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Sinjari B, Santilli M, Di Carlo P, Aruffo E, Caputi S. The Correlation between Oral Health and Air Pollution: A Systematic Review. Dent J (Basel) 2024; 12:215. [PMID: 39057002 PMCID: PMC11275324 DOI: 10.3390/dj12070215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/03/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
This systematic review assessed to evaluate the potential correlation between oral health and air pollution. To the best of the authors' knowledge, this is the first systematic review endeavoring to compare air pollution and oral health. A systematic search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement and employed the PICO(S) approach (Patient or Population, Intervention, Control or Comparison, Outcome, and Study types). The search was limited to English-language articles, and publications within a 15-year timeframe were included in the electronic search. A comprehensive search was conducted across PubMed, Scopus, Embase, and Web of Science databases, spanning the years 2008 to 2023, resulting in a total of 4983 scientific articles. A final selection of 11 scientific papers was made based on their study type and the specific air pollutants examined. The selected papers analyzed various air pollutants associated with health-related diseases, including Ozone, Nitrogen Dioxide, Nitrogen Monoxide, Carbon Monoxide, sulfur dioxide, and particulate matter. Three out of eleven of the reviewed studies assert a strong correlation between air pollutants and oral diseases, specifically periodontitis. However, the exact biological mechanisms underlying this correlation do not seem to be fully understood, indicating the need for further comprehensive investigation in this regard. Dentists can contribute to the collective effort by educating their patients about the oral health implications of air pollution, thereby supporting initiatives aimed at promoting environmental and health sustainability.
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Affiliation(s)
- Bruna Sinjari
- Unit of Prostodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (S.C.)
| | - Manlio Santilli
- Unit of Prostodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (S.C.)
| | - Piero Di Carlo
- Center of Advanced Studies and Technology (CAST), University of “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (P.D.C.); (E.A.)
| | - Eleonora Aruffo
- Center of Advanced Studies and Technology (CAST), University of “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (P.D.C.); (E.A.)
| | - Sergio Caputi
- Unit of Prostodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (S.C.)
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Rufo JC, Annesi-Maesano I, Carreiro-Martins P, Moreira A, Sousa AC, Pastorinho MR, Neuparth N, Taborda-Barata L. Issue 2 - "Update on adverse respiratory effects of indoor air pollution" Part 1): Indoor air pollution and respiratory diseases: A general update and a Portuguese perspective. Pulmonology 2024; 30:378-389. [PMID: 37230882 DOI: 10.1016/j.pulmoe.2023.03.006] [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: 03/05/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To quantify the impact of different air pollutants on respiratory health based on robust estimates based on international data and to summarise the evidence of associations between indoor exposure to those pollutants and respiratory morbidity in the Portuguese population. RESULTS Several systematic reviews and meta-analyses (MA) at the world level demonstrate the impact of indoor air quality on respiratory health, with indoor particulate matter and gasses exerting a significant effect on the airways. Volatile organic compounds (VOC) have been related to asthma and lung cancer. However, only meta-analyses on biomass use allowed documentation of long-term respiratory effects. While early publications concerning Portuguese-based populations mainly focused on indoor exposure to environmental tobacco smoke, later studies relocated the attention to relevant exposure environments, such as day care buildings, schools, residences and nursing homes. Looking at the pooled effects from the reviewed studies, high levels of carbon dioxide and particulate matter in Portuguese buildings were significantly associated with asthma and wheezing, with VOC and fungi showing a similar effect in some instances. CONCLUSIONS Despite the significant reduction of indoor air pollution effects after the 2008 indoor smoking prohibition in public buildings, studies show that several indoor air parameters are still significantly associated with respiratory health in Portugal. The country shares the worldwide necessity of standardisation of methods and contextual data to increase the reach of epidemiological studies on household air pollution, allowing a weighted evaluation of interventions and policies focused on reducing the associated respiratory morbidity.
