated on the basis of the measured heart rates). Specifically, 34 volunteers were continuously monitored for seven days and the data of sub-micron particle concentrations, activities performed, and inhalation rates were recorded. The received dose was calculated with the proposed method and compared with those obtained from different simplified methodologies that consider typical data of particle concentrations, time activity patterns and inhalation rates obtained from literature. The results show that, depending on the methodology used, the differences in the received daily dose can be significant, with a general underestimation of the most simplified method.

The effect of air-pollution and weather exposure on mortality and hospital admission and implications for further research: A systematic scoping review

BACKGROUND

Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. Yet, there is lack of information on wider aspects including the role of some effect modifiers and the interaction between air-pollution and weather. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research.

METHODS

We conducted a scoping literature review. The search on two databases (PubMed and Web-of-Science) from 2012 to 2020 using three conceptual categories of "environmental factors", "health outcomes", and "Geographical region" revealed a total of 951 records. The narrative synthesis included all original studies with time-series, cohort, or case cross-over design; with ambient air-pollution and/or weather exposure; and mortality and/or hospital admission outcomes.

RESULTS

The final review included 112 articles from which 70 involved mortality, 30 hospital admission, and 12 studies included both outcomes. Air-pollution was shown to act consistently as risk factor for all-causes, cardiovascular, respiratory, cerebrovascular and cancer mortality and hospital admissions. Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases. The role of effect modification in the included studies was investigated in terms of gender, age, and season but not in terms of ethnicity.

CONCLUSION

Air-pollution and weather exposure beyond certain thresholds affect human health negatively. Effect modification of important socio-demographics such as ethnicity and the interaction between air-pollution and weather is often missed in the literature. Our findings highlight the need of further research in the area of health behaviour and mortality in relation to air-pollution and weather, to guide effective environmental health precautionary measures planning.

Short-term effects of air pollutants on daily mortality in the Stockholm county - A spatiotemporal analysis

Short-term exposure to air pollutants has been extensively related to daily mortality, however most of the evidence comes from studies conducted in major cities, and little is known on the extent of the spatial heterogeneity in the effects within areas including both urban and non-urban settings. We aimed to investigate the short-term association of air pollutants with daily cause-specific mortality in the Stockholm county, and to test whether an association exists also outside the metropolitan area. We used a spatiotemporal random forest model to predict daily concentrations of fine and inhalable particulate matter (PM_2.5 and PM₁₀), nitrogen dioxide (NO₂) and ozone (O₃) at 1-km spatial resolution over Sweden for 2005-2016. We collected data on daily mortality for each small area for market statistics (SAMS) of the Stockholm county, to which we matched daily exposures to air pollutants and air temperature. We applied a case-crossover design to investigate the short-term association between the four pollutants and mortality from non-accidental, cardiovascular and respiratory causes. We compared the associations in and out the Stockholm urban area, by SAMS population density and across the 26 municipalities of the county. We found weak effects of most air pollutants on cause-specific mortality in the full year analysis, with estimates much larger and significant only during the warmer months (April to September): non-accidental mortality increased by 4.58% (95% confidence interval - 95% CI: 0.89%, 8.41%) and by 2.21% (95% CI: 0.71%, 3.73%) per 10 μg/m³ increase in lag 0-1 PM_2.5 and O₃, respectively. Associations were in general higher in the Stockholm city and in SAMS with high population density. When comparing the 26 municipalities, we didn't detect a significant heterogeneity in the short-term associations with air pollutants. In conclusion, we found a suggestion of a harmful role of air pollution also in non-urban areas, but the study was underpowered to draw firm conclusions. We consider this study as a pilot to investigate the spatial heterogeneity of the association between daily air pollution and mortality at the national level in Sweden.

Particulate matter pollution and hospital outpatient visits for endocrine, digestive, urological, and dermatological diseases in Nanjing, China

Clinical or pathological evidence demonstrated that air pollution could undermine other organ systems of human body besides respiratory and circulation systems. Investigations that directly relate hospital outpatient visits for endocrine (ENDO), digestive (DIGE), urological (UROL), and dermatological (DERM) diseases categories with ambient particulate matter (PM) are still lacking, particularly in heavily polluted cities. Here, we conducted a time-series analysis using 812,624, 1,111,342, 539,803, and 741,662 hospital visits for ENDO, DIGE, UROL, and DERM, respectively, in Nanjing, China from 2013 to 2019. A generalized additive model was applied to estimate the exposure-response associations. Results showed that a 10 μg/m³ increase in PM_2.5 concentration on lag 0 day was significantly associated with 0.59% (95% CI: 0.30%, 0.88%), 0.43% (0.15%, 0.70%), 0.36% (0.06%, 0.66%), and 0.65% (0.42%, 0.87%) increase for ENDO, DIGE, UROL, and DERM hospital visits, respectively. The estimated effects of PM₁₀ were slightly smaller but still statistically significant. The magnitude and significance of the associations between PM and four health outcomes were sensitive to additional adjustment for co-pollutants. Exposure-response relationships were linear for PM concentrations lower than 100 μg/m³ but the curves became nonlinear across the full range of exposures due to a flatten slope at higher concentrations. We also explored the effect modifications by season (cold or warm), age (5-18, 18-64, 65-74, or 75+ years), and sex (male or female). Results showed that the DERM-related population aged 65 years or older was more vulnerable to PM exposure, compared with the 5 to 17-year age group; the DERM-related population aged 75 years or older and 65 years or older was more vulnerable to PM_2.5 and PM₁₀ exposure, respectively, compared with the 18 to 64-year age group. Our study provided suggestive evidence that ambient PM pollution was associated with ENDO, DIGE, UROL, and DERM outpatient hospital visits in Nanjing, China.

