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Jeon HJ, Jeon HJ, Jeon SH. Predicting the daily number of patients for allergic diseases using PM10 concentration based on spatiotemporal graph convolutional networks. PLoS One 2024; 19:e0304106. [PMID: 38870112 PMCID: PMC11175429 DOI: 10.1371/journal.pone.0304106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/06/2024] [Indexed: 06/15/2024] Open
Abstract
Air pollution causes and exacerbates allergic diseases including asthma, allergic rhinitis, and atopic dermatitis. Precise prediction of the number of patients afflicted with these diseases and analysis of the environmental conditions that contribute to disease outbreaks play crucial roles in the effective management of hospital services. Therefore, this study aims to predict the daily number of patients with these allergic diseases and determine the impact of particulate matter (PM10) on each disease. To analyze the spatiotemporal correlations between allergic diseases (asthma, atopic dermatitis, and allergic rhinitis) and PM10 concentrations, we propose a multi-variable spatiotemporal graph convolutional network (MST-GCN)-based disease prediction model. Data on the number of patients were collected from the National Health Insurance Service from January 2013 to December 2017, and the PM10 data were collected from Airkorea during the same period. As a result, the proposed disease prediction model showed higher performance (R2 0.87) than the other deep-learning baseline methods. The synergic effect of spatial and temporal analyses improved the prediction performance of the number of patients. The prediction accuracies for allergic rhinitis, asthma, and atopic dermatitis achieved R2 scores of 0.96, 0.92, and 0.86, respectively. In the ablation study of environmental factors, PM10 improved the prediction accuracy by 10.13%, based on the R2 score.
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Affiliation(s)
- Hyeon-Ju Jeon
- Data Assimilation Group, Korea Institute of Atmospheric Prediction Systems (KIAPS), Seoul, Republic of Korea
| | - Hyeon-Jin Jeon
- Department of Artificial Intelligence, Dongguk University, Seoul, Republic of Korea
| | - Seung Ho Jeon
- Department of Occupational and Environmental Medicine, Korea Industrial Health Association (KIHA), Seoul, Gyeonggi-do, Republic of Korea
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Zheng X, Yang L, Liu Y. The impact of air pollution on outpatient medical service utilization and expenditure in a clean air city. Soc Sci Med 2023; 338:116301. [PMID: 37879134 DOI: 10.1016/j.socscimed.2023.116301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/30/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although there's increasing research on the health effects of air pollution in China, its direct influence on health-related expenditures, particularly during less severe pollution episodes, is still not well-understood. This study aims to quantify impact of three air pollutants (sulfur dioxide, nitrogen dioxide, and particulate matter) on individual healthcare spending in a city with relatively clean air. METHODS Using transaction-level medical social insurance data and temperature inversion as the instrumental variable, we estimate the current and cumulative effects of air pollutants on outpatient visits and medical expenses in an eastern city in China. RESULTS We find a significantly positive effect on outpatient visits for 15-day moving average, and a significantly positive effect on outpatient expenditure for 25-day moving average. Therefore, the cumulative effect of pollutants on medical expenditure should not be ignored. The effects on total outpatient expenditure are larger for the elderly and men. The cumulative pollution exposure increases the visits to respiratory department but also increases the expenditure on non-respiratory diseases in the long term. CONCLUSION Our findings provide empirical evidence that even for cities with good air quality, further improvements can improve patients' quality of life and lessen the expenditure burden on medical insurance.
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Affiliation(s)
- Xiaoting Zheng
- School of Economics, Jinan University, China; Institute of Resource, Environment and Sustainable Development Research, Jinan University, China.
| | - Lin Yang
- Urban Governance and Design Thrust, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China; Department of Economics, The Hong Kong University of Science and Technology, Hong Kong SAR, China.
| | - Yumeng Liu
- School of Economics, Jinan University, China
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3
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Uong SP, Hussain H, Thanik E, Lovinsky-Desir S, Stingone JA. Urinary metabolites of polycyclic aromatic hydrocarbons and short-acting beta agonist or systemic corticosteroid asthma medication use within NHANES. ENVIRONMENTAL RESEARCH 2023; 220:115150. [PMID: 36572332 PMCID: PMC9969867 DOI: 10.1016/j.envres.2022.115150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Within cross-sectional studies like the U.S. National Health and Nutritional Examination Survey (NHANES), researchers have observed positive associations between polycyclic aromatic hydrocarbon (PAH) exposure and asthma diagnosis. It is unclear whether similar relationships exist for measures of acute asthma outcomes, including short-term asthma medication use to alleviate symptoms. We examined the relationship between markers of recent PAH exposure and 30-day short-acting beta agonist (SABA) or systemic corticosteroid use, an indicator for recent asthma symptoms. MATERIALS AND METHODS For 16,550 children and adults across multiple waves of NHANES (2005-2016), we fit quasi-Poisson multivariable regression models to describe the association between urinary 1-hydroxypyrene (a metabolite of PAH) and SABA or systemic corticosteroid use. We assessed for effect modification by age group and asthma controller medication use. All models were adjusted for urinary creatinine, age, female/male designation, race/ethnicity, poverty, insurance coverage, and serum cotinine. RESULTS After controlling for confounding, an increase of one standard deviation of 1-hydroxypyrene was associated with greater prevalence of recent SABA or systemic corticosteroid use (PR: 1.06, 95% CI: 1.03-1.10). The results were similar among those with ever asthma diagnosis and across urine creatinine dilution methods. We did not observe effect modification by age group (p-interaction = 0.22) or asthma controller medication use (p-interaction = 0.73). CONCLUSION Markers of recent PAH exposure was positively associated with SABA or systemic corticosteroid use, across various urine dilution adjustment methods. It is important to ensure appropriate temporality between exposures and outcomes in cross-sectional studies.
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Affiliation(s)
- Stephen P Uong
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York City, NY, USA.
| | - Haider Hussain
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York City, NY, USA
| | - Erin Thanik
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York City, NY, USA
| | - Stephanie Lovinsky-Desir
- Department of Pediatrics, Division of Pulmonary Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York City, NY, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York City, NY, USA
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Lee HJ, Liu Y, Chatfield RB. Neighborhood-scale ambient NO 2 concentrations using TROPOMI NO 2 data: Applications for spatially comprehensive exposure assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159342. [PMID: 36223808 DOI: 10.1016/j.scitotenv.2022.159342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
This study estimated long-term average ambient NO2 concentrations using TROPOspheric Monitoring Instrument (TROPOMI) tropospheric NO2 data and land use information at the spatial resolution of 500 m in California for the years 2018-2019. Our satellite-land use regression model demonstrated reasonably high predictive power with cross-validation (CV) R2 = 0.76, mean absolute error (MAE) = 1.95 ppb, and root mean squared error (RMSE) = 2.51 ppb in a comparison between measured and estimated NO2 concentrations. Exploiting the high-resolution NO2 estimates, we further investigated the representativeness of ground NO2 monitors for population exposures and examined the spatial variation of NO2 in relation to parcel-level property data for exposure attributions. The ground NO2 monitors were the most representative of population exposures in Los Angeles and San Diego counties, supported by population-weighted average NO2 concentrations (satellite-derived estimations) similar to arithmetic average NO2 concentrations (ground measurements). On the contrary, the exposure assessment using the ground monitors was the least representative and protective in Humboldt, San Luis Obispo, and Yolo counties with population-weighted average NO2 greater than arithmetic average NO2 by 82.2 % (1.85 ppb), 67.1 % (1.89 ppb), and 58.2 % (2.48 ppb), respectively. In a case study of LA County, we identified comparatively high NO2 concentrations for the property types of food processing facilities and high-density residential complexes (such as high-rise apartments and apartments). This finding provides evidence that these emerging sources may be crucial to mitigate cumulative NO2 exposures and subsequent health risks from a regulatory perspective.
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Affiliation(s)
- Hyung Joo Lee
- Division of Environmental Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Gyeongbuk 37673, South Korea.
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Robert B Chatfield
- Earth Science Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
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Hua Y, Yuan X, Wang J, Zeng K, Zhi S, Liu L. Association between air pollution and hospital admissions for chronic respiratory disease in people aged over 65 years: a time series analysis in Ningbo, China, 2015-2017. Int Arch Occup Environ Health 2022; 95:1293-1304. [PMID: 35661917 DOI: 10.1007/s00420-022-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide essential information of environmental triggers leading to CRD. METHODS We investigated the short-term effects of ambient air pollutants on CRD-related hospitalizations in people aged ≥ 65 years in Ningbo. Data on 23,610 cases of CRD requiring hospitalization were collected from January 2015 to August 2017. After adjusting for temporal trends, seasonality, meteorological conditions, day of week (DOW), and public holidays, we used generalized additive Poisson distribution models to calculate the excess risks (ERs) and 95% confidence intervals (95% CIs) of CRD related hospitalizations. RESULTS Our results showed that fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were associated with CRD-related hospitalizations in people aged ≥ 65 years. We observed that each 10 μg/m3 increase (except for each 0.1 mg/m3 increase in CO) in the concentration of air pollutants, the percentage of CRD-related hospitalizations due to PM2.5, PM10, and SO2 exposure at lag 07, NO2 exposure at lag 03, and CO exposure at lag 0 increased by 2.13% (95% CI: 0.55%, 3.74%), 1.76% (95% CI: 0.70%, 2.83%), 8.24% (95% CI: 0.92%, 16.09%), 2.16% (95% CI: 0.26%, 4.05%), and 1.19% (95% CI: 0.26%, 2.12%), respectively. In addition, we found stronger effects of particulate matter in 75-84 years age group, on warmer days, and in asthmatics. CONCLUSION In conclusion, air pollution may have adverse effects on CRD-related hospitalizations among people aged ≥ 65 years in Ningbo. Therefore, public health measures should be taken to improve air quality.
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Affiliation(s)
- Yuzhe Hua
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqi Yuan
- Ningbo Women and Children Hospital, Ningbo, China
| | - Jichao Wang
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Ke Zeng
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Shuai Zhi
- School of Medicine, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Medicine, Ningbo University, Ningbo, China.
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Ambient PM Concentrations as a Precursor of Emergency Visits for Respiratory Complaints: Roles of Deep Learning and Multi-Point Real-Time Monitoring. SUSTAINABILITY 2022. [DOI: 10.3390/su14052703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Despite ample evidence that high levels of particulate matter (PM) are associated with increased emergency visits related to respiratory diseases, little has been understood about how prediction processes could be improved by incorporating real-time data from multipoint monitoring stations. While previous studies use traditional statistical models, this study explored the feasibility of deep learning algorithms to improve the accuracy of predicting daily emergency hospital visits by tracking their spatiotemporal association with PM concentrations. We compared the predictive accuracy of the models based on PM datasets collected between 1 December 2019 and 31 December 2021 from a single but more accurate air monitoring station in each district (Air Korea) and multiple but less accurate monitoring sites (Korea Testing & Research Institute; KTR) within Guro District in Seoul, South Korea. We used MLP (multilayer perceptron) to integrate PM data from multiple locations and then LSTM (long short-term memory) models to incorporate the intrinsic temporal PM trends into the learning process. The results reveal evidence that predictive accuracy is improved from 1.67 to 0.79 in RMSE when spatial variations of air pollutants from multi-point stations are incorporated in the algorithm as a 9-day time window. The findings suggest guidelines on how environmental and health policymakers can arrange limited resources for emergency care and design ambient air monitoring and prevention strategies.
