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Peters S, Bouma F, Hoek G, Janssen N, Vermeulen R. Air pollution exposure and mortality from neurodegenerative diseases in the Netherlands: A population-based cohort study. ENVIRONMENTAL RESEARCH 2024; 259:119552. [PMID: 38964584 DOI: 10.1016/j.envres.2024.119552] [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: 03/07/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Long-term exposure to ambient air pollution has been linked with all-cause mortality and cardiovascular and respiratory diseases. Suggestive associations between ambient air pollutants and neurodegeneration have also been reported, but due to the small effect and relatively rare outcomes evidence is yet inconclusive. Our aim was to investigate the associations between long-term air pollution exposure and mortality from neurodegenerative diseases. METHODS A Dutch national cohort of 10.8 million adults aged ≥30 years was followed from 2013 until 2019. Annual average concentrations of air pollutants (ultra-fine particles (UFP), nitrogen dioxide (NO2), fine particles (PM2.5 and PM10) and elemental carbon (EC)) were estimated at the home address at baseline, using land-use regression models. The outcome variables were mortality due to amyotrophic lateral sclerosis (ALS), Parkinson's disease, non-vascular dementia, Alzheimer's disease, and multiple sclerosis (MS). Hazard ratios (HR) were estimated using Cox models, adjusting for individual and area-level socio-economic status covariates. RESULTS We had a follow-up of 71 million person-years. The adjusted HRs for non-vascular dementia were significantly increased for NO2 (1.03; 95% confidence interval (CI) 1.02-1.05) and PM2.5 (1.02; 95%CI 1.01-1.03) per interquartile range (IQR; 6.52 and 1.47 μg/m3, respectively). The association with PM2.5 was also positive for ALS (1.02; 95%CI 0.97-1.07). These associations remained positive in sensitivity analyses and two-pollutant models. UFP was not associated with any outcome. No association with air pollution was found for Parkinson's disease and MS. Inverse associations were found for Alzheimer's disease. CONCLUSION Our findings, using a cohort of more than 10 million people, provide further support for associations between long-term exposure to air pollutants (PM2.5 and particularly NO2) and mortality of non-vascular dementia. No associations were found for Parkinson and MS and an inverse association was observed for Alzheimer's disease.
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Affiliation(s)
- Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands.
| | - Femke Bouma
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - Nicole Janssen
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
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Kilbo Edlund K, Andersson EM, Asker C, Barregard L, Bergström G, Eneroth K, Jernberg T, Ljunggren S, Molnár P, Sommar JN, Oudin A, Pershagen G, Persson Å, Pyko A, Spanne M, Tondel M, Ögren M, Ljungman P, Stockfelt L. Long-term ambient air pollution and coronary atherosclerosis: Results from the Swedish SCAPIS study. Atherosclerosis 2024; 397:117576. [PMID: 38797616 DOI: 10.1016/j.atherosclerosis.2024.117576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND AND AIMS Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis. METHODS We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders. RESULTS Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5-13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent. CONCLUSIONS In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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Affiliation(s)
- Karl Kilbo Edlund
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
| | - Eva M Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Christian Asker
- Swedish Meteorological & Hydrological Institute, Norrköping, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Clinical Physiology Sahlgrenska University Hospital, Göteborg, Sweden
| | - Kristina Eneroth
- SLB-analys, Environment and Health Administration, Stockholm, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Ljunggren
- Occupational and Environmental Medicine Center, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Peter Molnár
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Åsa Persson
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Mårten Spanne
- Environmental Department, City of Malmö, Malmö, Sweden
| | - Martin Tondel
- Occupational and Environmental Medicine, Department of Medical Sciences, Medical Faculty, Uppsala University, Sweden; Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Mikael Ögren
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Chen G, Qian Z(M, Zhang J, Wang X, Zhang Z, Cai M, Arnold LD, Abresch C, Wang C, Liu Y, Fan Q, Lin H. Associations between Changes in Exposure to Air Pollutants due to Relocation and the Incidence of 14 Major Disease Categories and All-Cause Mortality: A Natural Experiment Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:97012. [PMID: 39348288 PMCID: PMC11441638 DOI: 10.1289/ehp14367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/15/2024] [Accepted: 09/06/2024] [Indexed: 10/02/2024]
Abstract
BACKGROUND Though observational studies have widely linked air pollution exposure to various chronic diseases, evidence comparing different exposures in the same people is limited. This study examined associations between changes in air pollution exposure due to relocation and the incidence and mortality of 14 major diseases. METHODS We included 50,522 participants enrolled in the UK Biobank from 2006 to 2010. Exposures to particulate matter with a diameter ≤ 2.5 μ m (PM 2.5 ), particulate matter with a diameter ≤ 10 μ m (PM 10 ), nitrogen oxides (NO x ), nitrogen dioxide (NO 2 ), and sulfur dioxide (SO 2 ) were estimated for each participant based on their residential address and relocation experience during the follow-up. Nine exposure groups were classified based on changes in long-term exposures due to residential mobility. Incidence and mortality of 14 major diseases were identified through linkages to hospital inpatient records and death registries. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incidence and mortality of the 14 diseases of interest. RESULTS During a median follow-up of 12.6 years, 29,869 participants were diagnosed with any disease of interest, and 3,144 died. Significantly increased risk of disease and all-cause mortality was observed among individuals who moved from a lower to higher air polluted area. Compared with constantly low exposure, moving from low to moderate PM 2.5 exposure was associated with increased risk of all 14 diseases but not for all-cause mortality, with adjusted HRs (95% CIs) ranging from 1.18 (1.05, 1.33) to 1.48 (1.30, 1.69); moving from low to high PM 2.5 areas increased risk of all 14 diseases: infections [1.37 (1.19, 1.58)], blood diseases [1.57 (1.34, 1.84)], endocrine diseases [1.77 (1.50, 2.09)], mental and behavioral disorders [1.93 (1.68, 2.21)], nervous system diseases [1.51 (1.32, 1.74)], ocular diseases [1.76 (1.56, 1.98)], ear disorders [1.58 (1.35, 1.86)], circulatory diseases [1.59 (1.42, 1.78)], respiratory diseases [1.51 (1.33, 1.72)], digestive diseases [1.74 (1.58, 1.92)], skin diseases [1.39 (1.22, 1.58)], musculoskeletal diseases [1.62 (1.45, 1.81)], genitourinary diseases [1.54 (1.36, 1.74)] and cancer [1.42 (1.24, 1.63)]. We observed similar associations for PM 10 and SO 2 with 14 diseases (but not with all-cause mortality); increases in NO 2 and NO x were positively associated with 14 diseases and all-cause mortality. CONCLUSIONS This study supports potential associations between ambient air pollution exposure and morbidity as well as mortality. Findings also emphasize the importance of maintaining consistently low levels of air pollution to protect the public's health. https://doi.org/10.1289/EHP14367.
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Affiliation(s)
- Ge Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Zhengmin (Min) Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Junguo Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Lauren D. Arnold
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Chad Abresch
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chuangshi Wang
- Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiming Liu
- School of Atmospheric Sciences, Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Observation and Research Station for Climate Environment and Air Quality Change in the Pearl River Estuary, Guangzhou, China
- Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-Sen University, Zhuhai, China
| | - Qi Fan
- School of Atmospheric Sciences, Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Sun Yat-sen University, Zhuhai, China
- Guangdong Provincial Observation and Research Station for Climate Environment and Air Quality Change in the Pearl River Estuary, Guangzhou, China
- Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-Sen University, Zhuhai, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
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Chao TH, Lin TH, Cheng CI, Wu YW, Ueng KC, Wu YJ, Lin WW, Leu HB, Cheng HM, Huang CC, Wu CC, Lin CF, Chang WT, Pan WH, Chen PR, Ting KH, Su CH, Chu CS, Chien KL, Yen HW, Wang YC, Su TC, Liu PY, Chang HY, Chen PW, Juang JMJ, Lu YW, Lin PL, Wang CP, Ko YS, Chiang CE, Hou CJY, Wang TD, Lin YH, Huang PH, Chen WJ. 2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part I. ACTA CARDIOLOGICA SINICA 2024; 40:479-543. [PMID: 39308649 PMCID: PMC11413940 DOI: 10.6515/acs.202409_40(5).20240724a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/24/2024] [Indexed: 09/25/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide and in Taiwan. It is highly prevalent and has a tremendous impact on global health. Therefore, the Taiwan Society of Cardiology developed these best-evidence preventive guidelines for decision-making in clinical practice involving aspects of primordial prevention including national policies, promotion of health education, primary prevention of clinical risk factors, and management and control of clinical risk factors. These guidelines cover the full spectrum of ASCVD, including chronic coronary syndrome, acute coronary syndrome, cerebrovascular disease, peripheral artery disease, and aortic aneurysm. In order to enhance medical education and health promotion not only for physicians but also for the general public, we propose a slogan (2H2L) for the primary prevention of ASCVD on the basis of the essential role of healthy dietary pattern and lifestyles: "Healthy Diet and Healthy Lifestyles to Help Your Life and Save Your Lives". We also propose an acronym of the modifiable risk factors/enhancers and relevant strategies to facilitate memory: " ABC2D2EFG-I'M2 ACE": Adiposity, Blood pressure, Cholesterol and Cigarette smoking, Diabetes mellitus and Dietary pattern, Exercise, Frailty, Gout/hyperuricemia, Inflammation/infection, Metabolic syndrome and Metabolic dysfunction-associated fatty liver disease, Atmosphere (environment), Chronic kidney disease, and Easy life (sleep well and no stress). Some imaging studies can be risk enhancers. Some risk factors/clinical conditions are deemed to be preventable, and healthy dietary pattern, physical activity, and body weight control remain the cornerstone of the preventive strategy.
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Affiliation(s)
- Ting-Hsing Chao
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
- Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine Kaohsiung Medical University Hospital
- Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University
| | - Cheng-I Cheng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; School of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan
| | - Kwo-Chang Ueng
- Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung
| | - Yih-Jer Wu
- Department of Medicine and Institute of Biomedical Sciences, MacKay Medical College, New Taipei City
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital, Taipei
| | - Wei-Wen Lin
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
| | - Hsing-Ban Leu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Cardiovascular Research Center, National Yang Ming Chiao Tung University
- Healthcare and Management Center
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
| | - Hao-Min Cheng
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine; Division of Faculty Development; Center for Evidence-based Medicine, Taipei Veterans General Hospital; Institute of Public Health; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine
| | - Chin-Chou Huang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei
| | - Chih-Cheng Wu
- Center of Quality Management, National Taiwan University Hospital Hsinchu Branch, Hsinchu; College of Medicine, National Taiwan University, Taipei; Institute of Biomedical Engineering, National Tsing-Hua University, Hsinchu; Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan
| | - Chao-Feng Lin
- Department of Medicine, MacKay Medical College, New Taipei City; Department of Cardiology, MacKay Memorial Hospital, Taipei
| | - Wei-Ting Chang
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung; Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan
| | - Wen-Han Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei; Institute of Population Health Sciences, National Health Research Institutes, Miaoli; and Institute of Biochemistry and Biotechnology, National Taiwan University
| | - Pey-Rong Chen
- Department of Dietetics, National Taiwan University Hospital, Taipei
| | - Ke-Hsin Ting
- Division of Cardiology, Department of Internal Medicine, Yunlin Christian Hospital, Yunlin
| | - Chun-Hung Su
- Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung
| | - Chih-Sheng Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine; Population Health Research Center, National Taiwan University, Taipei
| | - Hsueh-Wei Yen
- Division of Cardiology, Department of Internal Medicine Kaohsiung Medical University Hospital
| | - Yu-Chen Wang
- Division of Cardiology, Asia University Hospital; Department of Medical Laboratory Science and Biotechnology, Asia University; Division of Cardiology, China Medical University College of Medicine and Hospital, Taichung
| | - Ta-Chen Su
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine
| | - Pang-Yen Liu
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center
| | - Hsien-Yuan Chang
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Po-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Jyh-Ming Jimmy Juang
- Heart Failure Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine, and National Taiwan University Hospital
| | - Ya-Wen Lu
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
- Cardiovascular Research Center, National Yang Ming Chiao Tung University
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Po-Lin Lin
- Division of Cardiology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu
| | - Chao-Ping Wang
- Division of Cardiology, E-Da Hospital; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung
| | - Yu-Shien Ko
- Cardiovascular Division, Chang Gung Memorial Hospital; College of Medicine, Chang Gung University, Taoyuan
| | - Chern-En Chiang
- General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital and National Yang Ming Chiao Tung University
| | - Charles Jia-Yin Hou
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital, Taipei
| | - Tzung-Dau Wang
- Cardiovascular Center and Divisions of Hospital Medicine and Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine
| | - Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Po-Hsun Huang
- Cardiovascular Research Center, National Yang Ming Chiao Tung University
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
| | - Wen-Jone Chen
- Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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He C, Liu J, Zhou Y, Zhou J, Zhang L, Wang Y, Liu L, Peng S. Synergistic PM 2.5 and O 3 control to address the emerging global PM 2.5-O 3 compound pollution challenges. ECO-ENVIRONMENT & HEALTH 2024; 3:325-337. [PMID: 39281068 PMCID: PMC11400616 DOI: 10.1016/j.eehl.2024.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 09/18/2024]
Abstract
In recent years, the issue of PM2.5-O3 compound pollution has become a significant global environmental concern. This study examines the spatial and temporal patterns of global PM2.5-O3 compound pollution and exposure risks, firstly at the global and urban scale, using spatial statistical regression, exposure risk assessment, and trend analyses based on the datasets of daily PM2.5 and surface O3 concentrations monitored in 120 cities around the world from 2019 to 2022. Additionally, on the basis of the common emission sources, spatial heterogeneity, interacting chemical mechanisms, and synergistic exposure risk levels between PM2.5 and O3 pollution, we proposed a synergistic PM2.5-O3 control framework for the joint control of PM2.5 and O3. The results indicated that: (1) Nearly 50% of cities worldwide were affected by PM2.5-O3 compound pollution, with China, South Korea, Japan, and India being the global hotspots for PM2.5-O3 compound pollution; (2) Cities with PM2.5-O3 compound pollution have exposure risk levels dominated by ST + ST (Stabilization) and ST + HR (High Risk). Exposure risk levels of compound pollution in developing countries are significantly higher than those in developed countries, with unequal exposure characteristics; (3) The selected cities showed significant positive spatial correlations between PM2.5 and O3 concentrations, which were consistent with the spatial distribution of the precursors NOx and VOCs; (4) During the study period, 52.5% of cities worldwide achieved synergistic reductions in annual average PM2.5 and O3 concentrations. The average PM2.5 concentration in these cities decreased by 13.97%, while the average O3 concentration decreased by 19.18%. This new solution offers the opportunity to construct intelligent and healthy cities in the upcoming low-carbon transition.
