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Liu C, Zhang B, Liu C, Zhang Y, Zhao K, Zhang P, Tian M, Lu Z, Guo X, Jia X. Association of ambient ozone exposure and greenness exposure with hemorrhagic stroke mortality at different times: A cohort study in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 278:116356. [PMID: 38678691 DOI: 10.1016/j.ecoenv.2024.116356] [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: 01/04/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
Evidence on the association between long-term ozone exposure and greenness exposure and hemorrhagic stroke (HS) is limited, with mixed results. One potential source of this inconsistency is the difference in exposure time metrics. This study aimed to investigate the association between long-term exposure to ambient ozone, greenness, and mortality from HS using exposure metrics at different times. We also examined whether greenness exposure modified the relationship between ozone exposure and mortality due to HS. The study population consisted of 45771 participants aged ≥40 y residing in 20 counties in Shandong Province who were followed up from 2013 to 2019. Ozone exposure metrics (annual mean and warm season) and the normalized difference a measure of greenness exposure, were calculated. The relationship between environmental exposures (ozone and greenness exposures) and mortality from HS was assessed using time-dependent Cox proportional hazards models, and the modification of greenness exposure was examined using stratified analysis with interaction terms. The person-years at the end of follow-up were 90,663. With full adjustments, the risk of death from hemorrhagic stroke increased by 5% per interquartile range increase in warm season ozone [hazard ratio =1.05; 95 % confidence interval: 1.01-1.08]. No clear association was observed between annual ozone and mortality HS. Both the annual and summer NDVI were found to reduce the risk of HS mortality. The relationships were influenced by age, sex, and residence (urban or rural). Furthermore, greenness exposure was shown to have a modifying effect on the relationship between ozone exposure and the occurrence of HS mortality (P for interaction = 0.001). Long-term exposure to warm season O3 was positively associated with HS mortality, while greenness exposure was inversely associated with HS mortality. Greenness exposure may mitigate the negative effects of warm season ozone exposure on HS mortality.
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Affiliation(s)
- Chengrong Liu
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Yingying Zhang
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Peiyao Zhang
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Meihui Tian
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China.
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Li Q, Wang H, Wang H, Deng J, Cheng Z, Lin W, Zhu R, Chen S, Guo J, Li H, Chen Y, Yuan X, Dai S, Tian Y, Xu Y, Wu P, Zhang F, Wang X, Tang LV, Hu Y. Season of delivery and risk of venous thromboembolism during hospitalization among pregnant women. Front Public Health 2023; 11:1272149. [PMID: 38026403 PMCID: PMC10663352 DOI: 10.3389/fpubh.2023.1272149] [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: 08/03/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Seasons were found to be related to the occurrences of venous thromboembolism (VTE) in hospitalized patients. No previous study has explored whether seasons were associated with VTE risk in pregnant women. This study aimed to investigate the relationships between the season of delivery and VTE risk during hospitalization among pregnant women. Methods This is a multi-center retrospective cohort study of pregnant women. Participants were those who delivered at seven designated sites in Hubei Province, China, during the period from January 2017 to December 2022. They were categorized according to their season/month of delivery. Information on new-onset VTE during hospitalization was followed. Results Approximately 0.28% (104/37,778) of the pregnant women developed new-onset VTE during hospitalization for delivery. After adjustment, compared with participants in the spring group, participants in the summer, autumn, and winter groups had an increased risk of VTE during hospitalization. The ORs were 2.59 [1.30, 5.15], 2.83 [1.43, 5.60], and 2.35 [1.17, 4.75] for the summer, autumn, and winter groups, respectively. Pregnant women in the combined group (summer + autumn + winter) had an increased risk of VTE during hospitalization than those in the spring group (OR, 2.59 [1.39, 4.85]). By restricting the analyses among pregnant women without in vitro fertilization, gestational diabetes mellitus, and preterm, the results still remained robust. Compared with participants who delivered in March, April, and May, participants who delivered in June, July, September, November, December, and February had a higher risk of VTE during hospitalization. Conclusion This study demonstrated that pregnant women who delivered in summer, autumn, and winter had an increased VTE risk during hospitalization compared with those who delivered in spring.
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Affiliation(s)
- Qian Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongfei Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huafang Wang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Deng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhipeng Cheng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenyi Lin
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ruiqi Zhu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shi Chen
- Department of Biobank, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinrong Guo
- Department of Medical Records Management and Statistics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huarong Li
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Chen
- Department of Obstetrics and Gynecology, Jingshan Union Hospital, Union Hospital, Huazhong University of Science and Technology, Jingshan, Hubei, China
| | - Xiaowei Yuan
- Department of Medical Services Division, People’s Hospital of Dongxihu District Wuhan City and Union Dongxihu Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shulan Dai
- Department of Obstetrics and Gynecology, People’s Hospital of Dongxihu District Wuhan City and Union Dongxihu Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Tian
- Department of Obstetrics and Gynecology, Central Hospital of Hefeng County, Enshi, Hubei, China
| | - Yanyan Xu
- Department of Obstetrics and Gynecology, Central Hospital of Hefeng County, Enshi, Hubei, China
| | - Ping Wu
- Department of Neurology, Central Hospital of Hefeng County, Enshi, Hubei, China
| | - Fan Zhang
- Department of Obstetrics and Gynecology, The Sixth General Hospital of Hubei Province, Wuhan, Hubei, China
| | - Xiaojiang Wang
- Department of Respiratory and Critical Care Medicine, The Sixth General Hospital of Hubei Province, Wuhan, Hubei, China
| | - Liang V. Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Li J, Lu A, Si S, Zhang K, Tang F, Yang F, Xue F. Exposure to various ambient air pollutants increases the risk of venous thromboembolism: A cohort study in UK Biobank. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 845:157165. [PMID: 35839901 DOI: 10.1016/j.scitotenv.2022.157165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/08/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Epidemiological evidence for the association between air pollutants exposure and venous thromboembolism (VTE) remains controversial. In this study, a total of 389,659 participants from the UK Biobank who were free of VTE in 2010 were included, and the annual mean concentrations of air pollutants near where participants lived were collected. During a median follow-up period of 8.25 years, 4986 VTEs were determined from the hospital admission records. The Cox proportional hazard model was used to examine the association between air pollutants and VTE. We firstly investigated the associations between air pollutants concentration and VTE and found only NO2 and NO increased VTE risk (P < 0.05). We further calculated the product of air pollutant concentrations and outdoor time to measure personal daily cumulative exposure and found that the hazard rates (HRs) of VTE for a 50-μg/m3∗day increase in daily cumulative exposure to PM10, PM2.5, PM2.5-10, NO, and NO2 were 1.08 (1.05-1.12), 1.16 (1.09-1.24), 1.23 (1.11-1.37), 1.04 (1.01-1.06), and 1.05 (1.03-1.08), respectively. To measure joint exposure to various air pollutants and its effect on VTE, we created a weighted air pollutants exposure score (APES) and found a dose-response relationship between APES and VTE risk (P < 0.001 for trend). Compared with participants in the lowest quintile of APES, the HRs of VTE were 1.19 (1.08-1.30) for those within the highest quintile groups. Furthermore, we also found the effect of air pollutants on VTE was statistically significant only in individuals with low-middle VTE genetic risk score (GRS) (P < 0.05), but not in the high VTE GRS groups (P > 0.05). Our findings suggest that exposure to various air pollutants including PM2.5, PM2.5-10, PM10, NO, and NO2, either individually or jointly, were associated with an increased risk of VTE in a dose-response pattern. Our study highlights the importance of a comprehensive assessment of various air pollutants in VTE prevention.
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Affiliation(s)
- Jiqing Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Aimei Lu
- Department of Pharmacy, Shandong Public Health Clinical Center, Jinan 250100, Shandong, China
| | - Shucheng Si
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Kai Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Fang Tang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China; Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fan Yang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
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Bumroongkit C, Liwsrisakun C, Deesomchok A, Pothirat C, Theerakittikul T, Limsukon A, Trongtrakul K, Tajarernmuang P, Niyatiwatchanchai N, Euathrongchit J, Inchai J, Chaiwong W. Correlation of Air Pollution and Prevalence of Acute Pulmonary Embolism in Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12808. [PMID: 36232104 PMCID: PMC9566050 DOI: 10.3390/ijerph191912808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The relationship between the level of air pollution and acute pulmonary embolism (APE) has had inconsistent results. OBJECTIVE This study aimed to analyze the relationship between the high level of air pollution exposure and APE. METHODS A ten-year retrospective cohort, single-center study was performed on patients diagnosed with APE from October 2010 to December 2020. The association between air pollution and monthly APE case diagnosis was analyzed. RESULTS A total number of 696 patients was included. The effect of every 10 µg/m3 increment of particulate matters with an aerodynamic diameter < 10 µm (PM10) on total monthly APE cases (unprovoked PE and provoked PE) was increased significantly at lag 4, 5 and 6 months with adjusted RR (95% CI) of 1.06 (1.01, 1.12), p = 0.011, 1.07 (1.01, 1.13), p = 0.021 and 1.06 (1.01, 1.12), p = 0.030, respectively. Adjusted RR for APE was significantly increased for PM10 in the second tertile ((adjusted RR (95% CI) 1.76 (1.12, 2.77)), p = 0.014. CONCLUSIONS We conclude that PM10 is associated with an increased prevalence of APE cases. The policy for tighter control of air pollution in our country is needed to reduce the impact of air pollutants on people's health.
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Affiliation(s)
- Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juntima Euathrongchit
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juthamas Inchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Miao H, Li X, Wang X, Nie S. Air pollution increases the risk of pulmonary embolism: a meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:259-266. [PMID: 34107570 DOI: 10.1515/reveh-2021-0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Air pollution can lead to many cardiovascular and respiratory diseases, but the impact of air pollution on pulmonary embolism is still uncertain. We conducted a meta-analysis to assess the relationship between air pollution and pulmonary embolism. CONTENT We searched PubMed, EMBASE, Web of Science, and the Cochran Library for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone and particulate matter) and pulmonary embolism. A total of nine citations met the inclusion criteria. There is no evidence of bias. CO, SO2, PM10 and PM2.5 had no significant effect on the occurrence of pulmonary embolism. NO2 and O3 can increase the risk of pulmonary embolism to a small extent. SUMMARY This meta-analysis suggests that some air pollutants are associated with an increased risk of pulmonary embolism. OUTLOOK Reducing air pollution and improving air quality can effectively reduce the risk of pulmonary embolism.
