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Shupler M, Huybrechts K, Leung M, Wei Y, Schwartz J, Hernandez-Diaz S, Papatheodorou S. The association of short-term increases in ambient PM2.5 and temperature exposures with stillbirth: racial/ethnic disparities among Medicaid recipients. Am J Epidemiol 2024; 193:1372-1383. [PMID: 38770979 PMCID: PMC11458190 DOI: 10.1093/aje/kwae083] [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: 06/07/2023] [Revised: 03/20/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024] Open
Abstract
Racial/ethnic disparities in the association between short-term (eg, days, weeks), ambient fine particulate matter (PM2.5) and temperature exposures and stillbirth in the United States have been understudied. A time-stratified, case-crossover design using a distributed lag nonlinear model (0- to 6-day lag) was used to estimate stillbirth odds due to short-term increases in average daily PM2.5 and temperature exposures among 118 632 Medicaid recipients from 2000 to 2014. Disparities by maternal race/ethnicity (Black, White, Hispanic, Asian, American Indian) and zip code-level socioeconomic status (SES) were assessed. In the temperature-adjusted model, a 10 μg m-3 increase in PM2.5 concentration was marginally associated with increased stillbirth odds at lag 1 (0.68%; 95% CI, -0.04% to 1.40%) and lag 2 (0.52%; 95% CI, -0.03 to 1.06) but not lag 0-6 (2.80%; 95% CI, -0.81 to 6.45). An association between daily PM2.5 concentrations and stillbirth odds was found among Black individuals at the cumulative lag (0-6 days: 9.26% 95% CI, 3.12%-15.77%) but not among other races or ethnicities. A stronger association between PM2.5 concentrations and stillbirth odds existed among Black individuals living in zip codes with the lowest median household income (lag 0-6: 14.13%; 95% CI, 4.64%-25.79%). Short-term temperature increases were not associated with stillbirth risk among any race/ethnicity. Black Medicaid enrollees, and especially those living in lower SES areas, may be more vulnerable to stillbirth due to short-term increases in PM2.5 exposure. This article is part of a Special Collection on Environmental Epidemiology.
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Affiliation(s)
- Matthew Shupler
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Krista Huybrechts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Harvard Medical School, Boston, MA 02120, United States
| | - Michael Leung
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Yaguang Wei
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Joel Schwartz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Sonia Hernandez-Diaz
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
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Liu Z, Meng H, Wang X, Lu W, Ma X, Geng Y, Su X, Pan D, Liang P. Interaction between ambient CO and temperature or relative humidity on the risk of stroke hospitalization. Sci Rep 2024; 14:16740. [PMID: 39033193 PMCID: PMC11271280 DOI: 10.1038/s41598-024-67568-8] [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: 09/24/2023] [Accepted: 07/12/2024] [Indexed: 07/23/2024] Open
Abstract
Although the independent effects of ambient CO, temperature or humidity on stroke have been confirmed, it is still unclear where there is an interaction between these factors and who is sensitive populations for these. The stroke hospitalization and ambient CO, temperature, humidity data were collected in 22 Counties and districts of Ningxia, China in 2014-2019. The lagged effect of ambient CO, temperature or humidity were analyze by the generalized additive model; the interaction were evaluated by the bivariate response surface model and stratified analysis with relative excessive risk (RERI). High temperature and CO levels had synergistic effects on hemorrhagic stroke (RERI = 0.05, 95% CI 0.033-0.086) and ischemic stroke (RERI = 0.035, 95% CI 0.006-0.08). Low relative humidity and CO were synergistic in hemorrhagic stroke (RERI = 0.192, 95% CI 0.184-0.205) and only in ischemic stroke in the elderly group (RERI = 0.056, 95% CI 0.025-0.085). High relative humidity and CO exhibited antagonistic effects on the risk of ischemic stroke hospitalization in both male and female groups (RERI = - 0.088, 95% CI - 0.151to - 0.031; RERI = - 0.144, 95% CI - 0.216 to - 0.197). Exposure to CO increases the risk of hospitalization related to hemorrhagic and ischemic strokes. CO and temperature or humidity interact with risk of stroke hospitalization with sex and age differences.
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Affiliation(s)
- Zhuo Liu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750000, China
| | - Hua Meng
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750000, China
| | - Xingtian Wang
- General hospital of Ningxia Medical University, No. 804, Shengli Street, Xingqing District, Yinchuan, 750001, Ningxia, China
| | - Wenwen Lu
- Shenzhen Futian District Chronic Disease Prevention and Treatment Hospital, 18 Xinzhou 8Th Street, Futian District, Shenzhen, 518048, China
| | - Xiaojuan Ma
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750000, China
| | - Yuhui Geng
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750000, China
| | - Xinya Su
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750000, China
| | - Dongfeng Pan
- Department of Emergency Medicine, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750000, China
| | - Peifeng Liang
- Public Health Center, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, 301 Zhengyuan North Street, Yinchuan, 750000, Ningxia, China.
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Yang C, Lei L, Li Y, Huang C, Chen K, Bao J. Bidirectional modification effects on nonlinear associations of summer temperature and air pollution with first-ever stroke morbidity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116034. [PMID: 38310820 DOI: 10.1016/j.ecoenv.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
High temperature and air pollution may induce stroke morbidity. However, whether associations between high temperature and air pollution with stroke morbidity are modified by each other is still unclear. Data on 23,578 first-ever stroke patients in Shenzhen, China, during the summers of 2014-2018 were collected. Distributed lag nonlinear models were used to assess the modifying effects of air pollution stratified by the median for the associations between summer temperature and stroke morbidity at 0-3 lag days; modifying effects of temperature stratified by the minimum morbidity temperature on the associations between air pollution and stroke morbidity at the same lags were also estimated. The attributable risks of high temperature and high pollution on stroke morbidity were quantified. Stratified analyses of gender, age, migration type, and complication type were conducted to assess vulnerable population characteristics. Summer high temperature may induce stroke morbidity at high-level PM2.5, PM10, O3, SO2, and NO2 conditions, with attributable fraction (AF) of 2.982% (95% empirical confidence interval [eCI]: 0.943, 4.929), 3.113% (0.948, 5.200), 2.841% (0.943, 4.620), 3.617% (1.539, 5.470), and 2.048% (0.279, 3.637), respectively. High-temperature effects were statistically insignificant at corresponding low-level air pollution conditions. High-level PM2.5, PM10, and O3 may induce stroke morbidity at high-temperature conditions, with AF of 3.664% (0.036, 7.196), 4.129% (0.076, 7.963), and 4.574% (1.009, 7.762), respectively. High-level PM2.5, PM10, and O3 were not associated with stroke morbidity at low-temperature conditions. The effects of high temperature and high pollution on stroke morbidity were statistically significant among immigrants and patients with hypertension, dyslipidemia, or diabetes but insignificant among natives and patients without complications. The associations of summer temperature and air pollution with first-ever stroke morbidity may be enhanced bidirectionally. Publicity on the health risks of combined high temperature and high pollution events should be strengthened to raise protection awareness of relevant vulnerable populations.
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Affiliation(s)
- Chenlu Yang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yike Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, China.
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De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F, Covino M. The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases. J Clin Med 2024; 13:759. [PMID: 38337453 PMCID: PMC10856578 DOI: 10.3390/jcm13030759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.
