Spatial mapping of land susceptibility to dust emissions using optimization of attentive Interpretable Tabular Learning (TabNet) model

Dust pollution poses significant risks to human health, air quality, and food safety, necessitating the identification of dust occurrence and the development of dust susceptibility maps (DSMs) to mitigate its effects. This research aims to detect dust occurrence using satellite images and prepare a DSM for Bushehr province, Iran, by enhancing the attentive interpretable tabular learning (TabNet) model through three swarm-based metaheuristic algorithms: particle swarm optimization (PSO), grey wolf optimizer (GWO), and hunger games search (HGS). A spatial database incorporating dust occurrence areas was created using Moderate Resolution Imaging Spectroradiometer (MODIS) images from 2002 to 2022, including 15 influential criteria related to climate, soil, topography, and land cover. Four models were employed for modeling and DSM generation: TabNet, TabNet-PSO, TabNet-GWO, and TabNet-HGS. Evaluation of the modeling results using performance metrics indicated that the TabNet-HGS model outperformed the other models in both training (mean absolute error (MAE) = 0.055, root-mean-square error (RMSE) = 0.1, coefficient of determination (R2) = 0.959), and testing (MAE = 0.063, RMSE = 0.114, R2 = 0.947) data. Following TabNet-HGS, the TabNet-PSO, TabNet-GWO, and TabNet models demonstrated progressively lower accuracy. The validation of the DSM was performed by assessing receiver operating characteristic (ROC) curves, revealing that the TabNet-HGS, TabNet-PSO, TabNet-GWO, and TabNet models exhibited the highest modeling accuracy, with corresponding area under the curve (AUC) values of 0.994, 0.986, 0.98, and 0.832, respectively. These results highlight the enhanced accuracy of dust susceptibility modeling achieved by integrating swarm-based metaheuristic algorithms with the TabNet model. The dust susceptibility map provides valuable insights into the sources, pathways, and impacts of dust particles on the environment and human health in the study area.

Ambient dust pollution with all-cause, cardiovascular and respiratory mortality: A systematic review and meta-analysis

A severe health crisis has been well-documented regarding dust particle exposure. We aimed to present the risk of all-cause, cardiovascular, and respiratory mortality due to particulate matter (PM) exposure during non-dust and dust storm events by performing a meta-analysis. A systematic review of the literature was conducted by an online search of the databases (Google Scholar, Web of Science, Scopus, and PubMed) with no restrictions according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines until December 2022. We performed a random-effects model to compute the pooled rate ratio (RR) of mortality with 95 % confidence intervals (CI). The Office of Health Assessment and Translation (OHAT) risk of bias rating tool was prepared to assess the quality of the individual study. The registration number in PROSPERO was CRD42023423212. We found a 16 % (95 % CI: 0.7 %, 24 %) increase in all-cause, 25 % (95 % CI: 14 %, 37 %) increase in cardiovascular, and 18 % (95 % CI: 13 %, 22 %) increase in respiratory mortality per 10 μg/m3 increment in dust exposure. Furthermore, the RRs per 10 μg/m3 increment in PM10-2.5 were 1.046 (95 % CI: 1.019, 1.072)¸ 1.085 (95 % CI: 1.045, 1.0124), and 1.089 (95 % CI: 0.939, 1.24) for all-cause, cardiovascular, and respiratory mortality, respectively. PM10 during dust days significantly increased the all-cause (1.013, 95 % CI: 1.007, 1.018) cardiovascular mortality risk (1.014, 95 % CI: 1.009, 1.02). We also found significant evidence for all-cause, cardiovascular, and respiratory mortality among females and the elderly age group due to dust particle (PM10-2.5 and PM10) exposure. Our results provided significant evidence about high concentrations of PM10-2.5 and PM10 during dust storm events related to mortality risk.

Long-term variations of global dust emissions and climate control

Dust discharged from the surface into the air has an important impact on global climate change, the ecological environment, and human health. However, the spatiotemporal variations of global dust emissions and the climate control of dust emissions from different dust sources in recent decades are still unclear. This study explores the spatiotemporal variations of global dust emissions from 1980 to 2020 based on the MERRA-2 dust emissions dataset and provides a detailed investigation of the interannual variations of dust emissions from major dust sources in the world and their contribution to the global dust cycle. On this basis, the association between global dust emissions and average wind speed (AWS), surface air temperature (SAT), precipitation (Ppt), relative humidity (RH), soil evaporation (SE), soil moisture (SM), and solar radiation (SR) were explored. In particular, the comparative importance of these climatic factors and their combined structures on dust emissions from different dust sources. The results show that North Africa contributed the most to global dust emissions, contributing 58% of the total global emissions, while South Africa and North America contributed the least to global dust emissions, at less than 1%, respectively. Classification and Regression Tree (CART) analysis shows that SR was the major factor affecting the dust emissions of Australia, East Asia, South America, and Central Asia. AWS was the major factor influencing dust emissions in North Africa and South Asia. SAT, RH, and SM were the major factors affecting dust emissions in West Asia, North America, and South Africa, respectively. There were great differences in the climatic factors combinations on dust emissions intensity in different dust sources. These findings assist us in better understanding the control of climatic factors on dust emissions from global dust sources and have important scientific significance for accurately predicting dust events and reducing disaster risks.

The impact of climate change related extreme weather events on people with pre-existing disabilities and chronic conditions: a scoping review

PURPOSE

People with disabilities experience a disproportionate impact of extreme weather events and there is a critical need to better understand the impact that climate change has for them. Most previous reviews focus on the risk of acquiring a new disability or injury after a climate-related event and not the impact on people with pre-existing disabilities or chronic conditions, which is the purpose of this study.

METHODS

We conducted a scoping review while searching seven international databases that identified 45 studies meeting our inclusion criteria.

RESULTS

The studies included in our review involved 2 337 199 participants with pre-existing disabilities and chronic conditions across 13 countries over a 20-year period. The findings demonstrated the following trends: (1) the impact on physical and mental health; (2) the impact on education and work; (3) barriers to accessing health and community services (i.e., lack of access to services, lack of knowledge about people with disabilities, communication challenges, lack of adequate housing); and (4) coping strategies (i.e., social supports and connecting to resources) and resilience.

CONCLUSIONS

Our findings highlight the critical need for rehabilitation clinicians and other service providers to explore opportunities to support their clients in preparing for climate-related emergencies.

Mortality risks from a spectrum of causes associated with sand and dust storms in China

Sand and Dust Storms (SDS) pose considerable health risks worldwide. Previous studies only indicated risk of SDS on overall mortality. This nationwide multicenter time-series study aimed to examine SDS-associated mortality risks extensively. We analyzed 1,495,724 deaths and 2024 SDS events from 1 February to 31 May (2013-2018) in 214 Chinese counties. The excess mortality risks associated with SDS were 7.49% (95% CI: 3.12-12.05%), 5.40% (1.25-9.73%), 4.05% (0.41-7.83%), 3.45% (0.34-6.66%), 3.37% (0.28-6.55%), 3.33% (0.07-6.70%), 8.90% (4.96-12.98%), 12.51% (6.31-19.08%), and 11.55% (5.55-17.89%) for ischemic stroke, intracerebral hemorrhagic stroke, hypertensive heart disease, myocardial infarction, acute myocardial infarction, acute ischemic heart disease, respiratory disease, chronic lower respiratory disease, and chronic obstructive pulmonary disease (COPD), respectively. SDS had significantly added effects on ischemic stroke, chronic lower respiratory disease, and COPD mortality. Our results suggest the need to implement public health policy against SDS.