Influence of Ultrafine Particles Exposure on Asthma Exacerbation in Children: A Meta-Analysis

BACKGROUND

Air pollution is a major cause of asthma exacerbation. Most studies have shown that exposure to coarse and fine particulate matter is associated with asthma exacerbation. Ultrafine particles (UFPs, aerodynamic diameter ≤ 0.1 µm) are the smallest airborne particles, which are capable of penetrating deep into the lungs. Toxicological studies have suggested that exposure to UFPs may have serious effects on respiratory health. However, epidemiological evidence on the effects of UFPs exposure on asthma exacerbation in children remains unclear.

OBJECTIVE

We conducted a meta-analysis to quantitatively assess the effects of exposure to UFPs on childhood asthma exacerbation.

METHODS

We searched four databases for epidemiological studies published until March 20, 2018. Pooled Odds Ratios (OR) and 95% confidence intervals (95% CIs) per 10000 particles/cm3 were estimated using fixed-effect models. Subgroup analyses, sensitivity analyses, and Begg's and Egger's regression were also performed.

RESULTS

Eight moderate-high quality studies with 51542 events in total satisfied the inclusion criteria. Exposure to UFPs showed a positive association with childhood asthma exacerbation [OR (95% CI): 1.070 (1.037, 1.104)], increased asthma-associated emergency department visits [OR (95% CI): 1.111 (1.055, 1.170)], and asthma-associated hospital admissions [OR (95% CI): 1.045 (1.004, 1.088)] and had a stronger association with childhood asthma exacerbation at long lags [OR (95% CI):1.060 (1.039, 1.082)]. A low heterogeneity and no publication bias were detected.

CONCLUSION

Exposure to UFPs may increase the risk of asthma exacerbation and may be strongly associated with childhood asthma exacerbation at long lags.

Exposure to Submicron Particles and Estimation of the Dose Received by Children in School and Non-School Environments

In the present study, the daily dose in terms of submicron particle surface area received by children attending schools located in three different areas (rural, suburban, and urban), characterized by different outdoor concentrations, was evaluated. For this purpose, the exposure to submicron particle concentration levels of the children were measured through a direct exposure assessment approach. In particular, measurements of particle number and lung-deposited surface area concentrations at “personal scale” of 60 children were performed through a handheld particle counter to obtain exposure data in the different microenvironments they resided. Such data were combined with the time–activity pattern data, characteristics of each child, and inhalation rates (related to the activity performed) to obtain the total daily dose in terms of particle surface area. The highest daily dose was estimated for children attending the schools located in the urban and suburban areas (>1000 mm2), whereas the lowest value was estimated for children attending the school located in a rural area (646 mm2). Non-school indoor environments were recognized as the most influential in terms of children’s exposure and, thus, of received dose (>70%), whereas school environments contribute not significantly to the children daily dose, with dose fractions of 15–19% for schools located in urban and suburban areas and just 6% for the rural one. Therefore, the study clearly demonstrates that, whatever the school location, the children daily dose cannot be determined on the basis of the exposures in outdoor or school environments, but a direct assessment able to investigate the exposure of children during indoor environment is essential.

Ultrafine Particle Features Associated with Pro-Inflammatory and Oxidative Responses: Implications for Health Studies

Suspected detrimental health effects associated with ultrafine particles (UFPs) are impressive. However, epidemiological evidence is still limited. This is potentially due to challenges related to UFP exposure assessment and the lack of consensus on a standard methodology for UFPs. It is imperative to focus future health studies on those UFP metrics more likely to represent health effects. This is the purpose of this paper, where we extend the results obtained during the CARE (“Carbonaceous Aerosol in Rome and Environs”) experiment started in 2017 in Rome. The major purpose is to investigate features of airborne UFPs associated with pro-inflammatory and oxidative responses. Aerosol chemical, microphysical, and optical properties were measured, together with the oxidative potential, at temporal scales relevant for UFPs (minutes to hours). The biological responses were obtained using both in-vivo and in-vitro tests carried out directly under environmental conditions. Findings indicate that caution should be taken when assessing health-relevant exposure to UFPs through the conventional metrics like total particle number concentration and PM2.5 and Black Carbon (BC) mass concentration. Conversely, we recommend adding to these, a UFP source apportionment analysis and indicators for both ultrafine black carbon and the size of particles providing most of the total surface area to available toxic molecules.

Relationship between indoor and outdoor size-fractionated particulate matter in urban microenvironments: Levels, chemical composition and sources

Exposure to particulate matter (PM) has been associated with adverse health outcomes, particularly in susceptible population groups such as children. This study aims to characterise children's exposure to PM and its chemical constituents. Size-segregated aerosol samples (PM0.25, PM0.25-0.5, PM0.5-1.0, PM1.0-2.5 and PM2.5-10) were collected in the indoor and outdoor of homes and schools located in Lisbon (Portugal). Organic and elemental carbon (OC and EC) were determined by a thermo-optical method, whereas major and trace elements were analysed by X-Ray Fluorescence. In school, the children were exposed to higher PM concentrations than in home, which might be associated not only to the elevated human occupancy but also to outdoor infiltration. The pattern of PM mass size distribution was dependent on the location (home vs. school and indoor vs. outdoor). The presence of EC in PM0.25 and OC in PM0.25-0.5 was linked to traffic exhaust emissions. OC and EC in PM2.5-10 may be explained by their adhesion to the surface of coarser particles. Generally, the concentrations of mineral and marine elements increased with increasing PM size, while for anthropogenic elements happened the opposite. In schools, the concentrations of mineral matter, anthropogenic elements and marine aerosol were higher than in homes. High mineral matter concentrations found in schools were related to the close proximity to busy roads and elevated human occupancy. Overall, the results suggest that exposure to PM is relevant and highlights the need for strategies that provide healthier indoor environments, principally in schools.