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Shin HH, Maquiling A, Thomson EM, Park IW, Stieb DM, Dehghani P. Sex-difference in air pollution-related acute circulatory and respiratory mortality and hospitalization. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150515. [PMID: 34627116 DOI: 10.1016/j.scitotenv.2021.150515] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Numerous studies have estimated adverse effects of short-term exposure to ambient air pollution on public health. Few have focused on sex-differences, and results have been inconsistent. The purpose of this study was three-fold: to identify sex-differences in air pollution-related health outcomes; to examine sex-differences by cause and season; and to examine time trends in sex-differences. METHODS Daily data were collected on circulatory- and respiratory-related mortality (for 29 years) and cause-specific hospitalization (for 17 years) with hourly concentrations of ozone (O3), nitrogen dioxide (NO2), and fine particulate matter (PM2.5). For hospitalization, more specific causes were examined: ischemic heart disease (IHD), other heart disease (OHD), cerebrovascular disease (CEV), chronic lower respiratory diseases (CLRD), and Influenza/Pneumonia (InfPn). Generalized Poisson models were applied to 24 Canadian cities, and the city-specific estimates were combined for nationwide estimates for each sex using Bayesian hierarchical models. Finally, sex-differences were tested statistically based on their interval estimates, considering the correlation between sex-specific national estimates. RESULTS Sex-differences were more frequently observed for hospitalization than mortality, respiratory than circulatory health outcomes, and warm than cold season. For hospitalization, males were at higher risk (M > F) for warm season (OHD and InfPn from O3; IHD from NO2; and InfPn from PM2.5), but F > M for cold season (CEV from O3 and OHD from NO2). For mortality, we found F > M only for circulatory diseases from ozone during the warm season. Among the above-mentioned sex-differences, three cases showed consistent time trends over the years: while M > F for OHD from O3 and IHD from NO2, F > M for OHD from NO2. CONCLUSIONS We found that sex-differences in effect of ambient air pollution varied over health outcome, cause, season and time. In particular, the consistent trends (either F > M or M > F) across 17 years provide stronger evidence of sex-differences in hospitalizations, and warrant investigation in other populations.
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Affiliation(s)
- Hwashin H Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
| | - Aubrey Maquiling
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada.
| | - In-Woo Park
- Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Dave M Stieb
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
| | - Parvin Dehghani
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
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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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Pallegedara A, Kumara AS. Impacts of firewood burning for cooking on respiratory health and healthcare utilisation: Empirical evidence from Sri Lankan micro-data. Int J Health Plann Manage 2021; 37:465-485. [PMID: 34655271 DOI: 10.1002/hpm.3350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/07/2022] Open
Abstract
Despite escalating income levels of Sri Lankan households, 70.3% of them still depend on firewood for cooking. This might lead to bad respiratory health and thereby, increased healthcare utilisation. With this backdrop, this paper examines how firewood burning for cooking influences respiratory health and healthcare utilisation of Sri Lankans. The study proposes a theoretical model to explain effects of firewood burning on respiratory health and healthcare utilisation and empirically tests it using nation-wide micro-data of 79,170 individuals belonging to 21,748 households. The data are drawn from the most recent wave of Sri Lankan household income and expenditure survey. After addressing potential endogeneity by applying instrumental variable regression models, the study finds that firewood burning increases households' probability of asthma prevalence by 10.9 percentage points (P < 0.001), out-patient care utilisation by 33.1 percentage points (P < 0.001), and in-patient care utilisation by 17.5 percentage points (P < 0.001), on average. Our individual level analysis demonstrates that females are more vulnerable to bad respiratory health induced by firewood burning (β = 0.055, P < 0.001) compared to males (β = 0.008, P > 0.1). The results imply policies on promoting improved-cooking stoves, separated-kitchen designs, and switching more towards cleaner energy sources, including LP gas and solar power.
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Affiliation(s)
- Asankha Pallegedara
- Department of Industrial Management, Wayamba University of Sri Lanka, Kuliyapitiya, Sri Lanka
| | - Ajantha Sisira Kumara
- Department of Public Administration, University of Sri Jayewardenepura, Gangodawila-Nugegoda, Sri Lanka
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Zhang Y, Ma Y, Feng F, Cheng B, Wang H, Shen J, Jiao H. Association between PM 10 and specific circulatory system diseases in China. Sci Rep 2021; 11:12129. [PMID: 34108571 PMCID: PMC8190074 DOI: 10.1038/s41598-021-91637-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/25/2021] [Indexed: 11/26/2022] Open
Abstract
Particulate matter (PM) has been proved to be a risk factor for the development of circulatory system diseases (CSDs) around the world. In this study, we collected daily air pollutants, emergency room (ER) visits for CSDs, and meteorological data from 2009 to 2012 in Beijing, China. After controlling for the long-term trend and eliminating the influence of confounding factors, the generalized additive model (GAM) was used to evaluate the short-term effects of PM10 on CSDs and cause-specific diseases. The results showed that for every 10 μg/m3 increase in PM10, the largest effect estimates in ER visits of total CSDs, arrhythmia, cerebrovascular diseases, high blood pressure, ischemic heart disease and other related diseases were 0.14% (95% CI: 0.06-0.23%), 0.37% (95% CI: - 0.23 to 0.97%), 0.20% (95% CI: 0.00-0.40%), 0.15% (95% CI: 0.02-0.27%), 0.18% (95% CI: 0.02-0.35%) and 0.35% (95% CI: - 0.04 to 0.79%), respectively. When NO2 or SO2 was added into the model, the effect estimates of PM10 were mostly attenuated, while in those models with PM2.5 added, the effect estimates of PM10 were mostly increased. Stratified analysis indicated that PM10 had a greater effect on males and the elderly.
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Affiliation(s)
- Yifan Zhang
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Fengliu Feng
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Jiahui Shen
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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Berman R, Min E, Huang J, Kopf K, Downey GP, Riemondy K, Smith HA, Rose CS, Seibold MA, Chu HW, Day BJ. Single-Cell RNA Sequencing Reveals a Unique Monocyte Population in Bronchoalveolar Lavage Cells of Mice Challenged With Afghanistan Particulate Matter and Allergen. Toxicol Sci 2021; 182:297-309. [PMID: 34051097 DOI: 10.1093/toxsci/kfab065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Upon returning from deployment to Afghanistan, a substantial number of U.S. military personnel report deployment-related lung disease (DRLD) symptoms, including those consistent with an asthma-like airways disease. DRLD is thought to be caused by prolonged inhalation of toxic desert particulate matter, which can persist in the postdeployment setting such as exposure to common household allergens. The goal of this study was to define the transcriptomic responses of lung leukocytes of mice exposed to Afghanistan desert particulate matter (APM) and house dust mite (HDM). C57BL/6 mice (n = 15/group) were exposed to filtered air or aerosolized APM for 12 days, followed by intranasal PBS or HDM allergen challenges for 24 h. Bronchoalveolar lavage (BAL) cells were collected for single-cell RNA sequencing (scRNAseq), and assessment of inflammation and airway hyper-responsiveness. Unsupervised clustering of BAL cell scRNAseq data revealed a unique monocyte population induced only by both APM and allergen treatments. This population of monocytes is characterized by the expression of genes involved in allergic asthma, including Alox15. We validated Alox15 expression in monocytes via immunostaining of lung tissue. APM pre-exposure, followed by the HDM challenge, led to significantly increased total respiratory system resistance compared with filtered air controls. Using this mouse model to mimic DRLD, we demonstrated that inhalation of airborne PM during deployment may prime airways to be more responsive to allergen exposure after returning home, which may be linked to dysregulated immune responses such as induction of a unique lung monocyte population.
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Affiliation(s)
- Reena Berman
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Elysia Min
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Jie Huang
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Katrina Kopf
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Gregory P Downey
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Kent Riemondy
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Harry A Smith
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Cecile S Rose
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Max A Seibold
- Center for Genes, Environment, and Health, National Jewish Health, Denver, CO 80206, USA
| | - Hong Wei Chu
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
| | - Brian J Day
- Department of Medicine, National Jewish Health, Denver, CO 80206, USA
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Short-Term Associations of Ambient Fine Particulate Matter (PM 2.5) with All-Cause Hospital Admissions and Total Charges in 12 Japanese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084116. [PMID: 33924698 PMCID: PMC8070111 DOI: 10.3390/ijerph18084116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 01/27/2023]
Abstract
The short-term association between ambient particulate matter ≤2.5 microns in diameter (PM2.5) and hospital admissions is not fully understood. Studies of this association with hospital admission costs are also scarce, especially in entire hospitalized populations. We examined the association between ambient PM2.5 and all-cause hospital admissions, the corresponding total charges, and the total charges per patient by analyzing the hospital admission data of 2 years from 628 hospitals in 12 cities in Japan. We used generalized additive models with quasi-Poisson regression for hospital admissions and generalized additive models with log-linear regression for total charges and total charges per patient. We first estimated city-specific results and the combined results by random-effect models. A total of 2,017,750 hospital admissions were identified. A 10 µg/m3 increase in the 2 day moving average was associated with a 0.56% (95% CI: 0.14–0.99%) increase in all-cause hospital admissions and a 1.17% (95% CI: 0.44–1.90%) increase in total charges, and a 10 µg/m3 increase in the prior 2 days was associated with a 0.75% (95% CI: 0.34–1.16%) increase in total charges per patient. Short-term exposure to ambient PM2.5 was associated with increased all-cause hospital admissions, total charges, and total charges per patient.
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Baek JO, Cho J, Roh JY. Associations between ambient air pollution and medical care visits for atopic dermatitis. ENVIRONMENTAL RESEARCH 2021; 195:110153. [PMID: 32926890 DOI: 10.1016/j.envres.2020.110153] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Previous studies have reported numerous environmental factors for atopic dermatitis (AD), such as allergens and chemical stimulants. However, few studies have addressed the relationship between ambient air pollution and AD at a population level. OBJECTIVE To evaluate the effect of air pollutants on medical care visits for AD and to identify susceptible populations. METHODS In this time-series study conducted on 513,870 medical care visits for AD from 2012 to 2015 identified by reviewing national health insurance claim data in Incheon, Republic of Korea. Treating daily number of medical care visits for AD as a dependent variable, generalized additive models with Poisson distributions were constructed, which included air pollutant levels, ambient temperature, relative humidity, day of the week, national holiday, and season. Risks were expressed as relative risks (RR) with 95% confidence intervals (95% CIs) per interquartile range increase of each air pollutant. RESULTS Higher levels of particulate matter of diameter ≤10 μm (PM10) (RR, 1.009; 95% CI, 1.007-1.012), ozone (1.028; 1.023-1.033), and sulfur dioxide (1.033; 1.030-1.037) were significantly associated with increased risk of medical care visits for AD on same days. In all age and sex groups, ozone was associated with a significantly higher risk of medical care visits, with the greatest risk among 13- to 18-year-old males (RR, 1.127; 95% CI, 1.095-1.159). CONCLUSION This study suggests relationships of ambient PM10, ozone, and sulfur dioxide levels with medical care visits for AD.