Inhalable Saharan dust induces oxidative stress, NLRP3 inflammasome activation, and inflammatory cytokine release

Desert dust is increasingly recognized as a major air pollutant affecting respiratory health. Since desert dust exposure cannot be regulated, the hazardousness of its components must be understood to enable health risk mitigation strategies. Saharan dust (SD) comprises about half of the global desert dust and contains quartz, a toxic mineral dust that is known to cause severe lung diseases via oxidative stress and activation of the NLRP3 inflammasome-interleukin-1β pathway. We aimed to assess the physicochemical and microbial characteristics of SD responsible for toxic effects. Also, we studied the oxidative and pro-inflammatory potential of SD in alveolar epithelial cells and the activation of the NLRP3 inflammasome in macrophage-like cells in comparison to quartz dusts and synthetic amorphous silica (SAS). Characterization revealed that SD contained Fe, Al, trace metals, sulfate, diatomaceous earth, and endotoxin and had the capacity to generate hydroxyl radicals. We exposed A549 lung epithelial cells and wild-type and NLRP3^-/- THP-1 macrophage-like cells to SD, three well-investigated quartz dusts, and SAS. SD induced oxidative stress in A549 cells after 24 h more potently than the quartz dusts. The quartz dusts and SAS upregulated interleukin 8 expression after 4 h and 24 h while SD only caused a transient upregulation. SD, the quartz dusts, and SAS induced interleukin-1β release from wild-type THP-1 cells>20-fold stronger than from NLRP3^-/- THP-1 cells. Interleukin-1β release was lower for SD, in which microbial components including endotoxin were heat-destructed. In conclusion, microbial components in SD are pivotal for its toxicity. In the epithelium, the effects of SD contrasted with crystalline and amorphous silica in terms of potency and persistence. In macrophages, the strong involvement of the NLRP3 inflammasome emphasizes the acute and chronic health risks associated with desert dust exposure.

Application of magnetic susceptibility and heavy metal bioaccessibility to assessments of urban sandstorm contamination and health risks: Case studies from Dunhuang and Lanzhou, Northwest China

Direct ingestion of sandstorm particles is an important pathway in human exposure to heavy metals. This study investigated the potential health risks of heavy metals transported in sandstorms from Dunhuang to Lanzhou in northwestern China using environmental magnetic parameters and metal bioaccessibilities in simulated gastric and intestinal tracts. The mean magnetic susceptibility of sandstorms in Lanzhou was 366.86 × 10^-8 m³/kg, which was more than 5-fold higher than that of sandstorms in Dunhuang, indicating that these sandstorms continuously receive heavy metals with high magnetic mineral content along their pathways. Heavy metal concentrations in sandstorms were higher than background values and those in urban topsoil. Enrichment factors and pollution load indices showed that these heavy metals were derived from both natural and anthropogenic sources, with Cu, Zn, Pb, and Cd being strongly influenced by anthropogenic sources. The bioaccessibilities of Cd, Cu, Zn, and Pb in the sandstorms of Lanzhou were very high, ranging from 22.69% (Cu) to 50.86% (Pb) for gastric phase, and 12.07% (Pb)-22.11% (Cd) for interstinal phase, with the significant reduction in χ_lf of the physiologically-based extraction testing (PBET) treated sandstorms. The magnetic minerals are significant correlation with the concentrations of heavy metals in sandstorm and effect the release of heavy metals during human digestion process. The overall ecological risk posed by heavy metals contained in sandstorms was relatively low; however, the risk was moderate to high at individual sites. Ingestion posed the highest carcinogenic and non-carcinogenic risks for both adults and children, with the risk for children being higher.

Tracheitis hospital admissions are associated with Asia dust storm

The risks of tracheitis have been widely studied, but no investigation has yet to assess the impact of air pollutants on tracheitis hospital admissions. This research explores the relationship between Asia dust storm (ADS) and tracheitis hospital admissions, by using a Poisson time-series model on the 2000-2012 National Health Insurance Research Database (NHIRB) from Taiwan and linking air pollutants and temperature data. From a total of 126,013 tracheitis hospital admissions, the average number of daily tracheitis hospital admissions is 26.53 and increases 10% notably one day after ADS. The empirical result shows that ADS does significantly affect tracheitis hospital admissions 3 and 5 days after an event for the overall sample and 2-4 days after it for females. For the age group <45, the number significantly increases 3-4 days after ADS, revealing that ADS has a prolonged effect on tracheitis hospital admissions.

Changes in Ambient Bacterial Community in Northern Taiwan during Long-Range Transport: Asian Dust Storm and Frontal Pollution

Long-range transport (LRT) can carry air pollutants to downwind areas. However, studies about the impacts of LRT on bacterial communities are few. This study investigated the influence of Asian dust storms (ADS) and frontal pollution (FP) on bacterial communities in ambient air using next-generation sequencing (NGS) and Terminal Restriction Fragment Length Polymorphism (T-RFLP). Air samples were collected at Cape Fugui (CF) and National Taiwan University (NTU) in northern Taiwan before (or background days), during, and after LRTs from November 2013 to March 2015. The richness, H index, and evenness increased during FPs and then decreased after FPs. During and after ADS and FP, the prevalence of the phylum Proteobacteria decreased, but that of Firmicutes increased. The dominant class of Proteobacteria changed from Alphaproteobacteria on background days to Betaproteobacteria during LRTs. At the genus level, the high abundance of Ralstonia and Bacillus during FP and Clostridium during ADS were detected at both locations. Additionally, Ralstonia was dominant at CF during ADS. In conclusion, FP and ADS both changed the bacterial community. The indicator genus was Clostridium and Ralstonia for ADS as well as Bacillus and Ralstonia for FP. Given the potential health threats posed by the bioaerosols transported, people should avoid outdoor activities during LRTs.

Atmospheric transport of microplastics during a dust storm

Dust storms are common events in arid and semi-arid regions that have a wide range of impacts on the environment and human health. This study addresses the presence, characteristics and potential sources of microplastics (MPs) in such events by analysing MPs deposited with dust particles in the metropolis of Shiraz, southwest Iran, following an intense storm in May 2018. At 22 locations throughout the city, MP concentrations on a number basis ranged from 0.04 to 1.06 per g of dust (median = 0.31 MP g^-1). Particles were mainly fibrous, with a mean diameter of about 20 μm and >60% under 100 μm in length, and polymer makeup was dominated by nylon, polypropylene and polyethylene terephthalate. Examination of selected MPs by scanning electron microscopy revealed varying degrees of weathering and contamination by extraneous geogenic particles amongst the samples. Using published MP concentrations in urban dusts and remote, arid soils, we estimate that between about 0.1 and 5% of MPs deposited by the dust storm are derived from local sources within the metropolis, with the remainder arising from more distant sources. HYSPLIT modelling, satellite imagery and published geochemical signatures of regional dust particles suggest that the deserts of Saudi Arabia constitute the principal distal and transboundary source. Dust storms may represent a significant means by which MPs are transported and redistributed in arid and semi-arid environments and an important source of MPs to the oceans.