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Affiliation(s)
- Antonio De Vita
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Antonietta Belmusto
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Federico Di Perna
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Saverio Tremamunno
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Giuseppe De Matteis
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Francesco Franceschi
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
| | - Marcello Covino
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
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Sun Y, Zhang M, Wu W, Liu R, Zhang Y, Su S, Zhang E, Sun L, Yue W, Wu Q, Chen G, Zhang W, Yin C. Ambient cold exposure amplifies the effect of ambient PM 1 on blood pressure and hypertensive disorders of pregnancy among Chinese pregnant women: A nationwide cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 897:165234. [PMID: 37400028 DOI: 10.1016/j.scitotenv.2023.165234] [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: 09/03/2022] [Revised: 05/05/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Little evidence exists regarding the combined effect between ambient temperature and air pollution exposure on maternal blood pressure (BP) and hypertensive disorders of pregnancy (HDP). OBJECTIVES To assess effect modification by temperature exposure on the PM1-BP/HDP associations among Chinese pregnant women based on a nationwide study. METHODS We conducted a cross-sectional country-based population study in China, enrolling 86,005 participants from November 2017 to December 2021. BP was measured with standardized sphygmomanometers. HDP was defined according to the American College of Obstetricians and Gynecologists' recommendations. Daily temperature data were obtained from the European Centre for Medium-Range Weather Forecasts. PM1 concentrations were evaluated using generalized additive model. Generalized linear mixed models were used to examine the health effects, controlling for multiple covariates. We also performed a series of stratified and sensitivity analyses. RESULTS The pro-hypertensive effect of PM1 was observed in the first trimester. Cold exposure amplifies the first-trimester PM1-BP/HDP associations, with adjusted estimate (aβ) for systolic blood pressure (SBP) of 3.038 (95 % CI: 2.320-3.755), aβ for diastolic blood pressure (DBP) of 2.189 (95 % CI: 1.503-2.875), and aOR for HDP of 1.392 (95 % CI: 1.160-1.670). Pregnant women who were educated longer than 17 years or living in urban areas appeared to be more vulnerable to the modification in the first trimester. These findings remained robust after sensitivity analyses. CONCLUSIONS First trimester maybe the critical exposure window for the PM1-BP/HDP associations among Chinese pregnant women. Cold exposure amplifies the associations, and those with higher education level or living in urban areas appeared to be more vulnerable.
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Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Man Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ruixia Liu
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yue Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shaofei Su
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Enjie Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Lijuan Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wentao Yue
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC3004, Australia.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
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Vargas VMF, da Silva Júnior FMR, Silva Pereira TD, Silva CSD, Coronas MV. A comprehensive overview of genotoxicity and mutagenicity associated with outdoor air pollution exposure in Brazil. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2023; 26:172-199. [PMID: 36775848 DOI: 10.1080/10937404.2023.2175092] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This review examined the mutagenicity and genotoxicity associated with exposure to outdoor air pollutants in Brazil. A search was performed on the Web of Science database using a combination of keywords that resulted in 134 articles. After applying exclusion criteria, a total of 75 articles were obtained. The articles were classified into three categories: (1) studies with plants and animals, (2) in vitro studies, and (3) human biomonitoring. The investigations were conducted in 11 of 27 Brazilian states with the highest prevalence in the southeast and south regions. Only 5 investigations focused on the effects of burning biomass on the quality of outdoor air. Plants, especially Tradescantia pallida, were the main air pollution biomonitoring tool. When available, a significant association between levels of air pollutants and genetic damage was described. Among the in vitro studies, Salmonella/microsome is the most used test to evaluate mutagenesis of outdoor air in Brazil (n = 26). Human biomonitoring studies were the least frequent category (n = 18). Most of the investigations utilized micronucleus bioassay, in oral mucosa cells (n = 15) and lymphocytes (n = 5), and the comet assay (n = 6). The analysis in this study points to the existence of gaps in genotoxicity studies and our findings indicate that future studies need to address the variety of potential sources of pollution existing in Brazil. In addition to extent of the impacts, consideration should be given to the enormous Brazilian biodiversity, as well as the determination of the role of socioeconomic inequality of the population in the observed outcomes.
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Affiliation(s)
- Vera Maria Ferrão Vargas
- Programa de Pós-graduação em Ecologia, Universidade Federal do Rio Grande do Sul (UFRGS). Av. Bento Gonçalves, Porto Alegre, RS, Brazil
| | | | - Tatiana da Silva Pereira
- Laboratório de Aquicultura de Peixes Ornamentais do Xingu, Universidade Federal do Pará (UFPA), Altamira, PA, Brazil
| | - Cristiane Silva da Silva
- Programa de Pós-graduação em Ecologia, Universidade Federal do Rio Grande do Sul (UFRGS). Av. Bento Gonçalves, Porto Alegre, RS, Brazil
- Instituto Federal de Educação, Ciênciae Tecnologia do Rio Grande do Sul (IFRS), Canoas, RS, Brazil
| | - Mariana Vieira Coronas
- Coordenaç'ão Acad"êmica, Universidade Federal de Santa Maria (UFSM), Cachoeira do Sul, RS, Brazil
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Koo GPY, Zheng H, Aik JCL, Tan BYQ, Sharma VK, Sia CH, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Ischaemic Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4979. [PMID: 36981888 PMCID: PMC10049712 DOI: 10.3390/ijerph20064979] [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: 01/11/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Acute ischaemic stroke (AIS) risk on days with similar environmental profiles remains unknown. We investigated the association between clusters of days with similar environmental parameters and AIS incidence in Singapore. We grouped calendar days from 2010 to 2015 with similar rainfall, temperature, wind speed, and Pollutant Standards Index (PSI) using k-means clustering. Three distinct clusters were formed 'Cluster 1' containing high wind speed, 'Cluster 2' having high rainfall, and 'Cluster 3' having high temperatures and PSI. We aggregated the number of AIS episodes over the same period with the clusters and analysed their association using a conditional Poisson regression in a time-stratified case-crossover design. Comparing the three clusters, Cluster 3 had the highest AIS occurrence (IRR 1.09; 95% confidence interval (CI) 1.05-1.13), with no significant difference between Clusters 1 and 2. Subgroup analyses in Cluster 3 showed that AIS risk was amplified in the elderly (≥65 years old), non-smokers, and those without a history of ischaemic heart disease/atrial fibrillation/vascular heart disease/peripheral vascular disease. In conclusion, we found that AIS incidence may be higher on days with higher temperatures and PSI. These findings have important public health implications for AIS prevention and health services delivery during at-risk days, such as during the seasonal transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Officer, Health Promotion Board, Singapore 168937, Singapore
| | - Joel C. L. Aik
- Environmental Epidemiology and Toxicology Division, Environmental Health Institute, National Environment Agency, Singapore 228231, Singapore
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Benjamin Y. Q. Tan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Vijay K. Sharma
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Ching Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Centre of Population Health Research and Implementation, SingHealth Regional Health System, Singapore 168753, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
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Outdoor Air Pollution and Childhood Respiratory Disease: The Role of Oxidative Stress. Int J Mol Sci 2023; 24:ijms24054345. [PMID: 36901776 PMCID: PMC10001616 DOI: 10.3390/ijms24054345] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
The leading mechanisms through which air pollutants exert their damaging effects are the promotion of oxidative stress, the induction of an inflammatory response, and the deregulation of the immune system by reducing its ability to limit infectious agents' spreading. This influence starts in the prenatal age and continues during childhood, the most susceptible period of life, due to a lower efficiency of oxidative damage detoxification, a higher metabolic and breathing rate, and enhanced oxygen consumption per unit of body mass. Air pollution is involved in acute disorders like asthma exacerbations and upper and lower respiratory infections, including bronchiolitis, tuberculosis, and pneumoniae. Pollutants can also contribute to the onset of chronic asthma, and they can lead to a deficit in lung function and growth, long-term respiratory damage, and eventually chronic respiratory illness. Air pollution abatement policies, applied in the last decades, are contributing to mitigating air quality issues, but more efforts should be encouraged to improve acute childhood respiratory disease with possible positive long-term effects on lung function. This narrative review aims to summarize the most recent studies on the links between air pollution and childhood respiratory illness.