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Affiliation(s)
- Jin-Ok Baek
- Department of Dermatology, Gil Medical Center, Gachon University, Incheon, Republic of Korea
| | - Jaelim Cho
- Department of Dermatology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
| | - Joo-Young Roh
- Department of Dermatology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
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Cisneros R, Gharibi H, Entwistle MR, Tavallali P, Singhal M, Schweizer D. Nitrogen dioxide and asthma emergency department visits in California, USA during cold season (November to February) of 2005 to 2015: A time-stratified case-crossover analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 754:142089. [PMID: 33254941 DOI: 10.1016/j.scitotenv.2020.142089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 06/12/2023]
Abstract
Nitrogen dioxide (NO2) is responsible for aggravating respiratory diseases, particularly asthma. The aim of this study is to investigate the association between NO2 exposure and asthma emergency department (ED) visits during the cold season (November-February) in five populated locations (Sacramento, San Francisco, Fresno, Los Angeles, and San Diego) of California from 2005 to 2015 (1320 Days). Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with a 5 ppb increase in NO2 concentration for the 19,735 ED visits identified. An increase in NO2 exposure increased the odds of having asthma ED visits for the studied population. The potential effect modification by sex (female and male), race (White, Black, Hispanic, and Asian), and age (2-5, 6-18, 19-40, 41-64, and ≥65) was explored. A 5 ppb increase in the concentration of NO2 during lag 0-30 was associated with a 56% increase in the odds of having an asthma ED visit (OR = 1.560, CI: 1.428-1.703). Sex was not found to be a modifier. Asthma ED visits among all the races/ethnicities (except Asians) were associated with NO2 exposure. Whites had the highest OR 75% (OR = 1.750, CI: 1.417-2.160) at lag 0-30 in response to NO2 exposure. The association between NO2 exposure and asthma ED visits was positive among all age groups except for 19 to 40 years old; the OR was higher among 2 to 18 year old (at lag 0-30: age group 2-5 (OR = 1.699, CI: 1.399-2.062), and age group 6-18 (OR = 1.568, CI 1.348-1.825)). For stratification by location, San Diego and Fresno were found to have the highest OR, compared to the other studied locations.
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Affiliation(s)
- Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, USA.
| | - Hamed Gharibi
- Health Sciences Research Institute, University of California, Merced, USA.
| | | | - Pooya Tavallali
- Electrical Engineering and Computer Science, University of California, Merced, USA.
| | - Mukesh Singhal
- Electrical Engineering and Computer Science, University of California, Merced, USA.
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, USA; USDA Forest Service, Pacific Southwest Region, 1600 Tollhouse Road, Clovis, CA 93611, USA.
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15
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Li M, Tang J, Yang H, Zhao L, Liu Y, Xu H, Fan Y, Hong J, Long Z, Li X, Zhang J, Guo W, Liu M, Yang L, Lai X, Zhang X. Short-term exposure to ambient particulate matter and outpatient visits for respiratory diseases among children: A time-series study in five Chinese cities. CHEMOSPHERE 2021; 263:128214. [PMID: 33297172 DOI: 10.1016/j.chemosphere.2020.128214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 06/12/2023]
Abstract
There was limited evidence regarding the association between short-term exposure to ambient particulate matter (PM) and respiratory outpatient visits among children at a multicity level. In this study, a time-series study was conducted among children aged 0-14 years in five Chinese cities from 2013 to 2018. City-specific effects of fine particles (PM2.5), inhalable particles (PM10) and coarse particles (PM10-2.5) were estimated for time lags of zero up to seven previous days using the overdispersed generalized additive models after adjusting for time trends, meteorological variables, day of the week and holidays. Meta-analyses were applied to pool the overall effects, while the exposure-response (E-R) curves were evaluated using a cubic regression spline. The overall effects of PM were significantly associated with total and cause-specific respiratory outpatients among children, even at PM2.5 and PM10 levels below the current Chinese Ambient Air Quality Standards (CAAQS) Grade II. Each 10 μg/m3 increment in PM2.5, PM10 and PM10-2.5 at lag 07 was associated with a 1.39% (95% CI: 0.38%, 2.40%), 1.10% (95% CI: 0.38%, 1.83%) and 2.93% (95% CI: 1.05%, 4.84%) increase in total respiratory outpatients, respectively. An E-R relationship was observed except for PM2.5 in Beijing and PM10 and PM10-2.5 in Shanghai. The effects of PM were stronger in cold season in 3 southern cities, while it was stronger in transition season in 2 northern cities. In conclusion, short-term PM exposures were dose-responsive associated with increased respiratory outpatient visits among children, even for PM2.5 and PM10 levels below current CAAQS II in certain cities.
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Affiliation(s)
- Meng Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huihua Yang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lei Zhao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Ya Liu
- Department of Medical Record, Beijing Hospital, Beijing, China
| | - Haoli Xu
- Department of Healthcare, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yali Fan
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Jun Hong
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Zhen Long
- Department of Pediatric respiratory Medicine, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, HUST, Wuhan, China
| | - Xiaojuan Li
- Department of Medical Record and Statistics, Emergency General Hospital, Beijing, China
| | - Jianduan Zhang
- Department of Woman and Child's Care and Adolescence Health, School of Public Health, Tongji Medical College, HUST, Wuhan, China
| | - Wenting Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Miao Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
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16
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Byrwa-Hill BM, Venkat A, Presto AA, Rager JR, Gentile D, Talbott E. Lagged Association of Ambient Outdoor Air Pollutants with Asthma-Related Emergency Department Visits within the Pittsburgh Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8619. [PMID: 33233547 PMCID: PMC7699695 DOI: 10.3390/ijerph17228619] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/07/2020] [Accepted: 11/11/2020] [Indexed: 01/23/2023]
Abstract
Asthma affects millions of people globally and is especially concerning in populations living with poor air quality. This study examines the association of ambient outdoor air pollutants on asthma-related emergency department (ED) visits in children and adults throughout the Pittsburgh region. A time-stratified case-crossover design is used to analyze the lagged effects of fine particulate matter (PM2.5) and gaseous pollutants, e.g., ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) on asthma-related ED visits (n = 6682). Single-, double-, and multi-pollutant models are adjusted for temperature and analyzed using conditional logistic regression. In children, all models show an association between O3 and increased ED visits at lag day 1 (OR: 1.12, 95% CI, 1.03-1.22, p < 0.05) for the double-pollutant model (OR: 1.10, 95% CI: 1.01-1.20, p < 0.01). In adults, the single-pollutant model shows associations between CO and increased ED visits at lag day 5 (OR: 1.13, 95% CI, 1.00-1.28, p < 0.05) and average lag days 0-5 (OR: 1.22, 95% CI: 1.00-1.49, p < 0.05), and for NO2 at lag day 5 (OR: 1.04, 95% CI: 1.00-1.07, p < 0.05). These results show an association between air pollution and asthma morbidity in the Pittsburgh region and underscore the need for mitigation efforts to improve public health outcomes.
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Affiliation(s)
- Brandy M. Byrwa-Hill
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA
| | - Arvind Venkat
- Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA;
| | - Albert A. Presto
- Center for Atmospheric Particle Studies and Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - Judith R. Rager
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA; (J.R.R.); (E.T.)
| | | | - Evelyn Talbott
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA; (J.R.R.); (E.T.)
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17
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Yang H, Yan C, Li M, Zhao L, Long Z, Fan Y, Zhang Z, Chen R, Huang Y, Lu C, Zhang J, Tang J, Liu H, Liu M, Guo W, Yang L, Zhang X. Short term effects of air pollutants on hospital admissions for respiratory diseases among children: A multi-city time-series study in China. Int J Hyg Environ Health 2020; 231:113638. [PMID: 33080524 DOI: 10.1016/j.ijheh.2020.113638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/21/2022]
Abstract
Evidence concerning short-term acute association between air pollutants and hospital admissions for respiratory diseases among children in a multi-city setting was quite limited. We conducted a time-series analysis to evaluate the association of six common air pollutants with hospital admissions for respiratory diseases among children aged 0-14 years in 4 cities (Guangzhou, Shanghai, Wuhan and Xining), China during 2013-2018. We used generalized additive models incorporating penalized smoothing splines and random-effect meta-analysis to calculate city-specific and pooled estimates, respectively. The exposure-response relationship curves were fitted using the cubic spline regression. Subgroup analyses by gender, age, season and disease subtype were also performed. A total of 183,036 respiratory diseases hospitalizations were recorded during the study period, and 94.1% of the cases were acute respiratory infections. Overall, we observed that increased levels of air pollutants except O3, were significantly associated with increased hospital admissions for respiratory disease. Each 10 μg/m3 increase in PM2.5, SO2 and NO2 at lag 07, PM10 at lag 03 and per 1 mg/m3 increase in CO at lag 01 corresponded to increments of 1.19%, 3.58%, 2.23%, 0.51% and 6.10% in total hospitalizations, respectively. Generally, exposure-response relationships of PM2.5 and SO2 in Guangzhou, SO2, NO2 and CO in Wuhan, as well as SO2 and NO2 in Xining with respiratory disease hospitalizations were also found. Moreover, the adverse effects of these pollutants apart from PM2.5 in certain cities remained significant even at exposure levels below the current Chinese Ambient Air Quality Standards (CAAQS) Grade II. Children aged 4-14 years appeared to be more vulnerable to the adverse effects of PM2.5, SO2 and NO2. Furthermore, with the exception of O3, the associations were stronger in cold season than in warm season. Short-term exposure to PM2.5, SO2, NO2 and CO were associated, in dose-responsive manners, with increased risks of hospitalizations for childhood respiratory diseases, and adverse effects of air pollutants except PM2.5 held even at exposure levels below the current CAAQS Grade II in certain cities.
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Affiliation(s)
- Huihua Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Chunxiang Yan
- Wuhan Children's Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Meng Li
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lei Zhao
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Zhen Long
- Department of Pediatric Respiratory Medicine, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, HUST, Wuhan, China
| | - Yali Fan
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Zhonggang Zhang
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yihui Huang
- Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Congbin Lu
- Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jianduan Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Hua Liu
- The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Miao Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Wenting Guo
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
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Suh MG, Choi HS, Cho K, Park SS, Kim WJ, Suh HJ, Kim H. Anti-inflammatory action of herbal medicine comprised of Scutellaria baicalensis and Chrysanthemum morifolium. Biosci Biotechnol Biochem 2020; 84:1799-1809. [DOI: 10.1080/09168451.2020.1769464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abstract
Various mixtures were prepared depending on the mixing ratio of Scutellaria baicalensis hot water extract (SB-HW), and Chrysanthemum morifolium ethanol extract (CM-E) and their anti-inflammatory activity were compared. Among them, SB-HW (80 μg/mL)/CM-E (120 μg/mL) or SB-HW (40 μg/mL)/CM-E (160 μg/mL) significantly inhibited LPS-stimulated NO and IL-6 levels in RAW 264.7 cells. The SB-HW (80 μg/mL)/CM-E (120 μg/mL) mixture, which was determined as active mixture, significantly reduced MUC5AC secretion in PMA and LPS-induced NCI-H292 cells. The active mixture also reduced the production of PGE2 and IL-8 in PMA-induced A549 cells. LC-MS/MS analysis showed that the active mixture was composed of high contents of flavone glycosides, such as baicalin and cynaroside. Western blot analysis indicated that the active mixture suppressed phosphorylation of ERK, JNK, and p38, associating with the inhibition of MAPK signaling. Taken together, our results suggest that the active mixture could be applied as a new anti-inflammatory herbal medicine.