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Affiliation(s)
- J C Rufo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - I Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - P Carreiro-Martins
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal; Immunoallergology Service, Dona Estefânia Hospital, Centro Hospitalar e Universitário de Lisboa Central (CHULC), Lisbon, Portugal.
| | - A Moreira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A C Sousa
- Comprehensive Health Research Centre (CHRC) and Department of Biology, University of Évora, Évora, Portugal; NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - M R Pastorinho
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Comprehensive Health Research Centre (CHRC) and Department of Medical and Health Sciences, University of Évora, Évora, Portugal
| | - N Neuparth
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal; Immunoallergology Service, Dona Estefânia Hospital, Centro Hospitalar e Universitário de Lisboa Central (CHULC), Lisbon, Portugal
| | - L Taborda-Barata
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; UBIAir-Clinical & Experimental Lung Centre, University of Beira Interior, CACB - Clinical Academic Centre of Beiras, Covilhã, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, CACB - Clinical Academic Centre of Beiras, Covilhã, Portugal; Immunoallergology Service, Centro Hospitalar Universitário Cova da Beira, CACB - Clinical Academic Centre of Beiras, Covilhã, Portugal
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Sun F, Gong X, Wei L, Zhang Y, Ge M, Xiong L. Assessing the impact of short-term ozone exposure on excess deaths from cardiovascular disease: a multi-pollutant model in Nanjing, China's Yangtze River Delta. Front Public Health 2024; 12:1353384. [PMID: 38939565 PMCID: PMC11208627 DOI: 10.3389/fpubh.2024.1353384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
Background Ozone pollution is associated with cardiovascular disease mortality, and there is a high correlation between different pollutants. This study aimed to assess the association between ozone and cardiovascular disease deaths and the resulting disease burden in Nanjing, China. Methods A total of 151,609 deaths from cardiovascular disease were included in Nanjing, China from 2013 to 2021. Daily data on meteorological and air pollution were collected to apply a generalized additional model with multiple pollutants to perform exposure-response analyses, stratification analysis, and evaluation of excess deaths using various standards. Results In the multi-pollutant model, an increase of 10 μg/m3 in O3 was significantly associated with a 0.81% (95%CI: 0.49, 1.12%) increase in cardiovascular disease deaths in lag05. The correlation weakened in both the single-pollutant model and two-pollutant models, but remained more pronounced in females, the older group, and during warm seasons. From 2013 to 2021, the number of excess deaths attributed to ozone exposure in cardiovascular disease continued to rise with an increase in ozone concentration in Nanjing. If the ozone concentration were to be reduced to the WHO standard and the minimum level, the number of deaths would decrease by 1,736 and 10,882, respectively. Conclusion The risk of death and excess deaths from cardiovascular disease due to ozone exposure increases with higher ozone concentration. Reducing ozone concentration to meet WHO standards or lower can provide greater cardiovascular disease health benefits.
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Affiliation(s)
| | | | | | | | | | - Liling Xiong
- Department of Environment Health, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
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4
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Miller MR, Landrigan PJ, Arora M, Newby DE, Münzel T, Kovacic JC. Environmentally Not So Friendly: Global Warming, Air Pollution, and Wildfires: JACC Focus Seminar, Part 1. J Am Coll Cardiol 2024; 83:2291-2307. [PMID: 38839204 DOI: 10.1016/j.jacc.2024.03.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/06/2024] [Indexed: 06/07/2024]
Abstract
Environmental stresses are increasingly recognized as significant risk factors for adverse health outcomes. In particular, various forms of pollution and climate change are playing a growing role in promoting noncommunicable diseases, especially cardiovascular disease. Given recent trends, global warming and air pollution are now associated with substantial cardiovascular morbidity and mortality. As a vicious cycle, global warming increases the occurrence, size, and severity of wildfires, which are significant sources of airborne particulate matter. Exposure to wildfire smoke is associated with cardiovascular disease, and these effects are underpinned by mechanisms that include oxidative stress, inflammation, impaired cardiac function, and proatherosclerotic effects in the circulation. In the first part of a 2-part series on pollution and cardiovascular disease, this review provides an overview of the impact of global warming and air pollution, and because of recent events and emerging trends specific attention is paid to air pollution caused by wildfires.