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He J, Liu Y, Zhang A, Liu Q, Yang X, Sun N, Yao B, Liang F, Yan X, Liu Y, Mao H, Chen X, Tang NJ, Yan H. Joint effects of meteorological factors and PM 2.5 on age-related macular degeneration: a national cross-sectional study in China. Environ Health Prev Med 2023; 28:3. [PMID: 36631073 PMCID: PMC9845061 DOI: 10.1265/ehpm.22-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM2.5) on AMD. METHODS Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM2.5 on AMD. RESULTS The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM2.5 level during the study period was 63.1 ± 15.3 µg/m3. A significant positive association was detected between AMD and PM2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM2.5 and atmospheric pressure. CONCLUSIONS This study is among the first to characterize the coordinated effects of meteorological factors and PM2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.
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Affiliation(s)
- Jiayu He
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Ai Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Qianfeng Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Naixiu Sun
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Xiaochang Yan
- National School of Development, Peking University, Beijing, 100871, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Nai-jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, 300052, China,Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, 300070, China,Tianjin Key Laboratory of Ocular Trauma, Tianjin, 300070, China
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10
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Hwang JK, Na JY, Lee KS, Oh JW, Choi YJ. Seasonal differences in the effects of local concentrations of atmospheric substances and meteorological elements on asthma exacerbation of children in metropolitan area, Korea: A 13-year retrospective single-center study. Front Pediatr 2023; 11:1028901. [PMID: 37187585 PMCID: PMC10175777 DOI: 10.3389/fped.2023.1028901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Purpose Air pollutants contribute to asthma exacerbation, and the types of air pollutants involved in acute asthma exacerbation may differ depending on climate and environmental conditions. This study aimed to identify factors affecting asthma exacerbation in each of the four seasons so that to prevent acute asthma exacerbation and to establish effective treatment strategies for each season. Methods Pediatric patients aged 0-18 years old hospitalized or admitted to the emergency room for asthma exacerbation at Hanyang University Guri Hospital between January 1, 2007, and December 31, 2019 were recruited. The number of asthma exacerbations comprised the total number of patients admitted to the emergency room or hospitalized for asthma and treated with systemic steroids. The association between the number of asthma exacerbations/week and average concentrations of atmospheric substances and meteorological elements in that week were analyzed. Multiple linear regression analyses were performed to examine the association between various atmospheric variables and the number of asthma exacerbations. Results The number of asthma exacerbations was found to be associated with the concentration of particulate matter with an aerodynamic diameter of ≤10 μm in that week in autumn. No atmospheric variables exhibited an association in other seasons. Conclusions Air pollutants and meteorological factors affecting asthma exacerbation vary by season. Moreover, their effects may change via their interaction with each other. The results of this study suggest that it will be helpful to establish differentiated measures for each season to prevent asthma exacerbation.
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Affiliation(s)
- Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Jae Yoon Na
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Young-Jin Choi
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
- Correspondence: Young-Jin Choi
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11
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Khraishah H, Alahmad B, Ostergard RL, AlAshqar A, Albaghdadi M, Vellanki N, Chowdhury MM, Al-Kindi SG, Zanobetti A, Gasparrini A, Rajagopalan S. Climate change and cardiovascular disease: implications for global health. Nat Rev Cardiol 2022; 19:798-812. [PMID: 35672485 DOI: 10.1038/s41569-022-00720-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 12/15/2022]
Abstract
Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth's weather and air conditions owing to anthropogenic activity. Climate change has resulted not only in extreme temperatures, but also in an increase in the frequency of droughts, wildfires, dust storms, coastal flooding, storm surges and hurricanes, as well as multiple compound and cascading events. The interactions between climate change and health outcomes are diverse and complex and include several exposure pathways that might promote the development of non-communicable diseases such as cardiovascular disease. A collaborative approach is needed to solve this climate crisis, whereby medical professionals, scientific researchers, public health officials and policymakers should work together to mitigate and limit the consequences of global warming. In this Review, we aim to provide an overview of the consequences of climate change on cardiovascular health, which result from direct exposure pathways, such as shifts in ambient temperature, air pollution, forest fires, desert (dust and sand) storms and extreme weather events. We also describe the populations that are most susceptible to the health effects caused by climate change and propose potential mitigation strategies, with an emphasis on collaboration at the scientific, governmental and policy levels.
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Affiliation(s)
- Haitham Khraishah
- Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. .,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.,Environmental & Occupational Health Department, Faculty of Public Health, Kuwait University, Hawalli, Kuwait
| | | | - Abdelrahman AlAshqar
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - Mazen Albaghdadi
- Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nirupama Vellanki
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mohammed M Chowdhury
- Department of Vascular and Endovascular Surgery, Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Sadeer G Al-Kindi
- University Hospitals, Harrington Heart & Vascular Institute, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Antonio Gasparrini
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK.,Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.,Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Sanjay Rajagopalan
- University Hospitals, Harrington Heart & Vascular Institute, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
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12
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Zhao J, Zhang Y, Ni Y, He J, Wang J, Li X, Guo Y, Li C, Zhang W, Cui Z. Effect of ambient temperature and other environmental factors on stroke emergency department visits in Beijing: A distributed lag non-linear model. Front Public Health 2022; 10:1034534. [PMID: 36466462 PMCID: PMC9709270 DOI: 10.3389/fpubh.2022.1034534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Most studies have focused on the relationship between ambient temperature and stroke mortality, but studies on the relationship between ambient temperature and stroke occurrence are still limited and inconsistent. Objective This study aimed to analyze the effect of ambient temperature and other environmental factors on emergency stroke visits in Beijing. Methods Our study utilized stroke visit data from the Beijing Red Cross Emergency Medical Center during 2017-2018, and applied a generalized additive model (GAM) as well as a distributed lag non-linear model (DLNM), respectively, regarding the direct, lagged, and cumulative effects of ambient temperature alone and with correction for other environmental factors on stroke occurrence. Results With a total of 26,984 emergency stroke patients in 2017-2018, both cold and hot effects were observed and weakened after correction for other environmental factors. Compared to the reference temperature, in the multi-factor model, extreme cold (-10°C) reached a maximum relative risk (RR) of 1.20 [95% Confidence Interval (CI): 1.09, 1.32] at lag 14 days, and extreme hot (30°C) had a maximum RR of 1.07 (95% CI: 1.04, 1.11) at lag 6 days. The cumulative effect of extreme cold reached a maximum of 2.02 (95% CI: 1.11, 3.67) at lag 0-14 days, whereas the cumulative effect of extreme hot temperature is greatest at lag 0-10 days, but no statistically significant effect was found. In addition, ischemic stroke patients, the elderly, and males were more susceptible to the effects of cold temperature. Conclusions There is a non-linear relationship between ambient temperature and stroke occurrence, with cold temperature having a greater and longer-lasting impact than hot temperature.