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Affiliation(s)
- Huangtai Miao
- Beijing An Zhen Hospital, Chaoyang-qu, Beijing, China
| | - Xiaoying Li
- Beijing Jishuitan Hospital, Beijing, Beijing, China
| | - Xiao Wang
- Beijing An Zhen Hospital, Chaoyang-qu, Beijing, China
| | - Shaoping Nie
- Beijing An Zhen Hospital, 2 Anzhen Rd, Chaoyang District, 100029, Chaoyang-qu, Beijing, China
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Li Z, Zhang Y, Yuan Y, Yan J, Mei Y, Liu X, Xu Q, Shi J. Association between exposure to air pollutants and the risk of hospitalization for pulmonary embolism in Beijing, China: A case-crossover design using a distributed lag nonlinear model. ENVIRONMENTAL RESEARCH 2022; 204:112321. [PMID: 34748777 DOI: 10.1016/j.envres.2021.112321] [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: 08/05/2021] [Revised: 10/15/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is a life-threatening condition. Few studies have evaluated the relationship between air pollution and PE, and these results have been inconsistent. Therefore, our study aimed to investigate the association between air pollutant exposure and the risk of hospitalization due to PE. MATERIALS AND METHODS Daily PE admissions, meteorological data, and ambient pollution data from January 1, 2015, to December 31, 2018, were collected in Beijing. A quasi-Poisson regression model combined with time-stratified case-crossover design and a distributed lag nonlinear model was used to determine the effect of air pollutant exposure on PE admission. To examine the stability of air pollutants' effects, multi-pollutant analyses were performed. Stratified analyses by age and sex were further conducted. RESULTS There were 5060 PE admissions during the study period, with an estimated incidence of 6.5 per 100,000. PM2.5, PM10, SO2, O3 and CO exposures were significantly associated with elevated risk of PE hospitalization. The highest cumulative risks were observed at a lag of 0-28 days for PM2.5 (relative risk [RR] = 1.056, 95% confidence intervals [CI]: 1.015-1.098), PM10 (RR = 1.042, 95%CI: 1.010-1.075), and CO (RR = 1.466, 95%CI: 1.127-1.906), at a lag of 0-27 days for SO2 (RR = 1.674, 95%CI: 1.200-2.335), and at a lag of 0-4 days for O3 (RR = 1.019, 95%CI: 1.001-1.038). All associations mentioned above except O3 remained significant in multi-pollutant models. Stratified analyses showed that women and those aged ≥65 years people were more sensitive to PM10 and CO exposure than men and those aged <65 years. The effect of PM2.5 exposure was statistically significant in all subgroups. CONCLUSIONS Exposure to PM2.5, PM10, SO2, and CO showed a positive association with PE hospitalization. High-risk PE groups should take special precautions on days with poor air quality.
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Affiliation(s)
- Zhaohui Li
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yunjian Zhang
- Department of Respiratory Medicine, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Yuan Yuan
- Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jingwen Yan
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Xiaoqing Liu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Clinical Epidemiology Unit, International Epidemiology Network, Beijing, 100730, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Juhong Shi
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Di Blasi C, Renzi M, Michelozzi P, De' Donato F, Scortichini M, Davoli M, Forastiere F, Mannucci PM, Stafoggia M. Association between air temperature, air pollution and hospital admissions for pulmonary embolism and venous thrombosis in Italy. Eur J Intern Med 2022; 96:74-80. [PMID: 34702659 DOI: 10.1016/j.ejim.2021.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/21/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous studies reported a link between short-term exposure to environmental stressors (air pollution and air temperature) and atherothrombotic cardiovascular diseases. However, only few of them reported consistent associations with venous thromboembolism (VTE). Our aim was to estimate the association between daily air temperature and particulate matter (PM) air pollution with hospital admissions for pulmonary embolism (PE) and venous thrombosis (VT) at national level in Italy. METHODS We collected daily hospital PE and VT admissions from the Italian Ministry of Health during 2006-2015 in all the 8,084 municipalities of Italy, and we merged them with air temperature and daily PM10 concentrations estimated by satellite-based spatiotemporal models. First, we applied multivariate Poisson regression models at province level. Then, we obtained national overall effects by random-effects meta-analysis. RESULTS This analysis was conducted on 219,952 PE and 275,506 VT hospitalizations. Meta-analytical results showed weak associations between the two exposures and the study outcomes in the full year analysis. During autumn and winter, PE hospital admissions increased by 1.07% (95% confidence intervals [CI]: 0.21%; 1.92%) and 0.96% (95% CI: 0.07%; 1.83%) respectively, per 1 °C decrement of air temperature in the previous 10 days (lag 0-10). In summer we observed adverse effects at high temperatures, with a 1% (95% CI: 0.10%; 1.91%) increasing risk per 1 °C increment. We found no association between VT and cold temperatures. CONCLUSION Results show a significant effect of air temperature on PE hospitalizations in the cold seasons and summer. No effect of particulate matter was detected.
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Affiliation(s)
- Chiara Di Blasi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma1.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma1
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma1
| | | | | | - Marina Davoli
- Department of Epidemiology, Lazio Region Health Service / ASL Roma1
| | - Francesco Forastiere
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
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Renzi M, Stafoggia M, Michelozzi P, Davoli M, Forastiere F, Solimini AG. Long-term exposure to air pollution and risk of venous thromboembolism in a large administrative cohort. Environ Health 2022; 21:21. [PMID: 35086531 PMCID: PMC8793234 DOI: 10.1186/s12940-022-00834-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Venous thromboembolisms (VTE) are one of the most frequent cause among the cardiovascular diseases. Despite the association between long-term exposure to air pollution and cardiovascular outcomes have been widely explored in epidemiological literature, little is known about the air pollution related effects on VTE. We aimed to evaluate this association in a large administrative cohort in 15 years of follow-up. METHODS Air pollution exposure (NO2, PM10 and PM2.5) was derived by land use regression models obtained by the ESCAPE framework. Administrative health databases were used to identify VTE cases. To estimate the association between air pollutant exposures and risk of hospitalizations for VTE (in total and divided in deep vein thrombosis (DVT) and pulmonary embolism (PE)), we used Cox regression models, considering individual, environmental (noise and green areas), and contextual characteristics. Finally, we considered potential effect modification for individual covariates and previous comorbidities. RESULTS We identified 1,954 prevalent cases at baseline and 20,304 cases during the follow-up period. We found positive associations between PM2.5 exposures and DVT, PE and VTE with hazard ratios (HRs) up to 1.082 (95% confidence intervals: 0.992, 1.181), 1.136 (0.994, 1.298) and 1.074 (0.996, 1.158) respectively for 10 μg/m3 increases. The association was stronger in younger subjects (< 70 years old compared to > 70 years old) and among those who had cancer. CONCLUSION The effect of pollutants on PE and VTE hospitalizations, although marginally non-significant, should be interpreted as suggestive of a health effect that deserves attention in future studies.
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Affiliation(s)
- Matteo Renzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, 00147, Rome, Italy.
- Department of Health Statistics and Biometry, University of Rome "La Sapienza", Rome, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Health Authority Service, ASL Rome 1, 00147, Rome, Italy
- Institute of Environmental Medicine, Karolinska Instituet, Stockholm, Sweden
| | - Paola Michelozzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, 00147, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Health Authority Service, ASL Rome 1, 00147, Rome, Italy
| | - Francesco Forastiere
- National Research Council of Italy, Institute of Innovation and Biomedical Research (IRIB), , Palermo, Italy
| | - Angelo G Solimini
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
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Relationship between Wildfire Smoke and Children’s Respiratory Health in the Metropolitan Cities of Central-Chile. ATMOSPHERE 2021. [DOI: 10.3390/atmos13010058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Wildfire causes multiple problems for people living in cities. One of them is the deterioration of air quality as a result of wildfire smoke. This smoke can consequently have effects on human health. The present study aims to characterize the relationship between the occurrence of wildfires in central Chile and the effects on children’s respiratory health. Public databases provided the number of emergency care visits, wildfires, and concentration of air pollutants, demographics and meteorological variables for the regions of Santiago and Valparaiso from 2010 to 2013. Time series analysis was used monthly on health care visits to determine the relative health risk in children when in the presence of additional wildfires. Significant health risks were observed in Santiago for children younger than 1-year-old of bronchitis (RR 1.007, CI 95% 1.007–1.008; chronic lower respiratory diseases (RR 1.012, CI 95% 1.012–1.013); and pneumonia (RR 1.026 CI 95% 1.026–1.027) and in children aged one to four years old (RR 1.016 CI 95% 1.015–1.016). A dose-response relationship was also observed for pneumonia, showing that it affects younger children particularly when there is an increase in the number of wildfires. In the Region of Valparaíso, wildfires did not significantly change the risk of respiratory illness, this could be due to favorable ventilation. Currently, Santiago has an urgent need for monitoring and the evaluation of the damage to children’s respiratory health, along with the development of comprehensive prevention strategies.
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Riedlova P, Kramna D, Ostrizkova S, Tomaskova H, Jirik V. Examination of in Factor V Leiden and Prothrombin II Thrombophilic Mutations in Czech Young Women Using ddPCR-Prevalence and Cost-Benefit Analysis. Healthcare (Basel) 2021; 9:1656. [PMID: 34946382 PMCID: PMC8701073 DOI: 10.3390/healthcare9121656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Thrombophilic mutations in genes for factor V Leiden and factor II prothrombin are among the most important risk factors for developing the thromboembolic disease (TED), along with the use of oral contraceptives (OCs) or smoking. AIM This study aimed to investigate the occurrence of risk factors in young women using droplet digital PCR (ddPCR) and, based on the results of this investigation, to perform a cost-benefit analysis of ddPCR-based screening in young women starting to take OCs compared to the treatment costs of patients who develop preventable TED in the Czech Republic. METHODS In this cross-sectional study, female university students filled in a questionnaire and provided a blood sample for DNA isolation and ddPCR analysis of both aforementioned genetic risk factors. The results, along with data from literature and web search, were used for cost-benefit analysis valid for the Czech Republic. RESULTS Out of 148 participants, 30 (20%) were smokers and 49 (33%) took OCs. A mutation was confirmed in 6 women (4.1%) in the factor V gene and in 3 women (2%) in the factor II gene, respectively. A model calculation on a cohort of 50,000 women starting to use contraceptives in the Czech Republic every year showed that at maximum compliance, (i.e., non-use of OC and smoking cessation), screening could prevent 68 cases of TED over the course of the mean period of OC use (5.7 years). Economically, the costs of testing in this cohort (2.25 mil. USD) would be significantly lower than prevented treatment costs (16 mil. USD at maximum compliance); the cost-benefit break-even point would be at 14.1% compliance. CONCLUSION The cost-benefit analysis based on our results indicates that screening for factor V Leiden and factor II prothrombin in young women before starting to use OCs would, in the conditions of the Czech Republic, likely be highly economically effective.
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Affiliation(s)
- Petra Riedlova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic; (D.K.); (S.O.); (H.T.); (V.J.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Dagmar Kramna
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic; (D.K.); (S.O.); (H.T.); (V.J.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Silvie Ostrizkova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic; (D.K.); (S.O.); (H.T.); (V.J.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Hana Tomaskova
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic; (D.K.); (S.O.); (H.T.); (V.J.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Vitezslav Jirik
- Centre for Epidemiological Research, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic; (D.K.); (S.O.); (H.T.); (V.J.)
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
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Signorelli SS, Oliveri Conti G, Carpinteri G, Lumera G, Fiore M, Dattilo G, Gaudio A, Ferrante M. Venous thromboembolism in hospital emergency room. A retrospective study on climatic effect. ENVIRONMENTAL RESEARCH 2021; 197:110950. [PMID: 33737078 DOI: 10.1016/j.envres.2021.110950] [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: 11/23/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
Several cardiovascular conditions exhibit seasonality in frequency and mortality, but little is known about the seasonality of Venous ThromboEmbolism (VTE), a very relevant medical condition, and seasonal influences are still conflicting. Patients having co-morbidities, individual suffered from dyspnea, swelling, edema of lower limb, pain (chest, lower limbs) are admitted frequently to the hospital emergency room (HER), particularly. Both mark a potential risk for VTE, that can be increased also by seasonality. A four years retrospective analysis (2016-2019) was carried out in individuals and patients admitted to the HER of the Hospital of Catania (a Mediterranean city of Sicily, Italy) to evaluate the VTE frequency and its seasonal differences, common symptoms, potential usage of some common laboratory tests. Dyspnea, swelling, edema of lower limb and pain (chest, lower limbs) were considered to suspect pulmonary embolism (PE) or for deep vein thrombosis of lower limb (DVT). Platelet count, platelet volume, fibrinogen, C-reactive protein, and D-dimer were considered. VTE frequency per year was 2.9/10,000 (2016), 4.9/10,000 (2017) 3.6/10,000 (2018), and 5.1/10,000 (2019) respectively. Dyspnea was highly frequent for PE, edema and lower limb pain were frequent in DVT patients. Fibrinogen, C reactive protein, and D-dimer values were found raised in all the VTE patients. Platelet volume was found higher in DVT than PE VTE events that occurred in warm periods were modestly greater (57 VTE: 38 DVT, 19 PE) compared to cold months (52 VTE: 34 DVT, 18 PE). Our results could be explained by the increased sweating due to the high temperatures, which in turn, can affect both on plasma concentration and on hematocrit value coupled to the reduction in atmospheric pressure determining both a hyper-coagulative condition. Climate seasonal characteristics, and environmental conditions in Catania city (Sicily) may be as reasonable items in expecting on different VTE rates in warm period compared to cold. This study highlights no specific symptoms, and confirms the common lab tests for individuals and patients admitted to HER as simple and helpful tools in initiating none or mini-invasive diagnostic strategy for the VTE. Finally, the climate/seasonality coupled with latitude can have a direct influence on the incidence of DVT.