Exploring Meteorological Conditions and Human Health Impacts during Two Dust Storm Events in Northern Cape Province, South Africa: Findings and Lessons Learnt

Dust storms are meteorological hazards associated with several adverse health impacts including eye irritations, respiratory and cardiovascular disorders, and vehicular road accidents due to poor visibility. This study investigated relations between admissions from a large, public hospital that serves people living in Northern Cape and Free State provinces, South Africa during 2011 to 2017, and meteorological variables (temperature and air quality) during two dust storms, one in October 2014 (spring) and the second in January 2016 (summer), identified from the media as no repository of such events exists for South Africa. Distributed nonlinear lag analysis and wavelet transform analysis were applied to explore the relationships between hospital admissions for respiratory and cardiovascular diseases, eye irritation, and motor vehicle accidents; maximum temperature, and two air quality ‘proxy measures,’ aerosol optical depth and Ångström exponent, were used as ground-based air quality data were unavailable. Eye irritation was the most common dust-related hospital admission after both dust storm events. No statistically significant changes in admissions of interest occurred at the time of the two dust storm events, using either of the statistical methods. Several lessons were learnt. For this type of study, ground-based air quality and local wind data are required; alternative statistical methods of analysis should be considered; and a central dust storm repository would help analyze more than two events. Future studies in South Africa are needed to develop a baseline for comparison of future dust storm events and their impacts on human health.

Burden of dust storms on years of life lost in Seoul, South Korea: A distributed lag analysis

Although dust storms have been associated with adverse health outcomes, studies on the burden of dust storms on deaths are limited. As global warming has induced significant climate changes in recent decades, which have accelerated desertification worldwide, it is necessary to evaluate the burden of dust storm-induced premature mortality using a critical measure of disease burden, such as the years of life lost (YLL). The YLL attributable to dust storms have not been examined to date. This study investigated the association between Asian dust storms (ADS) and the YLL in Seoul, South Korea, during 2002-2013. We conducted a time-series study using a generalized additive model assuming a Gaussian distribution and applied a distributed lag model with a maximum lag of 5 days to investigate the delayed and cumulative effects of ADS on the YLL. We also conducted stratified analyses using the cause of death (respiratory and cardiovascular diseases) and sociodemographic status (sex, age, education level, occupation, and marital status). During the study period, 108 ADS events occurred, and the average daily YLL was 1511 years due to non-accidental causes. The cumulative ADS exposure over the 6-day lag period was associated with a significant increase of 104.7 (95% CI, 31.0-178.5 years) and 34.4 years (4.0-64.7 years) in the YLL due to non-accidental causes and cardiovascular mortality, respectively. Sociodemographic analyses revealed associations between ADS exposure and the YLL in males, both <65 and ≥ 65 years old, those with middle-level education, and the unemployed, unmarried, and widowed (26.5-83.8 years). This study provides new evidence suggesting that exposure to dust storms significantly increases the YLL. Our findings suggest that dust storms are a critical environmental risk affecting premature mortality. These results could contribute to the establishment of public health policies aimed at managing dust storm exposure and reducing premature deaths.

Associations between Dust Exposure and Hospitalizations in El Paso, Texas, USA

The Southwestern USA has been identified as one of the most persistent dust-producing regions of North America, where exposure to inhalable particulate matter (PM10) originating from desertic landscape during dust events/dust exposures (DEs) can reach hazardous levels. El Paso, Texas’s ambient air has reached hazardous levels of PM10 from dust with near zero visibility due to these natural events originating in the surrounding Chihuahuan Desert. The aim of this study was to investigate whether dust exposures in El Paso (generally acute, short-term exposures from nearby source areas) are associated with significant increases in hospitalizations on the day of the exposure and up to seven days afterwards. Using a Poisson regression, it was found that the relative risks of hospitalizations due to a variety of conditions were associated with dust exposures (through increases of 100 μg/m3 maximum hourly PM10 and/or increases of 4.5 m/s maximum hourly wind speed) in El Paso County, Texas between 2010 and 2014. Valley fever, coronary atherosclerosis, genitourinary diseases, neurodegenerative diseases, injury and poisoning, circulatory system conditions, respiratory system diseases, births, septicemia, Associated Diseases (the aggregation of hospital admissions for all causes, each associated with at least 5% of hospitalizations), and all ICD-9 admissions were significantly positively associated with dust exposures, indicated from higher to lower significant risk, at different lag periods after exposure. These findings, showing that an association does exist between dust exposures and hospitalizations, have important implications for residents of the world’s dryland cities.

Short-term effects of air pollution on daily asthma-related emergency department visits in an industrial city

BACKGROUND

Epidemiological studies from Europe and North America have provided evidence that exposure to air pollution can aggravate symptoms in asthmatic patients.

METHODS

Daily number of AEDv, air pollution levels (PM10, PM2.5, SO2, NO2 and CO) and meteorological variables was obtained from Jubail Industrial City, Saudi Arabia, for the period of 2007-11. Data were analyzed using a time-series approach. Relative risks (RRs) were estimated using Poisson regression.

RESULTS

The associations between AEDv and PM10, PM2.5, SO2 and NO2 remained positive and statistically significant after mutual adjustment in the multi-pollutant model.The RR of AEDv increased by 5.4, 4.4, 3.4 and 2.2% per an inter-quartile range increase in SO2 (2.0 ppb), PM2.5 (36 μg/m3), NO2 (7.6 ppb) and PM10 (140 μg/m3), respectively. No significant associations between AEDv and CO were found.

CONCLUSIONS

Current levels of ambient air pollution are associated with AEDv in this industrial setting in the Middle East. Greater awareness of environmental health protection and the implementation of effective measures to improve the quality of air in such settings would be beneficial to public health.

Global Health Impacts of Dust Storms: A Systematic Review

BACKGROUND

Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue.

METHOD

In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table.

RESULTS

The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular.

CONCLUSION

The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.Registration: PROSPERO registration number CRD42018093325.

Biological effect of PM10 on airway epithelium-focus on obstructive lung diseases

Recently, a continuous increase in environmental pollution has been observed. Despite wide-scale efforts to reduce air pollutant emissions, the problem is still relevant. Exposure to elevated levels of airborne particles increased the incidence of respiratory diseases. PM₁₀ constitute the largest fraction of air pollutants, containing particles with a diameter of less than 10 μm, metals, pollens, mineral dust and remnant material from anthropogenic activity. The natural airway defensive mechanisms against inhaled material, such as mucus layer, ciliary clearance and macrophage phagocytic activity, may be insufficient for proper respiratory function. The epithelium layer can be disrupted by ongoing oxidative stress and inflammatory processes induced by exposure to large amounts of inhaled particles as well as promote the development and exacerbation of obstructive lung diseases. This review draws attention to the current state of knowledge about the physical features of PM₁₀ and its impact on airway epithelial cells, and obstructive pulmonary diseases.

Understanding the relationships between environmental factors and exacerbations of COPD

INTRODUCTION

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant health burden both for patients and healthcare systems. Exposure to various environmental factors increases the risk of exacerbations.

AREAS COVERED

We searched PubMed and assessed literature published within the last 10 years to include epidemiological evidence on the relationships between air pollution, temperature and COPD exacerbation risk as well as the implications of extreme weather events on exacerbations.

EXPERT OPINION

Ongoing climate change is expected to increase air pollution levels, global temperature and the frequency and severity of extreme weather events, all of which are associated with COPD exacerbations. Further research is needed using patient-focused methodological approaches to better understand and quantify these relationships, so that effective mitigation strategies that decrease the risk of exacerbations can be developed.