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Affiliation(s)
- Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Junyu He
- Ocean College, Zhejiang University, Zhoushan, China,Ocean Academy, Zhejiang University, Zhoushan, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China,Wenyi Zhang
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,*Correspondence: Zhuang Cui
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13
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Koo GPY, Zheng H, Pek PP, Hughes F, Lim SL, Yeo JW, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148476. [PMID: 35886328 PMCID: PMC9318360 DOI: 10.3390/ijerph19148476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Office, Health Promotion Board, Singapore 168937, Singapore;
| | - Pin Pin Pek
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
| | - Fintan Hughes
- Department of Anesthesiology, Duke University Hospital, Duke University, Durham, NC 27710, USA;
| | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore;
- Department of Medicine, National University Singapore, Singapore 119228, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School Singapore, Singapore 169857, Singapore
- Correspondence:
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14
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Dąbrowiecki P, Badyda A, Chciałowski A, Czechowski PO, Wrotek A. Influence of Selected Air Pollutants on Mortality and Pneumonia Burden in Three Polish Cities over the Years 2011-2018. J Clin Med 2022; 11:jcm11113084. [PMID: 35683472 PMCID: PMC9181391 DOI: 10.3390/jcm11113084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/14/2022] Open
Abstract
Poland has one of the worst air qualities in the European Union, particularly regarding concentrations of particulate matter (PM). This study aimed to evaluate the short-term effects of air pollution and weather conditions on all-cause mortality and pneumonia-related hospitalizations in three Polish agglomerations. We investigated data from 2011 to 2018 on a number of health outcomes, concentrations of PM2.5, PM10, nitrogen dioxide (NO2), ozone (O3), and selected meteorological parameters. To examine the impact of air pollutants and weather conditions on mortality and pneumonia burden, we identified optimal general regression models for each agglomeration. The final models explained <24% of the variability in all-cause mortality. In the models with interactions, O3 concentration in Warsaw, NO2, O3, and PM2.5 concentrations in Cracow and PM10 and O3 concentrations in the Tricity explained >10% of the variability in the number of deaths. Up to 46% of daily variability in the number of pneumonia-related hospitalizations was explained by the combination of both factors, i.e., air quality and meteorological parameters. The impact of NO2 levels on pneumonia burden was pronounced in all agglomerations. We showed that the air pollution profile and its interactions with weather conditions exert a short-term effect on all-cause mortality and pneumonia-related hospitalizations. Our findings may be relevant for prioritizing strategies to improve air quality.
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Affiliation(s)
- Piotr Dąbrowiecki
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
- Polish Federation of Asthma, Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
- Correspondence: (P.D.); (A.B.)
| | - Artur Badyda
- Polish Federation of Asthma, Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
- Faculty of Building Services, Hydro- and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland
- Correspondence: (P.D.); (A.B.)
| | - Andrzej Chciałowski
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | - Piotr Oskar Czechowski
- Department of Quantitative Methods and Environmental Management, Faculty of Management and Quality Science, Gdynia Maritime University, 81-225 Gdynia, Poland;
| | - August Wrotek
- Department of Pediatrics, The Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Department of Pediatrics, Bielanski Hospital, 01-809 Warsaw, Poland
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15
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Simmons W, Lin S, Luben TJ, Sheridan SC, Langlois PH, Shaw GM, Reefhuis J, Romitti PA, Feldkamp ML, Nembhard WN, Desrosiers TA, Browne ML, Stingone JA. Modeling complex effects of exposure to particulate matter and extreme heat during pregnancy on congenital heart defects: A U.S. population-based case-control study in the National Birth Defects Prevention Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 808:152150. [PMID: 34864029 PMCID: PMC8758551 DOI: 10.1016/j.scitotenv.2021.152150] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND/OBJECTIVE Research suggests gestational exposure to particulate matter ≤2.5 μm (PM2.5) and extreme heat may independently increase risk of birth defects. We investigated whether duration of gestational extreme heat exposure modifies associations between PM2.5 exposure and specific congenital heart defects (CHDs). We also explored nonlinear exposure-outcome relationships. METHODS We identified CHD case children (n = 2824) and non-malformed live-birth control children (n = 4033) from pregnancies ending between 1999 and 2007 in the National Birth Defects Prevention Study, a U.S. population-based multicenter case-control study. We assigned mothers 6-week averages of PM2.5 exposure during the cardiac critical period (postconceptional weeks 3-8) using the closest monitor within 50 km of maternal residence. We assigned a count of extreme heat days (EHDs, days above the 90th percentile of daily maximum temperature for year, season, and weather station) during this period using the closest weather station. Using generalized additive models, we explored logit-nonlinear exposure-outcome relationships, concluding logistic models were reasonable. We estimated joint effects of PM2.5 and EHDs on six CHDs using logistic regression models adjusted for mean dewpoint and maternal age, education, and race/ethnicity. We assessed multiplicative and additive effect modification. RESULTS Conditional on the highest observed EHD count (15) and at least one critical period day during spring/summer, each 5 μg/m3 increase in average PM2.5 exposure was significantly associated with perimembranous ventricular septal defects (VSDpm; OR: 1.54 [95% CI: 1.01, 2.41]). High EHD counts (8+) in the same population were positively, but non-significantly, associated with both overall septal defects and VSDpm. Null or inverse associations were observed for lower EHD counts. Multiplicative and additive effect modification estimates were consistently positive in all septal models. CONCLUSIONS Results provide limited evidence that duration of extreme heat exposure modifies the PM2.5-septal defects relationship. Future research with enhanced exposure assessment and modeling techniques could clarify these relationships.
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Affiliation(s)
- Will Simmons
- Department of Epidemiology, Columbia University, 722 West 168(th) Street, NY, New York 10032, USA
| | - Shao Lin
- Department of Epidemiology and Biostatistics, University at Albany, 1 University Place, Rensselaer, NY 12144, USA; Department of Environmental Health Sciences, University at Albany, 1 University Place, Rensselaer, NY, 12144, USA
| | - Thomas J Luben
- Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive, RTP, NC 27711, USA
| | - Scott C Sheridan
- Department of Geography, Kent State University, 325 S. Lincoln Street, Kent, OH 44242, USA
| | - Peter H Langlois
- Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas School of Public Health, 1616 Guadalupe Street, Austin, TX 78701, USA
| | - Gary M Shaw
- Stanford School of Medicine, 453 Quarry Road, Stanford, CA 94305, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Paul A Romitti
- Department of Epidemiology, The University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA
| | - Marcia L Feldkamp
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Wendy N Nembhard
- Departments of Pediatrics and Epidemiology, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR 72205, USA
| | - Tania A Desrosiers
- Department of Epidemiology, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Marilyn L Browne
- Department of Epidemiology and Biostatistics, University at Albany, 1 University Place, Rensselaer, NY 12144, USA; Birth Defects Registry, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Columbia University, 722 West 168(th) Street, NY, New York 10032, USA.