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Affiliation(s)
- Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine. University of Catania, Italy; Internal Medicine Unit. University Hospital "G. Rodolico", Catania, Italy.
| | - Gea Oliveri Conti
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy.
| | - Giuseppe Carpinteri
- Emergengy Medicine Division. University Hospital "G. Rodolico", Catania, Italy
| | - Giovanni Lumera
- Department of Clinical and Experimental Medicine. University of Catania, Italy; Internal Medicine Unit. University Hospital "G. Rodolico", Catania, Italy
| | - Maria Fiore
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy
| | - Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine. University of Catania, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy
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Effects of Short-Term Air Pollution Exposure on Venous Thromboembolism: A Case-Crossover Study. Ann Am Thorac Soc 2021; 18:1988-1996. [PMID: 33984246 DOI: 10.1513/annalsats.202010-1337oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Exposure to outdoor air pollution is associated with increased cardiovascular disease, respiratory illness, and mortality. The effect of air pollution on venous thromboembolism (VTE) is less certain. OBJECTIVES To test for associations between short-term exposure to air pollution and VTE. METHODS Retrospective case-crossover study of adult patients with an objectively confirmed VTE event. Exposure to mean and maximum PM2.5 and ozone were estimated with inverse distance squared weighting from multiple stationary air quality monitors. Conditional logistic regression with a 7-day individual lag model estimated the odds ratio of VTE occurrence during the case period relative to the referent period. Prespecified subgroup analysis was performed to further test associations in higher risk patients. RESULTS A total of 2,803 VTE events met inclusion criteria for analysis. Deep vein thrombosis was identified in 1,966 (70.1%) and pulmonary embolism in 915 (32.6%) subjects. Median age was 57 years. Small negative associations were observed for maximum PM2.5 exposure at 1 day (odds ratio [95% confidence interval]; OR=0.992 [0.986-0.997]) and mean PM2.5 exposure at 1 day (OR=0.982 [0.97-0.994]), 5 days (OR=0.987 [0.975-0.999]), 6 days (OR=0.984 [0.972-0.996]), 7 days (OR=0.982 [0.971-0.994]), prior to VTE diagnosis. Similar negative associations were observed for 8-hour mean (OR=0.989 [0.981-0.997]) and 8-hour maximum (OR=0.992 [0.985-0.999]) ozone exposure 4 days prior to VTE diagnosis. Positive relationships (ORs~1.02) between 8-hour mean and maximum ozone exposure 6-7 days preceding VTE diagnosis were observed in a recently hospitalized subgroup. CONCLUSIONS Short-term exposure to PM2.5 and ozone does not appear to be associated with an overall increased risk of VTE. Further well-designed studies are needed to test whether previously reported associations between VTE and air pollution exist.
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Wu J, Tian Y, Wu Y, Wang Z, Wu Y, Wu T, Qin X, Wang M, Wang X, Wang J, Hu Y. Seasonal association between ambient fine particulate matter and venous thromboembolism in Beijing, China: a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-13035-0. [PMID: 33634399 DOI: 10.1007/s11356-021-13035-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
Little is known about the influence of ambient fine particulate matter (PM2.5) on the incidence of venous thromboembolism in areas with heavy air pollution. We examined seasonal associations between airborne concentrations of fine particulate matter and outpatient visits for venous thromboembolism in Beijing using a city-wide time-series design that covered a period of 30 months (January 1, 2010 to June 30, 2012). Generalized additive models were used to investigate the associations with adjustment of temperature for various time lags (lag 0 for the warm season and lag 0-10 for the cold season). Overall, 92,435 outpatient visits were recorded by the Beijing Medical Claim Data for Employees database during the study period. We found a significant association between PM2.5 levels and outpatient visits for venous thromboembolism. A 10-μg/m3 increase in PM2.5 concentrations on lag days 0-2 corresponded to a 0.64% (95% confidence interval: 0.55-0.73%; P < 0.001) increase in outpatient visits for venous thromboembolism during the cold season, and a 10-μg/m3 increase in PM2.5 concentrations on lag days 0-3 corresponded to a 0.82% (95% confidence interval: 0.67-0.96%; P < 0.001) increase in outpatient visits for venous thromboembolism during the warm season. Our findings suggest that PM2.5 exposure is associated with outpatient visits for venous thromboembolism in Beijing, and a more pronounced association was observed during the warm season. We propose that various temperature-adjustment strategies should be used when investigating seasonal associations.
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Affiliation(s)
- Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing, 100191, China.
- Medical Informatics Center, Peking University, Beijing, 100191, China.
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Macro-Impacts of Air Quality on Property Values in China—A Meta-Regression Analysis of the Literature. BUILDINGS 2021. [DOI: 10.3390/buildings11020048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Air pollution has received increasing attention in recent years, particularly in China, due to the rapid industrialisation that has wrought intense levels of air pollution. A number of studies, therefore, have been devoted to quantifying the impacts of air pollution on property value in China. However, the empirical results are somewhat mixed. This naturally raises questions of whether there is a significant relationship between air quality and housing prices and the plausible reasons for the mixed results in previous studies. This study aims to fill this gap by explaining the variations in the findings by a meta-regression analysis. To control for heterogeneity, a weighted least square model was used to explore the factors influencing the magnitude and significance of the air quality effect based on empirical estimates from 117 observations. This study confirms that air quality does have a discernible impact on housing prices beyond the publication bias. Besides, the types of air quality indicator and the air data source do significantly influence estimates through affecting both the magnitude of the elasticity and the partial correlation coefficient (PCC). Further, the selections of control variables and estimation approaches also have significant impacts on estimates. This study also finds that published papers tend to be biased towards more economically significant estimates. The implications of the findings have also been discussed.
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Kacem I, Kahloul M, Hafsia M, Aroui H, Maoua M, Ajmi M, Jedidi M, Gouider J, Ghannouchi N, Laouani C, Chouchane I, Taieb D, Chaouch A, Naija W, Mrizak N. Influence of weather and air pollution on the occurrence of idiopathic pulmonary embolism in the region of Sousse (Tunisia). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:37660-37667. [PMID: 32607994 DOI: 10.1007/s11356-020-09893-9] [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: 12/18/2019] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
Pulmonary embolism (PE) is the most serious manifestation of thromboembolic conditions. Its incidence varies considerably between countries, suggesting its interaction with the external environment. To analyze the influence of climate and air pollution on the occurrence of idiopathic PE in the region of Sousse (Tunisia). A total of 142 patients with idiopathic PE at two academic hospitals in Sousse (Tunisia) were enrolled in the study over a 7-year period. An analysis of two time series (environmental data and PE cases) was performed. Climatic data were collected from the National Institute of Meteorology. Air pollution data were obtained from the modeling platform of the National Agency for Protection of the Environment. The year 2015 was marked by the occurrence of the highest number of cases (24.6%). A statistically significant decrease in PE risk of 41.9% was observed during the summer with an OR of 0.59 (95% CI [0.36-0.94] and p = 0.026), compared with other seasons. Poisson GLM regression showed a significant increased risk of PE of 3.3% for each 1 °C temperature drop. After multiple binary logistic regression, the elevation of PM10 concentration was independently associated with an increased risk of PE (p < 10-3, OR 79.55, 95% CI [42.28-149.6]). Some environmental parameters may predispose to the onset of idiopathic PE. Understanding their accurate influence may have preventive and curative implications.
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Affiliation(s)
- Imène Kacem
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Occupational Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Kahloul
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia.
- Department of Anesthesia and Intensive Care, Sahloul University Hospital, 4002, Sousse, Tunisia.
| | - Meriam Hafsia
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Occupational Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Haifa Aroui
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Occupational Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Maher Maoua
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Occupational Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Ajmi
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Anesthesia and Intensive Care, Sahloul University Hospital, 4002, Sousse, Tunisia
| | - Maher Jedidi
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Legal Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Jridi Gouider
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Cardiology, FarhatHached University Hospital, Sousse, Tunisia
| | - Neirouz Ghannouchi
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Internal Medicine, Farhat Hached University Hospital, Sousse, Tunisia
| | - Chadia Laouani
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Internal Medicine, Sahloul University Hospital, Sousse, Tunisia
| | - Imed Chouchane
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of intensive care, Farhat Hached University Hospital, Sousse, Tunisia
| | - Dalila Taieb
- National Agency for the Protection of the Environment, Tunis, Tunisia
| | - Ajmi Chaouch
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Anesthesia and Intensive Care, Sahloul University Hospital, 4002, Sousse, Tunisia
| | - Walid Naija
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Anesthesia and Intensive Care, Sahloul University Hospital, 4002, Sousse, Tunisia
| | - Nejb Mrizak
- Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
- Department of Occupational Medicine, Farhat Hached University Hospital, Sousse, Tunisia
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Borsi SH, Khanjani N, Nejad HY, Riahi A, Sekhavatpour Z, Raji H, Dastoorpoor M. Air pollution and hospital admissions due to deep vein thrombosis (DVT) in Ahvaz, Iran. Heliyon 2020; 6:e04814. [PMID: 32913913 PMCID: PMC7472851 DOI: 10.1016/j.heliyon.2020.e04814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/25/2020] [Accepted: 08/25/2020] [Indexed: 11/25/2022] Open
Abstract
There are limited studies on the relation between short-term exposure to air pollutants and the risk of deep venous thrombosis (DVT). The aim of this study was to determine the relation between the concentration of these pollutants and the risk of hospital admissions due to DVT in Ahvaz, which is one of the world's highly polluted cities. Daily data on pollutants including O3, NO, NO2, SO2, CO, PM10, and PM2.5and DVT hospital admissions were collected from2008until 2018. Quasi-Poisson regression combined with linear distributed lag models; adjusted for trend, seasonality, temperature, relative humidity, weekdays, and holidays were used to assess the relation between the daily average of air pollutants and hospital admission for DVT. The results showed that there was a significant increase in hospital admissions due to DVT in the total, men, women, and elderly populations in relation to NO and NO2. There was also a significant increase in DVT hospital admissions in the male and ≤60 years populations related to PM10; and among the female and ≤60 years old populations, related to PM2.5. Finally, the results showed that there were significant positive associations between SO2 and CO exposure and the incidence of DVT hospital admissions among men and women, respectively. The results of this study show the possible effect of short-term exposure to air pollution on the risk of DVT. Further studies are required to investigate whether direct interventions through industry and government policy may alter the impact of specific pollutants in order to alter the incidence of DVT and other identified health complications.