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Affiliation(s)
- Mark R Miller
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
| | - Philip J Landrigan
- Global Observatory on Planetary Health, Boston College, Boston, Massachusetts, USA; Scientific Center of Monaco, Monaco
| | - Manish Arora
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David E Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Thomas Münzel
- Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany; German Center for Cardiovascular Research, Partner Site Rhine-Main, Mainz, Germany
| | - Jason C Kovacic
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; School of Human Sciences, University of Western Australia, Perth, Australia
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5
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Romero-Tapia SDJ, García-Marcos L. Global burden of pediatric asthma and rhinitis - what we have recently learned from epidemiology. Curr Opin Allergy Clin Immunol 2024; 24:177-181. [PMID: 38386768 DOI: 10.1097/aci.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE OF REVIEW To analyze and present recently published information on the factors that modify the burden of asthma and rhinitis in pediatric ages, such as ecological determinants; highlighting access and adherence to medications, exposure to pollutants and climate change. In addition to individual determinants such as obesity, protective & risk factors and comorbidities. RECENT FINDINGS Asthma and rhinitis continue to have a significant impact worldwide on the health of affected patients, primarily children. The burden of asthma is greatest in developing countries and vulnerable populations, resulting in increased morbidity, potentially preventable asthma deaths and socioeconomic consequences. SUMMARY A better understanding and representation of the burden of asthma and rhinitis in children can contribute to prevention strategies and improvements in the care of pediatric patients.
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Affiliation(s)
- Sergio de Jesús Romero-Tapia
- División Académica de Ciencias de la Salud (DACS), Universidad Juárez Autónoma de Tabasco (UJAT), Villahermosa, Mexico
| | - Luis García-Marcos
- Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bio-health Research Institute, Murcia, Spain
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6
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Hu Y, Wang Y, Zhao Z, Zhao B. Reconsidering gas as clean energy: Switching to electricity for household cooking to reduce NO 2-attributed disease burden. ECO-ENVIRONMENT & HEALTH 2024; 3:174-182. [PMID: 38638171 PMCID: PMC11021829 DOI: 10.1016/j.eehl.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 04/20/2024]
Abstract
Nitrogen dioxide (NO2) is a prevalent air pollutant in urban areas, originating from outdoor sources, household gas consumption, and secondhand smoke. The limited evaluation of the disease burden attributable to NO2, encompassing different health effects and contributions from various sources, impedes our understanding from a public health perspective. Based on modeled NO2 exposure concentrations, their exposure-response relationships with lung cancer, chronic obstructive pulmonary disease, and diabetes mellitus, and baseline disability-adjusted life years (DALYs), we estimated that 1,675 (655-2,624) thousand DALYs were attributable to NO2 in urban China in 2019 [138 (54-216) billion Chinese yuan (CNY) economic losses]. The transition from gas to electricity for household cooking was estimated to reduce the attributable economic losses by 35%. This reduction falls within the range of reductions achieved when outdoor air meets the World Health Organization interim target 3 and air quality guidelines for annual NO2, highlighting the significance of raising awareness of gas as a polluting household energy for cooking. These findings align with global sustainable development initiatives, providing a sustainable solution to promote public health while potentially mitigating climate change.
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Affiliation(s)
- Ying Hu
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Ye Wang
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai 200433, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200433, China
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200433, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing 100084, China
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Yang J, Lin Z, Shi S. Household air pollution and attributable burden of disease in rural China: A literature review and a modelling study. JOURNAL OF HAZARDOUS MATERIALS 2024; 470:134159. [PMID: 38565018 DOI: 10.1016/j.jhazmat.2024.134159] [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: 11/21/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
Household air pollution prevails in rural residences across China, yet a comprehensive nationwide comprehending of pollution levels and the attributable disease burdens remains lacking. This study conducted a systematic review focusing on elucidating the indoor concentrations of prevalent household air pollutants-specifically, PM2.5, PAHs, CO, SO2, and formaldehyde-in rural Chinese households. Subsequently, the premature deaths and economic losses attributable to household air pollution among the rural population of China were quantified through dose-response relationships and the value of statistical life. The findings reveal that rural indoor air pollution levels frequently exceed China's national standards, exhibiting notable spatial disparities. The estimated annual premature mortality attributable to household air pollution in rural China amounts to 966 thousand (95% CI: 714-1226) deaths between 2000 and 2022, representing approximately 22.2% (95% CI: 16.4%-28.1%) of total mortality among rural Chinese residents. Furthermore, the economic toll associated with these premature deaths is estimated at 486 billion CNY (95% CI: 358-616) per annum, constituting 0.92% (95% CI: 0.68%-1.16%) of China's GDP. The findings quantitatively demonstrate the substantial disease burden attributable to household air pollution in rural China, which highlights the pressing imperative for targeted, region-specific interventions to ameliorate this pressing public health concern.