Ultrafine particles: Levels in ambient air during outdoor sport activities

Conducting aerobic activity on regular basis is recognised as one of the steps to maintain healthier lifestyle. The positive outcomes though can be outweighed if conducted in polluted atmosphere. Furthermore, the specific inhalation during exercising, which results in bypass of nasal filtration systems and deeper penetration into the respiratory system, might result in higher risks especially to pollutants such as ultrafine particles (UFP), which aerodynamic particle diameter are <100 nm. Thus, this work aims to evaluate UFP levels at sites used for conducting physical sport activities outdoors and to estimate the respective inhalation doses considering various scenarios and different physical activities. Monitoring of UFP was conducted during three weeks (May-June 2015) at four different sites (S1-S4) regularly used to conduct physical exercising. The results showed that UFP highly varied (medians 5.1-20.0 × 10³ # cm^-3) across the four sites, with the highest UFP obtained when exercising next to trafficked streets whereas S3 and S4 (a garden and city park) exhibited 2-4 times lower UFP. In view of the obtained UFP concentrations, the estimated inhalation doses ranged 1.73 × 10⁸-3.81 × 10⁸ # kg^-1 when conducting moderately intense sport activities and 1.93 × 10⁸-5.95 × 10⁸ # kg^-1 for highly intense ones. Highly intense activities (i.e. running) led to twice higher UFP exposure; children and youths (5-17 yrs old) experienced 203-267% higher doses. Considering the age- and gender- differences, estimated UFP doses of males were 1.1-2.8 times higher than of females. Finally, UFP inhalation doses estimated for walking (commuting to work and/or schools) were 1.6-7.5 times lower than when conducting sport activities. Thus to protect public health and to promote healthy and physically active lifestyle, strategies to minimize the negative impacts of air pollution should be developed and implemented.

Ultrafine Particle Number Concentration Model for Estimating Retrospective and Prospective Long-Term Ambient Exposures in Urban Neighborhoods

Short-term exposure to ultrafine particles (UFP; <100 nm in diameter), which are present at high concentrations near busy roadways, is associated with markers of cardiovascular and respiratory disease risk. To date, few long-term studies (months to years) have been conducted due to the challenges of long-term exposure assignment. To address this, we modified hybrid land-use regression models of particle number concentrations (PNCs; a proxy for UFP) for two study areas in Boston (MA) by replacing the measured PNC term with an hourly model and adjusting for overprediction. The hourly PNC models used covariates for meteorology, traffic, and sulfur dioxide concentrations (a marker of secondary particle formation). We compared model performance against long-term PNC data collected continuously from 9 years before and up to 3 years after the model-development period. Model predictions captured the major temporal variations in the data and model performance remained relatively stable retrospectively and prospectively. The Pearson correlation of modeled versus measured hourly log-transformed PNC at a long-term monitoring site for 9 years prior was 0.74. Our results demonstrate that highly resolved spatial-temporal PNC models are capable of estimating ambient concentrations retrospectively and prospectively with generally good accuracy, giving us confidence in using these models in epidemiological studies.

Source apportionment of particle number size distribution in urban background and traffic stations in four European cities

Ultrafine particles (UFP) are suspected of having significant impacts on health. However, there have only been a limited number of studies on sources of UFP compared to larger particles. In this work, we identified and quantified the sources and processes contributing to particle number size distributions (PNSD) using Positive Matrix Factorization (PMF) at six monitoring stations (four urban background and two street canyon) from four European cities: Barcelona, Helsinki, London, and Zurich. These cities are characterised by different meteorological conditions and emissions. The common sources across all stations were Photonucleation, traffic emissions (3 sources, from fresh to aged emissions: Traffic nucleation, Fresh traffic - mode diameter between 13 and 37 nm, and Urban - mode diameter between 44 and 81 nm, mainly traffic but influenced by other sources in some cities), and Secondary particles. The Photonucleation factor was only directly identified by PMF for Barcelona, while an additional split of the Nucleation factor (into Photonucleation and Traffic nucleation) by using NO_x concentrations as a proxy for traffic emissions was performed for all other stations. The sum of all traffic sources resulted in a maximum relative contributions ranging from 71 to 94% (annual average) thereby being the main contributor at all stations. In London and Zurich, the relative contribution of the sources did not vary significantly between seasons. In contrast, the high levels of solar radiation in Barcelona led to an important contribution of Photonucleation particles (ranging from 14% during the winter period to 35% during summer). Biogenic emissions were a source identified only in Helsinki (both in the urban background and street canyon stations), that contributed importantly during summer (23% in urban background). Airport emissions contributed to Nucleation particles at urban background sites, as the highest concentrations of this source took place when the wind was blowing from the airport direction in all cities.