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Affiliation(s)
- Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Yazdani Nejad
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Riahi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zohreh Sekhavatpour
- Department of Anesthesiology, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Keller K, Hobohm L, Münzel T, Konstantinides SV, Lankeit M. Sex-specific and age-related seasonal variations regarding incidence and in-hospital mortality of pulmonary embolism in Germany. ERJ Open Res 2020; 6:00181-2020. [PMID: 32607372 PMCID: PMC7306502 DOI: 10.1183/23120541.00181-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/15/2020] [Indexed: 01/12/2023] Open
Abstract
Background Studies have reported seasonal variations regarding the incidence and the short-term mortality of pulmonary embolism (PE). The aim of this study was to identify sex-specific and age-related differences in seasonal patterns regarding hospitalisations and mortality of PE patients. Methods We analysed the impact of seasons on incidence and in-hospital mortality of male and female hospitalised PE patients in Germany (2005-2015) based on the German nationwide inpatient sample. Results The German nationwide inpatient sample comprised 885 806 hospitalisations due to PE (2005-2015). Seasonal variations of both incidence (p=0.021) and in-hospital mortality (p<0.001) were of significant magnitude. Quarterly annual incidence (25.5 versus 23.7 of 100 000 citizens per year, p=0.021) and in-hospital mortality (17.0% versus 16.7%, p=0.008) were higher in winter than in summer. Risk of in-hospital mortality in winter was slightly higher (OR 1.03 (95% CI 1.01-1.06), p=0.015) compared to summer, independently of sex, age and comorbidities. Additionally, we observed sex-specific differences during seasons: the highest number of hospitalisations of PE patients of both sexes was during winter, whereas the nadir of male patients was in spring and that of female patients was in summer. Both sexes showed a maximum of in-hospital mortality in spring. Seasonal variation regarding incidence and mortality was pronounced in older patients. Conclusion Incidence and the in-hospital mortality of PE patients showed a significant seasonal variation with sex-specific differences. Although it has to be hypothesised that the seasonal variation of PE is multifactorially dependent, variation in each season was not explained by seasonal differences regarding age, sex and the prevalence of important comorbidities.
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Affiliation(s)
- Karsten Keller
- Center for Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
| | - Lukas Hobohm
- Center for Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Stavros V Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.,Dept of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Mareike Lankeit
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.,Dept of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité - University Medicine, Berlin, Germany.,DZHK, Partner Site Berlin, Berlin, Germany
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Ju S, Lim L, Jiao HY, Choi S, Jun JY, Ki YJ, Choi DH, Lee JY, Song H. Oxygenated polycyclic aromatic hydrocarbons from ambient particulate matter induce electrophysiological instability in cardiomyocytes. Part Fibre Toxicol 2020; 17:25. [PMID: 32527278 PMCID: PMC7288552 DOI: 10.1186/s12989-020-00351-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Epidemiologic studies have suggested that elevated concentrations of particulate matter (PM) are strongly associated with an increased risk of developing cardiovascular diseases, including arrhythmia. However, the cellular and molecular mechanisms by which PM exposure causes arrhythmia and the component that is mainly responsible for this adverse effect remains to be established. In this study, the arrhythmogenicity of mobilized organic matter from two different types of PM collected during summer (SPM) and winter (WPM) seasons in the Seoul metropolitan area was evaluated. In addition, differential effects between polycyclic aromatic hydrocarbons (PAHs) and oxygenated PAHs (oxy-PAHs) on the induction of electrophysiological instability were examined. Results We extracted the bioavailable organic contents of ambient PM, measuring 10 μm or less in diameter, collected from the Seoul metropolitan area using a high-volume air sampler. Significant alterations in all factors tested for association with electrophysiological instability, such as intracellular Ca2+ levels, reactive oxygen species (ROS) generation, and mRNA levels of the Ca2+-regulating proteins, sarcoplasmic reticulum Ca2+ATPase (SERCA2a), Ca2+/calmodulin-dependent protein kinase II (CaMK II), and ryanodine receptor 2 (RyR2) were observed in cardiomyocytes treated with PM. Moreover, the alterations were higher in WPM-treated cardiomyocytes than in SPM-treated cardiomyocytes. Three-fold more oxy-PAH concentrations were observed in WPM than SPM. As expected, electrophysiological instability was induced higher in oxy-PAHs (9,10-anthraquinone, AQ or 7,12-benz(a) anthraquinone, BAQ)-treated cardiomyocytes than in PAHs (anthracene, ANT or benz(a) anthracene, BaA)-treated cardiomyocytes; oxy-PAHs infusion of cells mediated by aryl hydrocarbon receptor (AhR) was faster than PAHs infusion. In addition, ROS formation and expression of calcium-related genes were markedly more altered in cells treated with oxy-PAHs compared to those treated with PAHs. Conclusions The concentrations of oxy-PAHs in PM were found to be higher in winter than in summer, which might lead to greater electrophysiological instability through the ROS generation and disruption of calcium regulation.
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Affiliation(s)
- Sujin Ju
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea
| | - Leejin Lim
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea.,Cancer mutation Research Center, Chosun University, Gwangju, 61452, South Korea
| | - Han-Yi Jiao
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Seok Choi
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Jae Yeoul Jun
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Ji Yi Lee
- Department of Environmental Science and Engineerings, Ewha Womans University, Seoul, 03760, South Korea.
| | - Heesang Song
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea. .,Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, 61452, South Korea.
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de Miguel-Diez J, Blasco-Esquivias I, Rodriguez-Matute C, Bedate-Diaz P, Lopez-Reyes R, Fernandez-Capitan C, Garcia-Fuika S, Lobo-Beristain JL, Garcia-Lozaga A, Quezada CA, Murga-Arizabaleta I, Garcia-Ortega A, Rodríguez-Davila MA, Marin-Barrera L, Otero-Candelera R, Praena-Fernandez JM, Jara-Palomares L. Correlation between short-term air pollution exposure and unprovoked lung embolism. Prospective observational (Contamina-TEP Group). Thromb Res 2020; 192:134-140. [PMID: 32480167 DOI: 10.1016/j.thromres.2020.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim was to analyze the temporal relationship between short-term air pollution exposure and acute symptomatic unprovoked pulmonary embolism (PE). PATIENTS/METHODS We performed a prospective, multicenter study in consecutive patients diagnosed with acute symptomatic unprovoked PE from February 2012 to January 2013. We analyzed demographic and clinical data, patients' addresses, meteorological and air pollutants data (PM10, SO2, CO, NO2, ozone emission data). We considered the number of days the patient had symptoms, and the study period constituted the previous 30 days. Likewise, the mean annual data of the reference season were calculated as well as the data of the 30-day study period corresponding to the same dates in the previous 3 years in order to obtain the monthly mean of the different pollutants for each period. RESULTS A total of 162 patients with acute symptomatic PE were recruited (43.2% unprovoked PE). The air pollutants could be determined in 50% of the patients with unprovoked PE, and a final analysis was performed in 35 patients. In the multiple comparison analysis to verify a possible correlation between the study period and the annual median, only NO2 showed a statistically significant association (p = 0.009). When comparing the study period with the previous 3 years, only NO2 maintained a statistically significant association for the 3 study periods. CONCLUSIONS We found a relationship between short-term exposure to NO2 and the presence of unprovoked PE.
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Affiliation(s)
- Javier de Miguel-Diez
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lucia Marin-Barrera
- Servicio de Neumología, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Remedios Otero-Candelera
- Servicio de Neumología, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Luis Jara-Palomares
- Servicio de Neumología, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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20
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Renzi M, Stafoggia M, Michelozzi P, Davoli M, Forastiere F, Solimini AG. Short-term exposure to PM 2.5 and risk of venous thromboembolism: A case-crossover study. Thromb Res 2020; 190:52-57. [PMID: 32302781 DOI: 10.1016/j.thromres.2020.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/10/2020] [Accepted: 03/09/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Short-term exposure to air pollution increases the risk of cardiovascular mortality and morbidity but little evidence is available on pollution effects on venous thromboembolism (VTE), a common vascular disease. METHODS We conducted a case-crossover analysis of all urgent hospitalizations for deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients >35 years during the period 2006 to 2017 in Rome (Italy). We examined whether 1) short-term exposure to particulate matter with aerodynamic diameter <2.5 μg (PM2.5) increases the risk of hospitalization for DVT or PE, and 2) if the associations are modified by the period of the year (warm and cold seasons), sex, age and comorbidity. RESULTS We found that short-term exposure to PM2.5 was associated with an increase of PE hospitalization risk of during the warm season (April to September) of 19.6% (95% confidence intervals: 8.3, 31%) per 10 μg/m3, while no statistically significant effects were displayed during the cold season or the whole year or for DVT hospitalizations. The effect of PM2.5 remained significant (%change: 21.3; 95%CI: 5.4, 39.5) after adjustment for nitrogen dioxide (NO2) co-exposure (a marker of traffic sources) and when limiting to primary diagnosis of PE (%change: 19.1; 95%CI: 4.2, 36.1). Age, sex and comorbid conditions did not modify the association. CONCLUSIONS Our results suggested a positive association between short-term exposure to PM2.5 and pulmonary embolism during the warm period of the year while no evidence emerged for deep vein thrombosis.
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Affiliation(s)
- Matteo Renzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy; Institute of Environmental Medicine, Karonlinska Instituet, Stockholm, Sweden
| | - Paola Michelozzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | | | - Angelo G Solimini
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
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21
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Mannucci PM, Harari S, Franchini M. Novel evidence for a greater burden of ambient air pollution on cardiovascular disease. Haematologica 2019; 104:2349-2357. [PMID: 31672903 PMCID: PMC6959193 DOI: 10.3324/haematol.2019.225086] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
Ambient and household air pollution is a major health problem worldwide, contributing annually to approximately seven million of all-cause avoidable deaths, shorter life expectancy, and significant direct and indirect costs for the community. Air pollution is a complex mixture of gaseous and particulate materials that vary depending on their source and physicochemical features. Each material has detrimental effects on human health, but a number of experimental and clinical studies have shown a strong impact for fine particulate matter (PM2.5). In particular, there is more and more evidence that PM2.5 exerts adverse effects particularly on the cardiovascular system, contributing substantially (mainly through mechanisms of atherosclerosis, thrombosis and inflammation) to coronary artery and cerebrovascular disease, but also to heart failure, hypertension, diabetes and cardiac arrhythmias. In this review, we summarize knowledge on the mechanisms and magnitude of the cardiovascular adverse effects of short-and long-term exposure to ambient air pollution, particularly for the PM2.5 size fraction. We also emphasize that very recent data indicate that the global mortality and morbidity burden of cardiovascular disease associated with this air pollutant is dramatically greater than what has been thought up to now.
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Affiliation(s)
| | - Sergio Harari
- Department of Pneumology and Semi-Intensive Care Unit, Department of Respiratory Physiopathology and Pulmonary Hemodynamics, Ospedale San Giuseppe MultiMedica, Milan and
| | - Massimo Franchini
- Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy
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22
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Signorelli SS, Oliveri Conti G, Zanobetti A, Baccarelli A, Fiore M, Ferrante M. Effect of particulate matter-bound metals exposure on prothrombotic biomarkers: A systematic review. ENVIRONMENTAL RESEARCH 2019; 177:108573. [PMID: 31323394 DOI: 10.1016/j.envres.2019.108573] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 05/25/2023]
Abstract
Environmental pollution is an important modifiable determinant for preventing cardiovascular diseases. Acute exposure to air pollution is linked to severe adverse cardiovascular events, including venous thromboembolism risk. The adverse health effects seem to arise from blood-borne metals and transition metal components from exposure to particulate matter that, when breathed, passes through the lungs into the heart and the blood stream. Pollution affects health via mechanisms including oxidative stress and inflammation, and metals may have a detrimental effect on both the blood cells, particularly platelets, and circulation. Some evidences demonstrates atherotrombotic consequences of acute and chronic exposure to air pollution, but few studies have examined exposure effects on the prothrombotic biomarkers leading to venous thromboembolism. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, we performed a systematic review (14 papers) of the past twelve years, focusing on the relationship between inhalable airborne metal exposures and coagulative biomarker disorders leading to lower limb venous thromboembolisms, e.g., deep vein thrombosis. Results support the hypothesis that exposure to inhalable metals, as elemental compounds in particulate matter, cause changes or activation of a number of human prothrombotic hemostatic biomarkers.