Abbreviations
JNK: c-Jun N-terminal kinases; COPD: chronic obstructive pulmonary disease; CM: Chrysanthemum morifolium; COX-2: cyclooxygenase-2; ERK: extracellular-signal-regulated kinase; IL-6: interleukin-6; IL-8: interleukin-8; IL-12: interleukin-12; LPS: lipopolysaccharide; MAPK: mitogen-activated protein kinase; NO: nitric oxide; NK- κB: nuclear factor kappa B; p38: p38 mitogen-activated protein kinases; PBS: phosphate buffered saline; PMA: phorbol-12-myristate-13-acetate; SB: Scutellaria baicalensis; PGE2: prostaglandin E2; TBST: Tris-buffered saline containing 0.1% Tween 20; TIC: total ion chromatogram; TNF-α: tumor necrosis factor-alpha
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Affiliation(s)
- Min Geun Suh
- Department of Integrated Biomedical and Life Science, Korea University, Seoul, Republic of Korea
| | - Hyeon-Son Choi
- Department of Food Science and Technology, Seoul Women’s University, Seoul, Republic of Korea
| | - Kyoungwon Cho
- R&D center, Chong Kun Dang Healthcare Corporation, Seoul, Republic of Korea
| | - Sung Sun Park
- R&D center, Chong Kun Dang Healthcare Corporation, Seoul, Republic of Korea
| | - Woo Jung Kim
- Biocenter, Gyeonggido Business & Science Accelerator, Suwon, Republic of Korea
| | - Hyung Joo Suh
- Department of Integrated Biomedical and Life Science, Korea University, Seoul, Republic of Korea
| | - Hoon Kim
- Skin-biotechnology Center, Kyunghee University, Seoul, Republic of Korea
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Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134846. [PMID: 32640508 PMCID: PMC7370127 DOI: 10.3390/ijerph17134846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/16/2022]
Abstract
Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities. This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas. A time-stratified case-crossover study was conducted using the hospitalization data from a children’s hospital and the air pollution data, including particulate matter 2.5 (PM2.5) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014. A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature. We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014. The single-pollutant models showed that PM2.5 concentration had a significant positive effect on risk for hospital readmissions (OR = 1.082, 95% CI = 1.008–1.162, p = 0.030). In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1.023, 95% CI = 1.001–1.045, p = 0.042) and PM2.5 concentrations (OR = 1.080, 95% CI = 1.005–1.161, p = 0.036). The effects of ambient air pollutants on hospital readmissions varied by age and season. Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients.
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Liu Y, Pan J, Zhang H, Shi C, Li G, Peng Z, Ma J, Zhou Y, Zhang L. Short-Term Exposure to Ambient Air Pollution and Asthma Mortality. Am J Respir Crit Care Med 2020; 200:24-32. [PMID: 30871339 DOI: 10.1164/rccm.201810-1823oc] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Rationale: Short-term exposure to air pollution has been associated with asthma exacerbation and increased healthcare use caused by asthma, but its effect on asthma mortality remains largely unknown. Objectives: To quantitatively assess the association between short-term exposure to air pollution and asthma mortality. Methods: We investigated 4,454 individuals who lived in Hubei province, China, and died from asthma between 2013 and 2018. A case-crossover design and conditional logistic regression models were applied for data analyses. Exposures to particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), particulate matter ≤10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were estimated by inverse distance weighted averages of all monitoring stations within 50 km from each case's home address. Measurements and Main Results: Each interquartile range (IQR) increase of PM2.5 (lag 3; IQR, 47.1 μg/m3), NO2 (lag 03; IQR, 26.3 μg/m3), and O3 (lag 3; IQR, 52.9 μg/m3) were positively associated with asthma mortality, with odds ratios of 1.07 (95% confidence interval, 1.01-1.12), 1.11 (95% confidence interval, 1.01-1.22), and 1.09 (95% confidence interval, 1.01-1.18), respectively. There was no evidence of departure from linearity for these associations. Further adjustment for other pollutants did not change the associations materially. We did not observe significant associations between PM10, SO2, and CO exposures and asthma mortality. Overall, the estimates remained consistent in various sensitivity analyses. Conclusions: Our results provide new evidence that short-term exposures to PM2.5, NO2, and O3 may increase asthma mortality risk. Further studies are needed to confirm our findings in other populations.
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Affiliation(s)
- Yuewei Liu
- 1 Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Jingju Pan
- 3 Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hai Zhang
- 2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Chunxiang Shi
- 4 National Meteorological Information Center, Beijing, China; and
| | - Guo Li
- 5 Department of Neurology, Tongji Hospital, and
| | - Zhe Peng
- 2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Jixuan Ma
- 6 Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Zhou
- 6 Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lan Zhang
- 3 Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
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Li X, Chen Q, Zheng X, Li Y, Han M, Liu T, Xiao J, Guo L, Zeng W, Zhang J, Ma W. Effects of ambient ozone concentrations with different averaging times on asthma exacerbations: A meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:549-561. [PMID: 31325855 DOI: 10.1016/j.scitotenv.2019.06.382] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/10/2019] [Accepted: 06/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Mounting evidence suggests that short-term exposure to ozone increases the risk of asthma exacerbations. However, ozone exposures have been assessed using ambient ozone concentrations averaged over different time periods in different studies. OBJECTIVE To evaluate the risks for asthma exacerbations related to ambient ozone measured as 1-hour or 8-hour daily maximum and 24-hour average concentrations. METHODS Based on a literature search in PubMed, EMBASE and Web of Science, we identified all time-series studies as of December 4th, 2018 and included 47 eligible studies in our analyses. Asthma exacerbation is defined as the risk for emergency room visits or hospital admissions. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) for a 10 μg/m3 increase in daily ozone concentration were estimated using random effect models. Subgroup analyses and sensitivity analyses were also performed to examine the risks for different seasons, regions and age groups and for the robustness of our main findings. RESULTS Significant and similar associations were found for O3-1 h max (RR,1.012; 95%CI, 1.005-1.019) and O3-8 h max (RR, 1.011; 95%CI, 1.007-1.014), while marginal effect was identified for O3-24 h average (RR, 1.005; 95%CI, 0.996-1.014). No significant publication bias but high heterogeneities were observed. During the warm season, ozone was significantly associated with asthma exacerbation. O3-1 h max had the highest RR of 1.014 (95%CI, 1.005-1.024), followed by O3-8 h max (RR, 1.012; 95%CI, 1.009-1.016), while marginal association was identified for O3-24 h avg (RR, 1.008; 95%CI, 0.998-1.017). During the cold season, null associations were identified for all the three averaging times. Variations were also observed in region and age. CONCLUSION Ozone exposure measured as 1-hour or 8-hour daily max were more consistently associated with asthma exacerbations than 24-hour average exposure during the warm season.
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Affiliation(s)
- Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China; Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Xueyan Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Yongzhi Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Min Han
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Junfeng Zhang
- Nicholas School of the Environment, Duke Global Health Institute, Duke University, Durham, NC 27705, USA; Duke Kunshan University, Kunshan, Jiangsu Province 215316, China.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China.
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Chang HH, Pan A, Lary DJ, Waller LA, Zhang L, Brackin BT, Finley RW, Faruque FS. Time-series analysis of satellite-derived fine particulate matter pollution and asthma morbidity in Jackson, MS. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:280. [PMID: 31254082 PMCID: PMC10072932 DOI: 10.1007/s10661-019-7421-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 03/20/2019] [Indexed: 05/10/2023]
Abstract
In order to examine associations between asthma morbidity and local ambient air pollution in an area with relatively low levels of pollution, we conducted a time-series analysis of asthma hospital admissions and fine particulate matter pollution (PM2.5) in and around Jackson, MS, for the period 2003 to 2011. Daily patient-level records were obtained from the Mississippi State Department of Health (MSDH) Asthma Surveillance System. Patient geolocations were aggregated into a grid with 0.1° × 0.1° resolution within the Jackson Metropolitan Statistical Area. Daily PM2.5 concentrations were estimated via machine-learning algorithms with remotely sensed aerosol optical depth and other associated parameters as inputs. Controlling for long-term temporal trends and meteorology, we estimated a 7.2% (95% confidence interval 1.7-13.1%) increase in daily all-age asthma emergency room admissions per 10 μg/m3 increase in the 3-day average of PM2.5 levels (current day and two prior days). Stratified analyses reveal significant associations between asthma and 3-day average PM2.5 for males and blacks. Our results contribute to the current epidemiologic evidence on the association between acute ambient air pollution exposure and asthma morbidity, even in an area characterized by relatively good air quality.
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Affiliation(s)
- Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Anqi Pan
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - David J Lary
- Hanson Center for Space Sciences, University of Texas at Dallas, 800 West Campbell Road Richardson, Dallas, TX, 75080, USA
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Lei Zhang
- Office of Health Data and Research, Mississippi State Department of Health, 570 East Woodrow Wilson, Jackson, MS, 39216, USA
| | - Bruce T Brackin
- Office of Epidemiology, Mississippi State Department of Health, 570 East Woodrow Wilson, Jackson, MS, 39216, USA
| | - Richard W Finley
- Department of Medicine, the University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - Fazlay S Faruque
- Department of Preventive Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA.
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23
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Wu J, Zhong T, Zhu Y, Ge D, Lin X, Li Q. Effects of particulate matter (PM) on childhood asthma exacerbation and control in Xiamen, China. BMC Pediatr 2019; 19:194. [PMID: 31196028 PMCID: PMC6563520 DOI: 10.1186/s12887-019-1530-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 05/08/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The short-term effects of particulate matter (PM) exposure on childhood asthma exacerbation and disease control rate is not thoroughly assessed in Chinese population yet. The previous toxic effects of PM exposure are either based on long-term survey or experimental data from cell lines or mouse models, which also needs to be validated by real-world evidences. METHODS We evaluated the short-term effects of PM exposure on asthma exacerbation in a Chinese population of 3106 pediatric outpatientsand disease control rate (DCR) in a population of 3344 children using case-crossover design. All the subjects enrolled are non-hospitalized outpatients. All data for this study were collected from the electronic health record (EHR) in the period between January 1, 2016 and June 30, 2018 in Xiamen, China. RESULTS We found that exposure to PM2.5 and PM10 within the past two weeks was significantly associated with elevated risk of exacerbation (OR = 1.049, p < 0.001 for PM2.5and OR = 1.027, p < 0.001 for PM10). In addition, exposure to PM10 was associated with decreased DCR (OR = 0.976 for PM10, p < 0.001). CONCLUSIONS Our results suggest that exposure to both PM10 and PM2.5 has significant short-term effects on childhood asthma exacerbation and DCR, which serves as useful epidemiological parameters for clinical management of asthma risk in the sensitive population.