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Affiliation(s)
- Junling Yang
- School of Architecture and Urban Planning, Nanjing University, Nanjing, Jiangsu Province 210093, China
| | - Zhi Lin
- School of Architecture and Urban Planning, Nanjing University, Nanjing, Jiangsu Province 210093, China
| | - Shanshan Shi
- School of Architecture and Urban Planning, Nanjing University, Nanjing, Jiangsu Province 210093, China.
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Li L, Zhang W, Liu S, Wang W, Ji X, Zhao Y, Shima M, Yoda Y, Yang D, Huang J, Guo X, Deng F. Cardiorespiratory effects of indoor ozone exposure during sleep and the influencing factors: A prospective study among adults in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171561. [PMID: 38458472 DOI: 10.1016/j.scitotenv.2024.171561] [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: 12/26/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Ambient ozone (O3) is recognized as a significant air pollutant with implications for cardiorespiratory health, yet the effects of indoor O3 exposure have received less consideration. Furthermore, while sleep occupies one-third of life, research on the health consequences of O3 exposure during this crucial period is scarce. This study aimed to investigate associations of indoor O3 during sleep with cardiorespiratory function and potential predisposing factors. A prospective study among 81 adults was conducted in Beijing, China. Repeated measurements of cardiorespiratory indices reflecting lung function, airway inflammation, cardiac autonomic function, blood pressure, systemic inflammation, platelet and glucose were performed on each subject. Real-time concentrations of indoor O3 during sleep were monitored. Associations of O3 with cardiorespiratory indices were evaluated using linear mixed-effect model. Effect modification by baseline lifestyles (diet, physical activity, sleep-related factors) and psychological status (stress and depression) were investigated through interaction analysis. The average indoor O3 concentration during sleep was 20.3 μg/m3, which was well below current Chinese indoor air quality standard of 160 μg/m3. O3 was associated with most respiratory indicators of decreased airway function except airway inflammation; whereas the cardiovascular effects were only manifested in autonomic dysfunction and not in others. An interquartile range increases in O3 at 6-h average was associated with changes of -3.60 % (95 % CI: -6.19 %, -0.93 %) and -9.60 % (95 % CI: -14.53 %, -4.39 %) in FVC and FEF25-75, respectively. Further, stronger effects were noted among participants with specific dietary patterns, poorer sleep and higher level of depression. This study provides the first general population-based evidence that low-level exposure to indoor O3 during sleep has greater effects on the respiratory system than on the cardiovascular system. Our findings identify the respiratory system as an important target for indoor O3 exposure, and particularly highlight the need for greater awareness of indoor air quality, especially during sleep.
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Affiliation(s)
- Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yetong Zhao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshiko Yoda
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
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Kashtan Y, Nicholson M, Finnegan CJ, Ouyang Z, Garg A, Lebel ED, Rowland ST, Michanowicz DR, Herrera J, Nadeau KC, Jackson RB. Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves. SCIENCE ADVANCES 2024; 10:eadm8680. [PMID: 38701214 PMCID: PMC11068006 DOI: 10.1126/sciadv.adm8680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024]
Abstract
Gas and propane stoves emit nitrogen dioxide (NO2) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization's exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO2 exposure alone. Short-term NO2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft2 in size incur four times more long-term NO2 exposure than people in residences >3000 ft2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO2 exposure, respectively, than the national average.