Air pollution and health: Evidence from epidemiological studies and population impact

Outdoor air pollution —in particular particulate matter, nitrogen dioxide and ozone— can exert its effects on health after acute (short-term) and chronic (long-term) exposures. Short-term exposures increase the probability of the onset of acute diseases within a few days, such as myocardial infarction or stroke, or even death in the case of susceptible individuals. Long-term exposures are associated with decreased survival and incidence of several non-communicable diseases, including cardiorespiratory conditions and lung cancer. In Europe, the large ESCAPE project (European Study of Cohorts for Air Pollution Effects — www.escapeproject.eu) evaluated the chronic effects of air pollution in the cohorts of adult subjects. The results of ESCAPE show an association between chronic exposure to air pollutants and natural mortality, cardiovascular events, lung, brain, breast and digestive tract cancer. The recent joint statement of the European Respiratory Society and the American Respiratory Society clarifies the wide spectrum of adverse effects of pollution, including “new” diseases such as neurological and metabolic syndrome previously not studied. The estimates by the Global Burden of Disease provide nowadays indications that air pollution causes illness and mortality, just after diet, smoking, hypertension and diabetes: 4.2 million premature deaths a year worldwide. Ischemic heart disease, stroke, chronic obstructive pulmonary disease, acute lower respiratory infections are the main conditions associated with air-pollution–related mortality.

The Effect of Particulate Matter Exposure on the Inflammatory Airway Response of Street Runners and Sedentary People

Physical exercise promotes many health benefits. However, its effects are not well known in a polluted environment. Thus, this study aimed to compare upper airway inflammatory responses between street runners and sedentary individuals. Twenty-eight volunteers were recruited: runners (n = 14) and sedentary individuals (n = 14), who lived and worked in the same metropolitan area of São Paulo, Brazil. Particulate matter (PM) levels were monitored ten weeks before winter (low PM levels) and ten weeks after the beginning of winter (high PM levels) [PM10 (p < 0.0001) and PM2.5 (p < 0.0001)]. The cytokines (TNF-α, IL-6, IL-10, and IL-17A) levels in the nasal lavage and fractional exhaled nitric oxide (FeNO) were taken at the beginning of the winter (baseline) and ten weeks afterwards (after ten weeks of high PM exposure). IL-6 concentration increased in both runners (p = 0.037) and sedentary individuals (p = 0.027) after high PM exposure compared to the baseline. IL-10 concentration increased in sedentary individuals (p = 0.037) while IL-17A levels were increased in runners (p = 0.001) after high PM exposure compared to the baseline. FeNO levels decreased in runners (p = 0.025) after high PM exposure compared to the baseline. Outdoor endurance training acts as an inducer of a differentiated immune response in the upper airways of runners compared to individuals with a sedentary lifestyle from the same community after elevated PM exposure.

Fine and ultrafine particle exposure during commuting by subway in Vienna

Mass concentrations of particulate matter (PM10, PM2.5, PM1), lung deposited surface area and particle number concentrations were measured for the first time in all Viennese subway lines inside cabins and in two subway stations, one aboveground and the other underground. The observed data were examined for significant differences between the exposure to fine particulate matter and ultrafine particles. Analysis of the trip averages in the five lines U1, U2, U3, U4 and U6 showed significant differences for PM10, PM2.5 and PM1 (all three mass concentrations: p < 0.001). Medians for PM10, PM2.5 and PM1 were highest in the U1 (73.6, 38.9, 27.1 µg/m3, respectively) and U3 (113.3, 47.1, 26.7 µg/m3, respectively) and significantly higher in the underground subway station than in the subway station on ground level. Regarding ultrafine particles no significant differences were found between the subway lines and no significant differences between the underground subway station and the subway station on ground level; however, new air-conditioned cabins had lower particle number concentrations and both particle number concentrations and lung deposited surface area were higher in cabins with open windows.

Potential health and equity co-benefits related to the mitigation policies reducing air pollution from residential wood burning in Athens, Greece

Athens, Greece has been in economic and social crises after the 2008 global recession, resulting in an increase in wood burning as a cheaper method of residential heating in the winter. Reducing wood burning emissions is a source-specific method to address air quality degradation, and indirectly climate change, through instituting policies aimed at human health co-benefits. In this work, we investigate and quantify the potential health co-benefits from policies reducing outdoor particulate matter (PM) pollution from residential wood burning by assessing the pollution conditions during the 2015 calendar year in Athens, Greece, emphasizing vulnerable populations. We conducted a systematic literature search to extract data regarding effective improvements to outdoor PM due to wood burning interventions, and get a range of potential ambient PM reduction estimates regarding realistic benefits from different interventions. We applied a health impact assessment methodology and used existing Athens specific data to calculate the preventable daily average non-accidental deaths associated with reducing PM, additionally considering low and high socioeconomic status (SES) groups. We found that the reduction in outdoor PM concentration showed the potential to benefit lower SES groups as much as 13.5 times more than the high SES group, representing an opportunity for policies to improve not only the health of the total population but also improve environmental equity and health disparities.