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Affiliation(s)
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratories (LIAA) - Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Catania University, Catania, Italy
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Maria Fiore
- Environmental and Food Hygiene Laboratories (LIAA) - Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Catania University, Catania, Italy
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratories (LIAA) - Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Catania University, Catania, Italy.
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23
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Shin S, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Brook JR, Goldberg MS, Tu K, Copes R, Martin RV, Liu Y, Kopp A, Chen H. Ambient Air Pollution and the Risk of Atrial Fibrillation and Stroke: A Population-Based Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:87009. [PMID: 31449466 PMCID: PMC6792368 DOI: 10.1289/ehp4883] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Although growing evidence links air pollution to stroke incidence, less is known about the effect of air pollution on atrial fibrillation (AF), an important risk factor for stroke. OBJECTIVES We assessed the associations between air pollution and incidence of AF and stroke. We also sought to characterize the shape of pollutant-disease relationships. METHODS The population-based cohort comprised 5,071,956 Ontario residents, age 35–85 y and without the diagnoses of both outcomes on 1 April 2001 and was followed up until 31 March 2015. AF and stroke cases were ascertained using health administrative databases with validated algorithms. Based on annual residential postal codes, we assigned 5-y running average concentrations of fine particulate matter ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and ozone ([Formula: see text]) from satellite-derived data, a land-use regression model, and a fusion-based method, respectively, as well as redox-weighted averages of [Formula: see text] and [Formula: see text] ([Formula: see text]) for each year. Using Cox proportional hazards models, we estimated the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of AF and stroke with each of these pollutants, adjusting for individual- and neighborhood-level variables. We used newly developed nonlinear risk models to characterize the shape of pollutant–disease relationships. RESULTS Between 2001 and 2015, we identified 313,157 incident cases of AF and 122,545 cases of stroke. Interquartile range increments of [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] were associated with increases in the incidence of AF [HRs (95% CIs): 1.03 (1.01, 1.04), 1.02 (1.01, 1.03), 1.01 (1.00, 1.02), and 1.01 (1.01, 1.02), respectively] and the incidence of stroke [HRs (95% CIs): 1.05 (1.03, 1.07), 1.04 (1.01, 1.06), 1.05 (1.03, 1.06), and 1.05 (1.04, 1.06), respectively]. Associations of similar magnitude were found in various sensitivity analyses. Furthermore, we found a near-linear association for stroke with [Formula: see text], whereas [Formula: see text], [Formula: see text]-, and [Formula: see text] relationships exhibited sublinear shapes. CONCLUSIONS Air pollution was associated with stroke and AF onset, even at very low concentrations. https://doi.org/10.1289/EHP4883.
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Affiliation(s)
- Saeha Shin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Richard T. Burnett
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Jeffrey C. Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Perry Hystad
- College of Public Health and Human Studies, Oregon State University, Corvallis, Oregon, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeffrey R. Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Air Quality Research Division, Environment Canada, Toronto, Ontario, Canada
| | - Mark S. Goldberg
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ray Copes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Randall V. Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | | | | | - Hong Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- ICES, Toronto, Ontario, Canada
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24
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Platikanova M, Hristova P, Milcheva H. Mathematical Model for Forecasting the Influence of Atmospheric Pollution on Population Morbidity in Stara Zagora Municipality (Bulgaria). Open Access Maced J Med Sci 2018; 6:934-939. [PMID: 29875875 PMCID: PMC5985859 DOI: 10.3889/oamjms.2018.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 11/08/2022] Open
Abstract
AIM: This paper aims to create a mathematical model for forecasting the morbidity of the population in the Republic of Bulgaria and the Stara Zagora Municipality in particular as a consequence of the atmospheric pollution. SUBJECTS AND METHODS: This model is based on a formula which determines the correlation between the average annual concentrations of atmospheric pollutants SO2, PM10, Pb aerosols, NO2 and H2S) and the morbidity of the population based on the number of people who visited their GPs in a relation with a chronic health problem or emergency condition and the number of hospitalisations in two age groups (newborn to 17 years olds and 18 and older) as well as for the entire population in the period 2009-2013, making it possible to predict morbidity levels. RESULTS: The expected morbidity level predictions based on the number of people who visited their GPs in Municipality are lower, while hospitalisation level predictions are higher. This model has been created and tested and is applicable in all residential areas. CONCLUSIONS: A new, very sensitive, mathematical model has been created and tested (average margin of error from 0.61% to 2.59%) and is applicable in all residential areas.
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Affiliation(s)
- Magdalena Platikanova
- Trakia University, Medical Faculty, Hygiene, Epidemiology and Infectious Diseases, 11 Armeyska, Stara Zagora 6000, Bulgaria
| | - Petya Hristova
- Trakia University, Medical Faculty, Stara Zagora, Bulgaria
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25
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Ageno W, Rancan E, Donati A, Galli L, Squizzato A, Venco A, Mannucci P, Manfredini R, Dentali F. Seasonal and monthly variability in the incidence of venous thromboembolism. Thromb Haemost 2017; 106:439-47. [DOI: 10.1160/th11-02-0116] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 06/02/2011] [Indexed: 11/05/2022]
Abstract
SummaryMany studies showed that the occurrence of cardiovascular and cerebrovascular events exhibits a seasonal and monthly variation. Evidences of a seasonal and monthly variation in the incidence of venous thromboembolism (VTE) are more conflicting. We conducted a systematic review and a meta-analysis of the literature to assess the presence of an infradian rhythm of this disease. MEDLINE and EMBASE databases were searched up to January 2010. Monthly and seasonal variation in the incidence of VTE were analysed. We included studies analysing seasonal or monthly aggregation in the incidence of deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) with an objective diagnosis of VTE. Two authors independently reviewed and extracted data. Seventeen studies for a total of about 35,000 patients were included. Twelve studies analysed the seasonal variation and 10 studies the monthly variation of VTE. Our results showed a significantly increased incidence of VTE in winter (chi-square 146.04, p <0.001), with a relative risk (RR) of VTE of 1.143 (99% CI [1.141, 1.144]), and a significantly increased incidence of VTE in January (chi-square 232.57, p <0.001) with an RR of VTE of 1.194 (99% CI 1.186, 1.203). Subgroup analyses including only idiopathic venous thromboembolic events confirmed the results of principal analyses. In conclusion, our data support the presence of an infradian pattern in the incidence of venous thromboembolic events, with a significantly higher risk in Winter and in January. Future studies are needed to better clarify the mechanisms behind this pattern.
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Gorr MW, Falvo MJ, Wold LE. Air Pollution and Other Environmental Modulators of Cardiac Function. Compr Physiol 2017; 7:1479-1495. [PMID: 28915333 PMCID: PMC7249238 DOI: 10.1002/cphy.c170017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in developed regions and a worldwide health concern. Multiple external causes of CVD are well known, including obesity, diabetes, hyperlipidemia, age, and sedentary behavior. Air pollution has been linked with the development of CVD for decades, though the mechanistic characterization remains unknown. In this comprehensive review, we detail the background and epidemiology of the effects of air pollution and other environmental modulators on the heart, including both short- and long-term consequences. Then, we provide the experimental data and current hypotheses of how pollution is able to cause the CVD, and how exposure to pollutants is exacerbated in sensitive states. Published 2017. Compr Physiol 7:1479-1495, 2017.
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Affiliation(s)
- Matthew W. Gorr
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner College of Medicine, Columbus, Ohio, USA
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Michael J. Falvo
- War Related Illness and Injury Study Center, Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey, USA
- New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Loren E. Wold
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner College of Medicine, Columbus, Ohio, USA
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio, USA
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27
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Mannucci PM, Franchini M. Health Effects of Ambient Air Pollution in Developing Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091048. [PMID: 28895888 PMCID: PMC5615585 DOI: 10.3390/ijerph14091048] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/26/2017] [Accepted: 09/09/2017] [Indexed: 02/08/2023]
Abstract
The deleterious effects of ambient air pollution on human health have been consistently documented by many epidemiologic studies worldwide, and it has been calculated that globally at least seven million deaths are annually attributable to the effects of air pollution. The major air pollutants emitted into the atmosphere by a number of natural processes and human activities include nitrogen oxides, volatile organic compounds, and particulate matter. In addition to the poor ambient air quality, there is increasing evidence that indoor air pollution also poses a serious threat to human health, especially in low-income countries that still use biomass fuels as an energy resource. This review summarizes the current knowledge on ambient air pollution in financially deprived populations.
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Affiliation(s)
- Pier Mannuccio Mannucci
- Scientific Direction, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, 20100 Milan, Italy.
| | - Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, 46100 Mantova, Italy.
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Signorelli SS, Ferrante M, Gaudio A, Fiore V. Deep vein thrombosis related to environment (Review). Mol Med Rep 2017; 15:3445-3448. [PMID: 28350083 DOI: 10.3892/mmr.2017.6395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/13/2017] [Indexed: 11/06/2022] Open
Abstract
The first-time venous thromboembolism (VTE) is less frequent than other thrombotic events, however, both the pulmonary embolism (PE) and the deep vein thrombosis (DVT) show a frequent morbidity. Many factors play as risk situations in determining VTE, and the air exposure to the fine and ultrafine particulate matter (PM) as PM10, PM2.5, PM0.1 is considered. Epidemiological studies have supported this association although both the effective burden of the association and the mechanisms are to date unclear. The PM concentrations and the exposure time are notable as emerging factors. Interestingly, the seasonal climate variations resulted as effective risk factor for appearance of VTE or DVT. There is a need to ameliorate the environment by reducing the air pollution at global scale.
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Affiliation(s)
| | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', University of Catania, I-95123 Catania, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Valerio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
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Short-term effects of fine particulate matter pollution on daily health events in Latin America: a systematic review and meta-analysis. Int J Public Health 2017; 62:729-738. [PMID: 28255648 DOI: 10.1007/s00038-017-0960-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/03/2017] [Accepted: 02/15/2017] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES Ambient air pollution is among the leading risks for health worldwide and by 2050 will largely overcome deaths due to unsafe sanitation and malaria, but local evidence from Latin America (LA) is scarce. We aimed to summarize the effect of short-term exposure to fine particulate air pollution (PM2.5) on morbidity and mortality in Latin America and evaluate evidence coverage and quality, using systematic review and meta-analysis. METHODS The comprehensive search (six online databases and hand-searching) identified studies investigating the short-term associations between PM2.5 and daily health events in LA. Two reviewers independently accessed the internal validity of the studies and used random-effect models in the meta-analysis. RESULTS We retrieved 1628 studies. Nine were elected for the qualitative analysis and seven for the quantitative analyses. Each 10 µg/m3 increments in daily PM2.5 concentrations was significantly associated with increased risk for respiratory and cardiovascular mortality in all-ages (polled RR = 1.02, 95% CI, 1.02-1.02 and RR = 1.01, 95% CI , 1.01-1.02, respectively). CONCLUSIONS Short-term exposure to PM2.5 in LA is significantly associated with increased risk for respiratory and cardiovascular mortality. Evidence is concentrated in few cities and some presented high risk of bias.