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Affiliation(s)
- Chao He
- College of Resources and Environment, Yangtze University, Wuhan 430100, China
- Hubei Key Laboratory of Petroleum Geochemistry and Environment, Yangtze University, Wuhan 430100, China
| | - Jianhua Liu
- College of Resources and Environment, Yangtze University, Wuhan 430100, China
- Hubei Key Laboratory of Petroleum Geochemistry and Environment, Yangtze University, Wuhan 430100, China
| | - Yiqi Zhou
- School of Geography and Ocean Science, Nanjing University, Nanjing 210023, China
| | - Jingwei Zhou
- Hydrology and Environmental Hydraulics Group, Wageningen University and Research, Wageningen 6700 HB, the Netherlands
| | - Lu Zhang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Yifei Wang
- State Key Joint Laboratory for Environmental Simulation and Pollution Control, School of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Lu Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, China
| | - Sha Peng
- Collaborative Innovation Center for Emissions Trading System Co-constructed by the Province and Ministry, Hubei University of Economics, Wuhan 430205, China
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6
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Amegbor PM, Sabel CE, Mortensen LH, Mehta AJ, Rosenberg MW. Early-life air pollution and green space exposures as determinants of stunting among children under age five in Sub-Saharan Africa. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:787-801. [PMID: 37386059 DOI: 10.1038/s41370-023-00572-8] [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: 10/06/2022] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Childhood malnutrition is a major public health issue in Sub-Saharan Africa (SSA) and 61.4 million children under the age of five years in the region are stunted. Although insight from existing studies suggests plausible pathways between ambient air pollution exposure and stunting, there are limited studies on the effect of different ambient air pollutants on stunting among children. OBJECTIVE Explore the effect of early-life environmental exposures on stunting among children under the age of five years. METHODS In this study, we used pooled health and population data from 33 countries in SSA between 2006 and 2019 and environmental data from the Atmospheric Composition Analysis Group and NASA's GIOVANNI platform. We estimated the association between early-life environmental exposures and stunting in three exposure periods - in-utero (during pregnancy), post-utero (after pregnancy to current age) and cumulative (from pregnancy to current age), using Bayesian hierarchical modelling. We also visualise the likelihood of stunting among children based on their region of residence using Bayesian hierarchical modelling. RESULTS The findings show that 33.6% of sampled children were stunted. In-utero PM2.5 was associated with a higher likelihood of stunting (OR = 1.038, CrI = 1.002-1.075). Early-life exposures to nitrogen dioxide and sulphate were robustly associated with stunting among children. The findings also show spatial variation in a high and low likelihood of stunting based on a region of residence. IMPACT STATEMENT This study explores the effect of early-life environmental exposures on child growth or stunting among sub-Saharan African children. The study focuses on three exposure windows - pregnancy, after birth and cumulative exposure during pregnancy and after birth. The study also employs spatial analysis to assess the spatial burden of stunted growth in relation to environmental exposures and socioeconomic factors. The findings suggest major air pollutants are associated with stunted growth among children in sub-Saharan Africa.
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Affiliation(s)
- Prince M Amegbor
- School of Gobal Public Health, New York University, 708 Broadway, New York, NY, 10003, USA.
- Denmark Statistics, Sejrøgade 11, DK-2100, Copenhagen, Denmark.
| | - Clive E Sabel
- Department of Public Health, Bartholins Allé 2, 8000, Aarhus C, Denmark
- The Big Data Centre for Environment and Health (BERTHA), Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Laust H Mortensen
- Denmark Statistics, Sejrøgade 11, DK-2100, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark
| | - Mark W Rosenberg
- Department of Geography & Planning, Queen's University, Kingston, ON, Canada
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7
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Tao C, Liu Z, Fan Y, Yuan Y, Wang X, Qiao Z, Li Z, Xu Q, Lou Z, Wang H, Li X, Li R, Lu C. Estimating neighborhood-based mortality risk associated with air pollution: A prospective study. JOURNAL OF HAZARDOUS MATERIALS 2024; 475:134861. [PMID: 38870855 DOI: 10.1016/j.jhazmat.2024.134861] [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: 04/08/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
Effect modification of integrated neighborhood environment on associations of air pollution with mortality remained unclear. We analyzed data from UK biobank prospective study (n = 421,650, median 12.5 years follow-up) to examine disparities of mortality risk associated with air pollution among varied neighborhood settings. Fine particulate matter (PM2.5), PM10 and nitrogen dioxide (NO2) were measured and assigned to each participants' address. Diverse ecological and societal settings of neighborhoods were integrated with principal component analysis and categorized into disadvantaged, intermediate and advantaged levels. We estimated mortality risk associated with air pollution across diverse neighborhoods using Cox regression. We calculated community-level proportions of mortality attributable to air pollutants. There was evidence of higher all-cause and respiratory disease mortality risk associated with PM2.5 and NO2 among those in disadvantaged neighborhoods. In disadvantaged communities, air pollutants explained larger proportions of deaths and such disparities persisted over past decades. Across 2010-2021, reducing PM2.5 and NO2 to 10 μg/m3 (World Health Organization limits) would save 87,000 (52,000-120,000) and 91,000 (37,000-145,000) deaths of populations aged ≥ 40 years, with 150 000 deaths occurred in disadvantaged neighborhood settings. These findings suggested that disadvantaged neighborhoods can exacerbate mortality risk associated with air pollution.
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Affiliation(s)
- Chengzhe Tao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhaoyin Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yun Fan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yiting Yuan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ziyan Qiao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qiaoqiao Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhe Lou
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Haowei Wang
- School of Public Health, Imperial College London, UK; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Xiang Li
- School of Public Health, Imperial College London, UK; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Ruiyun Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Chuncheng Lu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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8
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Qiang N, Bao Y, Li Y, Zhang N, Zhou Y, Deng X, Han L, Ran J. Associations of long-term exposure to low-level PM 2.5 and brain disorders in 260,922 middle-aged and older adults. CHEMOSPHERE 2024; 362:142703. [PMID: 38925519 DOI: 10.1016/j.chemosphere.2024.142703] [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: 02/08/2024] [Revised: 05/22/2024] [Accepted: 06/24/2024] [Indexed: 06/28/2024]
Abstract
Long-term exposure to high-level ambient PM2.5 was associated with increased risks of brain disorders, while the associations remain uncertain when the exposure is lower than current air quality standards in numerous countries. This study aimed to assess the effects of PM2.5 exposure on the brain system in the population with annual mean concentrations ≤15 μg/m3. We analyzed data from 260,922 participants without preexisting brain diseases at baseline in the UK Biobank. The geographical distribution of PM2.5 in 2010 was estimated by a land use regression model and linked with individual residential address. We investigated associations of ambient PM2.5 with incident neurological (dementia, Parkinson's diseases [PD], epilepsy, and migraine) and psychiatric (major depressive disorder [MDD] and anxiety disorder) diseases through Cox proportional hazard models. We further estimated the links with brain imaging phenotypes by neuroimaging analysis. Results showed that in the population with PM2.5 concentrations ≤15 μg/m3, each interquartile range (IQR, 1.28 μg/m3) increment in PM2.5 was related to incidence risks of dementia, epilepsy, migraine, MDD, and anxiety disorder with hazard ratios of 1.08 (95% confidence interval [CI]: 1.03, 1.13), 1.12 (1.05, 1.20), 1.07 (1.00, 1.13), 1.06 (1.03, 1.09), and 1.05 (1.02, 1.08), respectively. We did not observe a significant association with PD. The association with dementia was stronger among the population with poor cardiovascular health (measured by Life's Essential 8) than the counterpart (P for interaction = 0.037). Likewise, per IQR increase was associated with specific brain imaging phenotypes, including volumes of total brain (β = -0.036; 95% CI: -0.050, -0.022), white matter (-0.030; -0.046, -0.014), grey matter (-0.030; -0.042, -0.017), respectively. The findings suggest long-term exposure to ambient PM2.5 at low-level still has an adverse impact on the neuro-psychiatric systems. The brain-relevant epidemiological assessment suggests that each country should update the standard for ambient PM2.5 following the World Health Organization Air Quality Guidelines 2021.
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Affiliation(s)
- Ne Qiang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yujia Bao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yongxuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Na Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yanqiu Zhou
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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9
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Huang W, Xu H, Wu J, Ren M, Ke Y, Qiao J. Toward cleaner air and better health: Current state, challenges, and priorities. Science 2024; 385:386-390. [PMID: 39052781 DOI: 10.1126/science.adp7832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024]
Abstract
The most up-to-date estimate of the global burden of disease indicates that ambient air pollution, including fine particulate matter and ozone, contributes to an estimated 5.2 million deaths each year. In this review, we highlight the challenges in estimating population exposure to air pollution and attributable health risks, particularly in low- and middle-income countries and among vulnerable populations. To protect public health, the evidence so far confirms urgent needs to prioritize interdisciplinary research on air pollution exposure and risk assessment and to develop evidence-based intervention policies and risk communication strategies. Here, we synthesize the emerging evidence supporting the monitoring and evaluation of the progress in implementation of the Global Air Quality Guidelines prepared by the World Health Organization.
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Affiliation(s)
- Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
- Peking University Institute for Global Health, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minghui Ren
- Peking University Institute for Global Health, Beijing, China
- Department of Global Health, Peking University School of Public Health, and China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Ke
- Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jie Qiao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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10
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Boogaard H, Crouse DL, Tanner E, Mantus E, van Erp AM, Vedal S, Samet J. Assessing Adverse Health Effects of Long-Term Exposure to Low Levels of Ambient Air Pollution: The HEI Experience and What's Next? ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:12767-12783. [PMID: 38991107 PMCID: PMC11270999 DOI: 10.1021/acs.est.3c09745] [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: 11/21/2023] [Revised: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 07/13/2024]
Abstract
Although concentrations of ambient air pollution continue to decline in high-income regions, epidemiological studies document adverse health effects at levels below current standards in many countries. The Health Effects Institute (HEI) recently completed a comprehensive research initiative to investigate the health effects of long-term exposure to low levels of air pollution in the United States (U.S.), Canada, and Europe. We provide an overview and synthesis of the results of this initiative along with other key research, the strengths and limitations of the research, and remaining research needs. The three studies funded through the HEI initiative estimated the effects of long-term ambient exposure to fine particulate matter (PM2.5), nitrogen dioxide, ozone, and other pollutants on a broad range of health outcomes, including cause-specific mortality and cardiovascular and respiratory morbidity. To ensure high quality research and comparability across studies, HEI worked actively with the study teams and engaged independent expert panels for project oversight and review. All three studies documented positive associations between mortality and exposure to PM2.5 below the U.S. National Ambient Air Quality Standards and current and proposed European Union limit values. Furthermore, the studies observed nonthreshold linear (U.S.), or supra-linear (Canada and Europe) exposure-response functions for PM2.5 and mortality. Heterogeneity was found in both the magnitude and shape of this association within and across studies. Strengths of the studies included the large populations (7-69 million), state-of-the-art exposure assessment methods, and thorough statistical analyses that applied novel methods. Future work is needed to better understand potential sources of heterogeneity in the findings across studies and regions. Other areas of future work include the changing and evolving nature of PM components and sources, including wildfires, and the role of indoor environments. This research initiative provided important new evidence of the adverse effects of long-term exposures to low levels of air pollution at and below current standards, suggesting that further reductions could yield larger benefits than previously anticipated.
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Affiliation(s)
- Hanna Boogaard
- Health
Effects Institute, 75 Federal Street, Boston, Massachusetts 02110-1940, United States
| | - Dan L. Crouse
- Health
Effects Institute, 75 Federal Street, Boston, Massachusetts 02110-1940, United States
| | - Eva Tanner
- Health
Effects Institute, 75 Federal Street, Boston, Massachusetts 02110-1940, United States
| | - Ellen Mantus
- Health
Effects Institute, 75 Federal Street, Boston, Massachusetts 02110-1940, United States
| | - Annemoon M. van Erp
- Health
Effects Institute, 75 Federal Street, Boston, Massachusetts 02110-1940, United States
| | - Sverre Vedal
- Department
of Environmental & Occupational Health Sciences, University of Washington, 4225 Roosevelt Way N.E., Seattle, Washington 98105, United States
| | - Jonathan Samet
- Department
of Environmental & Occupational Health, Department of Epidemiology, Colorado School of Public Health, 13001 East 17th Place, Aurora, Colorado 80045, United States
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11
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Li C, Martin RV, van Donkelaar A. Understanding Reductions of PM 2.5 Concentration and Its Chemical Composition in the United States: Implications for Mitigation Strategies. ACS ES&T AIR 2024; 1:637-645. [PMID: 39021669 PMCID: PMC11251419 DOI: 10.1021/acsestair.4c00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 07/20/2024]
Abstract
Motivated by the recent tightening of the US annual standard of fine particulate matter (PM2.5) concentrations from 12 to 9 μg/m3, there is a need to understand the spatial variation and drivers of historical PM2.5 reductions. We evaluate and interpret the variability of PM2.5 reductions across the contiguous US using high-resolution estimates of PM2.5 and its chemical composition over 1998-2019, inferred from satellite observations, air quality modeling, and ground-based measurements. We separated the 3092 counties into four characteristic regions sorted by PM2.5 trends. Region 1 (primarily Central Atlantic states, 25.9% population) exhibits the strongest population-weighted annual PM2.5 reduction (-3.6 ± 0.4%/yr) versus Region 2 (primarily rest of the eastern US, -3.0 ± 0.3%/yr, 39.7% population), Region 3 (primarily western Midwest, -1.9 ± 0.3%/yr, 25.6% population), and Region 4 (primarily the Mountain West, -0.4 ± 0.5%/yr, 8.9% population). Decomposition of these changes by chemical composition elucidates that sulfate exhibits the fastest reductions among all components in 2720 counties (76% of population), mostly over Regions 1-3, with the 1998-2019 mean sulfate mass fraction in PM2.5 decreasing from Region 1 (29.5%) to Region 4 (11.8%). Complete elimination of the remaining sulfate may be insufficient to meet the new standard for many regions in exceedance. Additional measures are needed to reduce other PM2.5 sources and components for further progress.
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Affiliation(s)
- Chi Li
- Department of Energy, Environmental
& Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Randall V. Martin
- Department of Energy, Environmental
& Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Aaron van Donkelaar
- Department of Energy, Environmental
& Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
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12
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Kuntic M, Hahad O, Al-Kindi S, Oelze M, Lelieveld J, Daiber A, Münzel T. Pathomechanistic Synergy Between Particulate Matter and Traffic Noise-Induced Cardiovascular Damage and the Classical Risk Factor Hypertension. Antioxid Redox Signal 2024. [PMID: 38874533 DOI: 10.1089/ars.2024.0659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Affiliation(s)
- Marin Kuntic
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Omar Hahad
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Sadeer Al-Kindi
- Cardiovascular Prevention & Wellness and Center for CV Computational & Precision Health, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Matthias Oelze
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Atmospheric Chemistry, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Mainz, Germany
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13
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Wei X, Ho KF, Yu T, Lin C, Chang LY, Chen D, Tam T, Huang B, Lau AKH, Lao XQ. The joint effect of long-term exposure to multiple air pollutants on non-accidental and cause-specific mortality: A longitudinal cohort study. JOURNAL OF HAZARDOUS MATERIALS 2024; 472:134507. [PMID: 38718510 DOI: 10.1016/j.jhazmat.2024.134507] [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: 01/11/2024] [Revised: 04/20/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024]
Abstract
The long-term joint impacts of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) on mortality are inconclusive. To bridge this research gap, we included 283,568 adults from the Taiwan MJ cohort between 2005 and 2016 and linked with the mortality data until 31 May 2019. Participants' annual average exposures to PM2.5, NO2, and O3 were estimated using satellite-based spatial-temporal models. We applied elastic net-regularised Cox models to construct a weighted environmental risk score (WERS) for the joint effects of three pollutants on non-accidental, cardiovascular, and cancer mortality and evaluated the contribution of each pollutant. The three pollutants jointly raised non-accidental mortality risk with a WERS hazard ratio (HR) of 1.186 (95% CI: 1.118-1.259) per standard deviation increase in each pollutant and weights of 72.8%, 15.2%, and 12.0% for PM2.5, NO2, and O3, respectively. The WERS increased cardiovascular death risk [HR: 1.248 (1.042-1.496)], with PM2.5 as the first contributor and O3 as the second. The WERS also elevated the cancer death risk [HR: 1.173 (1.083-1.270)], where PM2.5 played the dominant role and NO2 ranked second. Coordinated control of these three pollutants can optimise the health benefits of air quality improvements.