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Affiliation(s)
- Yannai Kashtan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Metta Nicholson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Colin J. Finnegan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Zutao Ouyang
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Anchal Garg
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Eric D. Lebel
- PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, CA 94612, USA
| | | | | | - Janet Herrera
- Central California Asthma Collaborative, Suite J, 1400 Chester Ave., Bakersfield, CA 93301, USA
| | - Kari C. Nadeau
- T.H. Chan School of Public Health, Harvard University, 677 Huntington Ave., Boston, MA 02115, USA
| | - Robert B. Jackson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
- Woods Institute for the Environment and Precourt Institute for Energy, Stanford, CA 94305, USA
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10
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García G, Martín-Gisbert L, Candal-Pedreira C, Ruano-Ravina A. Does lung function mediate the role of environmental pollution on overall and cardiovascular disease mortality? ERJ Open Res 2024; 10:00141-2024. [PMID: 38686179 PMCID: PMC11057502 DOI: 10.1183/23120541.00141-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 05/02/2024] Open
Abstract
Lung function and its mediation role on environmental pollution and mortality https://bit.ly/3pdVYJX.
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Affiliation(s)
- Guadalupe García
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Lucía Martín-Gisbert
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Cross-disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Candal-Pedreira
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública), Madrid, Spain
| | - Alberto Ruano-Ravina
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Cross-disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública), Madrid, Spain
- University of Santiago de Compostela–Galician Department of Health, Santiago de Compostela, Spain
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11
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de Souza Fernandes Duarte E, Lucio PS, Costa MJ, Salgueiro V, Salgado R, Potes M, Hoelzemann JJ, Bortoli D. Pollutant-meteorological factors and cardio-respiratory mortality in Portugal: Seasonal variability and associations. ENVIRONMENTAL RESEARCH 2024; 240:117491. [PMID: 37884072 DOI: 10.1016/j.envres.2023.117491] [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: 05/13/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Seasonal variations in cardiorespiratory diseases may be influenced by air pollution and meteorological factors. This work aims to highlight the relevance of a complete seasonal characterization of the pollutant-meteorological factors and cardio-respiratory mortality in Portugal and the relationships between health outcomes and environmental risk factors. To this end, air pollution and meteorological variables along with health outcomes were analyzed at national level and on a monthly basis for the period of 2011-2020. It was found that cardiorespiratory mortality rates during winter were 44% higher than during the summer. Furthermore, particulate matter with aerodynamic diameters of 10 and 2.5 μm (μm) or smaller (PM10 and PM2.5), carbon monoxide (CO) and nitrogen dioxide (NO2) showed a seasonal variability with the highest concentrations during winter while ozone (O3) presented higher concentrations during spring and summer. PM10, PM2.5 and NO2, showed a positive correlation between seasons, indicating similar patterns of behavior. Canonical correlation analysis (CCA) applied to pollutant-meteorological and cardiorespiratory mortality data indicates a strong linear correlation between pollutant-meteorological factors and health outcomes. The first canonical correlation was 0.889, and the second was 0.545, both statistically significant (p-value < 0.001). The CCA results suggest that there is a strong association between near-surface temperature, relative humidity, PM10, PM2.5, CO and NO2 and health outcomes. The results of this study provide important information of the seasonal variability of air pollutants and meteorological factors in Portugal and their associations with cardiorespiratory mortality.
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Affiliation(s)
- Ediclê de Souza Fernandes Duarte
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal.