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Affiliation(s)
- Jinzhun Wu
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003 China
| | - Taoling Zhong
- National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, South Xiang’an Road, Xiamen, 361102 China
| | - Yu Zhu
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003 China
| | - Dandan Ge
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003 China
| | - Xiaoliang Lin
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003 China
| | - Qiyuan Li
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003 China
- National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, South Xiang’an Road, Xiamen, 361102 China
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Nhung NTT, Schindler C, Dien TM, Probst-Hensch N, Künzli N. Association of ambient air pollution with lengths of hospital stay for hanoi children with acute lower-respiratory infection, 2007-2016. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 247:752-762. [PMID: 30721866 DOI: 10.1016/j.envpol.2019.01.115] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/26/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The association between ambient air pollution and length of hospital stay (LOS) for children with lower-respiratory infection is unclear. MATERIALS AND METHODS The association was examined using admission data for 75,432 children in Hanoi, aged 0-5 years, hospitalized with acute lower-respiratory infection (ALRI) and daily air pollutant levels in Hanoi between 2007 and 2016. We estimated the odds ratio of being discharged for an interquartile range (IQR) increment (IQR) of ambient pollutants during one to four days prior to admission date. We used pooled logistic regression models including a B-spline function of calendar time and terms describing the baseline odds, adjusting for meteorological factors, age, gender, residential location, week-day of admission, discharge on weekends or holidays, and number of respiratory hospitalizations one day prior to the discharge date. RESULTS An IQR increase in O3 concentrations (85.8 μg/m3) was associated with a 5% (95%CI: 2%-8%) decrease in the odds of discharge from hospital among children with ALRI. Results were similar for PM10, but only for children aged 2-5 years. For the other pollutants, corresponding associations were close to null or in the opposite direction. For example, increase in CO was associated with shorter LOS. CONCLUSIONS Our study provides the first investigation of the associations between lengths of hospital stays and air pollutant levels prior to hospitalization in Asian children. Increased levels of O3 prior to admission predicted prolonged hospitalizations. The inconsistencies in the findings for other pollutants call for further investigations.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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25
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Zhang Z, Chai P, Wang J, Ye Z, Shen P, Lu H, Jin M, Gu M, Li D, Lin H, Chen K. Association of particulate matter air pollution and hospital visits for respiratory diseases: a time-series study from China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:12280-12287. [PMID: 30840253 DOI: 10.1007/s11356-019-04397-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/25/2019] [Indexed: 05/13/2023]
Abstract
Fine particulate matter (PM2.5) is a mixture of multiple components, which is associated with several chronic diseases, including respiratory and cardiovascular diseases. We evaluated the association between daily PM2.5 and PM2.5-10 exposure and hospital visits for respiratory diseases. Hospital visits for respiratory diseases were collected from Yinzhou Health Information System database. We used generalized additive models to examine the excess relative risk (ERR) and 95% confidence interval for hospital visits for respiratory diseases associated with each 10-μg/m3 increase in PM2.5 and PM2.5-10 concentration. Non-linear exposure-response relationship between PM exposure and hospital visits for respiratory diseases was evaluated by a smooth spline. The ERRs for hospital visits for respiratory diseases associated with a 10-μg/m3 increase in the 6-day cumulative average concentration of PM2.5 and PM2.5-10 were 5.40 (95% CI 2.32, 8.57) and 6.37% (95% CI 1.84, 11.10), respectively. The findings remained stable when we adjusted other gaseous air pollution. PM2.5 and PM2.5-10 were associated with the increased visits for the acute upper respiratory infection, pneumonia, asthma, and COPD. In this time-series study, we found a positive association between daily particulate matter exposure and hospital visits for respiratory diseases.
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Affiliation(s)
- Zhenyu Zhang
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
| | - Pengfei Chai
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, 215100, Zhejiang, China
| | - Jianbing Wang
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China
| | - Zhenhua Ye
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China
| | - Peng Shen
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, 215100, Zhejiang, China
| | - Huaichu Lu
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, 215100, Zhejiang, China
| | - Mingjuan Jin
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China
| | - Mengjia Gu
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China
| | - Die Li
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China
| | - Hongbo Lin
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, 215100, Zhejiang, China.
| | - Kun Chen
- Welch Center for Prevention, Epidemiology and Clinical Research Department of Epidemiology, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, 21205, USA.
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang, China.
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26
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Bae S, Kwon HJ. Current State of Research on the Risk of Morbidity and Mortality Associated with Air Pollution in Korea. Yonsei Med J 2019; 60:243-256. [PMID: 30799587 PMCID: PMC6391524 DOI: 10.3349/ymj.2019.60.3.243] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The effects of air pollution on health can vary regionally. Our goal was to comprehensively review previous epidemiological studies on air pollution and health conducted in Korea to identify future areas of potential study. MATERIALS AND METHODS We systematically searched all published epidemiologic studies examining the association between air pollution and occurrence of death, diseases, or symptoms in Korea. After classifying health outcomes into mortality, morbidity, and health impact, we summarized the relationship between individual air pollutants and health outcomes. RESULTS We analyzed a total of 27 studies that provided 104 estimates of the quantitative association between risk of mortality and exposure to air pollutants, including particulate matter with aerodynamic diameter less than 10 μm, particulate matter with aerodynamic diameter less than 2.5 μm, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide in Korea between January 1999 and July 2018. Regarding the association with morbidity, there were 38 studies, with 98 estimates, conducted during the same period. Most studies examined the short-term effects of air pollution using a time series or case-crossover study design; only three cohort studies that examined long-term effects were found. There were four health impact studies that calculated the attributable number of deaths or disability-adjusted life years due to air pollution. CONCLUSION There have been many epidemiologic studies in Korea regarding air pollution and health. However, the present review shows that additional studies, especially cohort and experimental studies, are needed to provide more robust and accurate evidence that can be used to promote evidence-based policymaking.
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Affiliation(s)
- Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
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27
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Fan F, Lei Y, Li L. Health damage assessment of particulate matter pollution in Jing-Jin-Ji region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:7883-7895. [PMID: 30684179 DOI: 10.1007/s11356-018-04116-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/27/2018] [Indexed: 05/21/2023]
Abstract
Jing-Jin-Ji is the largest and most dynamic economic region in northern China, and its air pollution has attracted much public attention. Scientific evaluation of health losses caused by air pollution can provide decision-making basis for formulation and improvement of pollution reduction policies in the Jing-Jin-Ji region. This paper estimated the adverse effects of particulate matter pollution on health in the Jing-Jin-Ji region in 2016 by using logarithmic linear exposure-response function, and monetized the health effects by adjusting human capital method and disease cost method. The results show non-ignorable health hazards and economic impacts caused by atmospheric particulate pollution. The economic losses relevant to health hazards by PM2.5 in the Jing-Jin-Ji region are 122.40 billion yuan, and those relevant to PM10 are 118.34 billion yuan, accounting for 1.62% and 1.56% of the region's GDP, respectively. Similar evaluations previously conducted in other countries yielded figures within the same order of magnitude. Considering the difference in economic losses per unit among disease types, the economic losses caused by air pollution in the Jing-Jin-Ji region mainly come from premature deaths. Infants and elderly people are the main victims of particulate matter. Affected by population, pollutant concentration, industrial structure, and other factors, the economic losses of particulate matter pollution in Beijing, Tianjin, Shijiazhuang, Tangshan, and Baoding are large. In order to reduce health hazards and economic impacts caused by particulate matter pollution, this paper put forward to guide the urban population diversion, reduce the outgoing frequency of susceptible groups such as infants and the elderly in haze weather, adopt high-efficiency particulate matter air purifier indoors, and develop public transportation to reduce motor vehicle exhaust emissions. In Tianjin and Hebei, promoting cleaner production in industries such as steel and cement and reducing coal use in the power industry are also suggested.
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Affiliation(s)
- Fengyan Fan
- Research Center for Strategy of Global Mineral Resources, Chinese Academy of Geological Sciences, Beijing, 100037, China
- Institute of Mineral Resources, Chinese Academy of Geological Sciences, Beijing, 100037, China
- MNR Key Laboratory of Saline Lake Resources and Environments, Institute of Mineral Resources, GAGS, Beijing, 100037, China
| | - Yalin Lei
- School of Humanities and Economic Management, China University of Geosciences, Beijing, 100083, China.
- Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Natural Resources, Beijing, 100083, China.
| | - Li Li
- School of Humanities and Economic Management, China University of Geosciences, Beijing, 100083, China
- Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Natural Resources, Beijing, 100083, China
- State Key Laboratory of Water Resource Protection and Utilization in Coal Mining, Beijing, 100011, China
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28
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Yang SI. Particulate matter and childhood allergic diseases. KOREAN JOURNAL OF PEDIATRICS 2018; 62:22-29. [PMID: 30404430 PMCID: PMC6351801 DOI: 10.3345/kjp.2018.07045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
Particulate matter (PM) is a ubiquitous air pollutant that is a growing public health concern. Previous studies have suggested that PM is associated with asthma development and exacerbation of asthma symptoms. Although several studies have suggested increased risks of atopic dermatitis, allergic rhinitis, and allergic sensitization in relation to PM exposure, the evidence remains inconsistent. The plausible mechanisms underlying these effects are related to oxidative stress, enhancement of sensitization to allergens, inflammatory and immunological responses, and epigenetics. This review discusses the effect of PM on childhood allergic diseases, along with plausible mechanisms. Further studies are required to understand the role of PM exposure on childhood allergic diseases, to reduce these diseases in children.
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Affiliation(s)
- Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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29
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Tian Y, Liu H, Liang T, Xiang X, Li M, Juan J, Song J, Cao Y, Wang X, Chen L, Wei C, Gao P, Hu Y. Ambient air pollution and daily hospital admissions: A nationwide study in 218 Chinese cities. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 242:1042-1049. [PMID: 30096542 DOI: 10.1016/j.envpol.2018.07.116] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/09/2018] [Accepted: 07/24/2018] [Indexed: 06/08/2023]
Abstract
There have been few large multicity studies to evaluate the acute health effects of ambient air pollution on morbidity risk in developing counties. In this study, we examined the short-term associations of air pollution with daily hospital admissions in China. We conducted a nationwide time-series study in 218 Chinese cities between 2014 and 2016. Data on daily hospital admissions counts were obtained from the National Health Insurance Database for Urban Employees covering 0.28 billion enrollees. We used generalized additive model with Poisson regression to estimate the associations in each city, and we performed random-effects meta-analysis to pool the city-specific estimates. More than 60 million hospital admissions were analyzed in this study. At the national-average level, each 10 μg/m3 increase in PM10, SO2, and NO2, and 1 mg/m3 increase in CO at lag 0 day was associated with a 0.29% (95% CI, 0.23%-0.36%), 1.16% (95% CI, 0.92%-1.40%), 1.68% (95% CI, 1.40%-1.95%), and 2.59% (95% CI, 1.69%-3.50%) higher daily hospital admissions, respectively. The associations of air pollution with hospital admissions remained statistically significant at levels below the current Chinese Ambient Air Quality Standards. The effect estimates were larger in cities with lower air pollutants levels or higher air temperatures and relative humidity, as well as in the elderly. In conclusion, our findings provide robust evidence of increased hospital admissions in association with short-term exposure to ambient air pollution in China.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China; Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Tianlang Liang
- Beijing HealthCom Data Technology Co.Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Libo Chen
- Beijing HealthCom Data Technology Co.Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071, Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology Co.Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China.