Respiratory Health after Military Service in Southwest Asia and Afghanistan. An Official American Thoracic Society Workshop Report

Since 2001, more than 2.7 million U.S. military personnel have been deployed in support of operations in Southwest Asia and Afghanistan. Land-based personnel experienced elevated exposures to particulate matter and other inhalational exposures from multiple sources, including desert dust, burn pit combustion, and other industrial, mobile, or military sources. A workshop conducted at the 2018 American Thoracic Society International Conference had the goals of: 1) identifying key studies assessing postdeployment respiratory health, 2) describing emerging research, and 3) highlighting knowledge gaps. The workshop reviewed epidemiologic studies that demonstrated more frequent encounters for respiratory symptoms postdeployment compared with nondeployers and for airway disease, predominantly asthma, as well as case series describing postdeployment dyspnea, asthma, and a range of other respiratory tract findings. On the basis of particulate matter effects in other populations, it also is possible that deployers experienced reductions in pulmonary function as a result of such exposure. The workshop also gave particular attention to constrictive bronchiolitis, which has been reported in lung biopsies of selected deployers. Workshop participants had heterogeneous views regarding the definition and frequency of constrictive bronchiolitis and other small airway pathologic findings in deployed populations. The workshop concluded that the relationship of airway disease, including constrictive bronchiolitis, to exposures experienced during deployment remains to be better defined. Future clinical and epidemiologic research efforts should address better characterization of deployment exposures; carry out longitudinal assessment of potentially related adverse health conditions, including lung function and other physiologic changes; and use rigorous histologic, exposure, and clinical characterization of patients with respiratory tract abnormalities.

Association between African Dust Transport and Acute Exacerbations of COPD in Miami

Background: Air pollution is increasingly recognized as a risk factor for acute exacerbation of chronic obstructive pulmonary disease (COPD). Changing climate and weather patterns can modify the levels and types of air pollutants. For example, dust outbreaks increase particulate air pollution. Objective: This paper examines the effect of Saharan dust storms on the concentration of coarse particulate matter in Miami, and its association with the risk of acute exacerbation of COPD (AECOPD). Methods: In this prospective cohort study, 296 COPD patients (with 313 events) were followed between 2013 and 2016. We used Light Detection and Ranging (LIDAR) and satellite-based Aerosol Optical Depth (AOD) to identify dust events and quantify particulate matter (PM) exposure, respectively. Exacerbation events were modeled with respect to location- and time-lagged dust and PM exposures, using multivariate logistic regressions. Measurements and main results: Dust duration and intensity increased yearly during the study period. During dust events, AOD increased by 51% and particulate matter ≤2.5 µm in aerodynamic diameter (PM_2.5) increased by 25%. Adjusting for confounders, ambient temperature and local PM_2.5 exposure, one-day lagged dust exposure was associated with 4.9 times higher odds of two or more (2+ hereto after) AECOPD events (odds ratio = 4.9; 95% CI = 1.8–13.4; p < 0.001). Ambient temperature exposure also showed a significant association with 2+ and 3+ AECOPD events. The risk of AECOPD lasted up to 15 days after dust exposure, declining from 10× higher on day 0 to 20% higher on day 15. Conclusions: Saharan dust outbreaks observed in Miami elevate the concentration of PM and increase the risk of AECOPD in COPD patients with recurring exacerbations.

Associations Between Dust Storms and Intensive Care Unit Admissions in the United States, 2000-2015

Anthropogenic climate change is influencing the incidence of dust storms and associated human exposure to coarse particulate matter (PM2.5-10) in the United States. Studies have found adverse health consequences related to dust exposure. These consequences include respiratory disease exacerbations and premature mortality, resulting in increased health care utilization. However, the impact of dust storms on critical care demand has not been studied in the United States. We seek to quantify the relationship between dust storms and surges in critical care demand by investigating the association between dust storms and intensive care unit (ICU) admissions at nearby hospitals from 2000 to 2015. ICU data were acquired from Premier, Inc. and encompass 15-20% of all ICU admissions in the United States. Dust storm, meteorology, and air pollutant data were downloaded from the U.S. National Weather Service, the U.S. National Climatic Data Center, and the U.S. Environmental Protection Agency websites, respectively. Associations between ICU admission and dust storms, controlling for temperature, dew point temperature, ambient PM2.5 and ozone, as well as seasonally varying confounders, were estimated using a distributed lag conditional Poisson model with overdispersion. We found a 4.8% (95% CI: 0.4, 9.4; p = 0.033) increase in total ICU admissions on the day of the dust storm (Lag 0) and a 9.2% (95% CI: 1.8, 17.0; p = 0.013) and 7.5% (95% CI: 0.3, 15.2; p = 0.040) increase in respiratory admissions at Lags 0 and 5. North American dust storms are associated with increases in same day and lagged demand for critical care services at nearby hospitals.

Health Effects of Asian Dust: A Systematic Review and Meta-Analysis

BACKGROUND

Potential adverse health effects of Asian dust exposure have been reported, but systematic reviews and quantitative syntheses are lacking.

OBJECTIVE

We reviewed epidemiologic studies that assessed the risk of mortality, hospital admissions, and symptoms/dysfunction associated with exposure to Asian dust.

METHODS

We performed a systematic search of PubMed and Web of Science to identify studies that reported the association between Asian dust exposure and human health outcomes. We conducted separate meta-analyses using a random-effects model for mortality and hospital admissions for a specific health outcome and assessed pooled estimates for each lag when at least three studies were available for a specific lag.

RESULTS

We identified 89 studies that met our inclusion criteria for the systematic review, and 21 studies were included in the meta-analysis. The pooled estimates (percentage changes) of mortality from circulatory and respiratory causes for Asian dust days vs. non-Asian dust days were 2.33% [95% confidence interval (CI): 0.76, 3.93] increase at lag 0 and 3.99% (95% CI: 0.08, 8.06) increase at lag 3, respectively. The increased risk for hospital admissions for respiratory disease, asthma, and pneumonia peaked at lag 3 by 8.85% (95% CI: 0.80, 17.55), 14.55% (95% CI: 6.74, 22.94), and 8.51% (95% CI: 2.89, 14.44), respectively. Seven of 12 studies reported reduced peak expiratory flow, and 16 of 21 studies reported increased respiratory symptoms associated with Asian dust exposure. There were substantial variations between the studies in definitions of Asian dust, study designs, model specifications, and confounder controls.

DISCUSSION

We found evidence of increased mortality and hospital admissions for circulatory and respiratory events. However, the number of studies included in the meta-analysis was not large and further evidences are merited to strengthen our conclusions. Standardized protocols for epidemiological studies would facilitate interstudy comparisons. https://doi.org/10.1289/EHP5312.

Risk factors of chronic obstructive pulmonary disease exacerbations

Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory disease characterised by persistent respiratory symptoms and airflow limitation. COPD has a major impact on public health, mainly because of its increasing prevalence, morbidity and mortality. The natural course of COPD is aggravated by episodes of respiratory symptom worsening termed exacerbations that contribute to disease progression. Acute Exacerbations of COPD (AECOPD) can be triggered by a multitude of different factors, including respiratory tract infections, various exposures, prior exacerbations, non-adherence to treatment and associated comorbidities. AECOPD are associated with an inexorable decline of lung function and a significantly worse survival outcome. This review will summarise the most important aspects regarding the impact of different factors that contribute to COPD exacerbations.

Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran

Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM₁₀) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS).

Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM₁₀ were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM₁₀. The latent effects of PM₁₀ were estimated in single and cumulative lags, up to 14 days.

Results: In the adjusted model, for each IQR increase in the average daily PM₁₀ concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM₁₀ in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions.