Impact of winter droughts on air pollution over Southwest China

The meteorological causes of winter droughts over Southwest China (SWC) have been widely investigated in recent years; however, little information is available on the impact of these droughts on air pollution. This study (1) characterized and quantified the impact of winter droughts on air pollution over SWC and (2) investigated the atmospheric teleconnections associated with the winter droughts in this region using air pollution monitoring data, routinely observed meteorological data, and National Centers for Environmental Prediction/National Center for Atmospheric Research and ERA-Interim reanalysis data. The main results are as follows: (1) A surface high pressure system together with a weak descent in the middle troposphere was the main cause of the SWC drought in December 2017. (2) It has been found that precipitation, the number of precipitation days and the atmospheric boundary layer height all decreased during the droughts, resulting in unfavorable conditions for the dispersion of air pollutants. (3) The concentrations of PM_2.5 and PM₁₀ were much higher during dry periods than those during non-dry periods over SWC, especially in the Sichuan Basin of the SWC. (4) WRF-Chem simulations reproduced the observed changes in air pollutant concentrations between dry and non-dry conditions. (5) Atmospheric teleconnections associated with the winter droughts in SWC were negative phases of the conventional Eurasian teleconnection, Eastern Atlantic/Western Russia pattern, Arctic Oscillation and North Atlantic Oscillation, and a La Niña event. Overall, this study provides scientific support for the long-term potential and accurate short-term predictions of air pollution in SWC.

Ambient air pollution is associated with cardiac repolarization abnormalities in healthy adults

BACKGROUND

Ambient air pollution has been associated with acute cardiovascular events; however, the underlying mechanisms remain incompletely understood. We aimed to examine the impacts of ambient air pollutants on cardiac ventricular repolarization in a highly polluted urban region.

METHODS

Seventy-three healthy non-smoking young adults (66% female, mean age of 23.3 ± 5.4 years) were followed with four repeated 24-h electrocardiogram recordings in 2014-2016 in Beijing, China. Continuous concentrations of ambient particulates in size fractions of 5-560 nm diameter, black carbon (BC), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃) were measured at a fixed-location air pollution monitoring station. Generalized linear mixed models, with adjustment for individual risk factors, time-varying factors and meteorological parameters, were used to evaluate the effects of air pollution on 5-min segments of heart rate-corrected QT interval (QTc), an index of cardiac ventricular repolarization.

RESULTS

During the study period, the mean levels of number concentrations of particulates in size range of 5-560 nm (PNC_5-560) were 20,711 particles/cm³. Significant increases in QTc of 0.56% (95% CI: 0.27, 0.84) to 1.76% (95% CI: 0.73, 2.79) were associated with interquartile range increases in PNC_50-560 at prior 1-5 moving average days. Significant increases in QTc were also associated with increases in exposures to traffic-related air pollutants (BC, NO₂ and CO), a combustion pollutant SO₂, and the secondary pollutant O₃. The associations were stronger in participants who were male, overweight, with abdominal obesity, and with higher levels of high-sensitivity C-reactive protein.

CONCLUSIONS

Our findings suggest that exposures to higher levels of ambient particulates in small size fractions and traffic pollutants were associated with cardiac repolarization abnormalities in healthy adults, and the cardio-metabolic risks may modify the adverse cardiac effects attributable to air pollution.

Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden

In this study, the effects on daily mortality in Stockholm associated with short-term exposure to ultrafine particles (measured as number of particles with a diameter larger than 4 nm, PNC₄), black carbon (BC) and coarse particles (PM_2.5–10) have been compared with the effects from more common traffic-pollution indicators (PM₁₀, PM_2.5 and NO₂) and O₃ during the period 2000–2016. Air pollution exposure was estimated from measurements at a 20 m high building in central Stockholm. The associations between daily mortality lagged up to two days (lag 02) and the different air pollutants were modelled by using Poisson regression. The pollutants with the strongest indications of an independent effect on daily mortality were O₃, PM_2.5–10 and PM₁₀. In the single-pollutant model, an interquartile range (IQR) increase in O₃ was associated with an increase in daily mortality of 2.0% (95% CI: 1.1–3.0) for lag 01 and 1.9% (95% CI: 1.0–2.9) for lag 02. An IQR increase in PM_2.5–10 was associated with an increase in daily mortality of 0.8% (95% CI: 0.1–1.5) for lag 01 and 1.1% (95% CI: 0.4–1.8) for lag 02. PM₁₀ was associated with a significant increase only at lag 02, with 0.8% (95% CI: 0.08–1.4) increase in daily mortality associated with an IQR increase in the concentration. NO₂ exhibits negative associations with mortality. The significant excess risk associated with O₃ remained significant in two-pollutant models after adjustments for PM_2.5–10, BC and NO₂. The significant excess risk associated with PM_2.5–10 remained significant in a two-pollutant model after adjustment for NO₂. The significantly negative associations for NO₂ remained significant in two-pollutant models after adjustments for PM_2.5–10, O₃ and BC. A potential reason for these findings, where statistically significant excess risks were found for O₃, PM_2.5–10 and PM₁₀, but not for NO₂, PM_2.5, PNC₄ and BC, is behavioral factors that lead to misclassification in the exposure. The concentrations of O₃ and PM_2.5–10 are in general highest during sunny and dry days during the spring, when exposure to outdoor air tend to increase, while the opposite applies to NO₂, PNC₄ and BC, with the highest concentrations during the short winter days with cold weather, when people are less exposed to outdoor air.