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China.
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30
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Seposo X, Kondo M, Ueda K, Honda Y, Michikawa T, Yamazaki S, Nitta H. Health impact assessment of PM 2.5-related mitigation scenarios using local risk coefficient estimates in 9 Japanese cities. ENVIRONMENT INTERNATIONAL 2018; 120:525-534. [PMID: 30153646 DOI: 10.1016/j.envint.2018.08.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/25/2018] [Accepted: 08/16/2018] [Indexed: 06/08/2023]
Abstract
Previous studies have highlighted the negative effects of PM2.5 on mortality, expressed in terms of attributable deaths and life years lost. However, there are very few studies assessing the health impacts of air pollution in terms of economic burden/benefits. This study assessed the health impact of two hypothetical interventions among sex- and age-specific risk populations using a robust risk estimation and economic valuation process. We utilized the sex- and age-stratified daily all-cause mortality together with the daily PM2.5 of the 9 Japanese cities from 2002 to 2008 in estimating the relative risks. The estimated risks were then utilized for the economic valuation of co-benefits/burden with respect to the two hypothetical PM2.5-related mitigation scenarios, in comparison to status quo, namely: i) decrease to Japanese standards, and ii) decrease to WHO standards. Impact of these interventions on health were assessed using the following HIA metrics: attributable mortality, attributable years life lost, and environmental health impact. A 10-μg/m3 increase in PM2.5 would increase the risk by 0.52% (95% CI: -0.91% to 1.99%) for all-cause mortality, with varying risk estimates per subgroup. High economic burdens were estimated at status quo, with particularly distinct burden difference for age-specific mortality; 0.40 trillion yen (0-64 y.o.) and 1.50 trillion yen (>64 y.o.). If stricter standards, relative to status quo, were to be enforced, i.e. WHO standard, there is a potential to yield economic benefits in the same risk population; 0.26 trillion yen (0-64 y.o.) and 0.98 trillion yen (>64 y.o.). We did not observe any substantial difference with the burden and benefit related to sex-specific mortality. Using the estimated local risk coefficients complemented with the valuation of the risks, policymaking entities will have the opportunity to operate their own HIA to assess the relevant air pollution-related health impacts.
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Affiliation(s)
- Xerxes Seposo
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Department of Global Ecology, Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan.
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Department of Global Ecology, Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Takehiro Michikawa
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Shin Yamazaki
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Hiroshi Nitta
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
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Gharibi H, Entwistle MR, Ha S, Gonzalez M, Brown P, Schweizer D, Cisneros R. Ozone pollution and asthma emergency department visits in the Central Valley, California, USA, during June to September of 2015: a time-stratified case-crossover analysis. J Asthma 2018; 56:1037-1048. [PMID: 30299181 DOI: 10.1080/02770903.2018.1523930] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: The San Joaquin Valley (SJV) exceeds the state and national standards for ozone (O3). This study investigates whether short-term exposure to O3 is associated with asthma emergency department (ED) visits. Methods: We identified 1,101 ED visits in June-September of 2015 in SJV, California, who lived within 15 km of active air monitors. Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with an interquartile (IQR) increase in ozone. We explored the potential effect modification by sex (female and male), race (White, Black and Hispanic), age (2-5, 6-18, 19-40, 41-64 and > = 65) and county (Merced, Madera, Kings, Fresno and Kern). Results: An IQR range (18.1 ppb) increase in O3 exposure three days before an asthma attack (lag 3) was associated with a 6.6% [OR: 1.066 (95% CI: 1.032, 1.082)] increase in the odds of having an asthma ED visit. The overall ORs differed across age groups and races/ethnicities, with strongest for children aged 6-18 years [OR: 1.219 (95% CI: 1.159, 1.280)], adults 19-40 years [OR: 1.102 (95% CI: 1.053, 1.154)] and Blacks [OR: 1.159 (95% CI: 1.088, 1.236)], respectively. O3 exposure was not positively associated with asthma ED visits for Whites, while it was for other underrepresented groups. Fresno had the highest number of asthma ED visits and positive association among all five counties. Conclusion: We found that O3 exposure is associated with asthma ED visits in the SJV.
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Affiliation(s)
- Hamed Gharibi
- Department of Public Health, College of Social Sciences, Humanities and Arts, University of California, Merced, CA, USA.,Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Marcela R Entwistle
- Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Sandie Ha
- Department of Public Health, College of Social Sciences, Humanities and Arts, University of California, Merced, CA, USA.,Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Mariaelena Gonzalez
- Department of Public Health, College of Social Sciences, Humanities and Arts, University of California, Merced, CA, USA.,Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Paul Brown
- Department of Public Health, College of Social Sciences, Humanities and Arts, University of California, Merced, CA, USA.,Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, CA, USA.,USDA Forest Service, Pacific Southwest Region, Clovis, CA, USA
| | - Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, CA, USA
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Ambient Particulate Matter Concentrations and Hospital Admissions in 26 of China’s Largest Cities. Epidemiology 2018; 29:649-657. [DOI: 10.1097/ede.0000000000000869] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tian Y, Xiang X, Juan J, Song J, Cao Y, Huang C, Li M, Hu Y. Short-term Effect of Ambient Ozone on Daily Emergency Room Visits in Beijing, China. Sci Rep 2018; 8:2775. [PMID: 29426845 PMCID: PMC5807436 DOI: 10.1038/s41598-018-21154-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/30/2018] [Indexed: 12/30/2022] Open
Abstract
Little is known about the acute effects of ozone on morbidity risk in China. We conducted a time-series study to examine the association between ozone and daily emergency room visits (ERVs) in Beijing, China. We identified 7,088,309 ERVs between January 1, 2014 and December 31, 2015. A generalized additive model with Poisson regression incorporating penalized spline functions was employed to analyze ERVs in association with daily 8-h maximum ozone concentrations. An increase of 10 μg/m3 of same-day ozone concentration was significantly associated with a 0.24% (95% CI, 0.21%–0.26%), 0.31% (95% CI, 0.27%–0.35%), and 0.43% (95% CI, 0.36%–0.50%) increase in daily ERVs for the whole study period, days when the daily 8-h maximum ozone met the Chinese Ambient Air Quality Standards (CAAQS) Grade II standard, and days that met the CAAQS Grade I standard, respectively. These results were robust when considering the potential confounding effects of PM2.5, PM10, NO2, SO2, and CO. In conclusion, our findings suggested significant effects of ozone exposure on daily ERVs in Beijing. Improving air quality with even lower ozone level than the current CAAQS could yield important public health.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Chao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China.
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Tian Y, Xiang X, Juan J, Sun K, Song J, Cao Y, Hu Y. Fine particulate air pollution and hospital visits for asthma in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:227-233. [PMID: 28654880 DOI: 10.1016/j.envpol.2017.06.029] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 06/07/2023]
Abstract
Data on fine particulate matter (PM2.5) in China were first announced in 2013. The primary objective of this study was to evaluate the acute effects of PM2.5 on asthma morbidity in Beijing, China. A total of 978,658 asthma hospital visits consisting of 928,607 outpatient visits, 40,063 emergency room visits and 9988 hospital admissions from January 1, 2010, to June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to explore the association between PM2.5 and health service use. The mean daily PM2.5 concentration was 99.5 μg/m3 with a range from 7.2 μg/m3 to 492.8 μg/m3. Ambient PM2.5 concentration was significantly associated with increased use of asthma-related health services. Every 10 μg/m3 increase in PM2.5 concentration on the same day was significantly associated with a 0.67% (95% CI, 0.53%-0.81%), 0.65% (95% CI, 0.51%-0.80%), and 0.49% (95% CI, 0.35%-0.64%) increase in total hospital visits, outpatient visits and emergency room visits, respectively. The exposure-response association between PM2.5 concentration and hospital visits for asthma exacerbations was approximately linear. In conclusion, this study found that short-term elevations in PM2.5 concentration may increase the risk of asthma exacerbations. Our findings contribute to the limited scientific literature concerning the acute effects of PM2.5 on asthma morbidity outcomes in developing countries.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Kexin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
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35
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Associations of particulate matter and its components with emergency room visits for cardiovascular and respiratory diseases. PLoS One 2017; 12:e0183224. [PMID: 28813509 PMCID: PMC5557583 DOI: 10.1371/journal.pone.0183224] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 08/01/2017] [Indexed: 11/19/2022] Open
Abstract
Numerous studies have revealed an association between particulate matter (PM) and emergency room (ER) visits, although few studies have investigated the association between health and PM components. The present study evaluated the associations of ER visits for cardiovascular and respiratory diseases with PM2.5 components, including organic carbon (OC), elemental carbon (EC), and ion species (SO42-, NO3-, and NH4+). Statistical analyses were performed using the time-series approach, and generalized linear models with natural spline functions were used to adjust for the non-linear relationship between the confounders and ER visits. Our single-pollutant models revealed that the greatest increase in cardiovascular ER visits was associated with NH4+ (relative risk: 1.05; 95% confidence interval: 1.01–1.09), which was followed by OC, SO42-, NO3-, and EC. The associations of cardiovascular ER visits with EC and OC varied according to age and sex, with elderly and female patients exhibiting stronger associations. Lagged SO42- was associated with respiratory ER visits. To the best of our knowledge, this is the first study to evaluate the associations between ER visits and PM components in South Korea. As PM components are related to traffic and industrial sources, and exhibited positive associations with ER visits, our results may help improve air pollution regulation and public health.
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36
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Rietbergen C, Debray TPA, Klugkist I, Janssen KJM, Moons KGM. Reporting of Bayesian analysis in epidemiologic research should become more transparent. J Clin Epidemiol 2017; 86:51-58.e2. [PMID: 28428139 DOI: 10.1016/j.jclinepi.2017.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/13/2017] [Accepted: 04/07/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of this systematic review is to investigate the use of Bayesian data analysis in epidemiology in the past decade and particularly to evaluate the quality of research papers reporting the results of these analyses. STUDY DESIGN AND SETTING Complete volumes of five major epidemiological journals in the period 2005-2015 were searched via PubMed. In addition, we performed an extensive within-manuscript search using a specialized Java application. Details of reporting on Bayesian statistics were examined in the original research papers with primary Bayesian data analyses. RESULTS The number of studies in which Bayesian techniques were used for primary data analysis remains constant over the years. Though many authors presented thorough descriptions of the analyses they performed and the results they obtained, several reports presented incomplete method sections and even some incomplete result sections. Especially, information on the process of prior elicitation, specification, and evaluation was often lacking. CONCLUSION Though available guidance papers concerned with reporting of Bayesian analyses emphasize the importance of transparent prior specification, the results obtained in this systematic review show that these guidance papers are often not used. Additional efforts should be made to increase the awareness of the existence and importance of these checklists to overcome the controversy with respect to the use of Bayesian techniques. The reporting quality in epidemiological literature could be improved by updating existing guidelines on the reporting of frequentist analyses to address issues that are important for Bayesian data analyses.