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Affiliation(s)
- Xianglin Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Kin Fai Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Dezhong Chen
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Bo Huang
- Department of Geography, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong Special Administrative Region of China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China.
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14
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Zhang J, Ai B, Guo Y, Chen L, Chen G, Li H, Lin H, Zhang Z. Long-term exposure to ambient ozone and adult-onset asthma: A prospective cohort study. ENVIRONMENTAL RESEARCH 2024; 252:118962. [PMID: 38642637 DOI: 10.1016/j.envres.2024.118962] [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: 11/06/2023] [Revised: 03/25/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND The association between long-term exposure to ozone (O3) and adult-onset asthma (AOA) remains inconclusive, and analysis of causality is lacking. OBJECTIVES To examine the causal association between long-term O3 exposure and AOA. METHODS A prospective cohort study of 362,098 participants was conducted using the UK Biobank study. Incident cases of AOA were identified using health administrative data of the National Health Services. O3 exposure at participants' residential addresses was estimated by a spatio-temporal model. Instrumental variable (IV) modelling was used to analyze the causal association between O3 exposure and AOA, by incorporating wind speed and planetary boundary layer height as IVs into time-dependent Cox model. Negative control outcome (accidental injury) was also used to additionally evaluate unmeasured confounding. RESULTS During a mean follow-up of 11.38 years, a total of 10,973 incident AOA cases were identified. A U-shaped concentration-response relationship was observed between O3 exposure and AOA in the traditional Cox models with HR of 0.916 (95% CI: 0.888, 0.945) for O3 at low levels (<38.17 ppb), and 1.204 (95% CI: 1.168, 1.242) for O3 at high levels (≥38.17 ppb). However, in the IV analysis we only found a statistically significant association between high-level O3 exposure and AOA risk, but not for low-level O3 exposure. No significant associations between O3 exposure and accidental injury were observed. CONCLUSION Our findings suggest a potential causal relationship between long-term exposure to high-level ambient O3 and increased risks of AOA.
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Affiliation(s)
- Jiayue Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Baozhuo Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ge Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen, 518055, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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15
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Link MF, Robertson RL, Shore A, Hamadani BH, Cecelski CE, Poppendieck DG. Ozone generation and chemistry from 222 nm germicidal ultraviolet light in a fragrant restroom. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024; 26:1090-1106. [PMID: 38787731 PMCID: PMC11421862 DOI: 10.1039/d4em00144c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Devices using 222 nm germicidal ultraviolet light (GUV222) have been marketed to reduce virus transmission indoors with low risk of occupant harm from direct UV exposure. GUV222 generates ozone, an indoor air pollutant and oxidant, under constrained laboratory conditions, but the chemistry byproducts of GUV222-generated ozone in real indoor spaces is uncharacterized. We deployed GUV222 in a public restroom, with an air change rate of 1 h-1 one weekend and 2 h-1 the next, to measure ozone formation and byproducts generated from ozone chemistry indoors. Ozone from GUV222 increased background concentrations by 5 ppb on average for both weekends and reacted rapidly (e.g., at rates of 3.7 h-1 for the first weekend and 2.0 h-1 for the second) with gas-phase precursors emitted by urinal screens and on surfaces. These ozone reactions generated volatile organic compound and aerosol byproducts (e.g., up to 2.6 μg m-3 of aerosol mass). We find that GUV222 is enhancing indoor chemistry by at least a factor of two for this restroom. The extent of this enhanced chemistry will likely be different for different indoor spaces and is dependent upon ventilation rates, species and concentrations of precursor VOCs, and surface reactivity. Informed by our measurements of ozone reactivity and background aerosol concentrations, we present a framework for predicting aerosol byproduct formation from GUV222 that can be extended to other indoor spaces. Further research is needed to understand how typical uses of GUV222 could impact air quality in chemically diverse indoor spaces and generate indoor air chemistry byproducts that can affect human health.
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Affiliation(s)
- Michael F Link
- National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA.
| | - Rileigh L Robertson
- National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA.
| | - Andrew Shore
- National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA.
| | - Behrang H Hamadani
- National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA.
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16
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Karimi B, Samadi S. Long-term exposure to air pollution on cardio-respiratory, and lung cancer mortality: a systematic review and meta-analysis. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2024; 22:75-95. [PMID: 38887768 PMCID: PMC11180069 DOI: 10.1007/s40201-024-00900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 04/02/2024] [Indexed: 06/20/2024]
Abstract
Air pollution is a major cause of specific deaths worldwide. This review article aimed to investigate the results of cohort studies for air pollution connected with the all-cause, cardio-respiratory, and lung cancer mortality risk by performing a meta-analysis. Relevant cohort studies were searched in electronic databases (PubMed/Medline, Web of Science, and Scopus). We used a random effect model to estimate the pooled relative risks (RRs) and their 95% CIs (confidence intervals) of mortality. The risk of bias for each included study was also assessed by Office of Health Assessment and Translation (OHAT) checklists. We applied statistical tests for heterogeneity and sensitivity analyses. The registration code of this study in PROSPERO was CRD42023422945. A total of 88 cohort studies were eligible and included in the final analysis. The pooled relative risk (RR) per 10 μg/m3 increase of fine particulate matter (PM2.5) was 1.080 (95% CI 1.068-1.092) for all-cause mortality, 1.058 (95% CI 1.055-1.062) for cardiovascular mortality, 1.066 (95%CI 1.034-1.097) for respiratory mortality and 1.118 (95% CI 1.076-1.159) for lung cancer mortality. We observed positive increased associations between exposure to PM2.5, PM10, black carbon (BC), and nitrogen dioxide (NO2) with all-cause, cardiovascular and respiratory diseases, and lung cancer mortality, but the associations were not significant for nitrogen oxides (NOx), sulfur dioxide (SO2) and ozone (O3). The risk of mortality for males and the elderly was higher compared to females and younger age. The pooled effect estimates derived from cohort studies provide substantial evidence of adverse air pollution associations with all-cause, cardiovascular, respiratory, and lung cancer mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s40201-024-00900-6.
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Affiliation(s)
- Behrooz Karimi
- Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sadegh Samadi
- Department of Occupational Health and safety, School of Health, Arak University of Medical Sciences, Arak, Iran
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17
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Nobile F, Dimakopoulou K, Åström C, Coloma F, Dadvand P, de Bont J, de Hoogh K, Ibi D, Katsouyanni K, Ljungman P, Melén E, Nieuwenhuijsen M, Pickford R, Sommar JN, Tonne C, Vermeulen RCH, Vienneau D, Vlaanderen JJ, Wolf K, Samoli E, Stafoggia M. External exposome and all-cause mortality in European cohorts: the EXPANSE project. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1327218. [PMID: 38863881 PMCID: PMC11165119 DOI: 10.3389/fepid.2024.1327218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/13/2024] [Indexed: 06/13/2024]
Abstract
Background Many studies reported associations between long-term exposure to environmental factors and mortality; however, little is known on the combined effects of these factors and health. We aimed to evaluate the association between external exposome and all-cause mortality in large administrative and traditional adult cohorts in Europe. Methods Data from six administrative cohorts (Catalonia, Greece, Rome, Sweden, Switzerland and the Netherlands, totaling 27,913,545 subjects) and three traditional adult cohorts (CEANS-Sweden, EPIC-NL-the Netherlands, KORA-Germany, totaling 57,653 participants) were included. Multiple exposures were assigned at the residential addresses, and were divided into three a priori defined domains: (1) air pollution [fine particulate matter (PM2.5), nitrogen dioxide (NO₂), black carbon (BC) and warm-season Ozone (warm-O3)]; (2) land/built environment (Normalized Difference Vegetation Index-NDVI, impervious surfaces, and distance to water); (3) air temperature (cold- and warm-season mean and standard deviation). Each domain was synthesized through Principal Component Analysis (PCA), with the aim of explaining at least 80% of its variability. Cox proportional-hazards regression models were applied and the total risk of the external exposome was estimated through the Cumulative Risk Index (CRI). The estimates were adjusted for individual- and area-level covariates. Results More than 205 million person-years at risk and more than 3.2 million deaths were analyzed. In single-component models, IQR increases of the first principal component of the air pollution domain were associated with higher mortality [HRs ranging from 1.011 (95% CI: 1.005-1.018) for the Rome cohort to 1.076 (1.071-1.081) for the Swedish cohort]. In contrast, lower levels of the first principal component of the land/built environment domain, pointing to reduced vegetation and higher percentage of impervious surfaces, were associated with higher risks. Finally, the CRI of external exposome increased mortality for almost all cohorts. The associations found in the traditional adult cohorts were generally consistent with the results from the administrative ones, albeit without reaching statistical significance. Discussion Various components of the external exposome, analyzed individually or in combination, were associated with increased mortality across European cohorts. This sets the stage for future research on the connections between various exposure patterns and human health, aiding in the planning of healthier cities.
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Affiliation(s)
- Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Fabián Coloma
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Payam Dadvand
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorina Ibi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachś Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Regina Pickford
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roel C. H. Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jelle J. Vlaanderen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Kathrin Wolf
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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18
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Feng H, Yang Y, Ye H, Xu J, Zhao M, Jin Y, Zhang S. Associations between PM 2.5 Components and Mortality of Ischemic Stroke, Chronic Obstructive Pulmonary Disease and Diabetes in Beijing, China. TOXICS 2024; 12:381. [PMID: 38922061 PMCID: PMC11209520 DOI: 10.3390/toxics12060381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/06/2024] [Accepted: 05/16/2024] [Indexed: 06/27/2024]
Abstract
Ischemic stroke (IS), chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) account for a large burden of premature deaths. However, few studies have investigated the associations between fine particular matter (PM2.5) components and mortality of IS, COPD and DM. We aimed to examine these associations in Beijing, China. Data on daily mortality, air pollutants and meteorological factors from 2008 to 2011 in Beijing were collected. Daily concentrations of five PM2.5 components, namely, sulfate ion (SO42-), ammonium ion (NH4+), nitrate ion (NO3-), organic matter (OM) and black carbon (BC), were obtained from the Tracking Air Pollution (TAP) database in China. The association between PM2.5 components and daily deaths was explored using a quasi-Poisson regression with the distributed lag nonlinear model (DLNM). The average daily concentrations of SO42-, NH4+, NO3-, OM and BC were 11.24, 8.37, 12.00, 17.34 and 3.32 μg/m3, respectively. After adjusting for temperature, relative humidity, pressure, particulate matter less than 10 μm in aerodynamic diameter (PM10), nitrogen dioxide (NO2) and sulfur dioxide (SO2), an IQR increase in OM at lag day 2 and lag day 6 was associated with an increased DM mortality risk (RR 1.038; 95% CI: 1.005-1.071) and COPD mortality risk (RR 1.013; 95% CI: 1.001-1.026). An IQR increase in BC at lag day 0 and lag day 6 was associated with increased COPD mortality risk (RR 1.228; 95% CI: 1.017-1.48, RR 1.059; 95% CI: 1.001-1.121). Cumulative exposure to SO42- and NH4+ was associated with an increased mortality risk for IS, with the highest effect found for lag of 0-7 days (RR 1.085; 95% CI: 1.010-1.167, RR 1.083; 95% CI: 1.003-1.169). These effects varied by sex and age group. This study demonstrated associations of short-term exposure to PM2.5 components with increased risk of IS, COPD and DM mortality in the general population. Our study also highlighted susceptible subgroups.
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Affiliation(s)
- Hao Feng
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
| | - Yisen Yang
- 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; (Y.Y.); (H.Y.); (J.X.); (M.Z.)
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Hong Ye
- 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; (Y.Y.); (H.Y.); (J.X.); (M.Z.)
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Jing 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; (Y.Y.); (H.Y.); (J.X.); (M.Z.)
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- 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; (Y.Y.); (H.Y.); (J.X.); (M.Z.)
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Ye Jin
- Center for Digital Medicine and Artificial Intelligence, Institute of Clinical Medicine, Peking Union Medical College Hospital, Beijing 100730, China
- Department of Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Shuyang Zhang
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
- Department of Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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19
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Cheng SL, Hedges M, Keski-Rahkonen P, Chatziioannou AC, Scalbert A, Chung KF, Sinharay R, Green DC, de Kok TMCM, Vlaanderen J, Kyrtopoulos SA, Kelly F, Portengen L, Vineis P, Vermeulen RCH, Chadeau-Hyam M, Dagnino S. Multiomic Signatures of Traffic-Related Air Pollution in London Reveal Potential Short-Term Perturbations in Gut Microbiome-Related Pathways. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:8771-8782. [PMID: 38728551 PMCID: PMC11112755 DOI: 10.1021/acs.est.3c09148] [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: 11/02/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
This randomized crossover study investigated the metabolic and mRNA alterations associated with exposure to high and low traffic-related air pollution (TRAP) in 50 participants who were either healthy or were diagnosed with chronic pulmonary obstructive disease (COPD) or ischemic heart disease (IHD). For the first time, this study combined transcriptomics and serum metabolomics measured in the same participants over multiple time points (2 h before, and 2 and 24 h after exposure) and over two contrasted exposure regimes to identify potential multiomic modifications linked to TRAP exposure. With a multivariate normal model, we identified 78 metabolic features and 53 mRNA features associated with at least one TRAP exposure. Nitrogen dioxide (NO2) emerged as the dominant pollutant, with 67 unique associated metabolomic features. Pathway analysis and annotation of metabolic features consistently indicated perturbations in the tryptophan metabolism associated with NO2 exposure, particularly in the gut-microbiome-associated indole pathway. Conditional multiomics networks revealed complex and intricate mechanisms associated with TRAP exposure, with some effects persisting 24 h after exposure. Our findings indicate that exposure to TRAP can alter important physiological mechanisms even after a short-term exposure of a 2 h walk. We describe for the first time a potential link between NO2 exposure and perturbation of the microbiome-related pathways.
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Affiliation(s)
- Sibo Lucas Cheng
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Michael Hedges
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | | | | | - Augustin Scalbert
- International
Agency for Research on Cancer (IARC), Lyon 69366 Cedex, France
| | - Kian Fan Chung
- National
Heart & Lung Institute, Imperial College
London, London SW7 2AZ, U.K.
- Royal Brompton
& Harefield NHS Trust, London SW3 6NP, U.K.
| | - Rudy Sinharay
- National
Heart & Lung Institute, Imperial College
London, London SW7 2AZ, U.K.