Quantifying high-resolution spatial variations and local source impacts of urban ultrafine particle concentrations

To quantify the fine-scale spatial variations and local source impacts of urban ultrafine particle (UFP) concentrations, we conducted 3-6 weeks of continuous measurements of particle number (a proxy for UFP) and other air pollutant (CO, NO₂, and PM_2.5) concentrations at 32 sites in Pittsburgh, Pennsylvania during the winters of 2017 and 2018. Sites were selected to span a range of urban land use attributes, including urban background, near local and arterial roads, traffic intersections, urban street canyon, near-highway, near large industrial source, and restaurant density. The spatial variations in urban particle number concentrations varied by about a factor of three. Particle number concentrations are 2-3 times more spatially heterogeneous than PM_2.5 mass. The observed order of spatial heterogeneity is UFP > NO₂ > CO > PM_2.5. On average, particle number concentrations near local roads with a cluster of restaurants and near arterial roads are roughly two times higher than the urban background. Particle number concentrations in the urban street canyon, downwind of a major highway, and near large industrial sources are 2-4 times higher than background concentrations. While traffic is known as an important contributor to particle number concentrations, restaurants and industrial emissions also contribute significantly to spatial variations in Pittsburgh. Particle size distribution measurements using a mobile laboratory show that the local spatial variations in particle number concentrations are dictated by concentrations of particles smaller than 50 nm. A large fraction of urban residents (e.g., ~50%) in Pittsburgh live near local sources and are therefore exposed to 50%-300% higher particle number concentrations than urban background location. These locally emitted particles may have greater health effects than background particles.

Occupational Exposure to Fine Particles and Ultrafine Particles in a Steelmaking Foundry

Several studies have shown an increased mortality rate for different types of tumors, respiratory disease and cardiovascular morbidity associated with foundry work. Airborne particles were investigated in a steelmaking foundry using an electric low-pressure impactor (ELPI+™), a Philips Aerasense Nanotracer and traditional sampling equipment. Determination of metallic elements in the collected particles was carried out by inductively coupled plasma mass spectrometry. The median of ultrafine particle (UFP) concentration was between 4.91 × 103 and 2.33 × 105 part/cm3 (max. 9.48 × 106 part/cm3). Background levels ranged from 1.97 × 104 to 3.83 × 104 part/cm3. Alveolar and deposited tracheobronchial surface area doses ranged from 1.3 × 102 to 8.7 × 103 mm2, and 2.6 × 101 to 1.3 × 103 mm2, respectively. Resulting inhalable and respirable fraction and metallic elements were below limit values set by Italian legislation. A variable concentration of metallic elements was detected in the different fractions of UFPs in relation to the sampling site, the emission source and the size range. This data could be useful in order to increase the knowledge about occupational exposure to fine and ultrafine particles and to design studies aimed to investigate early biological effects associated with the exposure to particulate matter in the foundry industries.

The traffic signature on the vertical PM profile: Environmental and health risks within an urban roadside environment

In an attempt to investigate the traffic-impacted vertical aerosols profile and its relationship with potential carcinogenicity and/or mutagenicity, samples of different sized airborne particles were collected in parallel at the 1st and 5th floor of a 19 m high building located next to one of the busiest roads of Athens. The maximum daily concentrations were 65.9, 42.5 and 38.5 μg/m³, for PM₁₀, PM_2.5 and PM₁, respectively. The vertical concentration ratio decreased with increasing height verifying the role of the characteristics of the area (1st/5th floor: 1.21, 1.13, 1.09 for PM₁₀, PM_2.5 and PM₁, respectively). Chemically, strengthening the previous hypothesis, the collected particles were mainly carbonaceous (68%-93%) with the maximum budget of the polyaromatic hydrocarbons being recorded near the surface (1st/5th floor: 1.84, 1.07, 1.15 for PM₁₀, PM_2.5 and PM₁, respectively). The detected PM-bound PAHs along with the elements as well as the carbonaceous and ionic constituents were used in a source apportionment study. Exhaust and non-exhaust emissions, a mixed source of biomass burning and high temperature combustion processes (natural gas, gasoline/diesel engines), sea salt, secondary and soil particles were identified as the major contributing sources to the PM pollution of the investigated area. With respect to the health hazards, the calculation of the Benzo[a]Pyrene toxicity equivalency factors underlined the importance of the height of residence in buildings for the level of the exposure (1st/5th floor: B[a]P_TEQ: 1.82, 1.12, 1.10, B[a]P_MEQ: 1.85, 1.13, 1.09 for PM₁₀, PM_2.5 and PM₁, respectively). Finally, despite its verified significance as a surrogate compound for the mixture of the hydrocarbons (its contribution up to 72%, 79% on the level of the 1st and 5th floor, respectively), the importance of the incorporation of PAH species in addition to B[a]P when assessing PAH toxicity was clearly documented.

Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areas

BACKGROUND

Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature.

OBJECTIVE

We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 μm (PM_2.5) and ≤ 10 μm (PM₁₀), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999-2013.

METHODS

We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis.

RESULTS

Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm³ in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (<25th percentile) [-0.18% (95% CI: -0.97%, 0.62%)]. On days with high air pollution (>50th percentile), both heat- and cold-related mortality risks increased.

CONCLUSION

Our findings showed that high temperature could modify the effects of air pollution on daily mortality and high air pollution might enhance the air temperature effects.