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Affiliation(s)
- Charlotte Rietbergen
- Department of Methodology and Statistics, Utrecht University, Padualaan 14, Utrecht 3584 CH, The Netherlands.
| | - Thomas P A Debray
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands; Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Irene Klugkist
- Department of Methodology and Statistics, Utrecht University, Padualaan 14, Utrecht 3584 CH, The Netherlands; Section of Research Methodology, Measurement and Data Analysis, Department of Behavioural, Management and Social Sciences, Twente University, P.O. Box 217, Enschede 7500 AE, The Netherlands
| | - Kristel J M Janssen
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Karel G M Moons
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
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Allergies in urban versus countryside settings in Poland as part of the Epidemiology of the Allergic Diseases in Poland (ECAP) study - challenge the early differential diagnosis. Postepy Dermatol Alergol 2016; 33:359-368. [PMID: 28182031 PMCID: PMC5110618 DOI: 10.5114/pdia.2016.61338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/02/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction The incidence of allergies depends on a number of factors, including adopting
an urban “western” lifestyle, genetic predispositions, and
different regions of residence. Aim To compare the prevalence of allergic conditions (seasonal allergic rhinitis
(SAR) and perennial allergic rhinitis (PAR), bronchial asthma (BA), atopic
dermatitis (AD)) in a group of countryside versus urban residents in
Poland. Material and methods The prevalence of allergic conditions in urban versus countryside settings
was assessed using the translated and approved questionnaire developed for
international ECRHS II and ISAAC studies. Respondents were selected via
random multistage sampling, with proportionate stratified sampling, and the
Polish Resident Identification Number (PESEL) as the basis. A total of
18,617 respondents took part in the study. Subsequently, approximately 25%
of the subjects underwent outpatient assessments: skin-prick, lung function,
peak nasal inspiratory flow (PNIF) tests, as well as history-taking. Results Allergic rhinitis (AR) proved to be the most common condition in the entire
study population. Children residing in the countryside were twice more
likely to be diagnosed with BA (8.33% vs. 4%; p <
0.05). Conversely, in the adult subgroup, BA was more commonly observed in
urban areas. Whereas reported symptom rates were much higher in AR and AD
patients, symptomatic BA was proportionately lower with respect to the
official diagnoses (underdiagnosed BA phenomenon). Atopic dermatitis was
considerably more common in the metropolitan population. One factor that
significantly correlated with allergic diseases was a positive family
history. Conclusions Inhabitants of metropolitan areas are to a greater extent predisposed to
allergic conditions. One factor significantly contributing to allergies is
genetic predisposition. Given the scale of the problem, there is an urgent
need to implement measures for early prevention and diagnosis of allergies
to minimize distant health effects.
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Sohn J, You SC, Cho J, Choi YJ, Joung B, Kim C. Susceptibility to ambient particulate matter on emergency care utilization for ischemic heart disease in Seoul, Korea. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:19432-19439. [PMID: 27380182 DOI: 10.1007/s11356-016-7144-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 06/23/2016] [Indexed: 06/06/2023]
Abstract
Many epidemiological studies have reported associations between ambient particulate matter (PM) and cardiovascular diseases. However, the effects associated with PM that promote cardiovascular events among susceptible populations who may respond differently than the general population to the same ambient air pollutants remain unclear. We conducted a time-series study with generalized additive models to assess the association between ambient PM10 and emergency department (ED) visits for ischemic heart disease (IHD) in Seoul, Republic of Korea from 2005 to 2009. The ED data and previous medical records within the 5 years of each IHD event to examine the effect of PM10 in a susceptible population were obtained from Health Insurance Review and Assessment Service. Overall, the adjusted relative risks (RRs) of ED visits for IHD were not statistically significant for PM10, but significant positive RRs were found for groups with hypertension (1.018; 95 % confidence interval [CI] 1.002-1.035) and those who are ≥80 years of age (1.019; 1.002-1.037) for same-day exposure and with diabetes (1.019; 1.002-1.037) for single-lag models. Subgroup analyses revealed gender differences in ED visits for IHD in hypertensive patients and those who are ≥80 years of age; positive correlations were found only in males with the lag models. Our study suggests that ambient PM10 is significantly associated with ED visits for IHD, especially in males with hypertension, diabetes mellitus, or who are aged ≥80 years. Identification of populations susceptible to air pollution is of paramount importance to establishing recommendations or guidelines for high-risk individuals.
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Affiliation(s)
- Jungwoo Sohn
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Seng Chan You
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Jaelim Cho
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Yoon Jung Choi
- Health Insurance Review & Assessment Service, 267 Hyoyeong-ro, Seocho-gu, Seoul, 137-706, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Chen K, Glonek G, Hansen A, Williams S, Tuke J, Salter A, Bi P. The effects of air pollution on asthma hospital admissions in Adelaide, South Australia, 2003-2013: time-series and case-crossover analyses. Clin Exp Allergy 2016; 46:1416-1430. [PMID: 27513706 DOI: 10.1111/cea.12795] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 07/15/2016] [Accepted: 07/17/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND Air pollution can have adverse health effects on asthma sufferers, but the effects vary with geographic, environmental and population characteristics. There has been no long time-series study in Australia to quantify the effects of environmental factors including pollen on asthma hospitalizations. OBJECTIVES This study aimed to assess the seasonal impact of air pollutants and aeroallergens on the risk of asthma hospital admissions for adults and children in Adelaide, South Australia. METHODS Data on hospital admissions, meteorological conditions, air quality and pollen counts for the period 2003-2013 were sourced. Time-series analysis and case-crossover analysis were used to assess the short-term effects of air pollution on asthma hospitalizations. For the time-series analysis, generalized log-linear quasi-Poisson and negative binomial regressions were used to assess the relationships, controlling for seasonality and long-term trends using flexible spline functions. For the case-crossover analysis, conditional logistic regression was used to compute the effect estimates with time-stratified referent selection strategies. RESULTS A total of 36,024 asthma admissions were considered. Findings indicated that the largest effects on asthma admissions related to PM2.5 , NO2 , PM10 and pollen were found in the cool season for children (0-17 years), with the 5-day cumulative effects of 30.2% (95% CI: 13.4-49.6%), 12.5% (95% CI: 6.6-18.7%), 8.3% (95% CI: 2.5-14.4%) and 4.2% (95% CI: 2.2-6.1%) increases in risk of asthma hospital admissions per 10 unit increments, respectively. The largest effect for ozone was found in the warm season for children with the 5-day cumulative effect of an 11.7% (95% CI: 5.8-17.9%) increase in risk of asthma hospital admissions per 10 ppb increment in ozone level. CONCLUSION Findings suggest that children are more vulnerable and the associations between exposure to air pollutants and asthma hospitalizations tended to be stronger in the cool season compared to the warm season, with the exception of ozone. This study has important public health implications and provides valuable evidence for the development of policies for asthma management.
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Affiliation(s)
- K Chen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - G Glonek
- School of Mathematical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - A Hansen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - S Williams
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - J Tuke
- School of Mathematical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - A Salter
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - P Bi
- School of Public Health, University of Adelaide, Adelaide, SA, Australia.
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Noh J, Sohn J, Cho J, Cho SK, Choi YJ, Kim C, Shin DC. Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History. J Prev Med Public Health 2016; 49:329-341. [PMID: 27744674 PMCID: PMC5066424 DOI: 10.3961/jpmph.16.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 09/08/2016] [Indexed: 01/29/2023] Open
Abstract
Objectives The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients’ prior history of allergic diseases. Methods Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [NO2], ozone [O3], sulfur dioxide [SO2], and particulate matter with an aerodynamic diameter <10 μm [PM10]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in O3 concentration. IQR changes in NO2 and PM10 concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in PM10 concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.
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Affiliation(s)
- Juhwan Noh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jungwoo Sohn
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jaelim Cho
- Department of Occupational and Environmental Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Seong-Kyung Cho
- Department of Medical Informatics and Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Jung Choi
- Health Insurance Review and Assessment Service, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Chun Shin
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea
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Ding PH, Wang GS, Chen BY, Wan GH. Urban Air Pollution in Taiwan before and after the Installation of a Mass Rapid Transit System. JOURNAL OF ENVIRONMENTAL QUALITY 2016; 45:1731-1739. [PMID: 27695753 DOI: 10.2134/jeq2015.08.0432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Urbanization causes air pollution in metropolitan areas, coupled with meteorological factors that affect air quality. Although previous studies focused on the relationships of urbanization, air pollution, and climate change in Western countries, this study evaluated long-term variations of air quality and meteorological factors in Taiwanese metropolitan areas (Taipei area, Taichung City, and Kaohsiung City) and a rural area (Hualien County) between 1993 and 2012. The influence of a mass rapid transit (MRT) system on air quality was also evaluated. Air pollutant concentrations and meteorology data were collected from Taiwan Environmental Protection Administration (TEPA) air monitoring stations and Central Weather Bureau stations in the surveyed areas, respectively. Analyses indicate that levels of air pollution in metropolitan areas were greater than in the rural area. Kaohsiung City had the highest levels of O, SO, and particulate matter 2.5 or 10 µm in diameter (PM and PM). Clear downward trends for CO, NO, PM, PM, and especially SO concentrations were found in the surveyed areas, whereas O showed no decrease. Both O and PM concentrations showed similar bimodal seasonal distributions. Taiwan's air quality has improved significantly since 1993, indicating the effectiveness of promoting air pollution strategies and policies by the TEPA. Air pollution had an obvious improvement in Taipei area after the MRT system began operations in 1996. Because global climate may potentially affect urban air pollution in Taiwan, further study to clarify the mechanisms by which air pollution may affect human health and other biological effects is warranted.
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Zhang S, Li G, Tian L, Guo Q, Pan X. Short-term exposure to air pollution and morbidity of COPD and asthma in East Asian area: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2016; 148:15-23. [PMID: 26995350 DOI: 10.1016/j.envres.2016.03.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND The association between short-term exposure to air pollution and morbidity of COPD and asthma has been observed in many studies. However, there is a lack of systematic review of the overall risk ratios in East Asian area to provide scientific evidence for health risk assessment. METHODS A systematic literature retrieval was conducted in December 2014. The results from eligible studies were stratified by pollutants, diseases, types of hospital utilization, and age groups of the subject. For each pollutant-outcome pair, meta-analysis was conducted to calculate the pooled risk ratios (RR) with 95% confidence intervals for every 10μg/m(3) increase in pollutants (1mg/m(3) in CO). We also performed meta-regression to explore the source of heterogeneity and funnel plots to detect publication bias. RESULTS Based on results from 26 studies, statistically significant pooled RRs of different pollutants and age groups ranged from 1.007 (SO2 in all ages) to 1.028 (O3 in all ages) for COPD general hospital admissions, 1.011 (SO2 in all ages) to 1.028 (O3 in all ages) for COPD emergency hospital admissions, 1.013 (PM10 in all ages) to 1.141 (CO in children) for all-type asthma hospital utilization, 1.010 (PM10 in all ages) to 1.141 (CO in children) for asthma general hospital admissions, and 1.009 (SO2 in all ages) to 1.040 (NO2 in children) for asthma emergency hospital admissions. The association between air pollution and asthma morbidity was generally stronger in children, but not significant in people aged 15-64. CONCLUSIONS Evidence was found that short-term exposure to air pollution was associated with increasing risk of hospital utilization for COPD and asthma in the whole population, the elderly and children, but not in people aged 15-64. Children tended to be more susceptible to the effect of air pollution on asthma morbidity.