Conclusion: Increase in daily PM₁₀ concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

The disappearing Salton Sea: A critical reflection on the emerging environmental threat of disappearing saline lakes and potential impacts on children's health

Changing weather patterns, droughts and competing water demands are dramatically altering the landscape and creating conditions conducive to the production of wind-blown dust and dust storms. In California, such factors are leading to the rapid shrinking of the Salton Sea, a 345 mile² land-locked "sea" situated near the southeastern rural border region known as the Imperial Valley. The region is anticipated to experience a dramatic increase in wind-blown dust and existing studies suggest a significant impact on the health and quality of life for nearby residents of this predominantly low-income, Mexican-American community. The discussion calls attention to the public health dimensions of the Salton Sea crisis. We know little about the possible long-term health effects of exposure to mobilized lakebed sediments or the numerous toxic contaminants that may become respirable on entrained particles. We draw on existing epidemiological literature of other known sources of wind-blown dust, such as desert dust storms, and related health effects to begin to understand the potential public health impact of wind-blown dust exposure. The increased production of wind-blown dust and environmental exposures to such non-combustion related sources of particulate matter are a growing health threat, due in part to drought coupled with increasing pressures on limited water resources. Recent population-based studies have linked dust storms with cardiovascular mortality, asthma hospitalization and decrease in pulmonary function in both adults and children. A growing number of studies provide evidence of the acute health effects of wind-blown dust exposures among children, which with repeated insults have the potential to influence respiratory health over time. The shrinking of the Salton Sea illustrates a public health and environmental justice crisis that requires action and attention to protect the health and well-being of local communities.

Preparedness components of health systems in the Eastern Mediterranean Region for effective responses to dust and sand storms: a systematic review

Background: Dust and Sand Storm (DSS), according to estimates by global reports, will increase dramatically in the Eastern Mediterranean Region (EMR). Numerous health problems caused by DSS will be severely affected regions and vulnerable groups. This study aimed to identify the components of the preparedness of health systems for the DSS phenomenon in EMR. Methods: In this systematic review, the peer-reviewed papers in four electronic databases, including Medline through PubMed, Scopus, ISI Web of Science and the Cochrane library, as well as available grey literature, were searched and selected. The research process was carried out by including papers whose results were related to the potential health effects caused by desert dusts in EMR. Was used the combination of three groups of keywords: the exposure factor, health effects as outcomes, and the countries located in EMR. The focus was on the PRISMA checklist, with no time limitations until December 2017. Finally, through 520 related citations, 30 articles were included. Descriptive and thematic content analyses were evaluated. Results: The preparedness components were divided into three and ten main categories and subcategories, respectively. The three categories covered the areas of DSS hazard identification, planning and policy-making, and risk assessment. Conclusions: Recognition of the health system preparedness factors for DSS in EMR will help policy-makers and managers perform appropriate measures when dealing with this hazard. More studies should be conducted to understand these factors in other parts of the world. Registration: PROSPERO registration number CRD42018093325.

Short-term effects of ambient air pollution on chronic obstructive pulmonary disease admissions in Beijing, China (2013-2017)

Purpose

Evidence between air pollution and COPD admissions is inconsistent and limited in China. In this study, we aimed to explore the effects of air pollutants on COPD admissions in Beijing, China.

Patients and methods

Daily COPD hospital admission visits derived from tertiary and secondary hospitals in Beijing were retrieved from January 2013 to February 2017. Air pollutant levels and meteorological data over the same periods were also achieved. Generalized additive model was applied to estimate the percentage changes with 95% CIs in daily admissions corresponding to 10 µg/m³ increases in pollutants levels [1 mg/m³ in carbon monoxide (CO)], stratified by age, gender, and season.

Results

Seventy-three thousand seventy-six COPD hospital admission visits were included with mean daily visits of 48 (21). Cumulative lag effect with per 10 µg/m³ increase in air pollutant levels was largest for nitrogen dioxide (NO₂) with 3.03% (95% CI: 1.82%-4.26%) at lag 06, for sulfur dioxide (SO₂) with 2.07% (95% CI: 1.00%-3.15%) at lag 01, for particulate matter ≤10 µm in aerodynamic diameter (PM₁₀) with 0.92% (95% CI: 0.55%-1.30%) at lag 07, and for particulate matter ≤2.5 µm in aerodynamic diameter (PM_2.5) with 0.82% (95% CI: 0.38%-1.26%) at lag 06, respectively. Percentage increase for each 1 mg/m³ increase in CO was 5.99% (95% CI: 2.74%-9.34%) at lag 06. Further, stronger effects on COPD admissions were found in warm seasons than in cold seasons.

Conclusion

Short-term exposures to PM_2.5, PM₁₀, NO₂, SO₂, and CO had adverse effects on COPD hospitalizations in Beijing with different magnitudes and lag days.

Temporal and spatial variations in sand and dust storm events in East Asia from 2007 to 2016: Relationships with surface conditions and climate change

We analyzed the frequency and intensity of sand and dust storms (SDSs) in East Asia from 2007 to 2016 using observational data from ground stations, numerical modeling, and vegetation indices obtained from both satellite and reanalysis data. The relationships of SDSs with surface conditions and the synoptic circulation pattern were also analyzed. The statistical analyses demonstrated that the number and intensity of SDS events recorded in spring during 2007 to 2016 showed a decreasing trend. The total number of spring SDSs decreased from at least ten events per year before 2011 to less than ten events per year after 2011. The overall average annual variation of the surface dust concentration in the main dust source regions decreased 33.24μg/m³ (-1.75%) annually. The variation in the temperatures near and below the ground surface and the amount of precipitation and soil moisture all favored an improvement in vegetation coverage, which reduced the intensity and frequency of SDSs. The strong winds accompanying the influx of cold air from high latitudes showed a decreasing trend, leading to a decrease in the number of SDSs and playing a key role in the decadal decrease of SDSs. The decrease in the intensity of the polar vortex during study period was closely related to the decrease in the intensity and frequency of SDSs.

Meta-Prediction of MTHFR Gene Polymorphism and Air Pollution on the Risks of Congenital Heart Defects Worldwide: A Transgenerational Analysis

Congenital heart disease (CHD) is the leading cause of death in children, and is affected by genetic and environmental factors. To investigate the association of air pollution with methylene-tetrahydrofolate reductase (MTHFR) polymorphisms and the risk of CHD, we included 58 study groups of children and parents, with 12,347 cases and 18,106 controls worldwide. Both MTHFR C677T (rs 1801133) and A1298C (rs 1801131) gene polymorphisms were risks for CHD in children with transgenerational effects from their parents. Countries with greater risks of CHD with a pooled risk ratio (RR) > 2 from MTHFR 677 polymorphisms included Germany, Portugal, China, and Egypt for children; and Brazil, Puerto Rico, Mexico, China, and Egypt for mothers. Whereas, countries with greater risk of CHD with RR > 2 from MTHFR 1298 polymorphisms included Taiwan, Turkey, and Egypt for children; and Brazil, China, and Egypt for mothers. Additionally, meta-prediction analysis revealed that the percentages of MTHFR 677TT and TT plus CT polymorphisms together were increased in countries with higher levels of air pollution, with a trend of increased CHD risks with higher levels of air pollution for children (p = 0.07). Our findings may have significant implications for inflammatory pathways in association with MTHFR polymorphisms and future intervention studies to correct for folate-related enzyme deficits resulted from MTHFR polymorphisms to prevent CHDs for future generations.