Combining Measurements from Mobile Monitoring and a Reference Site To Develop Models of Ambient Ultrafine Particle Number Concentration at Residences

Significant spatial and temporal variation in ultrafine particle (UFP; <100 nm in diameter) concentrations creates challenges in developing predictive models for epidemiological investigations. We compared the performance of land-use regression models built by combining mobile and stationary measurements (hybrid model) with a regression model built using mobile measurements only (mobile model) in Chelsea and Boston, MA (USA). In each study area, particle number concentration (PNC; a proxy for UFP) was measured at a stationary reference site and with a mobile laboratory driven along a fixed route during an ∼1-year monitoring period. In comparing PNC measured at 20 residences and PNC estimates from hybrid and mobile models, the hybrid model showed higher Pearson correlations of natural log-transformed PNC ( r = 0.73 vs 0.51 in Chelsea; r = 0.74 vs 0.47 in Boston) and lower root-mean-square error in Chelsea (0.61 vs 0.72) but no benefit in Boston (0.72 vs 0.71). All models overpredicted log-transformed PNC by 3-6% at residences, yet the hybrid model reduced the standard deviation of the residuals by 15% in Chelsea and 31% in Boston with better tracking of overnight decreases in PNC. Overall, the hybrid model considerably outperformed the mobile model and could offer reduced exposure error for UFP epidemiology.

Source apportionment of PM2.5 using positive matrix factorization (PMF) at a rural site in Korea

The sources of different pollutants contributing to ambient fine particles (PM_2.5) on Daebu Island, Korea, were estimated. Twenty four hour integrated filter samples were collected from May 21-November 1, 2016, and analyzed for organic carbon, elemental carbon, ions, and trace elements. Positive matrix factorization was conducted on the PM_2.5 chemical speciation data from the samples to define the pathways and sources of PM_2.5 at the sampling site. A total of 80 samples and 24 chemical species were used to run the model and a total of nine sources were identified: secondary sulfate (29.0%), mobile (22.0%), secondary nitrate (13.2%), oil combustion (10.1%), coal combustion (9.4%), aged sea salt (7.9%), soil (5.6%), non-ferrous smelting (1.7%), and industrial activity (1.1%). Conditional probability and potential source contribution functions were then used to determine whether these sources were local or came from pollutants transported over long-range distances. The anthropogenic sources came from local emissions and originated from both industrialized and metropolitan areas, whereas the secondary inorganic aerosols were strongly influenced by the long-range transport of air pollutants from Shandong and Jiangsu provinces in China.

Particle-related exposure, dose and lung cancer risk of primary school children in two European countries

Schools represent a critical microenvironment in terms of air quality due to the proximity to outdoor particle sources and the frequent lack of proper ventilation and filtering systems. Moreover, the population exposed in schools (i.e. children) represents a susceptible population due to their age. Air quality-based studies involving students' exposure at schools are still scarce and often limited to mass-based particle metrics and may thus underestimate the possible effect of sub-micron particles and particle toxicity. To this purpose, the present paper aims to evaluate the exposure to different airborne particle metrics (including both sub- and super-micron particles) and attached carcinogenic compounds. Measurements in terms of particle number, lung-deposited surface area, and PM fraction concentrations were measured inside and outside schools in Barcelona (Spain) and Cassino (Italy). Simultaneously, PM samples were collected and chemically analysed to obtain mass fractions of carcinogenic compounds. School time airborne particle doses received by students in classrooms were evaluated as well as their excess lung cancer risk due to a five-year primary school period. Median surface area dose received by students during school time in Barcelona and Cassino resulted equal to 110mm² and 303mm², respectively. The risk related to the five-year primary school period was estimated as about 2.9×10^-5 and 1.4×10^-4 for students of Barcelona and Cassino, respectively. The risk in Barcelona is slightly higher with respect to the maximum tolerable value (10^-5, according to the U.S. Environmental Protection Agency), mainly due to toxic compounds on particles generated from anthropogenic emissions (mainly industry). On the other hand, the excess lung cancer risk in Cassino is cause of concern, being one order of magnitude higher than the above-mentioned threshold value due to the presence of biomass burning heating systems and winter thermal inversion that cause larger doses and great amount of toxic compounds on particles.

Ultrafine and Fine Particle Number and Surface Area Concentrations and Daily Cause-Specific Mortality in the Ruhr Area, Germany, 2009-2014

BACKGROUND

Although epidemiologic studies have shown associations between particle mass and daily mortality, evidence on other particle metrics is weak.

OBJECTIVES

We investigated associations of size-specific particle number concentration (PNC) and lung-deposited particle surface area concentration (PSC) with cause-specific daily mortality in contrast to PM₁₀.

METHODS

We used time-series data (March 2009-December 2014) on daily natural, cardiovascular, and respiratory mortality (NM, CVM, RM) of three adjacent cities in the Ruhr Area, Germany. Size-specific PNC (electric mobility diameter of 13.3-750 nm), PSC, and PM₁₀ were measured at an urban background monitoring site. In single- and multipollutant Poisson regression models, we estimated percentage change (95% confidence interval) [% (95% CI)] in mortality per interquartile range (IQR) in exposure at single-day (0-7) and aggregated lags (0-1, 2-3, 4-7), accounting for time trend, temperature, humidity, day of week, holidays, period of seasonal population decrease, and influenza.

RESULTS

PNC_100-750 and PSC were highly correlated and had similar immediate (lag0-1) and delayed (lag4-7) associations with NM and CVM, for example, 1.12% (95% CI: 0.09, 2.33) and 1.56% (95% CI: 0.22, 2.92) higher NM with IQR increases in PNC_100-750 at lag0-1 and lag4-7, respectfully, which were slightly stronger then associations with IQR increases in PM₁₀. Positive associations between PNC and NM were strongest for accumulation mode particles (PNC 100-500 nm), and for larger UFPs (PNC 50-100 nm). Associations between NM and PNC_<100 changed little after adjustment for O₃ or PM₁₀, but were more sensitive to adjustment for NO₂.