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16
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Weng L, Li N, Feng T, Zhu R, Zheng ZJ. Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China. Front Public Health 2021; 9:716153. [PMID: 34646803 PMCID: PMC8503471 DOI: 10.3389/fpubh.2021.716153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/23/2021] [Indexed: 11/19/2022] Open
Abstract
The epidemiological evidence on relationships between air pollution, temperature, and stroke remains inconclusive. Limited evidence is available for the effect modification by apparent temperature, an indicator reflecting reactions to the thermal environment, on short-term associations between air pollution and hospital admissions for stroke. We used a generalized additive model with Poisson regression to estimate the relative risk (RR) of stroke admissions in Shanghai, China, between 2014 and 2016 associated with air pollutants, with subgroup analyses by age, sex, apparent temperature, and season. During the study period, changes in the daily number of stroke admissions per 10 μg/m3 increase in nitrogen dioxide (at lags 0, 1, 0–1, and 0–2) ranged from 1.05 (95% CI: 0.82%, 2.88%) to 2.24% (95% CI: 0.84%, 3.65%). For each 10 μg/m3 increase in sulfur dioxide concentrations at lags 1, 2, 0–1, and 0–2, the RR of daily stroke admissions increased by 3.34 (95% CI: 0.955%, 5.79%), 0.32 (95% CI: −1.97%, 2.67%), 3.33 (95% CI: 0.38%, 6.37%), and 2.86% (95% CI: −0.45%, 6.28%), respectively. The associations of same-day exposure to nitrogen dioxide with stroke admissions remained significant after adjustment for ozone levels. These associations were not modified by sex, age, apparent temperature, or season. More research is warranted to determine whether apparent temperature modifies the associations between air pollution and stroke admissions.
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Affiliation(s)
- Lvkan Weng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Chest Hospital, Shanghai, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Tienan Feng
- Clinic Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongjia Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,Clinic Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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17
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Jiang W, Liu Z, Ni B, Xie W, Zhou H, Li X. Independent and interactive effects of air pollutants and ambient heat exposure on congenital heart defects. Reprod Toxicol 2021; 104:106-113. [PMID: 34311057 DOI: 10.1016/j.reprotox.2021.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022]
Abstract
Accumulating studies have been focused on the independent effects of air pollutants and ambient heat exposure on congenital heart defects (CHDs) but with inconsistent results, and their interactive effect remains unclear. A case-control study including 921 cases and 9210 controls was conducted in Changsha, China in warm season in 2015-2018. The gravidas were assigned monthly averages of daily air pollutants and daily maximum temperature using the nearest monitoring station method and city-wide average method, respectively, during the first trimester of pregnancy. Multivariate logistic regression models were used to estimate the independent effects of each air pollutant and different ambient heat exposure indicators. Their additive joint effects were quantified using attribute proportions of interaction (API). Increasing SO2 consistently increased the risk of CHDs in the first trimester of pregnancy, with aORs ranging from 1.78 to 2.04. CO, NO2 and PM2.5 exposure in the first month of pregnancy, and O3 exposure in the second and third month of pregnancy were also associated with elevated risks of CHDs, with aORs ranging from 1.04 to 1.15. Depending on the ambient heat exposure indicator used, air pollutants showed more apparent synergistic effects (API > 0) with less and moderately intense heat exposure. Maternal exposure to CO, NO2, SO2, PM2.5 and O3 during early pregnancy increased risk of CHDs, and ambient heat exposure may enhance these effects. Our findings help to understand the interactive effect of air pollution with ambient heat exposure on CHDs, which is of vital public health significance.
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Affiliation(s)
- Wen Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Zhiyu Liu
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Bin Ni
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Wanqin Xie
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Haiyan Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
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18
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Morici G, Cibella F, Cogo A, Palange P, Bonsignore MR. Respiratory Effects of Exposure to Traffic-Related Air Pollutants During Exercise. Front Public Health 2020; 8:575137. [PMID: 33425832 PMCID: PMC7793908 DOI: 10.3389/fpubh.2020.575137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Traffic-related air pollution (TRAP) is increasing worldwide. Habitual physical activity is known to prevent cardiorespiratory diseases and mortality, but whether exposure to TRAP during exercise affects respiratory health is still uncertain. Exercise causes inflammatory changes in the airways, and its interaction with the effects of TRAP or ozone might be detrimental, for both athletes exercising outdoor and urban active commuters. In this Mini-Review, we summarize the literature on the effects of exposure to TRAP and/or ozone during exercise on lung function, respiratory symptoms, performance, and biomarkers. Ozone negatively affected pulmonary function after exercise, especially after combined exposure to ozone and diesel exhaust (DE). Spirometric changes after exercise during exposure to particulate matter and ultrafine particles suggest a decrease in lung function, especially in patients with chronic obstructive pulmonary disease. Ozone frequently caused respiratory symptoms during exercise. Women showed decreased exercise performance and higher symptom prevalence than men during TRAP exposure. However, performance was analyzed in few studies. To date, research has not identified reliable biomarkers of TRAP-related lung damage useful for monitoring athletes' health, except in scarce studies on airway cells obtained by induced sputum or bronchoalveolar lavage. In conclusion, despite partly counteracted by the positive effects of habitual exercise, the negative effects of TRAP exposure to pollutants during exercise are hard to assess: outdoor exercise is a complex model, for multiple and variable exposures to air pollutants and pollutant concentrations. Further studies are needed to identify pollutant and/or time thresholds for performing safe outdoor exercise in cities.
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Affiliation(s)
- Giuseppe Morici
- Biomedicine, Neuroscience and Advanced Diagnostics Department, University of Palermo, Palermo, Italy.,Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Annalisa Cogo
- Biomedical Sport Studies Center, University of Ferrara, Ferrara, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria R Bonsignore
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy.,Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
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Sun Y, Ilango SD, Schwarz L, Wang Q, Chen JC, Lawrence JM, Wu J, Benmarhnia T. Examining the joint effects of heatwaves, air pollution, and green space on the risk of preterm birth in California. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:104099. [PMID: 34659452 PMCID: PMC8516119 DOI: 10.1088/1748-9326/abb8a3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Exposure to high air temperature in late pregnancy is increasingly recognized as a risk factor for preterm birth (PTB). However, the combined effects of heatwaves with air pollution and green space are still unexplored. In the context of climate change, investigating the interaction between environmental factors and identifying communities at higher risk is important to better understand the etiological mechanisms and design targeted interventions towards certain women during pregnancy. OBJECTIVES To examine the combined effects of heatwaves, air pollution and green space exposure on the risk of PTB. METHODS California birth certificate records for singleton births (2005-2013) were obtained. Residential zip code-specific daily temperature during the last week of gestation was used to create 12 definitions of heatwave with varying temperature thresholds and durations. We fit multi-level Cox proportional hazard models with time to PTB as the outcome and gestational week as the temporal unit. Relative risk due to interaction (RERI) was applied to estimate the additive interactive effect of air pollution and green space on the effect of heatwaves on PTB. RESULTS In total, 1,967,300 births were included in this study. For PM2.5, PM10 and O3, we found positive additive interactions (RERIs >0) between heatwaves and higher air pollution levels. Combined effects of heatwaves and green space indicated negative interactions (RERIs <0) for less intense heatwaves (i.e., shorter duration or relatively low temperature), whereas there were potential positive interactions (RERIs >0) for more intense heatwaves. CONCLUSION This study found synergistic harmful effects for heatwaves with air pollution, and potential positive interactions with lack of green space on PTB. Implementing interventions, such as heat warning systems and behavioral changes, targeted toward pregnant women at risk for high air pollution and low green space exposures may optimize the benefits of reducing acute exposure to extreme heat before delivery.