| | - Paulo Sérgio Lucio
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Maria João Costa
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Vanda Salgueiro
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Rui Salgado
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Miguel Potes
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
| | - Judith J Hoelzemann
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Daniele Bortoli
- Instituto de Ciências da Terra - ICT (Pólo de Évora), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671, Évora, Portugal; Earth Remote Sensing Laboratory (EaRSLab), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, Évora, Portugal; Departamento de Física, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, Évora, Portugal
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12
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Otuyo MK, Nadzir MSM, Latif MT, Din SAM. A review of personal exposure studies in selected Asian countries' public transport microenvironments: lessons learned and future directions. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:121306-121337. [PMID: 37993649 DOI: 10.1007/s11356-023-30923-9] [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: 07/07/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
This comprehensive paper conducts an in-depth review of personal exposure and air pollutant levels within the microenvironments of Asian city transportation. Our methodology involved a systematic analysis of an extensive body of literature from diverse sources, encompassing a substantial quantity of studies conducted across multiple Asian cities. The investigation scrutinizes exposure to various pollutants, including particulate matters (PM10, PM2.5, and PM1), carbon dioxide (CO2), formaldehyde (CH2O), and total volatile organic compounds (TVOC), during transportation modes such as car travel, bus commuting, walking, and train rides. Notably, our review reveals a predominant focus on PM2.5, followed by PM10, PM1, CO2, and TVOC, with limited attention given to CH2O exposure. Across the spectrum of Asian cities and transportation modes, exposure concentrations exhibited considerable variability, a phenomenon attributed to a multitude of factors. Primary sources of exposure encompass motor vehicle emissions, traffic dynamics, road dust, and open bus doors. Furthermore, our findings illuminate the influence of external environments, particularly in proximity to train stations, on pollutant levels inside trains. Crucial factors affecting exposure encompass ventilation conditions, travel-specific variables, seat locations, vehicle types, and meteorological influences. The culmination of this rigorous review underscores the need for standardized measurements, enhanced ventilation systems, air filtration mechanisms, the adoption of clean energy sources, and comprehensive public education initiatives aimed at reducing pollutant exposure within city transportation microenvironments. Importantly, our study contributes to the growing body of knowledge surrounding this subject, offering valuable insights for policymakers and researchers dedicated to advancing air quality standards and safeguarding public health.
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Affiliation(s)
- Muhsin Kolapo Otuyo
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| | - Mohd Shahrul Mohd Nadzir
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia.
| | - Mohd Talib Latif
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| | - Shamzani Affendy Mohd Din
- Department of Building Technology & Engineering, Kulliyyah of Architecture & Environmental Design, International Islamic University Malaysia, P.O. Box 10, 50728, Kuala Lumpur, Malaysia
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13
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Tran HM, Tsai FJ, Lee YL, Chang JH, Chang LT, Chang TY, Chung KF, Kuo HP, Lee KY, Chuang KJ, Chuang HC. The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 898:166340. [PMID: 37591374 DOI: 10.1016/j.scitotenv.2023.166340] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
The impacts of climate change and air pollution on respiratory diseases present significant global health challenges. This review aims to investigate the effects of the interactions between these challenges focusing on respiratory diseases. Climate change is predicted to increase the frequency and intensity of extreme weather events amplifying air pollution levels and exacerbating respiratory diseases. Air pollution levels are projected to rise due to ongoing economic growth and population expansion in many areas worldwide, resulting in a greater burden of respiratory diseases. This is especially true among vulnerable populations like children, older adults, and those with pre-existing respiratory disorders. These challenges induce inflammation, create oxidative stress, and impair the immune system function of the lungs. Consequently, public health measures are required to mitigate the effects of climate change and air pollution on respiratory health. The review proposes that reducing greenhouse gas emissions contribute to slowing down climate change and lessening the severity of extreme weather events. Enhancing air quality through regulatory and technological innovations also helps reduce the morbidity of respiratory diseases. Moreover, policies and interventions aimed at improving healthcare access and social support can assist in decreasing the vulnerability of populations to the adverse health effects of air pollution and climate change. In conclusion, there is an urgent need for continuous research, establishment of policies, and public health efforts to tackle the complex and multi-dimensional challenges of climate change, air pollution, and respiratory health. Practical and comprehensive interventions can protect respiratory health and enhance public health outcomes for all.