CONCLUSION

Size-specific PNC (50-500 nm) and lung-deposited PSC were associated with natural and cardiovascular mortality in the Ruhr Area. Although associations were similar to those estimated for an IQR increase in PM₁₀, particle number size distributions can be linked to emission sources, and thus may be more informative for potential public health interventions. Moreover, PSC could be used as an alternative metric that integrates particle size distribution as well as deposition efficiency. https://doi.org/10.1289/EHP2054.

Short-term effects of ultrafine particles on daily mortality by primary vehicle exhaust versus secondary origin in three Spanish cities

BACKGROUND

Evidence on the short-term effects of ultrafine particles (with diameter<100nm, UFP) on health is still inconsistent. New particles in ambient urban air are the result of direct emissions and also the formation of secondary UFP from gaseous precursors. We segregated UFP into these two components and investigated their impact on daily mortality in three Spanish cities affected by different sources of air pollution.

METHODS

We separated the UFP using a method based on the high correlation between black carbon (BC) and particle number concentration (N). The first component accounts for aerosol constituents emitted by vehicle exhaust (N1) and the second for the photochemical new particle formation enhancements (N2). We applied city-specific Poisson regression models, adjusting for long-term trends, temperature and population dynamics.

RESULTS

Mean BC levels were higher in Barcelona and Tenerife (1.8 and 1.2μg·m^-3, respectively) than in Huelva (0.8μg·m^-3). While mean UFP concentrations were similar in the three cities, from which N1 was 40% in Barcelona, 46% in Santa Cruz de Tenerife, and 27% in Huelva. We observed an association with N1 and daily mortality in Barcelona, by increasing approximately 1.5% between lags 0 and 2, per an interquartile increase (IQR) of 3277cm^-3, but not with N2. A similar pattern was found in Santa Cruz de Tenerife, although none of the associations were significant. Conversely, in the industrial city of Huelva mortality was associated with N2 at lag 0, by increasing 3.9% per an IQR of 12,032·cm^-3.

CONCLUSION

The pattern and origin of UFP determines their short-term effect on human health. BC is possibly the better parameter to evaluate the health effects of particulate vehicle exhaust emissions, although in areas influenced by domestic solid fuel combustion this should also be taken into account.

Commuter exposure to fine and ultrafine particulate matter in Vienna

Mass concentrations PM10, PM2.5, PM1, particle number concentrations of ultrafine particles and lung deposited surface area were measured during commutes with a subway, tram, bus, car and bicycle in Vienna for the first time. Obtained data were examined for significant differences in personal exposure when using various transport modalities along similar routes. Mean PM2.5 and PM1 mass concentrations were significantly higher in the subway when compared to buses. Mean PM10, PM2.5 and PM1 mass concentrations were significantly higher in the subway when compared to cars using low ventilation settings. Particle number concentrations of ultrafine particles were significantly higher in trams when compared to the subway and lung deposited surface area was significantly greater on bicycles when compared to the subway. After adjusting for different vehicle speeds, exposure to PM10, PM2.5 and PM1 along the same route length was significantly higher in the subway when compared to cars while exposure to ultrafine particles and partly also lung deposited surface area was significantly higher in bus, tram and on bicycle when compared to the subway. Car and bus passengers could be better isolated from ambient fine particulate matter than passengers in the subway, where a lot of ventilation occurs through open windows and larger doors. Tram passengers and cyclists might be exposed to increased amounts of ultrafine particles and larger lung deposited surface area due to a closer proximity to road traffic. Comparing cumulative exposure along the same route length leads to different results and favors faster traffic modes, such as the subway.

Exploratory assessment of indoor and outdoor particle number concentrations in Hanoi households

No studies have been conducted in Vietnam to understand the levels of atmospheric ultrafine particles, despite having adverse health effects. Information about indoor air quality in Vietnam is also limited. Hence we aimed to conduct the first assessment of ultrafine particle concentrations in terms of particle number (PN) in Hanoi, by simultaneously measuring indoor and outdoor PN concentrations from six households at different locations across the city in January 2016. We also acquired PM_2.5 data for this monitoring period from an air quality monitoring station located at the US Embassy in Hanoi, to compare the general trends between PN and PM_2.5 concentrations. The mean daily indoor and outdoor PN concentrations for the monitoring period were 1.9×10⁴p/cm³ and 3.3×10⁴p/cm³, respectively, with an increase during rush hour traffic. It was concluded that traffic was the main contributor to outdoor PN concentrations, with agricultural burning having a small influence at one study location. The mean ratio of indoor to outdoor PN concentrations for all six sites was 0.66±0.26, which points to outdoor air as the main driver of indoor PN concentrations, rather than indoor sources. These PN concentrations and I/O ratios are similar to those reported for a number of cities in developed countries. However, in contrast to PN, ambient mean PM_2.5 concentrations in Hanoi (60-70μg/m³) were significantly higher than those typically recorded in developed countries. These findings demonstrate that urban particle mass (PM_2.5) concentrations are not indicative of the PN concentrations, which can be explained by different sources contributing to PN and PM, and that direct measurements of PN are necessary to provide information about population exposure to ultrafine particles and for management of air quality.