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Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, University of California, Irvine, CA 92697-3957, USA
| | - Sindana D. Ilango
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, San Diego, CA, 92182, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, San Diego, CA, 92182, USA
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jean M. Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, University of California, Irvine, CA 92697-3957, USA
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- Scripps Institution of Oceanography, UC San Diego, La Jolla, CA, 92037, USA
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Ji S, Zhou Q, Jiang Y, He C, Chen Y, Wu C, Liu B. The Interactive Effects between Particulate Matter and Heat Waves on Circulatory Mortality in Fuzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165979. [PMID: 32824676 PMCID: PMC7459691 DOI: 10.3390/ijerph17165979] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022]
Abstract
The interactive effects between particulate matter (PM) and heat waves on circulatory mortality are under-researched in the context of global climate change. We aimed to investigate the interaction between heat waves and PM on circulatory mortality in Fuzhou, a city characterized by a humid subtropical climate and low level of air pollution in China. We collected data on deaths, pollutants, and meteorology in Fuzhou between January 2016 and December 2019. Generalized additive models were used to examine the effect of PM on circulatory mortality during the heat waves, and to explore the interaction between different PM levels and heat waves on the circulatory mortality. During heat waves, circulatory mortality was estimated to increase by 8.21% (95% confidence intervals (CI): 0.32–16.72) and 3.84% (95% CI: 0.28–7.54) per 10 μg/m3 increase of PM2.5 and PM10, respectively, compared to non-heat waves. Compared with low-level PM2.5 concentration on non-heat waves layer, the high level of PM2.5 concentration on heat waves layer has a significant effect on the cardiovascular mortality, and the effect value was 48.35% (95% CI: 6.37–106.89). Overall, we found some evidence to suggest that heat waves can significantly enhance the impact of PM on circulatory mortality.
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Affiliation(s)
- Shumi Ji
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
| | - Quan Zhou
- Fuzhou Center for Disease Control and Prevention, Fuzhou 350000, China;
| | - Yu Jiang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
| | - Chenzhou He
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
| | - Yu Chen
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
| | - Chuancheng Wu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
- Fujian Provincial Key Laboratory of Environment Factors and Cancer, Fuzhou 350108, China
- Correspondence:
| | - Baoying Liu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou 350108, China; (S.J.); (Y.J.); (C.H.); (Y.C.); (B.L.)
- Fujian Provincial Key Laboratory of Environment Factors and Cancer, Fuzhou 350108, China
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Interaction of Air Pollutants and Meteorological Factors on Birth Weight in Shenzhen, China. Epidemiology 2020; 30 Suppl 1:S57-S66. [PMID: 31181007 DOI: 10.1097/ede.0000000000000999] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to assess if air pollutants and meteorological factors synergistically affect birth outcomes in Shenzhen, China. METHODS A total of 1,206,158 singleton live births between 2005 and 2012 were identified from a birth registry database. Daily average measurements of particulate matter ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ambient air temperature (T), and dew point temperature (Td), a marker of humidity, were collected. Multivariable logistic regression models were used to evaluate associations between air pollution and small for gestational age (SGA), and full-term low birth weight (TLBW). We classified births into those conceived in the warm (May-October) and cold seasons (November-April) and then estimated interactions between air pollutants and meteorological factors. RESULTS An interquartile range (IQR) increase in PM10 exposure during the first trimester (23.1 µg/m) and NO2 during both the first and second trimesters (15.1 and 13.4 µg/m) was associated with SGA and TLBW risk; odds ratios ranged from 1.01 (95% confidence interval [CI] = 1.00, 1.02) to 1.09 (1.07, 1.12). We observed interactive effects of both air temperature and humidity on PM10 and SGA for newborns conceived in the warm season. Each IQR increase in PM10 (11.1 µg/m) increased SGA risk by 90% (95% CI = 19%, 205%), 29% (23, 34%), 61% (10, 38%), and 26% (21, 32%) when T < 5th percentile, 5th < T < 95th percentile, Td < 5th percentile, and 5th < Td < 95th percentile, respectively. CONCLUSIONS Our study found evidence of an interactive effect of air temperature and humidity on the relationship between PM10 exposure and SGA among newborns conceived in the warm season (May-October). Relatively low air temperature or humidity exacerbated the effects of PM10.
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[Combined effects of different environmental factors on health: air pollution, temperature, green spaces, pollen, and noise]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:962-971. [PMID: 32661561 DOI: 10.1007/s00103-020-03186-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Environmental factors affect the health and wellbeing of urban residents. However, they do not act individually on humans, but instead show potential synergistic or antagonistic effects. Questions that arise from this are: How does a combination of air pollutants with other environmental factors impact health? How well are these associations evidenced? What methods can we use to look at them? In this article, methodical approaches regarding the effects of a combination of various environmental factors are first described. Environmental factors are then examined, which together with different air pollutants, have an impact on human health such as ambient temperature, noise, and pollen as well as the effect of green spaces. Physical activity and nutrition are addressed regarding the attenuation of health effects from air pollution.While there is often clear evidence of health effects of single environmental stressors, there are still open questions in terms of their interaction. The research methods required for this still need to be further developed. The interrelationship between the different environmental factors make it clear that (intervention) measures for reducing single indicators are also interlinked. Regarding traffic, switching from passive to active transport (e.g., due to safe cycle paths and other measures) leads to less air pollutants, smaller increases in temperature in the long term, and at the same time improved health of the individual. As a result, sensible planning of the built environment has great potential to reduce environmental stressors and improve people's health and wellbeing.
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Januszek R, Staszczak B, Siudak Z, Bartuś J, Plens K, Bartuś S, Dudek D. The relationship between increased air pollution expressed as PM 10 concentration and the frequency of percutaneous coronary interventions in patients with acute coronary syndromes-a seasonal differences. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:21320-21330. [PMID: 32266627 PMCID: PMC7245590 DOI: 10.1007/s11356-020-08339-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/05/2020] [Indexed: 05/30/2023]
Abstract
The aim of the presented study was to assess the relationship between air pollution expressed as particulate air matters less than 10 μm (PM10) and acute coronary syndromes (ACSs). In this observational study, we selected regions with low pollution according to PM10 (non-polluted) and with the highest pollution (polluted). The occurrence of percutaneous coronary interventions (PCIs) in patients with ACSs was matched according to the location. The current study included 7678 patients in polluted areas and 4327 patients from non-polluted regions. Analysing the period from January to December 2017, the number of patients undergoing angioplasty in monitored catheterization laboratories and the mean daily concentration of PM10 in all selected cities were calculated for each day. The annual average concentration of PM10 amounts to 50.95 μg/m3 in polluted and 26.62 μg/m3 in non-polluted cities (P < 0.01). The rise in PM10 pollution levels was related with the increased frequency of PCIs in patients with ACSs in polluted (P < 0.01) and non-polluted (P < 0.01) areas. In the non-polluted regions, the increase in PM10 concentration by every 1 μg/m3 causes 0.22 additional ACS angioplasties per week. In polluted regions, the same increase in PM10 concentration causes 0.18 additional ACS angioplasties per week. In non-winter weeks, the mean number of ACS PCIs expressed in promiles was lower than in winter weeks in polluted (P = 0.03) and non-polluted cities (P = 0.02). The study shows that the increase in air pollution expressed as PM10 concentration and winter time influences the frequency of ACS-related PCIs.