- Imperial
College Healthcare NHS Trust, London W2 1NY, U.K.
| | - David C. Green
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | - Theo M. C. M. de Kok
- Department
of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, Maastricht 6229 ER, The Netherlands
| | - Jelle Vlaanderen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
| | | | - Frank Kelly
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | - Lützen Portengen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
| | - Paolo Vineis
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Roel C. H. Vermeulen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University
Medical
Centre, Utrecht University, Utrecht 3584 CG, The Netherlands
| | - Marc Chadeau-Hyam
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Sonia Dagnino
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
- Transporters
in Imaging and Radiotherapy in Oncology (TIRO), School
of Medicine, Direction de la Recherche Fondamentale (DRF), Institut
des Sciences du Vivant Fréderic Joliot, Commissariat à
l’Energie Atomique et aux Énergies Alternatives (CEA), Université Côte d’Azur (UniCA), Nice 06107, France
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20
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Cummins MR, Shishupal S, Wong B, Wan N, Han J, Johnny JD, Mhatre-Owens A, Gouripeddi R, Ivanova J, Ong T, Soni H, Barrera J, Wilczewski H, Welch BM, Bunnell BE. Travel Distance Between Participants in US Telemedicine Sessions With Estimates of Emissions Savings: Observational Study. J Med Internet Res 2024; 26:e53437. [PMID: 38536065 PMCID: PMC11137427 DOI: 10.2196/53437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/22/2023] [Accepted: 01/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Digital health and telemedicine are potentially important strategies to decrease health care's environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine. OBJECTIVE This study aimed to (1) determine the travel distance between participants in US telemedicine sessions and (2) estimate the net reduction in carbon dioxide (CO2) emissions attributable to telemedicine in the United States, based on national observational data describing the geographical characteristics of telemedicine session participants. METHODS We conducted a retrospective observational study of telemedicine sessions in the United States between January 1, 2022, and February 21, 2023, on the doxy.me platform. Using Google Distance Matrix, we determined the median travel distance between participating providers and patients for a proportional sample of sessions. Further, based on the best available public data, we estimated the total annual emissions costs and savings attributable to telemedicine in the United States. RESULTS The median round trip travel distance between patients and providers was 49 (IQR 21-145) miles. The median CO2 emissions savings per telemedicine session was 20 (IQR 8-59) kg CO2). Accounting for the energy costs of telemedicine and US transportation patterns, among other factors, we estimate that the use of telemedicine in the United States during the years 2021-2022 resulted in approximate annual CO2 emissions savings of 1,443,800 metric tons. CONCLUSIONS These estimates of travel distance and telemedicine-associated CO2 emissions costs and savings, based on national data, indicate that telemedicine may be an important strategy in reducing the health care sector's carbon footprint.
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Affiliation(s)
- Mollie R Cummins
- College of Nursing, University of Utah, Salt Lake City, UT, United States
- Spencer Fox Eccles School of Medicine, Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
- Doxy.me Inc, Charleston, SC, United States
| | - Sukrut Shishupal
- Spencer Fox Eccles School of Medicine, Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Neng Wan
- Department of Geography, University of Utah, Salt Lake City, UT, United States
| | - Jiuying Han
- Department of Geography, University of Utah, Salt Lake City, UT, United States
| | - Jace D Johnny
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Amy Mhatre-Owens
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Ramkiran Gouripeddi
- Spencer Fox Eccles School of Medicine, Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | | | - Triton Ong
- Doxy.me Inc, Charleston, SC, United States
| | - Hiral Soni
- Doxy.me Inc, Charleston, SC, United States
| | - Janelle Barrera
- Doxy.me Inc, Charleston, SC, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Salt Lake City, UT, United States
| | | | - Brandon M Welch
- Doxy.me Inc, Charleston, SC, United States
- Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me Inc, Charleston, SC, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Salt Lake City, UT, United States
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21
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Song J, Wang BH, Gao Y, Chen Y, Sun X, Zhang Z, Wu IXY, Dai W. Interaction of physical activity and low-level air pollution on cardiovascular disease: a prospective cohort study in UK Biobank. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:188. [PMID: 38696021 DOI: 10.1007/s10653-024-01922-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/19/2024] [Indexed: 06/17/2024]
Abstract
To investigate the associations of physical activity (PA), low-level air pollution, and interaction on cardiovascular diseases (CVD) incidence based on the UK Biobank. PA was measured by the International Physical Activity Questionnaire and five air pollutants were estimated using Land Use Regression. All association estimates were based on Cox regression. Dose-response relationship was explored by restricted cubic spline, while multiplicative and additive interaction were examined by Pinteraction and relative excess risk due to interaction (RERI). As deviating proportional hazards assumption, we analyzed data as follow-up < 4 years and ≥ 4 years, separately. PA with 1000-4000 Metabolic Equivalent Task (MET) min/week showed the strongest protective impact on CVD incidence, while only low-level nitrogen dioxides (NO2) showed negative impact among five air pollutants and was considered for further analysis. Multiplicative interaction between PA and NO2 was observed during ≥ 4 years follow-up (Pinteraction = 0.049) while not during < 4 years (Pinteraction = 0.290). Positive additive interactions were found for high PA and low NO2 (< 20 μg/m3) group (RERI: 0.07, 95% confidence intervals: 0.02-0.11) during < 4 years, and for moderate PA with NO2 at 40- μg/m3 (0.07, 0.02-0.13) and < 20 μg/m3 (0.07, 0.02-0.12), while high PA showed similar results with NO2 at 40-, 20- and < 20 μg/m3 during ≥ 4 years. PA about 1000-4000 METs min/week showed the lowest CVD risk. Possibility of interaction with PA and NO2 is more likely to present with the increase in follow-up duration. We call for the optimal thresholds of PA, and exploring interaction thoroughly by considering types of PA.
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Affiliation(s)
- Jinlu Song
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Zixuan Zhang
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, Hunan, China.
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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22
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Liu J, He C, Si Y, Li B, Wu Q, Ni J, Zhao Y, Hu Q, Du S, Lu Z, Jin J, Xu C. Toward Better and Healthier Air Quality: Global PM 2.5 and O 3 Pollution Status and Risk Assessment Based on the New WHO Air Quality Guidelines for 2021. GLOBAL CHALLENGES (HOBOKEN, NJ) 2024; 8:2300258. [PMID: 38617028 PMCID: PMC11009431 DOI: 10.1002/gch2.202300258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/14/2023] [Indexed: 04/16/2024]
Abstract
To reduce the high burden of disease caused by air pollution, the World Health Organization (WHO) released new Air Quality Guidelines (AQG) on September 22, 2021. In this study, the daily fine particulate matter (PM2.5) and surface ozone (O3) data of 618 cities around the world is collected from 2019 to 2022. Based on the new AQG, the number of attainment days for daily average concentrations of PM2.5 (≤ 15 µg m-3) and O3 (≤ 100 µg m-3) is approximately 10% and 90%, respectively. China and India exhibit a decreasing trend in the number of highly polluted days (> 75 µg m-3) for PM. Every year over 68% and 27% of cities in the world are exposed to harmful PM2.5 (> 35 µg m-3) and O3 (> 100 µg m-3) pollution, respectively. Combined with the United Nations Sustainable Development Goals (SDGs), it is found that more than 35% of the world's cities face PM2.5-O3 compound pollution. Furthermore, the exposure risks in these cities (China, India, etc.) are mainly categorized as "High Risk", "Risk", and "Stabilization". In contrast, economically developed cities are mainly categorized as "High Safety", "Safety", and "Deep Stabilization." These findings indicate that global implementation of the WHO's new AQG will minimize the inequitable exposure risk from air pollution.
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Affiliation(s)
- Jianhua Liu
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Chao He
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Yajun Si
- College of Water Resources and Architectural EngineeringNorthwest A&F UniversityYanglingShaanxi712100China
| | - Bin Li
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Qian Wu
- School of Resource and Environmental ScienceWuhan UniversityWuhanHubei430079China
| | - Jinmian Ni
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Yue Zhao
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Qixin Hu
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Shenwen Du
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Zhendong Lu
- Interdisciplinary Graduate Program in InformaticsThe University of IowaIowa CityIA52242USA
| | - Jiming Jin
- College of Resources and EnvironmentYangtze UniversityWuhan430100China
- Hubei Key Laboratory of Petroleum Geochemistry and EnvironmentYangtze UniversityWuhan430100China
| | - Chao Xu
- College of Resource and EnvironmentXinjiang Agricultural UniversityUrumqi830052China
- Xinjiang Key Laboratory of Soil and Plant Ecological ProcessesUrumqi830052China
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23
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Shen Y, de Hoogh K, Schmitz O, Clinton N, Tuxen-Bettman K, Brandt J, Christensen JH, Frohn LM, Geels C, Karssenberg D, Vermeulen R, Hoek G. Monthly average air pollution models using geographically weighted regression in Europe from 2000 to 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170550. [PMID: 38320693 DOI: 10.1016/j.scitotenv.2024.170550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/02/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
Detailed spatial models of monthly air pollution levels at a very fine spatial resolution (25 m) can help facilitate studies to explore critical time-windows of exposure at intermediate term. Seasonal changes in air pollution may affect both levels and spatial patterns of air pollution across Europe. We built Europe-wide land-use regression (LUR) models to estimate monthly concentrations of regulated air pollutants (NO2, O3, PM10 and PM2.5) between 2000 and 2019. Monthly average concentrations were collected from routine monitoring stations. Including both monthly-fixed and -varying spatial variables, we used supervised linear regression (SLR) to select predictors and geographically weighted regression (GWR) to estimate spatially-varying regression coefficients for each month. Model performance was assessed with 5-fold cross-validation (CV). We also compared the performance of the monthly LUR models with monthly adjusted concentrations. Results revealed significant monthly variations in both estimates and model structure, particularly for O3, PM10, and PM2.5. The 5-fold CV showed generally good performance of the monthly GWR models across months and years (5-fold CV R2: 0.31-0.66 for NO2, 0.4-0.79 for O3, 0.4-0.78 for PM10, 0.46-0.87 for PM2.5). Monthly GWR models slightly outperformed monthly-adjusted models. Correlations between monthly GWR model were generally moderate to high (Pearson correlation >0.6). In conclusion, we are the first to develop robust monthly LUR models for air pollution in Europe. These monthly LUR models, at a 25 m spatial resolution, enhance epidemiologists to better characterize Europe-wide intermediate-term health effects related to air pollution, facilitating investigations into critical exposure time windows in birth cohort studies.
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Affiliation(s)
- Youchen Shen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Kees de Hoogh
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Oliver Schmitz
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Nick Clinton
- Google, Inc, Mountain View, California, United States
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Derek Karssenberg
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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24
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Guyatt AL, Cai YS, Doiron D, Tobin MD, Hansell AL. Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank. ERJ Open Res 2024; 10:00093-2024. [PMID: 38686181 PMCID: PMC11057504 DOI: 10.1183/23120541.00093-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background Air pollution is associated with lower lung function, and both are associated with premature mortality and cardiovascular disease (CVD). Evidence remains scarce on the potential mediating effect of impaired lung function on the association between air pollution and mortality or CVD. Methods We used data from UK Biobank (n∼200 000 individuals) with 8-year follow-up to mortality and incident CVD. Exposures to particulate matter <10 µm (PM10), particulate matter <2.5 µm (PM2.5) and nitrogen dioxide (NO2) were assessed by land-use regression modelling. Lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the FEV1/FVC ratio) was measured between 2006 and 2010 and transformed to Global Lung Function Initiative (GLI) z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted, stratified by smoking status. Results Lower FEV1 and FVC were associated with all-cause and CVD mortality, and incident CVD, with larger estimates in ever- than never-smokers (all-cause mortality hazard ratio per FEV1 GLI z-score decrease 1.29 (95% CI 1.24-1.34) for ever-smokers and 1.16 (95% CI 1.12-1.21) for never-smokers). Long-term exposure to PM2.5 or NO2 was associated with incident CVD, with similar effect sizes for ever- and never-smokers. Mediated proportions of the air pollution-all-cause mortality estimates driven by FEV1 were 18% (95% CI 2-33%) for PM2.5 and 27% (95% CI 3-51%) for NO2. Corresponding mediated proportions for incident CVD were 9% (95% CI 4-13%) for PM2.5 and 16% (95% CI 6-25%) for NO2. Conclusions Lung function may mediate a modest proportion of associations between air pollution and mortality and CVD outcomes. Results likely reflect the extent of either shared mechanisms or direct effects relating to lower lung function caused by air pollution.
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Affiliation(s)
- Anna L. Guyatt
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- These authors are joint first authors
| | - Yutong Samuel Cai
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
- National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, University of Leicester, Leicester, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Research & Innovation, Leicester General Hospital, Leicester, UK
- These authors are joint first authors
| | - Dany Doiron
- Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University, Montréal, QC, Canada
| | - Martin D. Tobin
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Research & Innovation, Leicester General Hospital, Leicester, UK
| | - Anna L. Hansell
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
- National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, University of Leicester, Leicester, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Research & Innovation, Leicester General Hospital, Leicester, UK
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Lim YH, Bilsteen JF, Mortensen LH, Lanzky LRM, Zhang J, Tuffier S, Brandt J, Ketzel M, Flensborg-Madsen T, Wimmelmann CL, Okholm GT, Hegelund ER, Napolitano GM, Andersen ZJ, Loft S. Lifetime exposure to air pollution and academic achievement: A nationwide cohort study in Denmark. ENVIRONMENT INTERNATIONAL 2024; 185:108500. [PMID: 38430583 DOI: 10.1016/j.envint.2024.108500] [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: 09/29/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 03/04/2024]
Abstract
Recent research suggests a link between air pollution and cognitive development in children, and studies on air pollution and academic achievement are emerging. We conducted a nationwide cohort study in Denmark to explore the associations between lifetime exposure to air pollution and academic performance in 9th grade. The study encompassed 785,312 children born in Denmark between 1989 and 2005, all of whom completed 9th-grade exit examinations. Using linear mixed models with a random intercept for each school, we assessed the relationship between 16 years of exposure to PM2.5, PM10, and gaseous pollutants and Grade Point Averages (GPA) in exit examinations, covering subjects such as Danish literature, Danish writing, English, mathematics, and natural sciences. The study revealed that a 5 µg/m3 increase in PM2.5 and PM10 was associated with a decrease of 0.99 (95 % Confidence Intervals: -1.05, -0.92) and 0.46 (-0.50, -0.41) in GPA, respectively. Notably, these negative associations were more pronounced in mathematics and natural sciences compared to language-related subjects. Additionally, girls and children with non-Danish mothers were found to be particularly susceptible to the adverse effects of air pollution exposure. These results underscore the potential long-term consequences of air pollution on academic achievement, emphasizing the significance of interventions that foster healthier environments for children's cognitive development.