Global Ramifications of Dust and Sandstorm Microbiota

Dust and sandstorm events inject substantial quantities of foreign microorganisms into global ecosystems, with the ability to impact distant environments. The majority of these microorganisms originate from deserts and drylands where the soil is laden with highly stress-resistant microbes capable of thriving under extreme environmental conditions, and a substantial portion of them survive long journeys through the atmosphere. This large-scale transmission of highly resilient alien microbial contaminants raises concerns with regards to the invasion of sensitive and/or pristine sink environments, and to human health-concerns exacerbated by increases in the rate of desertification. Further increases in the transport of dust-associated microbiota could extend the spread of foreign microbes to new ecosystems, increase their load in present sink environments, disrupt ecosystem balance, and potentially introduce new pathogens. Our present understanding of these microorganisms, their phylogenic affiliations and functional significance, is insufficient to determine their impact. The purpose of this review is to provide an overview of available data regarding dust and sandstorm microbiota and their potential ramifications on human and ecosystem health. We conclude by discussing current gaps in dust and sandstorm microbiota research, and the need for collaborative studies involving high-resolution meta-omic approaches in conjunction with extensive ecological time-series studies to advance the field towards an improved and sufficient understanding of these invisible atmospheric travelers and their global ramifications.

Meta-Analysis of NOS3 G894T Polymorphisms with Air Pollution on the Risk of Ischemic Heart Disease Worldwide

The purpose of this updated meta-analysis was to investigate the effect of nitric oxide synthase-3 (NOS3) G894T polymorphisms, air pollution and their interaction on ischemic heart disease (IHD) risk across populations worldwide. Recursive partition trees, nonlinear association curve fit and geographic information system maps were incorporated to verify results of conventional pooled analyses for sources of heterogeneity. Results from 61 studies (16,219 cases, 12,222 controls) revealed a significant increased relative risk (RR) of IHD associated with NOS3 894 polymorphisms TT (RR = 1.44) and GT (RR = 1.37). Subgroup analysis revealed that the TT polymorphism genotype had significantly increased risk of IHD in Caucasian, East Asian, South Asian, and Middle Eastern populations (all p < 0.05). It is important to point out that many countries demonstrated an average risk of greater than two, which identifies the NOS3 894 TT polymorphism as a potential causal factor and biological marker of IHD, based on criteria for strong evidence used in international consensus panels. These 10 countries include Ukraine, the United Kingdom, Brazil, Chile, Japan, South Korea, India, Iran, Egypt and Morocco. For these countries with elevated risk (RR > 2) from the NOS3 894 TT polymorphism, meta-predictive analysis demonstrated an increasing trend in air pollution association with increased NOS3 894 polymorphisms. Further studies are needed to explore the complexity of the associations among NOS3 gene polymorphisms per population stratifications within countries, detailed air pollution data for added specificity for geographic location across time, and disease risk.

The Impacts of Taklimakan Dust Events on Chinese Urban Air Quality in 2015

Aerosols are an important factor affecting air quality. As the largest source of dust aerosol of East Asia, the Taklimakan Desert in Northwest China witnesses frequent dust storm events, which bring about significant impacts on the downstream air quality. However, the scope and timing of the impacts of Taklimakan dust events on Chinese urban air quality have not yet been fully investigated. In this paper, based on multi-source dust data including ground observations, satellite monitoring, and reanalysis products, as well as air quality index (AQI) and the mass concentrations of PM10 and PM2.5 at 367 urban stations in China for 2015, we examined the temporal and spatial characteristics of the impacts of the Taklimakan dust events on downstream urban air quality in China. The results show that the Taklimakan dust events severely affected the air quality of most cities in Northwest China including eastern Xinjiang, Hexi Corridor and Guanzhong Basin, and even northern Southwest China, leading to significant increases in mass concentrations of PM10 and PM2.5 in these cities correlating with the occurrence of dust events. The mass concentrations of PM10 on dust days increased by 11–173% compared with the non-dust days, while the mass concentration of PM2.5 increased by 21–172%. The increments of the mass concentrations of PM10 and PM2.5 on dust days decreased as the distances increased between the cities and the Taklimakan Desert. The influence of the Taklimakan dust events on the air quality in the downstream cities usually persisted for up to four days. The mass concentrations of PM10 and PM2.5 increased successively and the impact duration shortened gradually with increasing distances to the source area as a strong dust storm progressed toward the southeast from the Taklimakan Desert. The peaks of the PM10 concentrations in the downstream cities of eastern Xinjiang, the Hexi Corridor and the Guanzhong Basin occurred on the second, third and fourth days, respectively, after the initiation of the Taklimakan dust storm.

A Comparison of the Health Effects of Ambient Particulate Matter Air Pollution from Five Emission Sources

This article briefly reviews evidence of health effects associated with exposure to particulate matter (PM) air pollution from five common outdoor emission sources: traffic, coal-fired power stations, diesel exhaust, domestic wood combustion heaters, and crustal dust. The principal purpose of this review is to compare the evidence of health effects associated with these different sources with a view to answering the question: Is exposure to PM from some emission sources associated with worse health outcomes than exposure to PM from other sources? Answering this question will help inform development of air pollution regulations and environmental policy that maximises health benefits. Understanding the health effects of exposure to components of PM and source-specific PM are active fields of investigation. However, the different methods that have been used in epidemiological studies, along with the differences in populations, emission sources, and ambient air pollution mixtures between studies, make the comparison of results between studies problematic. While there is some evidence that PM from traffic and coal-fired power station emissions may elicit greater health effects compared to PM from other sources, overall the evidence to date does not indicate a clear ‘hierarchy’ of harmfulness for PM from different emission sources. Further investigations of the health effects of source-specific PM with more advanced approaches to exposure modeling, measurement, and statistics, are required before changing the current public health protection approach of minimising exposure to total PM mass.

Lung health in era of climate change and dust storms

Dust storms are strong winds which lead to particle exposure over extensive areas. These storms influence air quality on both a local and global scale which lead to both short and long-term effects. The frequency of dust storms has been on the rise during the last decade. Forecasts suggest that their incidence will increase as a response to the effects of climate change and anthropogenic activities. Elderly people, young children, and individuals with chronic cardiopulmonary diseases are at the greatest risk for health effects of dust storms. A wide variety of infectious and non-infectious diseases have been associated with dust exposure. Influenza A virus, pulmonary coccidioidomycosis, bacterial pneumonia, and meningococcal meningitis are a few examples of dust-related infectious diseases. Among non-infectious diseases, chronic obstructive pulmonary disease, asthma, sarcoidosis and pulmonary fibrosis have been associated with dust contact. Here, we review two molecular mechanisms of dust induced lung disease for asthma and sarcoidosis. We can also then further understand the mechanisms by which dust particles disturb airway epithelial and immune cells.

Saharan dust and the impact on adult and elderly allergic patients: the effect of threshold values in the northern sector of Gran Canaria, Spain

Gran Canaria Island is frequently impacted by Saharan dust, a health hazard of particular concern to the island population and health agencies. Airborne mineral dust has the severest impact on the higher age groups of the population, and those with respiratory conditions; despite that, on average, the ambient particulate matter (PM) concentrations fall within international PM guidelines. During 2010 and 2011, an epidemiological survey, in parallel with an air quality study, was conducted at the Dr Negrín hospital in Gran Canaria. This included the quarterly monitoring of outpatients and recording of emergency patients with respiratory diseases, together with the measurement of aerosol, meteorological, and PM-related air quality levels. The finer more toxic particles were collected with PM_2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) aerosol samplers. The filter samples were gravimetrically and chemically analyzed for their elemental, water-soluble ions, carbon, and mineralogical contents. Individual particle morphology was measured by Scanning Electron Microscopy. Statistical analysis of the chemical and clinical data included the analysis of variance and calculation of Spearman correlation coefficients. No statistically significant relations were found between the allergic control group, the emergency room admissions, pulmonary conditions, medication, and elevated Saharan dust levels. However, changing environmental conditions, such as an increase in humidity or a reduction in ambient air temperature made a significant difference to the outcomes recorded on the health statements of the allergic and respiratory illness groups of the Gran Canary population.