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Affiliation(s)
- Rafał Januszek
- Department of Clinical Rehabilitation, University of Physical Education, Krakow, Poland.
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Kopernika 17, 31-501, Krakow, Poland.
| | | | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Jerzy Bartuś
- Jagiellonian University Medical College, Krakow, Poland
| | | | - Stanisław Bartuś
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Kopernika 17, 31-501, Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Kopernika 17, 31-501, Krakow, Poland
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
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Lokotola CL, Wright CY, Wichmann J. Temperature as a modifier of the effects of air pollution on cardiovascular disease hospital admissions in Cape Town, South Africa. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:16677-16685. [PMID: 32133609 DOI: 10.1007/s11356-020-07938-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 01/29/2020] [Indexed: 05/20/2023]
Abstract
Climate change and air pollution are two independent risk factors to cardiovascular diseases (CVD). Few studies investigated their interaction and potential effect modification of one another in developing countries. Individual level CVD hospital admission (ICD10: I00-I99) data for 1 January 2011 to 31 October 2016 were obtained from seven private hospitals in Cape Town. NO2, SO2, PM10, temperature and relative humidity data were obtained from the South African Weather Services and the City of Cape Town. A case-crossover epidemiological study design and conditional logistic regression model were applied. Various cut-off values were applied to classify cold and warm days. In total, 54,818 CVD hospital admissions were included in the study. In general, on warm and cold days the 15-64 years old group was more at risk for CVD hospitalization with increasing air pollution levels compared to all ages combined or the ≥ 65 years old group. Females appeared to be more at risk than males with increasing PM10 levels. In contrast, males were more vulnerable to the effects of NO2 and SO2 than females. The study showed the modification effect of temperature on air pollution associated with CVD hospital admissions. The consideration of such interaction will help in policy making and public health interventions dealing with climate change-related health risks.
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Affiliation(s)
- Christian L Lokotola
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Caradee Y Wright
- South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Wang Q, Li B, Benmarhnia T, Hajat S, Ren M, Liu T, Knibbs LD, Zhang H, Bao J, Zhang Y, Zhao Q, Huang C. Independent and Combined Effects of Heatwaves and PM2.5 on Preterm Birth in Guangzhou, China: A Survival Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:17006. [PMID: 31909654 PMCID: PMC7015562 DOI: 10.1289/ehp5117] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Both extreme heat and air pollution exposure during pregnancy have been associated with preterm birth; however, their combined effects are unclear. OBJECTIVES Our goal was to estimate the independent and joint effects of heatwaves and fine particulate matter [PM <2.5μm in aerodynamic diameter (PM2.5)], exposure during the final gestational week on preterm birth. METHODS Using birth registry data from Guangzhou, China, we included 215,059 singleton live births in the warm season (1 May-31 October) between January 2015 and July 2017. Daily meteorological variables from 5 monitoring stations and PM2.5 concentrations from 11 sites were used to estimate district-specific exposures. A series of cut off temperature thresholds and durations (2, 3, and 4 consecutive d) were used to define 15 different heatwaves. Cox proportional hazard models were used to estimate the effects of heatwaves and PM2.5 exposures during the final week on preterm birth, and departures from additive joint effects were assessed using the relative excess risk due to interaction (RERI). RESULTS Numbers of preterm births increased in association with heatwave exposures during the final gestational week. Depending on the heatwave definition used, hazard ratios (HRs) ranged from 1.10 (95% CI: 1.01, 1.20) to 1.92 (1.39, 2.64). Associations were stronger for more intense heatwaves. Combined effects of PM2.5 exposures and heatwaves appeared to be synergistic (RERIs>0) for less extreme heatwaves (i.e., shorter or with relatively low temperature thresholds) but were less than additive (RERIs<0) for more intense heatwaves. CONCLUSIONS Our research strengthens the evidence that exposure to heatwaves during the final gestational week can independently trigger preterm birth. Moderate heatwaves may also act synergistically with PM2.5 exposure to increase risk of preterm birth, which adds new evidence to the current understanding of combined effects of air pollution and meteorological variables on adverse birth outcomes. https://doi.org/10.1289/EHP5117.
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Affiliation(s)
- Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Bing Li
- Department of Healthcare, Guangdong Women and Children Hospital, Guangzhou, China
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, USA
- Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, USA
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Luke D. Knibbs
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Huanhuan Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yawei Zhang
- School of Public Health, Yale University, New Haven, USA
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Research Institute of Guangdong Province/Family Planning Special Hospital of Guangdong Province, Guangzhou, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
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26
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Duan Y, Liao Y, Li H, Yan S, Zhao Z, Yu S, Fu Y, Wang Z, Yin P, Cheng J, Jiang H. Effect of changes in season and temperature on cardiovascular mortality associated with nitrogen dioxide air pollution in Shenzhen, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 697:134051. [PMID: 31487586 DOI: 10.1016/j.scitotenv.2019.134051] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/26/2019] [Accepted: 08/21/2019] [Indexed: 04/13/2023]
Abstract
BACKGROUND The intricate association of mortality risk with ambient air pollution and temperature is of growing concern. Little is known regarding effect of changes in season and temperature on daily cardiovascular mortality associated with air pollutant nitrogen dioxide (NO2). OBJECTIVES Our study aimed to assess the effect of NO2 on cardiovascular mortality modified by season and daily air temperature in the effect, and further to identify the population highly susceptible to cardiovascular mortality associated with NO2 and air temperature. METHODS We collected daily cause-specific death data, weather conditions, and air pollutant concentrations in Shenzhen from 2013 to 2017. Distributed-lag linear models were employed to analyze the effect of season on the NO2-associated mortality. Furthermore, generalized additive models were combined with stratification parametric analysis to estimate the interaction effect of NO2 with air temperature on cardiovascular mortality. RESULTS In the cold season, the percentage increase in daily mortality for every 10 μg/m3 increment in NO2 concentration over lags of 0-2 days was 4.45% (95% CI: 2.71-6.21%). However, no statistically significant effect of NO2 was observed in the warm season. Compared with high-temperature days (>median temperature), a 3.51% increase in mortality (95% CI: 2.04-5.01%) over low-temperature days (≤median temperature) for the same increase in NO2 was significant. Air temperature modified the effect of NO2 on daily mortality by 4.08% (95% CI: 2.28-5.91%) for the elderly (age ≥ 65 years) on low-temperature days vs. -0.82% (95% CI: -3.88-2.34%) on high-temperature days, and 3.38% (95% CI: 1.50-5.29%) for males on low-temperature days vs. -0.73% (95% CI: -3.83-2.47%) on high air temperature days. CONCLUSIONS The cold season and low temperatures could significantly enhance the effect of NO2 on cardiovascular mortality. The elderly and males suffering from cardiovascular disease should take precautions against low temperature and NO2 air pollution.