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Affiliation(s)
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Josephine Funck Bilsteen
- Ministry of Children and Education, National Agency for Education and Quality, Copenhagen, Denmark
| | | | | | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stéphane Tuffier
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Roskilde, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, United Kingdom
| | - Trine Flensborg-Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | | | - George Maria Napolitano
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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26
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Hegelund ER, Mehta AJ, Andersen ZJ, Lim YH, Loft S, Brunekreef B, Hoek G, de Hoogh K, Mortensen LH. Air pollution and human health: a phenome-wide association study. BMJ Open 2024; 14:e081351. [PMID: 38423777 PMCID: PMC10910582 DOI: 10.1136/bmjopen-2023-081351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES To explore the associations of long-term exposure to air pollution with onset of all human health conditions. DESIGN Prospective phenome-wide association study. SETTING Denmark. PARTICIPANTS All Danish residents aged ≥30 years on 1 January 2000 were included (N=3 323 612). After exclusion of individuals with missing geocoded residential addresses, 3 111 988 participants were available for the statistical analyses. MAIN OUTCOME MEASURE First registered diagnosis of every health condition according to the International Classification of Diseases, 10th revision, from 2000 to 2017. RESULTS Long-term exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were both positively associated with the onset of more than 700 health conditions (ie, >80% of the registered health conditions) after correction for multiple testing, while the remaining associations were inverse or insignificant. As regards the most common health conditions, PM2.5 and NO2 were strongest positively associated with chronic obstructive pulmonary disease (PM2.5: HR 1.06 (95% CI 1.05 to 1.07) per 1 IQR increase in exposure level; NO2: 1.14 (95% CI 1.12 to 1.15)), type 2 diabetes (PM2.5: 1.06 (95% CI 1.05 to 1.06); NO2: 1.12 (95% CI 1.10 to 1.13)) and ischaemic heart disease (PM2.5: 1.05 (95% CI 1.04 to 1.05); NO2: 1.11 (95% CI 1.09 to 1.12)). Furthermore, PM2.5 and NO2 were both positively associated with so far unexplored, but highly prevalent outcomes relevant to public health, including senile cataract, hearing loss and urinary tract infection. CONCLUSIONS The findings of this study suggest that air pollution has a more extensive impact on human health than previously known. However, as this study is the first of its kind to investigate the associations of long-term exposure to air pollution with onset of all human health conditions, further research is needed to replicate the study findings.
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Affiliation(s)
| | | | | | | | | | | | - Gerard Hoek
- Utrecht University, Utrecht, the Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
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27
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Taj T, Chen J, Rodopoulou S, Strak M, de Hoogh K, Poulsen AH, Andersen ZJ, Bellander T, Brandt J, Zitt E, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Jørgensen JT, Katsouyanni K, Ketzel M, Lager A, Leander K, Liu S, Ljungman P, Severi G, Besson C, Magnusson PKE, Nagel G, Pershagen G, Peters A, Rizzuto D, Samoli E, Sørensen M, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-term exposure to ambient air pollution and risk of leukemia and lymphoma in a pooled European cohort. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123097. [PMID: 38065336 DOI: 10.1016/j.envpol.2023.123097] [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: 08/01/2023] [Revised: 11/08/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
Leukemia and lymphoma are the two most common forms of hematologic malignancy, and their etiology is largely unknown. Pathophysiological mechanisms suggest a possible association with air pollution, but little empirical evidence is available. We aimed to investigate the association between long-term residential exposure to outdoor air pollution and risk of leukemia and lymphoma. We pooled data from four cohorts from three European countries as part of the "Effects of Low-level Air Pollution: a Study in Europe" (ELAPSE) collaboration. We used Europe-wide land use regression models to assess annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) at residences. We also estimated concentrations of PM2.5 elemental components: copper (Cu), iron (Fe), zinc (Zn); sulfur (S); nickel (Ni), vanadium (V), silicon (Si) and potassium (K). We applied Cox proportional hazards models to investigate the associations. Among the study population of 247,436 individuals, 760 leukemia and 1122 lymphoma cases were diagnosed during 4,656,140 person-years of follow-up. The results showed a leukemia hazard ratio (HR) of 1.13 (95% confidence intervals [CI]: 1.01-1.26) per 10 μg/m3 NO2, which was robust in two-pollutant models and consistent across the four cohorts and according to smoking status. Sex-specific analyses suggested that this association was confined to the male population. Further, the results showed increased lymphoma HRs for PM2.5 (HR = 1.16; 95% CI: 1.02-1.34) and potassium content of PM2.5, which were consistent in two-pollutant models and according to sex. Our results suggest that air pollution at the residence may be associated with adult leukemia and lymphoma.
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Affiliation(s)
- Tahir Taj
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | | | - Zorana J Andersen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria.
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, United Kingdom.
| | - John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom.
| | - Ole Hertel
- Department of Ecoscience, Aarhus University, Roskilde, Denmark.
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
| | | | - Jeanette T Jørgensen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Shuo Liu
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
| | - Gianluca Severi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, 94805, Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti" (DISIA), University of Florence, Italy.
| | - Caroline Besson
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, 94805, Villejuif, France.
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Mette Sørensen
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy.
| | - Anne Tjønneland
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Ole Raaschou-Nielsen
- Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
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28
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Healy DR, Kårlund A, Mikkonen S, Puhakka S, Karhunen L, Kolehmainen M. Associations of low levels of air pollution with cardiometabolic outcomes and the role of diet quality in individuals with obesity. ENVIRONMENTAL RESEARCH 2024; 242:117637. [PMID: 37993047 DOI: 10.1016/j.envres.2023.117637] [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: 08/07/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Exposure to air pollution is associated with adverse cardiometabolic health effects and increased mortality, even at low concentrations. Some of the biological mechanisms through which air pollution can affect cardiometabolic health overlap with health outcomes associated with diet quality and changes in diet. OBJECTIVE The objective of this study is to investigate associations of air pollutants at average concentrations below the World Health Organization, 2021 air quality guidelines with cardiometabolic outcomes. Furthermore, potential interaction between air pollutants and diet quality will be assessed. METHODS 82 individuals with obesity participated in a combined weight loss and weight loss maintenance study for a total of 33 weeks. A secondary analysis was conducted incorporating air pollution measurements. Data were analysed with linear mixed-effects models. RESULTS A total of 17 significant associations were observed for single pollutants with 10 cardiometabolic outcomes, predominantly related to blood lipids, hormones, and glucose regulation. Diet quality, as measured by the Baltic Sea Diet score, did not appear to mediate the association of air pollution with cardiometabolic outcomes, however, diet quality was observed to significantly modify the association of PM2.5 with total cholesterol, and the associations of NO and O3 with ghrelin. DISCUSSION These findings suggest that exposure to ambient air pollutants, especially particulate matter, at levels below World Health Organization, 2021 air quality guidelines, were associated with changes in cardiometabolic risk factors. Diet may be a personal-level approach for individuals to modify the impact of exposure to air pollution on cardiometabolic health.
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Affiliation(s)
- Darren R Healy
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Anna Kårlund
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland; Department of Life Technologies, University of Turku, FI-20014, Turku, Finland
| | - Santtu Mikkonen
- Department of Technical Physics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland; Department of Environmental and Biological Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Soile Puhakka
- Department of Medicine, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P. O. Box 365, 90100, Oulu, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
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29
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Engelbert N, Rohayem R, Traidl-Hoffmann C. [Global environmental changes and the epithelial barrier hypothesis]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:118-125. [PMID: 38212394 DOI: 10.1007/s00105-023-05286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The global burden of noncommunicable diseases (NCD) has seen a strong increase in recent decades and attributable to the influence of environmental factors. For a multitude of diseases an association with epithelial barrier damage has been reported. OBJECTIVE This article provides an overview of the health effects of environmental pollution in the context of the epithelial barrier hypothesis of Cezmi Akdis. Additionally, exemplary mechanisms of a barrier damage are described. Finally, possible preventive and therapeutic consequences are discussed. MATERIAL AND METHODS The PubMed database was searched for the relevant topics and selected literature was reviewed. RESULTS A wide variety of substances can damage the epithelial barriers of the skin, lungs and gastrointestinal tract. The rise in the prevalences of atopic diseases could (partly) be due to an increased exposure to barrier-damaging substances, such as particulate matter and laundry detergents. A possible pathogenetic mechanism is the initiation and maintenance of an immune response by subepithelial penetration of microorganisms through damaged epithelia. CONCLUSION Based on the epithelial barrier hypothesis new therapeutic and prevention strategies can be developed. The regulation of hazardous chemicals and the fight against environmental pollution and climate change are necessary to reduce the burden of disease.
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Affiliation(s)
- Nicole Engelbert
- Lehrstuhl für Umweltmedizin - Medizinische Fakultät, Universität Augsburg, Neusässer Str. 47, 86156, Augsburg, Deutschland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Schweiz
| | - Robin Rohayem
- Lehrstuhl für Umweltmedizin - Medizinische Fakultät, Universität Augsburg, Neusässer Str. 47, 86156, Augsburg, Deutschland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Schweiz
| | - Claudia Traidl-Hoffmann
- Lehrstuhl für Umweltmedizin - Medizinische Fakultät, Universität Augsburg, Neusässer Str. 47, 86156, Augsburg, Deutschland.
- Institut für Umweltmedizin, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Augsburg, Deutschland.
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.
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Chen X, Qi L, Li S, Duan X. Long-term NO 2 exposure and mortality: A comprehensive meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 341:122971. [PMID: 37984474 DOI: 10.1016/j.envpol.2023.122971] [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: 03/20/2023] [Revised: 10/11/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
In response to the World Health Organization's (WHO) revised annual mean nitrogen dioxide (NO2) standard from 40 μg/m3 to 10 μg/m3, reflecting the growing evidence linking long-term exposure to ambient NO2 and excess mortality, we conducted a comprehensive meta-analysis incorporating 11 new studies published since the WHO analysis. Our investigation involved a systematic search of three major databases (PubMed, Web of Science, and Scopus) for articles published until July 1, 2022. We employed random effects models to calculate summarized risk ratios (RR) along with 95% confidence intervals (CIs) for overall and subgroup analyses. Sensitivity analyses were conducted to assess result robustness, and publication bias was evaluated using funnel plots and Egger's linear regression. Out of 2799 identified articles, 56 were included in our meta-analysis. The findings indicate a heightened risk of all-cause, cardiovascular, and respiratory mortality associated with long-term exposure to ambient NO2, with pooled RR values of 1.03 (95% CI: 1.02, 1.05), 1.07 (95% CI: 1.04, 1.10), and 1.03 (95% CI: 1.02, 1.05) per 10 μg/m3 increase, respectively. Substantial heterogeneity (I2 = 84%-96%) among studies was observed. Subgroup analysis revealed significantly elevated RR values in Asia and Oceania (p-value <0.05). The aggregated values for all-cause and cardiovascular mortality were slightly larger than those reported in previous studies. Our study emphasizes the imperative to develop more patient cohorts and conduct age-refined analyses to explore the impact of existing chronic diseases on these associations. Further, additional cohorts in Asia and Oceania are essential to fortify evidence in these regions. Lastly, we recommend using fused multi-source data with higher spatiotemporal resolution for individual exposure representation to minimize heterogeneity among studies in future research.
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Affiliation(s)
- Xiaoshi Chen
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, Beijing, 100083, China
| | - Ling Qi
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, Beijing, 100083, China
| | - Sai Li
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, Beijing, 100083, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, Beijing, 100083, China.
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Peng M, Zhang F, Yuan Y, Yang Z, Wang K, Wang Y, Tang Z, Zhang Y. Long-term ozone exposure and all-cause mortality: Cohort evidence in China and global heterogeneity by region. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115843. [PMID: 38141337 DOI: 10.1016/j.ecoenv.2023.115843] [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: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Cohort evidence linking long-term ozone (O3) exposure to mortality remained largely mixed worldwide and was extensively deficient in densely-populated Asia. This study aimed to assess the long-term effects of O3 exposure on all-cause mortality among Chinese adults, as well as to examine potential regional heterogeneity across the globe. METHODS A national dynamic cohort of 42153 adults aged 16+ years were recruited from 25 provinces across Chinese mainland and followed up during 2010-2018. Annual warm-season (April-September) O3 and year-round co-pollutants (i.e., nitrogen dioxide [NO2] and fine particulate matter [PM2.5]) were simulated through validated spatial-temporal prediction models and were assigned to each enrollee in each calendar year. Cox proportional hazards models with time-varying exposures were employed to assess the O3-mortality association. Concentration-response (C-R) curves were fitted by natural cubic spline function to investigate the potential nonlinear association. Both single-pollutant model and co-pollutant models additionally adjusting for PM2.5 and/or NO2 were employed to examine the robustness of the estimated association. The random-effect meta-analysis was adopted to pool effect estimates from the current and prior population-based cohorts (n = 29), and pooled C-R curves were fitted through the meta-smoothing approach by regions. RESULTS The study population comprised of 42153 participants who contributed 258921.5 person-years at risk (median 6.4 years), of whom 2382 death events occurred during study period. Participants were exposed to an annual average of 51.4 ppb (range: 22.7-74.4 ppb) of warm-season O3 concentration. In the single-pollutant model, a significantly increased hazard ratio (HR) of 1.098 (95% confidence interval [CI]: 1.023-1.179) was associated with a 10-ppb rise in O3 exposure. Associations remained robust to additional adjustments of co-pollutants, with HRs of 1.099 (95% CI: 1.023-1.180) in bi-pollutant model (+PM2.5) and 1.093 (95% CI: 1.018-1.174) in tri-pollutant model (+PM2.5+NO2), respectively. A J-shaped C-R relationship was identified among Chinese general population, suggesting significant excess mortality risk at high ozone exposure only. The combined C-R curves from Asia (n = 4) and North America (n = 17) demonstrated an overall increased risk of all-cause mortality with O3 exposure, with pooled HRs of 1.124 (95% CI: 0.966-1.307) and 1.023 (95% CI: 1.007-1.039) per 10-ppb rise, respectively. Conversely, an opposite association was observed in Europe (n = 8, HR: 0.914 [95% CI: 0.860-0.972]), suggesting significant heterogeneity across regions (P < 0.01). CONCLUSIONS This study provided national evidence that high O3 exposure may curtail long-term survival of Chinese general population. Great between-region heterogeneity of pooled O3-mortality was identified across North America, Europe, and Asia.