Ambient Air Pollution and Morbidity in Chinese

The rapid economic growth in China is coupled with a severe ambient air pollution, which poses a huge threat to human health and the sustainable development of social economy. The rapid urbanization and industrialization over the last three decades have placed China as one of countries with the greatest disease burden in world. Notably, the prevalence rate of chronic noncommunicable diseases (CND), including respiratory diseases, CVD, and stroke, in 2010 reaches 16.9%. The continuous growth of the incidence of CND urgent needs for effective regulatory action for health protection. This study aims to evaluate the impact of rapid urbanization on status of ambient air pollution and associated adverse health effects on the incidence and the burden of CND and risk assessment. Our findings would be greatly significant in the prediction of the risk of ambient air pollution on CND and for evidence-based policy making and risk management in China.

Spatial and temporal variability in desert dust and anthropogenic pollution in Iraq, 1997-2010

Satellite imaging has emerged as a method for monitoring regional air pollution and detecting areas of high dust concentrations. Unlike ground observations, continuous data monitoring is available with global coverage of terrestrial and atmospheric components. In this study we test the utility of different sources of satellite data to assess air pollution concentrations in Iraq. SeaWiFS and MODIS Deep Blue (DB) aerosol optical depth (AOD) products were evaluated and used to characterize the spatial and temporal pollution levels from the late 1990s through 2010. The AOD and Ångström exponent (an indicator of particle size, since smaller Ångström exponent values reflect a source that includes larger particles) were correlated on 50 × 50 km spatial resolution. Generally, AOD and Ångström exponent were inversely correlated, suggesting a significant contribution of coarse particles from dust storms to AOD maxima. Although the majority of grid cells exhibited this trend, a weaker relationship in other locations suggested an additional contribution of fine particles from anthropogenic sources. Tropospheric NO₂ densities from the OMI satellite were elevated over cities, also consistent with a contribution from anthropogenic sources. Our analysis demonstrates the use of satellite imaging data to estimate relative pollution levels and source contributions in areas of the world where direct measurements are not available.

IMPLICATIONS

The authors demonstrated how satellite data can be used to characterize exposures to dust and to anthropogenic pollution for future health related studies. This approach is of a great potential to investigate the associations between subject-specific exposures to different pollution sources and their health effects in inaccessible regions and areas where ground monitoring is unavailable.

Public health risks of prolonged fine particle events associated with stagnation and air quality index based on fine particle matter with a diameter <2.5 μm in the Kaoping region of Taiwan

The increasing frequency of droughts in tropical and sub-tropical areas since 1970 due to climate change requires a better understanding of the relationship between public health and long-duration fine particle events (FPE; defined as a day with an average PM_2.5 ≥ 35.5 μg/m³) associated with rainfall and wind speed. In the Kaoping region of Taiwan, 94.46 % of the daily average PM_2.5 in winter exceeds the limit established by 2005 World Health Organization (WHO) guidelines. This study investigated the differences in winter weather characteristics and health effects between non-FPE and FPE days, and the performance of air quality indexes on FPE days. Z-statistics for one-tailed tests, multiplicative decomposition models, logarithmic regression, and product-moment correlations were used for the analysis. The results indicate that mean wind speeds, rainfall hours, and air temperature were significantly decreased on FPE days. Daily mean PM_2.5 concentrations were positively correlated to the duration of FPE days. The duration of FPE days was positively related to the length of drought (r = 0.97, P < 0.05). The number of respiratory admissions was positively correlated with the FPE duration (r ² = 0.60). The age groups >15 years experienced the largest average reduction in asthma admissions on lag-days. Compared to the pollutant standard index (PSI) and revised air quality index (RAQI), the PM_2.5 index is more representative and sensitive to changes in PM_2.5 concentrations.

Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action

In China, where air pollution has become a major threat to public health, public awareness of the detrimental effects of air pollution on respiratory health is increasing-particularly in relation to haze days. Air pollutant emission levels in China remain substantially higher than are those in developed countries. Moreover, industry, traffic, and household biomass combustion have become major sources of air pollutant emissions, with substantial spatial and temporal variations. In this Review, we focus on the major constituents of air pollutants and their impacts on chronic respiratory diseases. We highlight targets for interventions and recommendations for pollution reduction through industrial upgrading, vehicle and fuel renovation, improvements in public transportation, lowering of personal exposure, mitigation of the direct effects of air pollution through healthy city development, intervention at population-based level (systematic health education, intensive and individualised intervention, pre-emptive measures, and rehabilitation), and improvement in air quality. The implementation of a national environmental protection policy has become urgent.

Effects of air pollution on human health and practical measures for prevention in Iran

Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer's and Parkinson's diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran.

Indirect estimation of emission factors for phosphate surface mining using air dispersion modeling

To date, phosphate surface mining suffers from lack of reliable emission factors. Due to complete absence of data to derive emissions factors, we developed a methodology for estimating them indirectly by studying a range of possible emission factors for surface phosphate mining operations and comparing AERMOD calculated concentrations to concentrations measured around the mine. We applied this approach for the Khneifiss phosphate mine, Syria, and the Al-Hassa and Al-Abyad phosphate mines, Jordan. The work accounts for numerous model unknowns and parameter uncertainties by applying prudent assumptions concerning the parameter values. Our results suggest that the net mining operations (bulldozing, grading and dragline) contribute rather little to ambient TSP concentrations in comparison to phosphate processing and transport. Based on our results, the common practice of deriving the emission rates for phosphate mining operations from the US EPA emission factors for surface coal mining or from the default emission factor of the EEA seems to be reasonable. Yet, since multiple factors affect dispersion from surface phosphate mines, a range of emission factors, rather than only a single value, was found to satisfy the model performance.

Pollutional haze and COPD: etiology, epidemiology, pathogenesis, pathology, biological markers and therapy

In recent years, serious pollutional haze occurs in the mainland of China thanks to the development of urbanization and industrialization. There is a close relationship between air pollution and the occurrence and development of chronic obstructive pulmonary disease (COPD), but there are some new characteristics in some aspects of COPD associated with pollutional haze compared with COPD induced by traditional physical and chemical factors. This article attempts to summarize the new progress from these new features of COPD related to pollutional haze, focus on etiology, epidemiology, pathogenesis, pathology, biological markers and therapy.

The joint return period analysis of natural disasters based on monitoring and statistical modeling of multidimensional hazard factors

As a random event, a natural disaster has the complex occurrence mechanism. The comprehensive analysis of multiple hazard factors is important in disaster risk assessment. In order to improve the accuracy of risk analysis and forecasting, the formation mechanism of a disaster should be considered in the analysis and calculation of multi-factors. Based on the consideration of the importance and deficiencies of multivariate analysis of dust storm disasters, 91 severe dust storm disasters in Inner Mongolia from 1990 to 2013 were selected as study cases in the paper. Main hazard factors from 500-hPa atmospheric circulation system, near-surface meteorological system, and underlying surface conditions were selected to simulate and calculate the multidimensional joint return periods. After comparing the simulation results with actual dust storm events in 54years, we found that the two-dimensional Frank Copula function showed the better fitting results at the lower tail of hazard factors and that three-dimensional Frank Copula function displayed the better fitting results at the middle and upper tails of hazard factors. However, for dust storm disasters with the short return period, three-dimensional joint return period simulation shows no obvious advantage. If the return period is longer than 10years, it shows significant advantages in extreme value fitting. Therefore, we suggest the multivariate analysis method may be adopted in forecasting and risk analysis of serious disasters with the longer return period, such as earthquake and tsunami. Furthermore, the exploration of this method laid the foundation for the prediction and warning of other nature disasters.