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Crous-Bou M, Harrington LB, Kabrhel C. Environmental and Genetic Risk Factors Associated with Venous Thromboembolism. Semin Thromb Hemost 2016; 42:808-820. [PMID: 27764878 DOI: 10.1055/s-0036-1592333] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism, and a combination of environmental and genetic risk factors contributes to VTE risk. Within environmental risk factors, some are provoking (e.g., cancer, surgery, trauma or fracture, immobilization, pregnancy and the postpartum period, long-distance travel, hospitalization, catheterization, and acute infection) and others are nonprovoking (e.g., age, sex, race/ethnicity, body mass index and obesity, oral contraceptive or hormone therapy use, corticosteroid use, statin use, diet, physical activity, sedentary time, and air pollution). Additionally, VTE has a strong genetic basis, with approximately 50 to 60% of the variance in VTE incidence attributed to genetic effects. Some genetic susceptibility variants that contribute to risk have been identified in candidate genes, mostly related to the clotting system and responsible for inherited hypercoagulable states (e.g., factor V Leiden, prothrombin, fibrinogen gamma, or blood group non-O). Other susceptibility single-nucleotide polymorphisms have been identified from genome-wide association studies, such as the two new loci in TSPAN15 (rs78707713) and SCL44A2 (rs2288904) genes. Risk factors are not always associated with VTE in isolation; however, and an understanding of how environmental and genetic factors interact may provide insight into the pathophysiology of VTE, possibly identifying opportunities for targeted prevention and treatment.
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Affiliation(s)
- Marta Crous-Bou
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Laura B Harrington
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Christopher Kabrhel
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Boston, Massachusetts
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Tang L, Wang QY, Cheng ZP, Hu B, Liu JD, Hu Y. Air pollution and venous thrombosis: a meta-analysis. Sci Rep 2016; 6:32794. [PMID: 27600652 PMCID: PMC5013712 DOI: 10.1038/srep32794] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/16/2016] [Indexed: 12/16/2022] Open
Abstract
Exposure to air pollution has been linked to cardiovascular and respiratory disorders. However, the effect of air pollution on venous thrombotic disorders is uncertain. We performed a meta-analysis to assess the association between air pollution and venous thrombosis. PubMed, Embase, EBM Reviews, Healthstar, Global Health, Nursing Database, and Web of Science were searched for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matters) and venous thrombosis. Using a random-effects model, overall risk estimates were derived for each increment of 10 μg/m3 of pollutant concentration. Of the 485 in-depth reviewed studies, 8 citations, involving approximately 700,000 events, fulfilled the inclusion criteria. All the main air pollutants analyzed were not associated with an increased risk of venous thrombosis (OR = 1.005, 95% CI = 0.998–1.012 for PM2.5; OR = 0.995, 95% CI = 0.984–1.007 for PM10; OR = 1.006, 95% CI = 0.994–1.019 for NO2). Based on exposure period and thrombosis location, additional subgroup analyses provided results comparable with those of the overall analyses. There was no evidence of publication bias. Therefore, this meta analysis does not suggest the possible role of air pollution as risk factor for venous thrombosis in general population.
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Affiliation(s)
- Liang Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.,Collaborative Innovation Center of Hematology, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qing-Yun Wang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Zhi-Peng Cheng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Bei Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.,Collaborative Innovation Center of Hematology, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing-Di Liu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.,Collaborative Innovation Center of Hematology, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China
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de Miguel-Díez J, Jiménez-García R, López de Andrés A, Hernández-Barrera V, Carrasco-Garrido P, Monreal M, Jiménez D, Jara-Palomares L, Álvaro-Meca A. Analysis of environmental risk factors for pulmonary embolism: A case-crossover study (2001-2013). Eur J Intern Med 2016; 31:55-61. [PMID: 27012471 DOI: 10.1016/j.ejim.2016.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 02/15/2016] [Accepted: 03/02/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND The relationship between environmental factors and pulmonary embolism (PE) has received little attention. The aim of this study was to estimate the influence of climatological factors and air pollution levels on PE in Spain from 2001 to 2013. METHODS We carried out a retrospective study. Data were collected from the Minimum Basic Data Set (MBDS) and the State Meteorological Agency (AEMET) of Spain. A case-crossover analysis was applied to identify environmental risk factors related to hospitalizations and deaths. For each patient, climatic and pollutant factors were assigned using data from the meteorological station closest to his/her postal code. RESULTS A seasonal effect for PE hospital admission was observed, with more frequent admissions noted during Spain's colder seasons with peaks in autumn and winter. Lower temperatures as well as higher concentrations of NO2 and O3 at the time of admission (when 2weeks and 3weeks respectively were used as controls) were significant risk factors for hospital admissions with PE. CONCLUSIONS Pulmonary embolism epidemiology was adversely influenced by colder climatological factors (absolute temperature, and seasonality) and higher concentrations of ambient air pollution (NO2, O3).
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Affiliation(s)
- Javier de Miguel-Díez
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ana López de Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - David Jiménez
- Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Madrid, Spain
| | - Luis Jara-Palomares
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocio, Seville, Spain
| | - Alejandro Álvaro-Meca
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Han MH, Yi HJ, Kim YS, Ko Y, Kim YS. Association between Diurnal Variation of Ozone Concentration and Stroke Occurrence: 24-Hour Time Series Study. PLoS One 2016; 11:e0152433. [PMID: 27015421 PMCID: PMC4807846 DOI: 10.1371/journal.pone.0152433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/14/2016] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Increasing ozone concentrations have been known to damage human health and ecosystems. Although ozone tends to display diurnal variation, most studies have reported only on the association between daily ozone concentrations and ischemic stroke occurrence on the same day, or with a 1-day lag. We investigated the effect of the diurnal variation of ozone on ischemic stroke occurrence during the same day. Methods We included a consecutive series of 1,734 patients from January 1, 2008, to December 31, 2014, at a single tertiary hospital in Seoul, South Korea. We evaluated differences between temperature and pollutants at the time of stroke onset for each time interval and averaged those parameters across the 7-year study period. Results During the interval from 13:00 to 16:59, we found a positive association between ischemic stroke occurrence and ozone concentration relative to other time periods. Upper median ozone levels from 13:00 to 16:59 were positively correlated with ischemic stroke (odds ratio, 1.550; 95% confidence intervals, 1.220 to 1.970; P = <0.001) when compared with lower median levels. Conclusions The results show diurnal patterns of ischemic stroke occurrence based on upper and lower median ozone levels for a 24-hour period, which extends understanding of the association between stroke occurrence and environmental influences.
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Affiliation(s)
- Myung-Hoon Han
- Department of Neurosurgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 471–701, Gyonggi-do, Korea
| | - Hyeong-Joong Yi
- Department of Neurosurgery, Hanyang University Medical Center, 222–1, Wangsimni-ro, Seongdong-gu, Seoul, Korea
- * E-mail:
| | - Young-Seo Kim
- Department of Neurology, Hanyang University Medical Center, 222–1, Wangsimni-ro, Seongdong-gu, Seoul, Korea
| | - Yong Ko
- Department of Neurosurgery, Hanyang University Medical Center, 222–1, Wangsimni-ro, Seongdong-gu, Seoul, Korea
| | - Young-Soo Kim
- Department of Neurosurgery, Hanyang University Medical Center, 222–1, Wangsimni-ro, Seongdong-gu, Seoul, Korea
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Törő K, Pongrácz R, Bartholy J, Váradi-T A, Marcsa B, Szilágyi B, Lovas A, Dunay G, Sótonyi P. Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:351-359. [PMID: 26178756 DOI: 10.1007/s00484-015-1032-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 06/04/2023]
Abstract
The objective of the present study was to identify risk factors among epidemiological factors and meteorological conditions in connection with fatal pulmonary embolism. Information was collected from forensic autopsy records in sudden unexpected death cases where pulmonary embolism was the exact cause of death between 2001 and 2010 in Budapest. Meteorological parameters were detected during the investigated period. Gender, age, manner of death, cause of death, place of death, post-mortem pathomorphological changes and daily meteorological conditions (i.e. daily mean temperature and atmospheric pressure) were examined. We detected that the number of registered pulmonary embolism (No 467, 211 male) follows power law in time regardless of the manner of death. We first described that the number of registered fatal pulmonary embolism up to the nth day can be expressed as Y(n) = α ⋅ n (β) where Y denotes the number of fatal pulmonary embolisms up to the nth day and α > 0 and β > 1 are model parameters. We found that there is a definite link between the cold temperature and the increasing incidence of fatal pulmonary embolism. Cold temperature and the change of air pressure appear to be predisposing factors for fatal pulmonary embolism. Meteorological parameters should have provided additional information about the predisposing factors of thromboembolism.
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Affiliation(s)
- Klára Törő
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Üllői st. 93, 1091, Hungary.
| | - Rita Pongrácz
- Department of Meteorology, Eötvös Loránd University, Budapest, Pázmány st. 1/a, 1117, Hungary.
| | - Judit Bartholy
- Department of Meteorology, Eötvös Loránd University, Budapest, Pázmány st. 1/a, 1117, Hungary.
| | - Aletta Váradi-T
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Üllői st. 93, 1091, Hungary.
| | - Boglárka Marcsa
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Üllői st. 93, 1091, Hungary.
| | - Brigitta Szilágyi
- Department of Geometry, Budapest University of Technology and Economics, Budapest, Egry József st. 1, 1111, Hungary.
| | - Attila Lovas
- Department of Geometry, Budapest University of Technology and Economics, Budapest, Egry József st. 1, 1111, Hungary.
| | - György Dunay
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Üllői st. 93, 1091, Hungary.
| | - Péter Sótonyi
- Department of Vascular Surgery, Semmelweis University, Budapest, Városmajor st. 68, 1122, Hungary.
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Franchini M, Mengoli C, Cruciani M, Bonfanti C, Mannucci PM. Association between particulate air pollution and venous thromboembolism: A systematic literature review. Eur J Intern Med 2016; 27:10-3. [PMID: 26639051 DOI: 10.1016/j.ejim.2015.11.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/26/2015] [Accepted: 11/11/2015] [Indexed: 01/18/2023]
Abstract
Air pollution is a leading global problem for public health. A number of ambient pollutants have been involved, including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and particulate matter (PM). Although exposure to PM has been linked to a wide array of cardiovascular and respiratory disorders, its effect on venous thrombotic disorders is still uncertain. To elucidate this issue, we have performed a systematic review on the existing literature on the association between PM and venous thromboembolism (VTE), using MEDLINE, EMBASE and Cochrane electronic databases. Of the 158 reviewed studies, 11 of them (3 case-crossover studies, 2 time-series studies, 2 case-control studies, 2 prospective cohort studies, 2 retrospective studies) involving more than 500,000 events fulfilled the inclusion criteria and results are presented here. Because there was substantial heterogeneity in study design, duration of follow-up, statistical measure of effects, clinical outcomes and threshold, we refrained to perform a quantitative analysis of the available data and carried out only a systematic review. Overall, the literature data suggest a link between PM and VTE, but further trials on larger populations of patients with homogeneous study designs and outcomes are warranted.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | | | - Mario Cruciani
- Centre of Community Medicine and Infectious Diseases Service, ULSS 20 Verona, Verona, Italy
| | - Carlo Bonfanti
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | - Pier Mannuccio Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Cà Granda Foundation Maggiore Hospital, Milan, Italy.