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Affiliation(s)
- Minjin Peng
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430072, China
| | - Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yaqi Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Ziqing Tang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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Dimakopoulou K, Nobile F, de Bont J, Wolf K, Vienneau D, Ibi D, Coloma F, Pickford R, Åström C, Sommar JN, Kasdagli MI, Souliotis K, Tsolakidis A, Tonne C, Melén E, Ljungman P, de Hoogh K, Vermeulen RCH, Vlaanderen JJ, Katsouyanni K, Stafoggia M, Samoli E. Disentangling associations between multiple environmental exposures and all-cause mortality: an analysis of European administrative and traditional cohorts. FRONTIERS IN EPIDEMIOLOGY 2024; 3:1328188. [PMID: 38455945 PMCID: PMC10910955 DOI: 10.3389/fepid.2023.1328188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
Background We evaluated the independent and joint effects of air pollution, land/built environment characteristics, and ambient temperature on all-cause mortality as part of the EXPANSE project. Methods We collected data from six administrative cohorts covering Catalonia, Greece, the Netherlands, Rome, Sweden, and Switzerland and three traditional cohorts in Sweden, the Netherlands, and Germany. Participants were linked to spatial exposure estimates derived from hybrid land use regression models and satellite data for: air pollution [fine particulate matter (PM2.5), nitrogen dioxide (NO₂), black carbon (BC), warm season ozone (O3)], land/built environment [normalized difference vegetation index (NDVI), distance to water, impervious surfaces], and ambient temperature (the mean and standard deviation of warm and cool season temperature). We applied Cox proportional hazard models accounting for several cohort-specific individual and area-level variables. We evaluated the associations through single and multiexposure models, and interactions between exposures. The joint effects were estimated using the cumulative risk index (CRI). Cohort-specific hazard ratios (HR) were combined using random-effects meta-analyses. Results We observed over 3.1 million deaths out of approximately 204 million person-years. In administrative cohorts, increased exposure to PM2.5, NO2, and BC was significantly associated with all-cause mortality (pooled HRs: 1.054, 1.033, and 1.032, respectively). We observed an adverse effect of increased impervious surface and mean season-specific temperature, and a protective effect of increased O3, NDVI, distance to water, and temperature variation on all-cause mortality. The effects of PM2.5 were higher in areas with lower (10th percentile) compared to higher (90th percentile) NDVI levels [pooled HRs: 1.054 (95% confidence interval (CI) 1.030-1.079) vs. 1.038 (95% CI 0.964-1.118)]. A similar pattern was observed for NO2. The CRI of air pollutants (PM2.5 or NO2) plus NDVI and mean warm season temperature resulted in a stronger effect compared to single-exposure HRs: [PM2.5 pooled HR: 1.061 (95% CI 1.021-1.102); NO2 pooled HR: 1.041 (95% CI 1.025-1.057)]. Non-significant effects of similar patterns were observed in traditional cohorts. Discussion The findings of our study not only support the independent effects of long-term exposure to air pollution and greenness, but also highlight the increased effect when interplaying with other environmental exposures.
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Affiliation(s)
- Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorina Ibi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Fabián Coloma
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Regina Pickford
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriakos Souliotis
- Department of Social and Education Policy, University of Peloponnese, Corinth, Greece
- Health Policy Institute, Athens, Greece
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachś Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Roel C. H. Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Jelle J. Vlaanderen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College London, United Kingdom NIHR HPRU in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Vanoli J, Mistry MN, De La Cruz Libardi A, Masselot P, Schneider R, Ng CFS, Madaniyazi L, Gasparrini A. Reconstructing individual-level exposures in cohort analyses of environmental risks: an example with the UK Biobank. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-023-00635-w. [PMID: 38191925 DOI: 10.1038/s41370-023-00635-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
Recent developments in linkage procedures and exposure modelling offer great prospects for cohort analyses on the health risks of environmental factors. However, assigning individual-level exposures to large population-based cohorts poses methodological and practical problems. In this contribution, we illustrate a linkage framework to reconstruct environmental exposures for individual-level epidemiological analyses, discussing methodological and practical issues such as residential mobility and privacy concerns. The framework outlined here requires the availability of individual residential histories with related time periods, as well as high-resolution spatio-temporal maps of environmental exposures. The linkage process is carried out in three steps: (1) spatial alignment of the exposure maps and residential locations to extract address-specific exposure series; (2) reconstruction of individual-level exposure histories accounting for residential changes during the follow-up; (3) flexible definition of exposure summaries consistent with alternative research questions and epidemiological designs. The procedure is exemplified by the linkage and processing of daily averages of air pollution for the UK Biobank cohort using gridded spatio-temporal maps across Great Britain. This results in the extraction of exposure summaries suitable for epidemiological analyses of both short and long-term risk associations and, in general, for the investigation of temporal dependencies. The linkage framework presented here is generally applicable to multiple environmental stressors and can be extended beyond the reconstruction of residential exposures. IMPACT: This contribution describes a linkage framework to assign individual-level environmental exposures to population-based cohorts using high-resolution spatio-temporal exposure. The framework can be used to address current limitations of exposure assessment for the analysis of health risks associated with environmental stressors. The linkage of detailed exposure information at the individual level offers the opportunity to define flexible exposure summaries tailored to specific study designs and research questions. The application of the framework is exemplified by the linkage of fine particulate matter (PM2.5) exposures to the UK Biobank cohort.
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Affiliation(s)
- Jacopo Vanoli
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Malcolm N Mistry
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Arturo De La Cruz Libardi
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Masselot
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Rochelle Schneider
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-lab, European Space Agency, Frascati, Italy
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Cao Z, Yuan Y, White AJ, Li C, Luo Z, D’Aloisio AA, Huang X, Kaufman JD, Sandler DP, Chen H. Air Pollutants and Risk of Parkinson's Disease among Women in the Sister Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:17001. [PMID: 38175185 PMCID: PMC10766011 DOI: 10.1289/ehp13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Air pollutants may contribute to the development of Parkinson's disease (PD), but empirical evidence is limited and inconsistent. OBJECTIVES This study aimed to prospectively investigate the associations of PD with ambient exposures to fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and nitrogen dioxide (NO 2 ). METHODS We analyzed data from 47,108 US women from the Sister Study, enrolled from 2003-2009 (35-80 years of age) and followed through 2018. Exposures of interest included address-level ambient PM 2.5 and NO 2 in 2009 and their cumulative averages from 2009 to PD diagnosis with varying lag-years. The primary outcome was PD diagnosis between 2009 and 2018 (n = 163 ). We used multivariable Cox proportional hazards and time-varying Cox models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS NO 2 exposure in 2009 was associated with PD risk in a dose-response manner. The HR and 95% CI were 1.22 (95% CI: 1.03, 1.46) for one interquartile [4.8 parts per billion (ppb)] increment in NO 2 , adjusting for age, race and ethnicity, education, smoking status, alcohol drinking, caffeine intake, body mass index, physical activity, census region, residential area type, area deprivation index (ADI), and self-reported health status. The association was confirmed in secondary analyses with time-varying averaged cumulative exposures. For example, the multivariable adjusted HR for PD per 4.8 ppb increment in NO 2 was 1.25 (95% CI: 1.05, 1.50) in the 2-year lag analysis using cumulative average exposure. Post hoc subgroup analyses overall confirmed the association. However, statistical interaction analyses found that the positive association of NO 2 with PD risk was limited to women in urban, rural, and small town areas and women with ≥ 50 th percentile ADI but not among women from suburban areas or areas with < 50 th percentile ADI. In contrast, PM 2.5 exposure was not associated with PD risk with the possible exception for women from the Midwest region of the US (HR interquartile -range = 2.49 , 95% CI: 1.20, 5.14) but not in other census regions. DISCUSSION In this nationwide cohort of US women, higher level exposure to ambient NO 2 is associated with a greater risk of PD. This finding needs to be independently confirmed and the underlying mechanisms warrant further investigation. https://doi.org/10.1289/EHP13009.
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Affiliation(s)
- Zichun Cao
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Yaqun Yuan
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Alexandra J. White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Aimee A. D’Aloisio
- Social & Scientific Systems, DLH Holdings Corporation, Durham, North Carolina, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
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Wang J, Hu X, Yang T, Jin J, Hao J, Kelly FJ, Huang J, Li G. Ambient air pollution and the dynamic transitions of stroke and dementia: a population-based cohort study. EClinicalMedicine 2024; 67:102368. [PMID: 38169700 PMCID: PMC10758736 DOI: 10.1016/j.eclinm.2023.102368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Background Stroke and dementia are the leading causes of neurological disease burden. Detrimental effects of air pollution on both conditions are increasingly recognised, while the impacts on the dynamic transitions have not yet been explored, and whether critical time intervals exist is unknown. Methods This prospective study was conducted based on the UK Biobank. Annual average air pollution concentrations at baseline year 2010 estimated by land-use regression models were used as a proxy for long-term air pollution exposure. Associations between multiple air pollutants (PM2.5, PM2.5-10, and NO2) indicated by air pollution score and the dynamic transitions of stroke and dementia were estimated, and the impacts during critical time intervals were explored. The date cutoff of this study was February 29, 2020. Findings During a median follow-up of 10.9 years in 413,372 participants, 6484, 3813, and 376 participants developed incident stroke, dementia, and comorbidity of stroke and dementia. For the overall transition from stroke to comorbid dementia, the hazard ratio (HR) for each interquartile range (IQR) increase in air pollution score was 1.38 (95% CI, 1.15, 1.65), and the risks were limited to two time intervals (within 1 year and over 5 years after stroke). As for the transition from dementia to comorbid stroke, increased risk was only observed during 2-3 years after dementia. Interpretation Our findings suggested that air pollution played an important role in the dynamic transition of stroke and dementia even at concentrations below the current criteria. The findings provided new evidence for alleviating the disease burden of neurological disorders related to air pollution during critical time intervals. Funding The State Scholarship Fund of China Scholarship Council.
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Affiliation(s)
- Jiawei Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Xin Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Frank J. Kelly
- Environmental Research Group, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
- Environmental Research Group, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
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36
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Hvidtfeldt UA, Chen J, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Forastiere F, Brynedal B, Hertel O, Hoffmann B, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Nagel G, Pershagen G, Rizzuto D, Samoli E, So R, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Zitt E, Brunekreef B, Hoek G, Raaschou-Nielsen O. Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts. ENVIRONMENTAL RESEARCH 2023; 239:117230. [PMID: 37806476 DOI: 10.1016/j.envres.2023.117230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Air pollution is a growing concern worldwide, with significant impacts on human health. Multiple myeloma is a type of blood cancer with increasing incidence. Studies have linked air pollution exposure to various types of cancer, including leukemia and lymphoma, however, the relationship with multiple myeloma incidence has not been extensively investigated. METHODS We pooled four European cohorts (N = 234,803) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), and ozone (O3) and multiple myeloma. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. RESULTS During 4,415,817 person-years of follow-up (average 18.8 years), we observed 404 cases of multiple myeloma. The results of the fully adjusted linear analyses showed hazard ratios (95% confidence interval) of 0.99 (0.84, 1.16) per 10 μg/m³ NO2, 1.04 (0.82, 1.33) per 5 μg/m³ PM2.5, 0.99 (0.84, 1.18) per 0.5 10-5 m-1 BCE, and 1.11 (0.87, 1.41) per 10 μg/m³ O3. CONCLUSIONS We did not observe an association between long-term ambient air pollution exposure and incidence of multiple myeloma.
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Affiliation(s)
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Boel Brynedal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ole Hertel
- Departments of Ecoscience, Aarhus University, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, And Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Rina So
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Anne Tjønneland
- The Danish Cancer Institute, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Institute, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Abed Al Ahad M, Demšar U, Sullivan F, Kulu H. Long-term exposure to air pollution and mortality in Scotland: A register-based individual-level longitudinal study. ENVIRONMENTAL RESEARCH 2023; 238:117223. [PMID: 37793592 DOI: 10.1016/j.envres.2023.117223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Air pollution is associated with several adverse health outcomes. However, heterogeneity in the size of effect estimates between cohort studies for long-term exposures exist and pollutants like SO2 and mental/behavioural health outcomes are little studied. This study examines the association between long-term exposure to multiple ambient air pollutants and all-cause and cause-specific mortality from both physical and mental illnesses. METHODS We used individual-level administrative data from the Scottish-Longitudinal-Study (SLS) on 202,237 individuals aged 17 and older, followed between 2002 and 2017. The SLS dataset was linked to annual concentrations of NO2, SO2, and particulate-matter (PM10, PM2.5) pollution at 1 km2 spatial resolution using the individuals' residential postcode. We applied survival analysis to assess the association between air pollution and all-cause, cardiovascular, respiratory, cancer, mental/behavioural disorders/suicides, and other-causes mortality. RESULTS Higher all-cause mortality was associated with increasing concentrations of PM2.5, PM10, NO2, and SO2 pollutants. NO2, PM10, and PM2.5 were also associated with cardiovascular, respiratory, cancer and other-causes mortality. For example, the mortality hazard from respiratory diseases was 1.062 (95%CI = 1.028-1.096), 1.025 (95%CI = 1.005-1.045), and 1.013 (95%CI = 1.007-1.020) per 1 μg/m3 increase in PM2.5, PM10 and NO2 pollutants, respectively. In contrast, mortality from mental and behavioural disorders was associated with 1 μg/m3 higher exposure to SO2 pollutant (HR = 1.042; 95%CI = 1.015-1.069). CONCLUSION This study revealed an association between long-term (16-years) exposure to ambient air pollution and all-cause and cause-specific mortality. The results suggest that policies and interventions to enhance air quality would reduce the mortality hazard from cardio-respiratory, cancer, and mental/behavioural disorders in the long-term.
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Affiliation(s)
- Mary Abed Al Ahad
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom.
| | - Urška Demšar
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
| | - Frank Sullivan
- School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Hill Kulu
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
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Li W, Tian A, Shi Y, Chen B, Ji R, Ge J, Su X, Pu B, Lei L, Ma R, Wang Q, Ban J, Song L, Xu W, Zhang Y, He W, Yang H, Li X, Li T, Li J. Associations of long-term fine particulate matter exposure with all-cause and cause-specific mortality: results from the ChinaHEART project. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100908. [PMID: 37767374 PMCID: PMC10520991 DOI: 10.1016/j.lanwpc.2023.100908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Background The chronic effects of fine particulate matter (PM2.5) at high concentrations remains uncertain. We aimed to examine the relationship of long-term PM2.5 exposure with all-cause and the top three causes of death (cardiovascular disease [CVD], cancer, and respiratory disease), and to analyze their concentration-response functions over a wide range of concentrations. Methods We enrolled community residents aged 35-75 years from 2014 to 2017 from all 31 provinces of the Chinese Mainland, and followed them up until 2021. We used a long-term estimation dataset for both PM2.5 and O3 concentrations with a high spatiotemporal resolution to assess the individual exposure, and used Cox proportional hazards models to estimate the associations between PM2.5 and mortalities. Findings We included 1,910,923 participants, whose mean age was 55.6 ± 9.8 years and 59.4% were female. A 10 μg/m3 increment in PM2.5 exposure was associated with increased risk for all-cause death (hazard ratio 1.02 [95% confidence interval 1.012-1.028]), CVD death (1.024 [1.011-1.037]), cancer death (1.037 [1.023-1.052]), and respiratory disease death (1.083 [1.049-1.117]), respectively. Long-term PM2.5 exposure nonlinearly related with all-cause, CVD, and cancer mortalities, while linearly related with respiratory disease mortality. Interpretation The overall effects of long-term PM2.5 exposure on mortality in the high concentration settings are weaker than previous reports from settings of PM2.5 concentrations < 35 μg/m³. The distinct concentration-response relationships of CVD, cancer, and respiratory disease mortalities could facilitate targeted public health efforts to prevent death caused by air pollution. Funding The Chinese Academy of Medical Sciences Innovation Fund for Medical Science, the National High Level Hospital Clinical Research Funding, the Ministry of Finance of China and National Health Commission of China, the 111 Project from the Ministry of Education of China.