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Affiliation(s)
- Siqi Zhang
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Lin Tian
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Qun Guo
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
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Alhanti BA, Chang HH, Winquist A, Mulholland JA, Darrow LA, Sarnat SE. Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:180-8. [PMID: 26350981 DOI: 10.1038/jes.2015.57] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/16/2015] [Indexed: 05/22/2023]
Abstract
Previous studies have found strong associations between asthma morbidity and major ambient air pollutants. Relatively little research has been conducted to assess whether age is a factor conferring susceptibility to air pollution-related asthma morbidity. We investigated the short-term relationships between asthma emergency department (ED) visits and ambient ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and fine particulate matter (PM2.5) in Atlanta (1993-2009), Dallas (2006-2009), and St. Louis (2001-2007). City-specific daily time-series analyses were conducted to estimate associations by age group (0-4, 5-18, 19-39, 40-64, and 65+ years). Sub-analyses were performed stratified by race and sex. City-specific rate ratios (RRs) were combined by inverse-variance weighting to provide an overall association for each strata. The overall RRs differed across age groups, with associations for all pollutants consistently strongest for children aged 5-18 years. The patterns of association across age groups remained generally consistent when models were stratified by sex and race, although the strong observed associations among 5-18 year olds appeared to be partially driven by non-white and male patients. Our findings suggest that age is a susceptibility factor for asthma exacerbations in response to air pollution, with school-age children having the highest susceptibility.
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Affiliation(s)
- Brooke A Alhanti
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Lyndsey A Darrow
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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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: 277] [Impact Index Per Article: 30.8] [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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Leem JH, Kim ST, Kim HC. Public-health impact of outdoor air pollution for 2(nd) air pollution management policy in Seoul metropolitan area, Korea. Ann Occup Environ Med 2015; 27:7. [PMID: 25866666 PMCID: PMC4392455 DOI: 10.1186/s40557-015-0058-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 02/04/2015] [Indexed: 11/25/2022] Open
Abstract
Objectives Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor air pollution on public health in Seoul metropolitan area, Korea. Attributable cases of morbidity and mortality were estimated. Methods Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM2.5 and PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults ≥ 30 years), respiratory and cardiovascular hospital admissions (all ages), chronic bronchitis (all ages), and acute bronchitis episodes (≤18 years). Environmental exposure (PM2.5 and PM10) was modeled for each 3 km × 3 km. Results In 2010, air pollution caused 15.9% of total mortality or approximately 15,346 attributable cases per year. Particulate air pollution also accounted for: 12,511 hospitalized cases of respiratory disease; 20,490 new cases of chronic bronchitis (adults); 278,346 episodes of acute bronchitis (children). After performing the 2nd Seoul metropolitan air pollution management plan, the reducible death number associated with air pollution is 14,915 cases per year in 2024. We can reduce 57.9% of death associated with air pollution. Conclusion This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are remarkable. Particulate air pollution remains a key target for public-health action in the Seoul metropolitan area. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.
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Affiliation(s)
- Jong Han Leem
- Department of Occupational and Environmental Medicine, Inha University Hospital, 27 Inhang road Jung-gu, Incheon, 400-711 South Korea
| | - Soon Tae Kim
- Division of Environmental Engineering, Ajou University Woncheon-dong, Yeongtong-gu, Suwon, 443-749 South Korea
| | - Hwan Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, 27 Inhang road Jung-gu, Incheon, 400-711 South Korea
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Zhang Q, Qiu Z, Chung KF, Huang SK. Link between environmental air pollution and allergic asthma: East meets West. J Thorac Dis 2015; 7:14-22. [PMID: 25694814 DOI: 10.3978/j.issn.2072-1439.2014.12.07] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/03/2014] [Indexed: 01/21/2023]
Abstract
With the levels of outdoor air pollution from industrial and motor vehicle emissions rising rapidly in the fastly-industrializing countries of South East Asia, the prevalence of asthma and allergic diseases has also been increasing to match those in the West. Epidemiological and experimental exposure studies indicate a harmful impact of outdoor air pollution from vehicles and factories both on the development of allergic diseases and asthma and the increase in asthma symptoms and exacerbations. The level of outdoor pollution in Asia is much higher and more diverse than those encountered in Western countries. This may increase the impact of outdoor pollution on health, particularly lung health in Asia. This review discusses the constituents of air pollution in Asia with a special focus on studies in mainland China and Taiwan where the levels of pollution have reached high levels and where such high levels particularly in winter can cause a thick haze that reduces visibility. The onus remains on regulatory and public health authorities to curb the sources of pollution so that the health effects on the population particularly those with lung and cardiovascular diseases and with increased susceptibility can be mitigated.
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Affiliation(s)
- Qingling Zhang
- 1 State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 National Heart & Lung Institute, Imperial College London & Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK ; 3 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, 115 Zhunan, Taiwan ; 4 Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Zhiming Qiu
- 1 State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 National Heart & Lung Institute, Imperial College London & Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK ; 3 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, 115 Zhunan, Taiwan ; 4 Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Kian Fan Chung
- 1 State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 National Heart & Lung Institute, Imperial College London & Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK ; 3 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, 115 Zhunan, Taiwan ; 4 Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Shau-Ku Huang
- 1 State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 National Heart & Lung Institute, Imperial College London & Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK ; 3 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, 115 Zhunan, Taiwan ; 4 Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
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Yang HJ, Kim SH, Jang AS, Kim SH, Song WJ, Kim TB, Ye YM, Yoo Y, Yu J, Yoon JS, Jee HM, Suh DI, Kim CW. Guideline for the prevention and management of particulate matter/yellow dust-induced adverse health effects on the patients with bronchial asthma. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.11.1034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - An-Soo Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol-Woo Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
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Franck U, Leitte AM, Suppan P. Multifactorial airborne exposures and respiratory hospital admissions--the example of Santiago de Chile. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 502:114-21. [PMID: 25244038 DOI: 10.1016/j.scitotenv.2014.08.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 07/18/2014] [Accepted: 08/25/2014] [Indexed: 05/05/2023]
Abstract
UNLABELLED Our results provide evidence for respiratory effects of combined exposure to airborne pollutants in Santiago de Chile. Different pollutants account for varying adverse effects. Ozone was not found to be significantly associated with respiratory morbidity. BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of respiratory diseases. The findings of different studies vary in effect strength and are sometimes inconsistent. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to respiratory disease groups under the special orographic and meteorological conditions of Santiago de Chile. METHODS The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5 - particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for respiratory illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to respiratory admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were CO and PM10 followed by PM2.5, while in 2-pollutant models effects of NO2 persisted in most cases whereas other effects weakened and significant effects remain for PM2.5, only. In addition the strongest effects seemed to be immediate or with a delay of up to one day, but effects were found until day 7, too. Adverse effects of ozone could not be detected. CONCLUSIONS Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants especially CO, NO2, and PM10.
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Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Arne Marian Leitte
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Peter Suppan
- Institute of Meteorology and Climate Research (IMK-IFU), Karlsruhe Institute of Technology (KIT), Garmisch-Partenkirchen, Germany.
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Brown JS. Nitrogen dioxide exposure and airway responsiveness in individuals with asthma. Inhal Toxicol 2014; 27:1-14. [PMID: 25431034 DOI: 10.3109/08958378.2014.979960] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Controlled human exposure studies evaluating the effect of inhaled nitrogen dioxide (NO2) on the inherent responsiveness of the airways to challenge by broncho-constricting agents have had mixed results. In general, existing meta-analyses show statistically significant effects of NO2 on the airway responsiveness of individuals with asthma. However, no meta-analysis has provided a comprehensive assessment of the clinical relevance of changes in airway responsiveness, the potential for methodological biases in the original papers, and the distribution of responses. This paper provides analyses showing that a statistically significant fraction (i.e. 70% of individuals with asthma exposed to NO2 at rest) experience increases in airway responsiveness following 30-min exposures to NO2 in the range of 200 to 300 ppb and following 60-min exposures to 100 ppb. The distribution of changes in airway responsiveness is log-normally distributed with a median change of 0.75 (provocative dose following NO2 divided by provocative dose following filtered air exposure) and geometric standard deviation of 1.88. About a quarter of the exposed individuals experience a clinically relevant reduction in their provocative dose due to NO2 relative to air exposure. The fraction experiencing an increase in responsiveness was statistically significant and robust to exclusion of individual studies. Results showed minimal change in airway responsiveness for individuals exposed to NO2 during exercise.
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Affiliation(s)
- James S Brown
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
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Son JY, Bell ML, Lee JT. The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:1893-903. [PMID: 24445484 DOI: 10.1007/s00484-014-0791-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 10/25/2013] [Accepted: 01/06/2014] [Indexed: 05/20/2023]
Abstract
Although the impact of temperature on mortality is well documented, relatively fewer studies have evaluated the associations of temperature with morbidity outcomes such as hospital admissions, and most studies were conducted in North America or Europe. We evaluated weather and hospital admissions including specific causes (allergic disease, asthma, selected respiratory disease, and cardiovascular disease) in eight major cities in Korea from 2003 to 2008. We also explored potential effect modification by individual characteristics such as sex and age. We used hierarchical modeling to first estimate city-specific associations between heat, cold, or heat waves and hospitalizations, and then estimated overall effects. Stratified analyses were performed by cause of hospitalization, sex, and age (0-14, 15-64, 65-74, and ≥75 years). Cardiovascular hospitalizations were significantly associated with high temperature, whereas hospitalizations for allergic disease, asthma, and selected respiratory disease were significantly associated with low temperature. The overall heat effect for cardiovascular hospitalization was a 4.5% (95% confidence interval 0.7, 8.5%) increase in risk comparing hospitalizations at 25 to 15 °C. For cold effect, the overall increase in risk of hospitalizations comparing 2 with 15 °C was 50.5 (13.7, 99.2%), 43.6 (8.9, 89.5%), and 53.6% (9.8, 114.9%) for allergic disease, asthma, and selected respiratory disease, respectively. We did not find statistically significant effects of heat waves compared with nonheat wave days. Our results suggest susceptible populations such as women and younger persons. Our findings provide suggestive evidence that both high and low ambient temperatures are associated with the risk of hospital admissions, particularly in women or younger person, in Korea.
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Affiliation(s)
- Ji-Young Son
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
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