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Pun VC, Hart JE, Kabrhel C, Camargo CA, Baccarelli AA, Laden F. Prospective Study of Ambient Particulate Matter Exposure and Risk of Pulmonary Embolism in the Nurses' Health Study Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:1265-70. [PMID: 25956005 PMCID: PMC4671228 DOI: 10.1289/ehp.1408927] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 05/06/2015] [Indexed: 05/04/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is the most serious manifestation of venous thromboembolism and a leading cause of sudden death. Several studies have suggested associations of venous thromboembolism with short-term particulate matter (PM) exposure; evidence on long-term PM and traffic exposure is mixed. OBJECTIVES We examined the association of long-term exposure to PM2.5, PM2.5-10, and PM10 (PM with diameter of ≤ 2.5, 2.5-10, and ≤ 10 μm) and distance to roadways with overall incident PE and with PE subtypes in a cohort of U.S. women. METHODS The study included 115,745 women from the Nurses' Health Study, followed from 1992 through 2008. Incident PE cases were self-reported biennially. Nonidiopathic PE were cases for which the medical record revealed an underlying health condition related to PE (i.e., surgery, trauma, or malignancy); idiopathic PE were cases with no such history. We used spatiotemporal models combining spatial smoothing and geographic covariates to quantify exposure at residential addresses, and Cox proportional hazards models to calculate hazard ratios (HR) and 95% confidence intervals (CIs). RESULTS PM2.5 averaged over 1 month (HR = 1.22; 95% CI: 1.04, 1.44) or 12 months (HR = 1.17; 95% CI: 0.93, 1.48) was associated with incident PE, after adjusting for known risk factors and PM2.5-10. Equivalent analyses restricted to PE subtypes showed a positive association for PM2.5 with nonidiopathic PE, but not with idiopathic PE. We did not find evidence of an association between distance to roadways and PE risk. CONCLUSIONS We provide evidence that PM in the prior 1 and 12 months is associated with PE risk. Our results also suggest that women with underlying health conditions may be more susceptible to PE after PM exposure.
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Affiliation(s)
- Vivian C Pun
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Mannucci PM, Harari S, Martinelli I, Franchini M. Effects on health of air pollution: a narrative review. Intern Emerg Med 2015; 10:657-62. [PMID: 26134027 DOI: 10.1007/s11739-015-1276-7] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/15/2015] [Indexed: 12/20/2022]
Abstract
Air pollution is a complex and ubiquitous mixture of pollutants including particulate matter, chemical substances and biological materials. There is growing awareness of the adverse effects on health of air pollution following both acute and chronic exposure, with a rapidly expanding body of evidence linking air pollution with an increased risk of respiratory (e.g., asthma, chronic obstructive pulmonary disease, lung cancer) and cardiovascular disease (e.g., myocardial infarction, heart failure, cerebrovascular accidents). Elderly subjects, pregnant women, infants and people with prior diseases appear especially susceptible to the deleterious effects of ambient air pollution. The main diseases associated with exposure to air pollutants will be summarized in this narrative review.
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Affiliation(s)
- Pier Mannuccio Mannucci
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy,
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Ekstrand-Hammarström B, Hong J, Davoodpour P, Sandholm K, Ekdahl KN, Bucht A, Nilsson B. TiO 2 nanoparticles tested in a novel screening whole human blood model of toxicity trigger adverse activation of the kallikrein system at low concentrations. Biomaterials 2015; 51:58-68. [DOI: 10.1016/j.biomaterials.2015.01.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/22/2014] [Accepted: 01/20/2015] [Indexed: 01/06/2023]
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Kloog I, Zanobetti A, Nordio F, Coull BA, Baccarelli AA, Schwartz J. Effects of airborne fine particles (PM2.5 ) on deep vein thrombosis admissions in the northeastern United States. J Thromb Haemost 2015; 13:768-74. [PMID: 25678264 PMCID: PMC4424156 DOI: 10.1111/jth.12873] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Literature relating air pollution exposure to deep vein thrombosis (DVT) and pulmonary embolism (PE), despite biological plausibility, is sparse. No comprehensive study examining associations between both short- and long-term exposure to particulate matter (PM)2.5 and DVT or PE has been published. Using a novel PM2.5 prediction model, we study whether long- and short-term PM2.5 exposure is associated with DVT and PE admissions among elderly across the northeastern United States. METHODS We estimated daily exposure of PM2.5 in each ZIP code. We investigated the long- and short-term effects of PM2.5 on DVT and PE hospital admissions. There were 453,413 DVT and 151,829 PE admissions in the study. For short-term exposure, we performed a case crossover analysis matching month and year and defined the hazard period as lag 01 (exposure of day of admission and previous day). For the long-term association, we used a Poisson regression. RESULTS A 10-μg m(-3) increase in short-term exposure was associated with a 0.63% increase in DVT admissions (95% confidence interval [CI] = 0.03% to 1.25%) and a 6.98% (95% CI = 5.65% to 8.33%) increase in long-term exposure admissions. For PE, the associated risks were 0.38% (95% CI = -0.68% to 1.25%) and 2.67% (95% CI = 5.65% to 8.33%). These results persisted when analyses were restricted to location-periods meeting the current Environmental Protection Agency annual standard of 12 μg m(-3) . CONCLUSIONS Our findings showed that PM2.5 exposure was associated with DVT and PE hospital admissions and that current standards are not protective of this result.
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Affiliation(s)
- Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653 Beer Sheva, Israel
| | - Antonella Zanobetti
- Department of Environmental Health - Exposure, Epidemiology and Risk Program, Harvard School of Public Health, Landmark Center 401 Park Dr West, Boston MA USA 02215
| | - Francesco Nordio
- Department of Environmental Health - Exposure, Epidemiology and Risk Program, Harvard School of Public Health, Landmark Center 401 Park Dr West, Boston MA USA 02215
| | - Brent A. Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA, 02215
| | - Andrea A. Baccarelli
- Department of Environmental Health - Exposure, Epidemiology and Risk Program, Harvard School of Public Health, Landmark Center 401 Park Dr West, Boston MA USA 02215
| | - Joel Schwartz
- Department of Environmental Health - Exposure, Epidemiology and Risk Program, Harvard School of Public Health, Landmark Center 401 Park Dr West, Boston MA USA 02215
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MERONI PIERLUIGI, CHIGHIZOLA CECILIAB, GEROSA MARIA, TRESPIDI LAURA, ACAIA BARBARA. Obstetric Antiphospholipid Syndrome: Lobsters Only? Or Should We Also Look for Selected Red Herrings? J Rheumatol 2015; 42:158-60. [DOI: 10.3899/jrheum.141407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Madronich S, Shao M, Wilson SR, Solomon KR, Longstreth JD, Tang XY. Changes in air quality and tropospheric composition due to depletion of stratospheric ozone and interactions with changing climate: implications for human and environmental health. Photochem Photobiol Sci 2015; 14:149-69. [DOI: 10.1039/c4pp90037e] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UV radiation is an essential driver for the formation of photochemical smog, which includes ground-level ozone and particulate matter (PM).
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Affiliation(s)
- S. Madronich
- Atmospheric Chemistry Division
- National Center for Atmospheric Research
- Boulder
- USA
| | - M. Shao
- Peking University
- College of Environmental Science and Engineering
- Beijing 100871
- China
| | - S. R. Wilson
- School of Chemistry
- University of Wollongong
- NSW
- Australia
| | - K. R. Solomon
- Centre for Toxicology and School of Environmental Sciences
- University of Guelph
- ON
- Canada
| | | | - X. Y. Tang
- Peking University
- College of Environmental Science and Engineering
- Beijing 100871
- China
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Guijarro R, Trujillo-Santos J, Bernal-Lopez MR, de Miguel-Díez J, Villalobos A, Salazar C, Fernandez-Fernandez R, Guijarro-Contreras A, Gómez-Huelgas R, Monreal M. Trend and seasonality in hospitalizations for pulmonary embolism: a time-series analysis. J Thromb Haemost 2015; 13:23-30. [PMID: 25363025 DOI: 10.1111/jth.12772] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The existence of seasonal variability in patients with acute pulmonary embolism (PE) has been debated for years, with contradictory results. The aim of this study was to identify the trend and possible existence of a seasonal pattern in hospitalizations for PE in Spain. METHODS We analyzed the hospital discharge database of the Spanish National Health System from 2001 to 2010. Patients aged > 14 years diagnosed with PE were selected and a time series was constructed considering mean daily admissions for PE by month. The trend and seasonality factor of the series were determined using time-series analysis, and time-series modeling was used for analysis. Exponential smoothing models and the autoregressive integrated moving average test were used to generate a predictive model. RESULTS From 2001 to 2010, there were 162,032 diagnoses of PE (5.07 per 1000 hospitalizations). In 105,168 cases, PE was the reason for admission. The PE diagnosis rate ranged from 4.14 per 1000 in 2001 to 6.56 per 1000 in 2010; and hospital admissions due to PE ranged from 2.67 to 4.28 per 1000 hospital discharges. Time-series analysis showed a linear increase in the incidence and a significant seasonal pattern with 17% more admissions in February and 12% fewer in June-July with respect to the central tendency (difference from February to June, 29%). CONCLUSIONS The incidence of hospitalizations for PE showed a linear increase and a seasonal pattern, with the highest number of admissions in winter and the lowest number in summer.
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Affiliation(s)
- R Guijarro
- Internal Medicine Department, Biomedical Institute of Malaga (IBIMA), Regional University Hospital of Malaga (Carlos Haya Hospital), Malaga, Spain
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Chighizola CB, Gerosa M, Trespidi L, Di Giacomo A, Rossi F, Acaia B, Meroni PL. Update on the current recommendations and outcomes in pregnant women with antiphospholipid syndrome. Expert Rev Clin Immunol 2014; 10:1505-17. [DOI: 10.1586/1744666x.2014.968129] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Talbott EO, Rager JR, Benson S, Brink LA, Bilonick RA, Wu C. A case-crossover analysis of the impact of PM(2.5) on cardiovascular disease hospitalizations for selected CDC tracking states. ENVIRONMENTAL RESEARCH 2014; 134:455-65. [PMID: 25277761 DOI: 10.1016/j.envres.2014.06.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 05/23/2014] [Accepted: 06/19/2014] [Indexed: 05/21/2023]
Abstract
BACKGROUND Information is currently being collected by the CDC Environmental Public Health Tracking (EPHT) network on hospitalizations due to Acute Myocardial Infarction (AMI) and there is interest by CDC in exploring the relationship between fine particulate matter (PM2.5) and other cardiovascular (CVD) outcomes in the context of the EPHT program. The goal of this study was to assess the short term effects of daily PM(2.5) air pollution levels on hospitalizations for CVD for seven states within the CDC EPHT network (Florida, Massachusetts, New Hampshire, New Jersey, New Mexico, New York, and Washington). METHODS Hospitalization data was obtained for 2001-2008 admissions for circulatory disease (primary discharge diagnosis of ICD-9 codes 390-459) from data stewards in those states and included admission date, age, gender, and zip code of residence. We used CMAQ-derived predicted daily PM2.5 data as estimated by EPA at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) and linked to zip code of patient residence. A time-stratified case-crossover study design with conditional logistic regression was used to evaluate the short-term association of PM2.5 on risk of non-elective hospitalizations for CVD. Specifically, we considered all circulatory disease, ischemic heart disease, acute myocardial infarction, heart failure, cardiac arrhythmia, cerebrovascular disease and peripheral vascular disease endpoints. RESULTS Data were obtained on over 7,500,000 hospitalizations for this time period. Mean annual PM2.5 exposure levels were lowest for New Mexico and Washington (6.5 μg/m3 PM2.5 and 8.4 μg/m3 PM2.5). New Jersey, New York and Massachusetts exhibited the highest annual averages for PM2.5, (12.8 μg/m3, 11.1 μg/m3 and 10.8 μg/m3), respectively. The Northeast states (Massachusetts, New Jersey, New Hampshire and New York) exhibited significant effects of PM2.5 during the cooler months across most disease categories after adjustment for ozone and maximum apparent temperature. Ischemic heart disease risk per 10 μg/m3 increase in PM2.5 varied from 1.02 to 1.05 for the cooler months. The largest lag effect was noted on lag days 0 and 1. New Mexico and Washington exhibited no cool or warm month significant effects. Although Florida showed no cooler month effects, significant increases were noted in odds ratios for the warm weather months for all outcomes except peripheral vascular disease. This study is one of the first large scale applications of linkage of hospitalization data by state with national US EPA statistically modeled air pollution data. The results demonstrate that state-wide, there are multiple cardiovascular outcomes in addition to AMI which may be impacted by particulate air pollution.