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Affiliation(s)
- Wei Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Aoxi Tian
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, People’s Republic of China
| | - Bowang Chen
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Runqing Ji
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Jinzhuo Ge
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Xiaoming Su
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Boxuan Pu
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Lubi Lei
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Runmei Ma
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Qing Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Lijuan Song
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Wei Xu
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Yan Zhang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Wenyan He
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Hao Yang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
- Central China Sub-center of the National Center for Cardiovascular Diseases, Zhengzhou, People’s Republic of China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China
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Baranyi G, Williamson L, Feng Z, Tomlinson S, Vieno M, Dibben C. Early life PM 2.5 exposure, childhood cognitive ability and mortality between age 11 and 86: A record-linkage life-course study from Scotland. ENVIRONMENTAL RESEARCH 2023; 238:117021. [PMID: 37659643 DOI: 10.1016/j.envres.2023.117021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Living in areas with high air pollution concentrations is associated with all-cause and cause-specific mortality. Exposure in sensitive developmental periods might be long-lasting but studies with very long follow-up are rare, and mediating pathways between early life exposure and life-course mortality are not fully understood. METHODS Data were drawn from the Scottish Longitudinal Study Birth Cohort of 1936, a representative record-linkage study comprising 5% of the Scottish population born in 1936. Participants had valid age 11 cognitive ability test scores along with linked mortality data until age 86. Fine particle (PM2.5) concentrations estimated with the EMEP4UK atmospheric chemistry transport model were linked to participants' residential address derived from the National Identity Register in 1939 (age 3). Confounder-adjusted Cox regression estimated associations between PM2.5 and mortality; regression-based causal mediation analysis explored mediation through childhood cognitive ability. RESULTS The final sample consisted of 2734 individuals with 1608 deaths registered during the 1,833,517 person-months at risk follow-up time. Higher early life PM2.5 exposure increased the risk of all-cause mortality (HR = 1.03, 95% CI: 1.01-1.04 per 10 μg m-3 increment), associations were stronger for mortality between age 65 and 86. PM2.5 increased the risk of cancer-related mortality (HR = 1.05, 95% CI: 1.02-1.08), especially for lung cancer among females (HR = 1.11, 95% CI: 1.02-1.21), but not for cardiovascular and respiratory diseases. Higher PM2.5 in early life (≥50 μg m-3) was associated with lower childhood cognitive ability, which, in turn, increased the risk of all-cause mortality and mediated 25% of the total associations. CONCLUSIONS In our life-course study with 75-year of continuous mortality records, we found that exposure to air pollution in early life was associated with higher mortality in late adulthood, and that childhood cognitive ability partly mediated this relationship. Findings suggest that past air pollution concentrations will likely impact health and longevity for decades to come.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK.
| | - Lee Williamson
- Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK; Longitudinal Studies Centre - Scotland, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Zhiqiang Feng
- Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK
| | - Sam Tomlinson
- UK Centre for Ecology & Hydrology, Library Ave, Bailrigg, Lancaster, UK
| | - Massimo Vieno
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, UK
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK
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Alvarado-Molina M, Curto A, Wheeler AJ, Tham R, Cerin E, Nieuwenhuijsen M, Vermeulen R, Donaire-Gonzalez D. Improving traffic-related air pollution estimates by modelling minor road traffic volumes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 338:122657. [PMID: 37813140 DOI: 10.1016/j.envpol.2023.122657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Accurately estimating annual average daily traffic (AADT) on minor roads is essential for assessing traffic-related air pollution (TRAP) exposure, particularly in areas where most people live. Our study assessed the direct and indirect external validity of three methods used to estimate AADT on minor roads in Melbourne, Australia. We estimated the minor road AADT using a fixed-value approach (assuming 600 vehicles/day) and linear and negative binomial (NB) models. The models were generated using road type, road importance index, AADT and distance of the nearest major road, population density, workplace density, and weighted road density. External measurements of traffic counts, as well as black carbon (BC) and ultrafine particles (UFP), were conducted at 201 sites for direct and indirect validation, respectively. Statistical tests included Akaike information criterion (AIC) to compare models' performance, the concordance correlation coefficient (CCC) for direct validation, and Spearman's correlation coefficient for indirect validation. Results show that 88.5% of the roads in Melbourne are minor, yet only 18.9% have AADT. The performance assessment of minor road models indicated comparable performance for both models (AIC of 1,023,686 vs. 1,058,502). In the direct validation with external traffic measurements, there was no difference between the three methods for overall minor roads. However, for minor roads within residential areas, CCC (95% confidence interval [CI]) values were -0.001 (-0.17; 0.18), 0.47 (0.32; 0.60), and 0.29 (0.18; 0.39) for the fixed-value approach, the linear model, and the NB model, respectively. In the indirect validation, we found differences only on UFP where the Spearman's correlation (95% CI) for both models and fixed-value approach were 0.50 (0.37; 0.62) and 0.34 (0.19; 0.48), respectively. In conclusion, our linear model outperformed the fixed-value approach when compared against traffic and TRAP measurements. The methodology followed in this study is relevant to locations with incomplete minor road AADT data.
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Affiliation(s)
- Miguel Alvarado-Molina
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
| | - Ariadna Curto
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; ISGlobal, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Amanda J Wheeler
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Environment, Melbourne, VIC 3195, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia
| | - Rachel Tham
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia
| | - Ester Cerin
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Sandy Bay, Hong Kong; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
| | - Mark Nieuwenhuijsen
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; ISGlobal, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roel Vermeulen
- Institute for Risk, Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - David Donaire-Gonzalez
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Marchini T. Redox and inflammatory mechanisms linking air pollution particulate matter with cardiometabolic derangements. Free Radic Biol Med 2023; 209:320-341. [PMID: 37852544 DOI: 10.1016/j.freeradbiomed.2023.10.396] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
Air pollution is the largest environmental risk factor for disease and premature death. Among the different components that are present in polluted air, fine particulate matter below 2.5 μm in diameter (PM2.5) has been identified as the main hazardous constituent. PM2.5 mainly arises from fossil fuel combustion during power generation, industrial processes, and transportation. Exposure to PM2.5 correlates with enhanced mortality risk from cardiovascular diseases (CVD), such as myocardial infarction and stroke. Over the last decade, it has been increasingly suggested that PM2.5 affects CVD already at the stage of risk factor development. Among the multiple biological mechanisms that have been described, the interplay between oxidative stress and inflammation has been consistently highlighted as one of the main drivers of pulmonary, systemic, and cardiovascular effects of PM2.5 exposure. In this context, PM2.5 uptake by tissue-resident immune cells in the lung promotes oxidative and inflammatory mediators release that alter tissue homeostasis at remote locations. This pathway is central for PM2.5 pathogenesis and might account for the accelerated development of risk factors for CVD, including obesity and diabetes. However, transmission and end-organ mechanisms that explain PM2.5-induced impaired function in metabolic active organs are not completely understood. In this review, the main features of PM2.5 physicochemical characteristics related to PM2.5 ability to induce oxidative stress and inflammation will be presented. Hallmark and recent epidemiological and interventional studies will be summarized and discussed in the context of current air quality guidelines and legislation, knowledge gaps, and inequities. Lastly, mechanistic studies at the intersection between redox metabolism, inflammation, and function will be discussed, with focus on heart and adipose tissue alterations. By offering an integrated analysis of PM2.5-induced effects on cardiometabolic derangements, this review aims to contribute to a better understanding of the pathogenesis and potential interventions of air pollution-related CVD.
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Affiliation(s)
- Timoteo Marchini
- Vascular Immunology Laboratory, Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany; Universidad de Buenos Aires, CONICET, Instituto de Bioquímica y Medicina Molecular Prof. Alberto Boveris (IBIMOL), Facultad de Farmacia y Bioquímica, C1113AAD, Buenos Aires, Argentina.
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Sun HZ, Zhao J, Liu X, Qiu M, Shen H, Guillas S, Giorio C, Staniaszek Z, Yu P, Wan MW, Chim MM, van Daalen KR, Li Y, Liu Z, Xia M, Ke S, Zhao H, Wang H, He K, Liu H, Guo Y, Archibald AT. Antagonism between ambient ozone increase and urbanization-oriented population migration on Chinese cardiopulmonary mortality. Innovation (N Y) 2023; 4:100517. [PMID: 37822762 PMCID: PMC10562756 DOI: 10.1016/j.xinn.2023.100517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023] Open
Abstract
Ever-increasing ambient ozone (O3) pollution in China has been exacerbating cardiopulmonary premature deaths. However, the urban-rural exposure inequity has seldom been explored. Here, we assess population-scale O3 exposure and mortality burdens between 1990 and 2019 based on integrated pollution tracking and epidemiological evidence. We find Chinese population have been suffering from climbing O3 exposure by 4.3 ± 2.8 ppb per decade as a result of rapid urbanization and growing prosperity of socioeconomic activities. Rural residents are broadly exposed to 9.8 ± 4.1 ppb higher ambient O3 than the adjacent urban citizens, and thus urbanization-oriented migration compromises the exposure-associated mortality on total population. Cardiopulmonary excess premature deaths attributable to long-term O3 exposure, 373,500 (95% uncertainty interval [UI]: 240,600-510,900) in 2019, is underestimated in previous studies due to ignorance of cardiovascular causes. Future O3 pollution policy should focus more on rural population who are facing an aggravating threat of mortality risks to ameliorate environmental health injustice.
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Affiliation(s)
- Haitong Zhe Sun
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Junchao Zhao
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Xiang Liu
- School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China
| | - Minghao Qiu
- Department of Earth System Science, Stanford University, Stanford, CA 94305, USA
| | - Huizhong Shen
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Serge Guillas
- Department of Statistical Science, University College London, London WC1E 6BT, UK
- The Alan Turing Institute, London NW1 2DB, UK
| | - Chiara Giorio
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Zosia Staniaszek
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michelle W.L. Wan
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Man Mei Chim
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Kim Robin van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Heart and Lung Research Institute, University of Cambridge, Cambridge CB2 0BD, UK
- Barcelona Supercomputing Center, Department of Earth Sciences, 08034 Barcelona, Spain
| | - Yilin Li
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Zhenze Liu
- School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Mingtao Xia
- Department of Mathematics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Shengxian Ke
- State Key Laboratory of New Ceramics and Fine Processing, Key Laboratory of Advanced Materials of Ministry of Education, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Haifan Zhao
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Haikun Wang
- School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China
| | - Kebin He
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Huan Liu
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Alexander T. Archibald
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- National Centre for Atmospheric Science, Cambridge CB2 1EW, UK
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Haddad P, Ogurtsova K, Lucht S, Glaubitz L, Höppe P, Nowak D, Angerer P, Hoffmann B. Short-term exposure to ultrafine and fine particulate matter with multipollutant modelling on heart rate variability among seniors and children from the CorPuScula (coronary, pulmonary, sanguis) longitudinal study in Germany. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1278506. [PMID: 38455908 PMCID: PMC10910943 DOI: 10.3389/fepid.2023.1278506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/19/2023] [Indexed: 03/09/2024]
Abstract
Background Short-term exposure particulate matter with a diameter of 10 µm or less (PM10) and fine particulate matter (PM2.5) has been associated with heart rate variability (HRV), but exposure to ultrafine particles (UFP) has been less well examined. We investigated the associations between the HRV outcomes and short-term exposure to UFP, PM10 and PM2.5 among school-aged children and seniors. Methods CorPuScula (Coronary, Pulmonary and Sanguis) is a longitudinal, repeated-measure panel study conducted in 2000-2002 in Munich, Germany including 52 seniors (58-94 years old) with 899 observations and 50 children (6-10 years old) with 925 observations. A 10-min resting electrocardiogram was performed to assess resting HRV outcomes [Standard Deviation of Normal to Normal Intervals (SDNN), Root Mean Square of Successive Differences between Normal Heartbeats (RMSSD), Low Frequency power (LF), High Frequency power (HF), ration between low and high frequency (LF/HF)]. UFP and PM exposures were measured near the care home and school yard for seniors and children, respectively. Mean exposures during the day of examination (9-21 h) as well as 3-h, 12-h, 24-h, one-day, and two-day lags were assessed. Linear mixed-effect models were used to investigate the associations between short-term air pollution and HRV outcomes separately in children and seniors. The models were adjusted for sex, age, weather conditions (temperature, precipitation, and water vapor pressure), BMI, lifestyle and medical information. Two and multipollutant models adjusted for NO2 and O3 were performed. Results Among seniors, we observed increases in SDNN, LF, HF and LF/HF ratio after short-term exposure to UFP (hourly and daily lags) in contrast to decreases in SDNN and RMSSD after exposure to PM10. Associations were generally robust to two- and multipollutant adjustment. Among children, we observed increases of the LF/HF ratio after short-term exposures to UFP at lags 12 and 24 h. In contrast, we observed decreases of the ratio after exposure to PM2.5 and PM10. Results were largely unchanged for multipollutant modelling, however we found a more pronounced increase in SDNN and LF/HF (UFP lag 12 and 24 h) after adjusting for NO2. Conclusions Overall, among seniors, we observed associations of UFP and PM10 exposure with sympathetic responses of the ANS, which play an important role in sudden heart attacks or arrhythmia. Among children we found more inconsistent associations between UFP and a delayed increase in HRV. Adjusting for co-pollutants including NO2 and O3 yielded robust results.
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Affiliation(s)
- Pascale Haddad
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Katherine Ogurtsova
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sarah Lucht
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Real-World Evidence & Insights, Cardinal Health, Dublin, OH, United States
| | - Lina Glaubitz
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Peter Höppe
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Peter Angerer
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Barbara Hoffmann
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Dahlquist M, Frykman V, Hollenberg J, Jonsson M, Stafoggia M, Wellenius GA, Ljungman PLS. Short-Term Ambient Air Pollution Exposure and Risk of Out-of-Hospital Cardiac Arrest in Sweden: A Nationwide Case-Crossover Study. J Am Heart Assoc 2023; 12:e030456. [PMID: 37818697 PMCID: PMC10727387 DOI: 10.1161/jaha.123.030456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/22/2023] [Indexed: 10/12/2023]
Abstract
Background Air pollution is one of the main risk factors for cardiovascular disease globally, but its association with out-of-hospital cardiac arrest at low air pollution levels is unclear. This nationwide study in Sweden aims to investigate if air pollution is associated with a higher risk of out-of-hospital cardiac arrest in an area with relatively low air pollution levels. Methods and Results This study was a nationwide time-stratified case-crossover study investigating the association between short-term air pollution exposures and out-of-hospital cardiac arrest using data from the SRCR (Swedish Registry for Cardiopulmonary Resuscitation) between 2009 and 2019. Daily air pollution levels were estimated in 1×1-km grids for all of Sweden using a satellite-based machine learning model. The association between daily air pollutant levels and out-of-hospital cardiac arrest was quantified using conditional logistic regression adjusted for daily air temperature. Particulate matter <2.5 μm exposure was associated with a higher risk of out-of-hospital cardiac arrest among a total of 29 604 cases. In a multipollutant model, the association was most pronounced for intermediate daily lags, with an increased relative risk of 6.2% (95% CI, 1.0-11.8) per 10 μg/m3 increase of particulate matter <2.5 μm 4 days before the event. A similar pattern of association was observed for particulate matter <10 μm. No clear association was observed for O3 and NO2. Conclusions Short-term exposure to air pollution was associated with higher risk of out-of-hospital cardiac arrest. The findings add to the evidence of an adverse effect of particulate matter on out-of-hospital cardiac arrest, even at very low levels below current regulatory standards.