Geogenic PM₁₀ exposure exacerbates responses to influenza infection

Particulate matter (PM) exposure has been linked epidemiologically to exacerbations of lung disease, including respiratory infections. We investigated the effects of geogenic (earth-derived) PM10 (PM<10 μm diameter) on the response to a respiratory viral infection. Geogenic dust was sampled from four communities in arid environments in Western Australia. Adult female BALB/c mice were intranasally exposed to chronic doses of PM10 (10 μg/day for 10 days), and/or infected with influenza (A/Mem/1/71) virus. Inflammation (cells, IL-6, IFN-γ) was measured in bronchoalveolar lavage. Lung mechanics were measured using the forced oscillation technique. Geogenic PM10 induced lung inflammation (neutrophils, macrophages) with additive effects in mice also infected with influenza. PM10 also modified the influenza-induced IL-6 and IFN-γ responses. Geogenic PM10 increased airway resistance, and increased hysteresivity in those exposed to both insults. Viral titres were significantly higher after PM10 exposure. Iron concentration was inversely associated with IFN-γ and positively associated with viral titre and hysteresivity. Geogenic PM10 exposure increases inflammation, impairs lung function and increases viral load, exacerbating the response to respiratory viral infection. Iron in the particles may be a driver of these responses. This has important implications for respiratory health in communities exposed to high geogenic PM10, such as those in arid environments.

The Influence of Asian Dust, Haze, Mist, and Fog on Hospital Visits for Airway Diseases

Background

Asian dust is known to have harmful effects on the respiratory system. Respiratory conditions are also influenced by environmental conditions regardless of the presence of pollutants. The same pollutant can have different effects on the airway when the air is dry compared with when it is humid. We investigated hospital visits for chronic obstructive pulmonary disease (COPD) and asthma in relation to the environmental conditions.

Methods

We conducted a retrospective study using the Korean National Health Insurance Service claims database of patients who visited hospitals in Chuncheon between January 2006 and April 2012. Asian dust, haze, mist, and fog days were determined using reports from the Korea Meteorological Administration. Hospital visits for asthma or COPD on the index days were compared with the comparison days. We used two-way case-crossover techniques with one to two matching.

Results

The mean hospital visits for asthma and COPD were 59.37 ± 34.01 and 10.04 ± 6.18 per day, respectively. Hospital visits for asthma significantly increased at lag0 and lag1 for Asian dust (relative risk [RR], 1.10; 95% confidence interval [CI], 1.01-1.19; p<0.05) and haze (RR, 1.13; 95% CI, 1.06-1.22; p<0.05), but were significantly lower on misty (RR, 0.89; 95% CI, 0.80-0.99; p<0.05) and foggy (RR, 0.89; 95% CI, 0.84-0.93; p<0.05) days than on control days. The hospital visits for COPD also significantly increased on days with Asian dust (RR, 1.29; 95% CI, 1.05-1.59; p<0.05), and were significantly lower at lag4 for foggy days, compared with days without fog (RR, 0.85; 95% CI, 0.75-0.97; p<0.05).

Conclusion

Asian dust showed an association with airway diseases and had effects for several days after the exposure. In contrast to Asian dust, mist and fog, which occur in humid air conditions, showed the opposite effects on airway diseases, after adjusting to the pollutants. It would require more research to investigate the effects of various air conditions on airway diseases.

Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia

BACKGROUND AND OBJECTIVE

Triple combination therapy with tiotropium plus budesonide/formoterol has improved lung function and reduced exacerbation risk in patients with chronic obstructive pulmonary disease (COPD) in Western countries, but no such data exist for East Asian patients. This study aimed to evaluate the efficacy and tolerability of adding budesonide/formoterol to tiotropium compared with tiotropium alone in East Asian patients with severe/very severe COPD.

METHODS

This 12-week, randomized, parallel-group, multicentre, open-label study was conducted in East Asia. After a 14-day run-in period during which patients received tiotropium 18 μg once daily, patients were randomized to tiotropium (18 μg once daily) + budesonide/formoterol (160/4.5 μg 2 inhalations twice daily) or tiotropium alone (18 μg once daily). The primary endpoint was change from baseline in pre-dose forced expiratory volume in 1 s (FEV1 ) to the mean of values measured at Weeks 1, 6 and 12.

RESULTS

Pre-dose FEV1 significantly increased from baseline with tiotropium plus budesonide/formoterol (n = 287) versus tiotropium alone (n = 291) (5.0% vs 0.6%; treatment difference: 4.4% (95% CI: 1.9-6.9), P = 0.0004). Triple therapy also reduced the COPD exacerbation rate by 40.7% (P = 0.0032) and prolonged time to first exacerbation (38.6% risk reduction, P = 0.0167) versus tiotropium alone and markedly improved health-related quality of life (HRQoL), measured using the St George's Respiratory Questionnaire. Incidence of adverse events was 26% for both groups.

CONCLUSIONS

In East Asian patients with severe/very severe COPD, adding budesonide/formoterol to tiotropium was associated with significant improvements in FEV1 and HRQoL and lower COPD exacerbation rates. Treatment was generally well tolerated.

CLINICAL TRIAL REGISTRATION

NCT01397890 at Clinicaltrials.gov.

Desert dust and human health disorders

Dust storms may originate in many of the world's drylands and have an effect not only on human health in the drylands themselves but also in downwind environments, including some major urban centres, such as Phoenix, Kano, Athens, Madrid, Dubai, Jedda, Tehran, Jaipur, Beijing, Shanghai, Seoul, Taipei, Tokyo, Sydney, Brisbane and Melbourne. In some parts of the world dust storms occur frequently throughout the year. They can transport particulate material, pollutants, and potential allergens over thousands of km from source. The main sources include the Sahara, central and eastern Asia, the Middle East, and parts of the western USA. In some parts of the world, though not all, the frequency of dust storms is changing in response to land use and climatic changes, and in such locations the health implications may become more severe. Data on the PM10 and P2.5 loadings of dust events are discussed, as are various pollutants (heavy metals, pesticides, etc.) and biological components (spores, fungi, bacteria, etc.). Particulate loadings can far exceed healthy levels. Among the human health effects of dust storms are respiratory disorders (including asthma, tracheitis, pneumonia, allergic rhinitis and silicosis) cardiovascular disorders (including stroke), conjunctivitis, skin irritations, meningococcal meningitis, valley fever, diseases associated with toxic algal blooms and mortality and injuries related to transport accidents.

Short-term effect of dust storms on the risk of mortality due to respiratory, cardiovascular and all-causes in Kuwait

This study aimed to investigate the impact of dust storms on short-term mortality in Kuwait. We analyzed respiratory and cardiovascular mortality as well as all-cause mortality in relation to dust storm events over a 5-year study period, using data obtained through a population-based retrospective ecological time series study. Dust storm days were identified when the national daily average of PM10 exceeded 200 μg/m(3). Generalized additive models with Poisson link were used to estimate the relative risk (RR) of age-stratified daily mortality associated with dust events, after adjusting for potential confounders including weather variables and long-term trends. There was no significant association between dust storm events and same-day respiratory mortality (RR = 0.96; 95%CI 0.88-1.04), cardiovascular mortality (RR = 0.98; 95%CI 0.96-1.012) or all-cause mortality (RR = 0.99; 95%CI 0.97-1.00). Overall our findings suggest that local dust, that most likely originates from crustal materials, has little impact on short-term respiratory, cardiovascular or all-cause mortality.