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Affiliation(s)
- Evelyn O Talbott
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
| | - Judith R Rager
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
| | - Stacey Benson
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
| | - Lu Ann Brink
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
| | - Richard A Bilonick
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
| | - Candace Wu
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA 15261, United States
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Cisternas PC, Bronfman NC, Jimenez RB, Cifuentes LA, De La Maza C. Structured expert judgment to characterize uncertainty between PM2.5 exposure and mortality in Chile. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2014; 48:9717-9727. [PMID: 24999529 DOI: 10.1021/es500037k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To further the understanding and implementation of expert elicitation methods in the evaluation of public policies related to air pollution, the present study's main goal was to explore the potential strengths and weaknesses of structured expert judgment (SEJ) methodology as a way to derive a C-R function for chronic PM(2.5) exposure and premature mortality in Chile. Local experts were classified in two groups according to background and experience: physicians (Group 1) and engineers (Group 2). Experts were required to provide an estimate of the true percent change in nonaccidental mortality resulting from a permanent 1 μg/m(3) reduction in PM2.5 annual average ambient concentration across the entire Chilean territory. Cooke's Classical Model was used to combine the individual experts' assessments. Experts' mortality estimations varied markedly across groups: while experts in Group 1 delivered higher estimations than those reported in major international cohort studies, estimations from Group 2 were, to varying degrees, anchored to previous studies. Accordingly, combined distributions for each group and all experts were significantly different, due to the high sensitivity of the weighted distribution to experts' performance in calibration variables. Results of this study suggest that, while the use of SEJ has great potential for estimating C-R functions for chronic exposure to PM2.5 and premature mortality and its major sources of uncertainty in countries where no studies are available, its successful implementation is conditioned by a number of factors, which are analyzed and discussed.
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Affiliation(s)
- Pamela C Cisternas
- Engineering Sciences Department, Universidad Andres Bello , Santiago 8370146, Chile
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Cantone L, Angelici L, Bollati V, Bonzini M, Apostoli P, Tripodi A, Bertazzi PA, Baccarelli AA. Extracellular histones mediate the effects of metal-rich air particles on blood coagulation. ENVIRONMENTAL RESEARCH 2014; 132:76-82. [PMID: 24742731 PMCID: PMC4387237 DOI: 10.1016/j.envres.2014.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 02/10/2014] [Accepted: 03/10/2014] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiological studies have shown associations of particulate matter (PM) exposure with hypercoagulability and thrombosis. Extracellular circulating histones have recently been identified as novel mediators of inflammatory and procoagulant responses. The potential roles of extracellular histones in PM-related hypercoagulability have yet not been investigated. OBJECTIVES In 63 steel workers, we evaluated the effects of exposure to PM and PM metal components on two extracellular histone modifications (H3K4me3 and H3K9ac); and the association of H3K4me3 and H3K9ac with coagulation markers. METHODS Extracellular H3K4me3 and H3K9ac were determined in plasma through enzyme-linked immunosorbent assays. Coagulation markers included endogenous thrombin potentials (ETPs), tissue-type plasminogen activator antigen (t-PA) and D-dimer. Exposure to PM with aerodynamic diameters <1 μm (PM1) or <10 μm (PM10) and PM10 metal components were estimated for each participant. RESULTS The coagulation marker ETP, measured in the presence of soluble thrombomodulin (ETP TM+), showed significant positive associations with PM1 (β=107.84, p=0.03), PM10 (β=83.06, p=0.02), and zinc (β=75.14, p=0.03); and a marginal association with iron (β=122.58, p=0.07). Additional PM effects were observed on t-PA, D-dimer, and ETP TM+. PM1 exposure was associated with increased plasma H3K4me3 and H3K9ac (β=0.20, p=0.02; β=0.16, p=0.05, respectively). H3K4me3, but not H3K9ac, was associated with zinc (β=0.13, p=0.03) and iron (β=0.32, p=0.01) contained in PM. ETP TM+ was increased in association with higher plasma H3K4me3 (β=0.50, p=0.05) and H3K9ac (β=0.54, p=0.05). CONCLUSIONS This observational study suggests potential roles of extracellular histones in PM-induced hypercoagulability. Experimental studies are warranted to further characterize these findings.
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Affiliation(s)
- L Cantone
- Center of Molecular and Genetic Epidemiology, Department of Clinical Sciences and Community, Università di Milano and Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - L Angelici
- Center of Molecular and Genetic Epidemiology, Department of Clinical Sciences and Community, Università di Milano and Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - V Bollati
- Center of Molecular and Genetic Epidemiology, Department of Clinical Sciences and Community, Università di Milano and Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - M Bonzini
- Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | - P Apostoli
- Occupational Medicine and Industrial Hygiene, University of Brescia, Department of Experimental and Applied Medicine, Brescia, Italy
| | - A Tripodi
- Angelo Bianchi-Bonomi Haemophilia and Thrombosis Centre, Department of Medicine and Medical Specialties, IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milan, Italy
| | - P A Bertazzi
- Center of Molecular and Genetic Epidemiology, Department of Clinical Sciences and Community, Università di Milano and Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - A A Baccarelli
- Laboratory of Environmental Epigenetics, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
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Bell ML, Zanobetti A, Dominici F. Who is more affected by ozone pollution? A systematic review and meta-analysis. Am J Epidemiol 2014; 180:15-28. [PMID: 24872350 DOI: 10.1093/aje/kwu115] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ozone is associated with adverse health; however, less is known about vulnerable/sensitive populations, which we refer to as sensitive populations. We systematically reviewed epidemiologic evidence (1988-2013) regarding sensitivity to mortality or hospital admission from short-term ozone exposure. We performed meta-analysis for overall associations by age and sex; assessed publication bias; and qualitatively assessed sensitivity to socioeconomic indicators, race/ethnicity, and air conditioning. The search identified 2,091 unique papers, with 167 meeting inclusion criteria (73 on mortality and 96 on hospitalizations and emergency department visits, including 2 examining both mortality and hospitalizations). The strongest evidence for ozone sensitivity was for age. Per 10-parts per billion increase in daily 8-hour ozone concentration, mortality risk for younger persons, at 0.60% (95% confidence interval (CI): 0.40, 0.80), was statistically lower than that for older persons, at 1.27% (95% CI: 0.76, 1.78). Findings adjusted for publication bias were similar. Limited/suggestive evidence was found for higher associations among women; mortality risks were 0.39% (95% CI: -0.22, 1.00) higher than those for men. We identified strong evidence for higher associations with unemployment or lower occupational status and weak evidence of sensitivity for racial/ethnic minorities and persons with low education, in poverty, or without central air conditioning. Findings show that some populations, especially the elderly, are particularly sensitive to short-term ozone exposure.
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Short-term exposure to high levels of air pollution as a risk factor for acute isolated pulmonary embolism. Thromb Res 2014; 134:259-63. [PMID: 24909892 DOI: 10.1016/j.thromres.2014.05.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/05/2014] [Accepted: 05/07/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND The association between air pollution exposure and occurrence of venous thromboembolism is a matter of debate. This retrospective case-control study investigated the associations between one month's exposure to elevated levels of different pollutants (i.e. PM10, CO, NOx, O3, SO2, Benzene, Benzoapyrene, Nickel, Lead Arsenic) and the development of acute isolated pulmonary embolism (PE). METHODS The cases included 33 patients consecutively admitted to Padua Hospital with an objectively proven diagnosis of acute unprovoked (i.e. without predisposing conditions) isolated (i.e. without deep vein thrombosis) PE. The control group consisted of 72 consecutive patients with objectively proven acute provoked (i.e. associated to predisposing conditions) isolated PE. Average mean concentrations of pollutants in the month before PE diagnosis were computed by monitors located at 2 different sites throughout the city of Padua, and were obtained from the Regional Agency for Environmental Protection. RESULTS Individuals who had PM10, NOx, Benzene, Benzoapyrene, Cadmium, and Lead exposure equal/above the 2nd tertile, measured in controls, showed a significant increase in the risk of unprovoked PE. In case of PM10 and Benzoapyrene this risk was not affected after adjustment for possible confounders. In fact, in the multivariate logistic regression analysis, the OR values were 5.24 (95% CI: 1.52-18.12) for PM10 and 3.95 (95% CI: 1.06-14.71) for Benzoapyrene exposure in the month before PE diagnosis. CONCLUSIONS Our results, although preliminary, identify short-term (i.e. one month) exposure to elevate levels of air pollutants as a possible risk factor for the development of acute isolated PE. Larger studies are needed to confirm our results.
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Leiva G MA, Santibañez DA, Ibarra E S, Matus C P, Seguel R. A five-year study of particulate matter (PM2.5) and cerebrovascular diseases. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2013; 181:1-6. [PMID: 23796845 DOI: 10.1016/j.envpol.2013.05.057] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 05/21/2023]
Abstract
Cerebrovascular accidents, or strokes, are the second leading cause of mortality and the leading cause of morbidity in both Chile and the rest of the world. However, the relationship between particulate matter pollution and strokes is not well characterized. The association between fine particle concentration and stroke admissions was studied. Data on hospital admissions due to cerebrovascular accidents were collected from the Ministry of Health. Air quality and meteorological data were taken from the Air Quality database of the Santiago Metropolitan Area. Santiago reported 33,624 stroke admissions between January 1, 2002 and December 30, 2006. PM2.5 concentration was markedly seasonal, increasing during the winter. This study found an association between PM2.5 exposure and hospital admissions for stroke; for every PM2.5 concentration increase of 10 μg m(-3), the risk of emergency hospital admissions for cerebrovascular causes increased by 1.29% (95% CI 0.552%-2.03%).
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Affiliation(s)
- Manuel A Leiva G
- Centro de Ciencias Ambientales and Departamento de Química, Facultad de Ciencias, Universidad de Chile, Casilla 653, Santiago, Chile.
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Martinelli N, Olivieri O, Girelli D. Air particulate matter and cardiovascular disease: a narrative review. Eur J Intern Med 2013; 24:295-302. [PMID: 23647842 DOI: 10.1016/j.ejim.2013.04.001] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 11/13/2022]
Abstract
Consistent evidences from both epidemiological and experimental studies have demonstrated that short- and long-term exposure to particulate matter (PM), in particular to the finest particles (i.e. airborne PM with aerodynamic diameter less than 2.5 μm, PM2.5), is associated with cardiovascular morbidity and mortality. PM concentration has been linked with several clinical manifestations of cardiovascular diseases (CVD), including myocardial infarction, stroke, heart failure, arrhythmias, and venous thromboembolism. Noteworthy, some groups of subjects, like elderly, diabetics, or those with known coronary artery disease, appear specifically susceptible to the harmful effects triggered by PM exposure. Although the PM-related risk for a single individual appears relatively low, the PM-related population attributable risk is impressive. Recent studies indicate that the PM-CVD relationship is likely more complex than a mere quantitative association between overall PM concentration and disease risk. Indeed, the biological effects of PM may vary in function of both the aerodynamic diameter and the chemical composition. Moreover, it has been shown that the influence of air pollution on health is not limited to PM. Indeed, other gaseous pollutants may play an independent role in CVD, suggesting the need to develop multi-pollutant preventive approaches. Causality has been recently strongly supported by observations showing reduced CVD mortality after coordinated community policies resulting in lowering PM exposure at population level. An in-depth knowledge on the heterogeneous sources, chemical compounds, and biological effects of PM may help to propose more accurate and clinically effective recommendations for this important and modifiable factor contributing to CVD burden.
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Affiliation(s)
- Nicola Martinelli
- Department of Medicine, Section of Internal Medicine B, University of Verona, Italy.
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