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Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Viet Nam
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jer-Hwa Chang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Te Chang
- Department of Environmental Engineering and Science, Feng Chia University, Taichung, Taiwan
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart and Lung Institute, Imperial College London, London, UK; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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14
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Liu N, Liu W, Deng F, Liu Y, Gao X, Fang L, Chen Z, Tang H, Hong S, Pan M, Liu W, Huo X, Guo K, Ruan F, Zhang W, Zhao B, Mo J, Huang C, Su C, Sun C, Zou Z, Li H, Sun Y, Qian H, Zheng X, Zeng X, Guo J, Bu Z, Mandin C, Hänninen O, Ji JS, Weschler LB, Kan H, Zhao Z, Zhang Y. The burden of disease attributable to indoor air pollutants in China from 2000 to 2017. Lancet Planet Health 2023; 7:e900-e911. [PMID: 37940210 DOI: 10.1016/s2542-5196(23)00215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. METHODS We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. FINDINGS From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. INTERPRETATION DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. FUNDING The National Key Research and Development Program of China and the National Natural Science Foundation of China.
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Affiliation(s)
- Ningrui Liu
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Furong Deng
- School of Public Health, Peking University, Beijing, China
| | - Yumeng Liu
- Department of Building Science, Tsinghua University, Beijing, China
| | - Xuehuan Gao
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lin Fang
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Zhuoru Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Hao Tang
- School of Public Health, Fudan University, Shanghai, China
| | - Shijie Hong
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Minyi Pan
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Xinyue Huo
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Kangqi Guo
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Fangfang Ruan
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
| | - Wenlou Zhang
- School of Public Health, Peking University, Beijing, China
| | - Bin Zhao
- Department of Building Science, Tsinghua University, Beijing, China
| | - Jinhan Mo
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chunxiao Su
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Hao Li
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Xiangang Zeng
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
| | - Jianguo Guo
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhongming Bu
- Department of Energy and Environmental System Engineering, Zhejiang University of Science and Technology, Hangzhou, China
| | - Corinne Mandin
- Institute for Radiation Protection and Nuclear Safety, Fontenay-aux-Roses Cedex, Marne-la-Vallée, France
| | - Otto Hänninen
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio, Finland
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | | | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, China.
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai, China.
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China; Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China.
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15
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Sin DD, Doiron D, Agusti A, Anzueto A, Barnes PJ, Celli BR, Criner GJ, Halpin D, Han MK, Martinez FJ, Montes de Oca M, Papi A, Pavord I, Roche N, Singh D, Stockley R, Lopez Varlera MV, Wedzicha J, Vogelmeier C, Bourbeau J. Air pollution and COPD: GOLD 2023 committee report. Eur Respir J 2023; 61:2202469. [PMID: 36958741 DOI: 10.1183/13993003.02469-2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/04/2023] [Indexed: 03/25/2023]
Abstract
Exposure to air pollution is a major contributor to the pathogenesis of COPD worldwide. Indeed, most recent estimates suggest that 50% of the total attributable risk of COPD may be related to air pollution. In response, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Scientific Committee performed a comprehensive review on this topic, qualitatively synthesised the evidence to date and proffered recommendations to mitigate the risk. The review found that both gaseous and particulate components of air pollution are likely contributors to COPD. There are no absolutely safe levels of ambient air pollution and the relationship between air pollution levels and respiratory events is supra-linear. Wildfires and extreme weather events such as heat waves, which are becoming more common owing to climate change, are major threats to COPD patients and acutely increase their risk of morbidity and mortality. Exposure to air pollution also impairs lung growth in children and as such may lead to developmental COPD. GOLD recommends strong public health policies around the world to reduce ambient air pollution and for implementation of public warning systems and advisories, including where possible the use of personalised apps, to alert patients when ambient air pollution levels exceed acceptable minimal thresholds. When household particulate content exceeds acceptable thresholds, patients should consider using air cleaners and filters where feasible. Air pollution is a major health threat to patients living with COPD and actions are urgently required to reduce the morbidity and mortality related to poor air quality around the world.