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Affiliation(s)
- Marcus Dahlquist
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
- Department of CardiologyDanderyd University HospitalSweden
| | - Viveka Frykman
- Department of CardiologyDanderyd University HospitalSweden
- Department of Clinical SciencesDanderyd University Hospital, Karolinska InstitutetDanderydSweden
| | - Jacob Hollenberg
- Center for Resuscitation Science, Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Martin Jonsson
- Center for Resuscitation Science, Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Massimo Stafoggia
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
- Department of EpidemiologyLazio Region Health ServiceRoma 1Italy
| | - Gregory A. Wellenius
- Department of Environmental HealthBoston University School of Public HealthMAUSA
| | - Petter L. S. Ljungman
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
- Department of CardiologyDanderyd University HospitalSweden
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Sun W, Han X, Cao M, Pan Z, Guo J, Huang D, Mi J, Liu Y, Guan T, Li P, Huang C, Wang M, Xue T. Middle-term nitrogen dioxide exposure and electrocardiogram abnormalities: A nationwide longitudinal study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 266:115562. [PMID: 37866032 DOI: 10.1016/j.ecoenv.2023.115562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Recently, professionals, such as those from the World Health Organization, have recommended a rigorous standard for nitrogen dioxide (NO2), a typical urban air pollutant affected by regular traffic emissions, based on its short-term and long-term cardiorespiratory effects. However, the association between middle-term NO2 exposure and cardiovascular disorders remains unknown. OBJECTIVES This study was conducted to examine the relationship between NO2 exposure and its middle-term cardiovascular risks indicated by electrocardiogram (ECG) abnormalities. METHOD We included 61,094 subjects (132,249 visits) with repeated ECG observations based on longitudinal data from the China National Stroke Screening Survey (CNSSS). The NO2 exposure concentration was derived from a predictive model, measured as the monthly average concentration in the 6 months of preceding the ECG measurement. We used the generalized estimation equation to assess the association between NO2 exposure and ECG abnormalities. RESULT For each 10 µg/m3 increase in monthly average NO2 concentration, the odds ratio of ECG abnormalities was 1.10 (95% confidence interval [CI] 1.09-1.12) after multiple adjustments. Stratified regression analyses of urban and rural residents showed associations between middle-term NO2 exposure and ECG abnormalities in urban (OR 1.09 [95% CI 1.08-1.11]) and rural residents (OR 1.14 [95% CI 1.10-1.19]). The association was robust within different subpopulations. Associations generally remained statistically significant (OR 1.03 [95% CI 1.02-1.05]) after extra adjustment for PM2.5. Exposure-response relationship analysis revealed a nearly linear relationship between NO2 exposure and the risk for ECG abnormalities. CONCLUSION Using the variation in ECG signals as a potentially reversible indicator for subclinical risk in cardiovascular systems, our study provides additional evidence on the increased risk posed by middle-term NO2 exposure. Our study showed that policies controlling for NO2 concentrations are beneficial to prevent cardiovascular diseases among Chinese adults.
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Affiliation(s)
- Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jian Guo
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Dengmin Huang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Pengfei Li
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Conghong Huang
- College of Land Management, Nanjing Agricultural University, Nanjing 210095, China
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, United States
| | - Tao Xue
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
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46
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Abed Al Ahad M. The association of long-term exposure to outdoor air pollution with all-cause GP visits and hospital admissions by ethnicity and country of birth in the United Kingdom. PLoS One 2023; 18:e0275414. [PMID: 37819897 PMCID: PMC10566689 DOI: 10.1371/journal.pone.0275414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Air pollution is associated with poor health. Yet, more research is needed to reveal the association of long-term exposure to outdoor air pollution with less studied health outcomes like hospital admissions and general-practitioner (GP) visits and whether this association is stronger for ethnic minorities compared to the rest of population. This study investigates the association between air pollution and all-cause GP visits and hospital admissions by ethnicity in the United-Kingdom (UK). METHODS We used individual-level longitudinal data from the "UK Household Longitudinal Study" including 46,442 adult individuals who provided 140,466 responses across five years (2015-2019). This data was linked to yearly concentrations of NO2, SO2, and particulate-matter (PM10, PM2.5) outdoor pollution using the Lower Super Output Area (LSOA) of residence for each individual. Multilevel mixed-effects ordered logistic models were used to assess the association between air pollution and all-cause GP visits and hospital admissions. RESULTS We found higher odds of hospital admissions per 1 μg/m3 increase in annual concentrations of NO2 (OR = 1.008; 95%CI = 1.004-1.012), SO2 (OR = 1.048; 95%CI = 1.014-1.083), PM10 (OR = 1.011; 95%CI = 1.003-1.018), and PM2.5 (OR = 1.018; 95%CI = 1.007-1.029) pollutants. Higher odds of GP visits were also observed with increased exposure to NO2 (OR = 1.010; 95%CI = 1.006-1.014) and SO2 (OR = 1.114; 95%CI = 1.077-1.152) pollutants. The observed associations did not differ across ethnic groups, but by country of birth, they were more pronounced in individuals born outside UK than those born in UK. CONCLUSION This study supports an association between higher exposure to outdoor air pollution and increased all-cause hospital admissions and GP visits. Further longitudinal studies with longer follow-up time periods may be able to reveal more definite conclusions on the influence of ethnicity on the association between long-term outdoor air pollution and both hospital admissions and GP visits.
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Affiliation(s)
- Mary Abed Al Ahad
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
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Marais EA, Kelly JM, Vohra K, Li Y, Lu G, Hina N, Rowe EC. Impact of Legislated and Best Available Emission Control Measures on UK Particulate Matter Pollution, Premature Mortality, and Nitrogen-Sensitive Habitats. GEOHEALTH 2023; 7:e2023GH000910. [PMID: 37885915 PMCID: PMC10599219 DOI: 10.1029/2023gh000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
Past emission controls in the UK have substantially reduced precursor emissions of health-hazardous fine particles (PM2.5) and nitrogen pollution detrimental to ecosystems. Still, 79% of the UK exceeds the World Health Organization (WHO) guideline for annual mean PM2.5 of 5 μg m-3 and there is no enforcement of controls on agricultural sources of ammonia (NH3). NH3 is a phytotoxin and an increasingly large contributor to PM2.5 and nitrogen deposited to sensitive habitats. Here we use emissions projections, the GEOS-Chem model, high-resolution data sets, and contemporary exposure-risk relationships to assess potential human and ecosystem health co-benefits in 2030 relative to the present day of adopting legislated or best available emission control measures. We estimate that present-day annual adult premature mortality attributable to exposure to PM2.5 is 48,625 (95% confidence interval: 45,188-52,595), that harmful amounts of reactive nitrogen deposit to almost all (95%) sensitive habitat areas, and that 75% of ambient NH3 exceeds levels safe for bryophytes and lichens. Legal measures decrease the extent of the UK above the WHO guideline to 58% and avoid 6,800 premature deaths by 2030. This improves with best available measures to 36% of the UK and 13,300 avoided deaths. Both legal and best available measures are insufficient at reducing the extent of damage of nitrogen pollution to sensitive habitats. Far more ambitious reductions in nitrogen emissions (>80%) than is achievable with best available measures (34%) are required to halve the amount of excess nitrogen deposited to sensitive habitats.
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Affiliation(s)
| | - Jamie M. Kelly
- Department of GeographyUniversity College LondonLondonUK
- Now at Centre for Research and Clean AirHelsinkiFinland
| | - Karn Vohra
- Department of GeographyUniversity College LondonLondonUK
| | - Yifan Li
- Reading AcademyNanjing University of Information Science and TechnologyNanjingChina
| | - Gongda Lu
- Department of GeographyUniversity College LondonLondonUK
| | - Naila Hina
- UK Centre for Ecology & HydrologyEnvironment Centre WalesBangorUK
| | - Ed C. Rowe
- UK Centre for Ecology & HydrologyEnvironment Centre WalesBangorUK
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Turner MC, Andersen ZJ, Neira M, Krzyzanowski M, Malmqvist E, González Ortiz A, Kiesewetter G, Katsouyanni K, Brunekreef B, Melén E, Ljungman P, Tolotto M, Forastiere F, Dendale P, Price R, Bakke O, Reichert S, Hoek G, Pershagen G, Peters A, Querol X, Gerometta A, Samoli E, Markevych I, Basthiste R, Khreis H, Pant P, Nieuwenhuijsen M, Sacks JD, Hansen K, Lymes T, Stauffer A, Fuller GW, Boogaard H, Hoffmann B. Clean air in Europe for all! Taking stock of the proposed revision to the ambient air quality directives: a joint ERS, HEI and ISEE workshop report. Eur Respir J 2023; 62:2301380. [PMID: 37827574 PMCID: PMC10894647 DOI: 10.1183/13993003.01380-2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Abstract
Ambient air pollution is a major public health concern and comprehensive new legislation is currently being considered to improve air quality in Europe. The European Respiratory Society (ERS), Health Effects Institute (HEI), and International Society for Environmental Epidemiology (ISEE) organised a joint meeting on May 24, 2023 in Brussels, Belgium, to review and critically evaluate the latest evidence on the health effects of air pollution and discuss ongoing revisions of the European Ambient Air Quality Directives (AAQDs). A multi-disciplinary expert group of air pollution and health researchers, patient and medical societies, and policy representatives participated. This report summarises key discussions at the meeting.
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Affiliation(s)
- Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Maria Neira
- World Health Organization (WHO), Geneva, Switzerland
| | | | | | | | - Gregor Kiesewetter
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | | | | | - Erik Melén
- Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Paul Dendale
- European Society of Cardiology (ESC), Sophia Antipolis, France
| | - Richard Price
- European Cancer Organisation (ECO), Brussels, Belgium
| | - Ole Bakke
- Standing Committee of European Doctors (CPME), Brussels, Belgium
| | - Sibylle Reichert
- International Association of Mutual Benefit Societies (AIM), Brussels, Belgium
| | - Gerard Hoek
- Utrecht University, Utrecht, The Netherlands
| | | | - Annette Peters
- Helmholtz München - German Center for Environmental Health, Neuherberg, Germany
- IBE, Medical Faculty, Ludwig Maximilians Universität, Munich, Germany
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xavier Querol
- Institute of Environmental Assessment and Water Research, IDAEA-CSIC, Barcelona, Spain
| | | | - Evangelia Samoli
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
- Health and Quality of Life in a Green and Sustainable Environment, SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | - Haneen Khreis
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jason D Sacks
- Center for Public Health and Environmental Assessment, Office of Research and Development, US Environmental Protection Agency (EPA), Research Triangle Park, NC, USA
| | - Kjeld Hansen
- European Lung Foundation, Sheffield, UK
- Kristiania University College, Oslo, Norway
| | | | | | - Gary W Fuller
- MRC Centre for Environment and Health, Imperial College London, London, UK
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Li J, Dai L, Deng X, Zhang J, Song C, Xu J, Wang A, Xiong Z, Shan Y, Huang X. Association between long-term exposure to low level air pollutants and incident end-stage kidney disease in the UK Biobank: A prospective cohort. CHEMOSPHERE 2023; 338:139470. [PMID: 37437622 DOI: 10.1016/j.chemosphere.2023.139470] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/22/2023] [Accepted: 07/09/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Previous studies suggest that air pollution can increase the risk of incident chronic kidney disease (CKD). However, the association between end-stage kidney disease (ESKD) and co-exposure to relatively low-level air pollutants remains unclear. METHODS A prospective cohort was designed based on UK Biobank. From 1 January 2010 to 12 November 2021, 453,347 participants were followed up over a median of 11.87 years. Principal component analysis was used to identify major patterns of five air pollutants, including PM2.5, PM2.5-10, PM10, NO2, and NOx. Sub-distribution hazards models were used to estimate the associations between air pollution, individually or jointly, and incident ESKD, CKD, and all-cause death, respectively. RESULTS Principal component analysis identified two principal components, namely RC1 (PM2.5, NO2, and NOx) and RC2 (PM2.5-10 and PM10). An elevated risk of incident ESKD was associated with an interquartile range (IQR) increase in PM2.5 (hazard ratio: 1.11, 95% confidence interval: 1.02-1.22), NO2 (1.16, 1.04-1.30), NOx (1.08, 1.00-1.17), and RC1 (1.12, 1.02-1.23). An elevated risk of incident CKD was associated with an IQR increase in PM2.5 (1.05, 1.03-1.07), NO2 (1.04, 1.02-1.06), NOx (1.03, 1.02-1.05), and RC1 (1.04, 1.02-1.06). An increased risk of all-cause mortality was associated with an IQR increase in PM2.5 (1.02, 1.00-1.04). Restricted cubic spline analyses indicated a monotonic elevating association of PM2.5, NO2, NOx, and RC1 with ESKD incidence. CONCLUSIONS Long-term exposure to PM2.5, NO2, NOx, and their complex was associated with elevated ESKD incidence, even at relatively lower levels of air pollution.
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Affiliation(s)
- Jing Li
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China; Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liang Dai
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Xiaowei Deng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jingwen Zhang
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Congying Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zuying Xiong
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Ying Shan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China.
| | - Xiaoyan Huang
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China; Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China.
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50
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Li D, Ma Y, Cui F, Yang Y, Liu R, Tang L, Wang J, Tian Y. Long-term exposure to ambient air pollution, genetic susceptibility, and the incidence of bipolar disorder: A prospective cohort study. Psychiatry Res 2023; 327:115396. [PMID: 37549511 DOI: 10.1016/j.psychres.2023.115396] [Citation(s) in RCA: 1] [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: 05/11/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/09/2023]
Abstract
There is mounting recent evidence showing that air pollution exposure may be related to the risk of mental health, yet the association between long-term exposure to air pollution and the risk of incident bipolar disorder (BD) remains unclear. Thus we aim to identify associations between air pollution and the incidence of BD in a prospective population-based cohort. In total, 482,726 participants who were free of BD from the UK Biobank were included in this prospective study. We applied time-varying Cox proportional hazards models, accounting for relevant confounders, and used annual-year moving averages of air pollution as time-varying exposures. The genetic risk for BD was categorized into three categories (low, intermediate, and high) according to the tertiles of polygenic risk score. During a median of 10.79-year follow-up, 923 incident BD events were recorded. Long-term exposures to PM2.5, PM10, NO2, and NOx were associated with increased BD risk. Estimated HRs (95% CIs) for each interquartile range increase in PM2.5, PM10, NO2, and NOx concentrations were 1.31 (1.18-1.45), 1.19 (1.09-1.31), 1.19 (1.08-1.30), and 1.16 (1.07-1.26), respectively. Associations were still observed and even stronger at pollutant concentrations lower than WHO air quality guideline. In subgroup analysis stratified by genetic risk, we observed consistent associations between all pollutants and BD risk in intermediate and high genetic risk groups, but not in low genetic risk group. For example, the HRs (95% CIs) for PM2.5 were 1.00 (0.94-1.53), 1.30 (1.06-1.59), and 1.34 (1.16-1.54) in low, intermediate, and high genetic groups, respectively. In conclusion, long-term exposure to air pollution was significantly associated with an elevated risk of BD. Associations of air pollution with BD occurred only within intermediate and high genetic risk categories and were even stronger at the pollutants levels below WHO air quality guidelines. These findings could help inform policy makers regarding ambient air quality standards and BD management.
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Affiliation(s)
- Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Feipeng Cui
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Yingping Yang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Run Liu
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Jianing Wang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.
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