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Affiliation(s)
- Don D Sin
- Centre for Heart Lung Innovation, St Paul's Hospital and University of British Columbia Division of Respiratory Medicine, Vancouver, BC, Canada
| | - Dany Doiron
- McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBERES, Barcelona, Spain
| | - Antonio Anzueto
- South Texas Veterans Health Care System, University of Texas, San Antonio, TX, USA
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - David Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Fernando J Martinez
- Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, USA
| | - Maria Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico de Caracas, Caracas, Venezuela
| | - Alberto Papi
- Respiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nicolas Roche
- Service de Pneumologie, Hôpital Cochin, AP-HP, Université Paris Cité, UMR 1016, Institut Cochin, Paris, France
| | - Dave Singh
- University of Manchester, Manchester, UK
| | | | | | - Jadwiga Wedzicha
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Claus Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Hospital Giessen and Marburg, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany
| | - Jean Bourbeau
- McGill University Health Centre, McGill University, Montreal, QC, Canada
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16
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Li Z, Lu F, Liu M, Guo M, Tao L, Wang T, Liu M, Guo X, Liu X. Short-Term Effects of Carbon Monoxide on Morbidity of Chronic Obstructive Pulmonary Disease With Comorbidities in Beijing. GEOHEALTH 2023; 7:e2022GH000734. [PMID: 36992869 PMCID: PMC10042128 DOI: 10.1029/2022gh000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
The association between CO and chronic obstructive pulmonary disease (COPD) has been widely reported; however, the association among patients with type 2 diabetes mellitus (T2DM) or hypertension has remained largely unknown in China. Over-dispersed generalized additive model was adopted to quantity the associations between CO and COPD with T2DM or hypertension. Based on principal diagnosis, COPD cases were identified according to the International Classification of Diseases (J44), and a history of T2DM and hypertension was coded as E12 and I10-15, O10-15, P29, respectively. A total of 459,258 COPD cases were recorded from 2014 to 2019. Each interquartile range uptick in CO at lag 03 corresponded to 0.21% (95%CI: 0.08%-0.34%), 0.39% (95%CI: 0.13%-0.65%), 0.29% (95%CI: 0.13%-0.45%) and 0.27% (95%CI: 0.12%-0.43%) increment in admissions for COPD, COPD with T2DM, COPD with hypertension and COPD with both T2DM and hypertension, respectively. The effects of CO on COPD with T2DM (Z = 0.77, P = 0.444), COPD with hypertension (Z = 0.19, P = 0.234) and COPD with T2DM and hypertension (Z = 0.61, P = 0.543) were insignificantly higher than that on COPD. Stratification analysis showed that females were more vulnerable than males except for T2DM group (COPD: Z = 3.49, P < 0.001; COPD with T2DM: Z = 0.176, P = 0.079; COPD with hypertension: Z = 2.48, P = 0.013; COPD with both T2DM and hypertension: Z = 2.44, P = 0.014); No statistically significant difference could be found between age groups (COPD: Z = 1.63, P = 0.104; COPD with T2DM: Z = 0.23, P = 0.821; COPD with hypertension: Z = 0.53, P = 0.595; COPD with both T2DM and hypertension: Z = 0.71, P = 0.476); Higher effects appeared in cold seasons than warm seasons on COPD (Z = 0.320, P < 0.001). This study demonstrated an increased risk of COPD with comorbidities related to CO exposure in Beijing. We further provided important information on lag patterns, susceptible subgroups, and sensitive seasons, as well as the characteristics of the exposure-response curves.
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Affiliation(s)
- Zhiwei Li
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
| | - Feng Lu
- Beijing Municipal Health Commission Information CentreBeijingChina
| | - Mengmeng Liu
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
- National Institute for Data Science in Health and MedicineCapital Medical UniversityBeijingChina
| | - Moning Guo
- Beijing Municipal Health Commission Information CentreBeijingChina
| | - Lixin Tao
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
| | - Tianqi Wang
- Beijing Municipal Health Commission Information CentreBeijingChina
| | - Mengyang Liu
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
- School of Public HealthHebei Medical UniversityShijiazhuangChina
| | - Xiuhua Guo
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
- National Institute for Data Science in Health and MedicineCapital Medical UniversityBeijingChina
- Centre for Precision HealthSchool of Medical and Health SciencesEdith Cowan UniversityWAJoondalupAustralia
| | - Xiangtong Liu
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyBeijingChina
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