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Affiliation(s)
- Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Liao
- Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiguang Zhao
- Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Department of environment and health, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhihui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China.
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Does Particulate Matter Modify the Short-Term Association between Heat Waves and Hospital Admissions for Cardiovascular Diseases in Greater Sydney, Australia? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183270. [PMID: 31492044 PMCID: PMC6765779 DOI: 10.3390/ijerph16183270] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022]
Abstract
Little is known about the potential interactive effects of heat waves and ambient particulate matter on cardiovascular morbidity. A time-stratified case-crossover design was used to examine whether particulate matter (PM10) modifies the association between heat waves and emergency hospital admissions for six cardiovascular diseases in Greater Sydney, Australia during the warm season for 2001–2013. We estimated and compared the effect of heat waves on high- and low-level PM10 days at lag0–lag2, adjusting for dew-point temperature, ambient ozone, ambient nitrogen dioxide, and public holidays. We also investigated the susceptibility of both younger (0–64 years) and older populations (65 years and above), and tested the sensitivity of three heat wave definitions. Stronger heat wave effects were observed on high- compared to low-level PM10 days for emergency hospital admissions for cardiac arrest for all ages combined, 0–64 years and 65 years and above; conduction disorders for 0–64 years; and hypertensive diseases for all ages combined and 0–64 years. Overall, we found some evidence to suggest that PM10 may modify the association between heat waves and hospital admissions for certain cardiovascular diseases, although our findings largely differed across disease, age group, lag, and heat wave definition.
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Yitshak-Sade M, Bobb JF, Schwartz JD, Kloog I, Zanobetti A. The association between short and long-term exposure to PM 2.5 and temperature and hospital admissions in New England and the synergistic effect of the short-term exposures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:868-875. [PMID: 29929325 PMCID: PMC6051434 DOI: 10.1016/j.scitotenv.2018.05.181] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/25/2018] [Accepted: 05/15/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Particulate matter < 2.5 μm in diameter (PM2.5) and heat are strong predictors of morbidity, yet few studies have examined the effects of long-term exposures on non-fatal events, or assessed the short and long-term effect on health simultaneously. OBJECTIVE We jointly investigated the association of short and long-term exposures to PM2.5 and temperature with hospital admissions, and explored the modification of the associations with the short-term exposures by one another and by temperature variability. METHODS Daily ZIP code counts of respiratory, cardiac and stroke admissions of adults ≥65 (N = 2,015,660) were constructed across New-England (2001-2011). Daily PM2.5 and temperature exposure estimates were obtained from satellite-based spatio-temporally resolved models. For each admission cause, a Poisson regression was fit on short and long-term exposures, with a random intercept for ZIP code. Modifications of the short-term effects were tested by adding interaction terms with temperature, PM2.5 and temperature variability. RESULTS Associations between short and long-term exposures were observed for all of the outcomes, with stronger effects of long-term exposures to PM2.5. For respiratory admissions, the short-term PM2.5 effect (percent increase per IQR) was larger on warmer days (1.12% versus -0.53%) and in months of higher temperature variability (1.63% versus -0.45%). The short-term temperature effect was higher in months of higher temperature variability as well. For cardiac admissions, the PM2.5 effect was larger on colder days (0.56% versus -0.30%) and in months of higher temperature variability (0.99% versus -0.56%). CONCLUSIONS We observed synergistic effects of short-term exposures to PM2.5, temperature and temperature variability. Long-term exposures to PM2.5 were associated with larger effects compared to short-term exposures.
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Affiliation(s)
- Maayan Yitshak-Sade
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer F Bobb
- Biostatistics Unit, Kaiser Permanent Washington Health Research Institute, Seattle, WA, USA
| | - Joel D Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Chen K, Wolf K, Breitner S, Gasparrini A, Stafoggia M, Samoli E, Andersen ZJ, Bero-Bedada G, Bellander T, Hennig F, Jacquemin B, Pekkanen J, Hampel R, Cyrys J, Peters A, Schneider A. Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areas. ENVIRONMENT INTERNATIONAL 2018; 116:186-196. [PMID: 29689465 DOI: 10.1016/j.envint.2018.04.021] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/24/2018] [Accepted: 04/16/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature. OBJECTIVE We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 μm (PM2.5) and ≤ 10 μm (PM10), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999-2013. METHODS We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis. RESULTS Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm3 in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (<25th percentile) [-0.18% (95% CI: -0.97%, 0.62%)]. On days with high air pollution (>50th percentile), both heat- and cold-related mortality risks increased. CONCLUSION Our findings showed that high temperature could modify the effects of air pollution on daily mortality and high air pollution might enhance the air temperature effects.
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Affiliation(s)
- Kai Chen
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Zorana Jovanovic Andersen
- Department of Public Health, Center for Epidemiology and Screening, University of Copenhagen, Copenhagen, Denmark
| | - Getahun Bero-Bedada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Stockholm County Council, Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Frauke Hennig
- Institute for Occupational, Social and Environmental Medicine, Center for health and Society, University of Düsseldorf, Düsseldorf, Germany
| | - Bénédicte Jacquemin
- INSERM-Aging and Chronic Diseases, Epidemiological and Public Health Approaches (VIMA), Villejuif, France; Barcelona Institute for Global Health - Campus MAR (ISGlobal), Barcelona, Spain
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, Helsinki, Finland; Environment and Health Unit, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Regina Hampel
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Josef Cyrys
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
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The Interaction Effects of Meteorological Factors and Air Pollution on the Development of Acute Coronary Syndrome. Sci Rep 2017; 7:44004. [PMID: 28276507 PMCID: PMC5343658 DOI: 10.1038/srep44004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/02/2017] [Indexed: 11/08/2022] Open
Abstract
This study investigated the interaction effects of meteorological factors and air pollutants on the onset of acute coronary syndrome (ACS). Data of ACS patients were obtained from the Taiwan ACS Full Spectrum Registry and comprised 3164 patients with a definite onset date during the period October 2008 and January 2010 at 39 hospitals. Meteorological conditions and air pollutant concentrations at the 39 locations during the 488-day period were obtained. Time-lag Poisson and logistic regression were used to explore their association with ACS incidence. One-day lag atmospheric pressure (AP), humidity, particulate matter (PM2.5, and PM10), and carbon monoxide (CO) all had significant interaction effects with temperature on ACS occurrence. Days on which high temperatures (>26 °C) and low AP (<1009 hPa) occurred the previous day were associated with a greater likelihood of increased incidence of developing ACS. Typhoon Morakot was an example of high temperature with extremely low AP associated with higher ACS incidence than the daily average. Combinations of high concentrations of PM or CO with low temperatures (<21 °C) and high humidity levels with low temperatures were also associated with increased incidence of ACS. Atmospheric pollution and weather factors have synergistic effects on the incidence of ACS.
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Abstract
BACKGROUND The reported estimated effects between long-term PM2.5 exposures and mortality vary spatially. We assessed whether community-level variables, including socioeconomic status indicators and temperature, modify this association. METHODS We used data from >35 million Medicare enrollees from 207 US cities (2000-2010). For each city, we calculated annual PM2.5 averages, measured at ambient central monitoring sites. We used a variation of a causal modeling approach and fitted city-specific Cox models, which we then pooled using a random effects meta-regression. In this second stage, we assessed whether temperature and city-level variables, including smoking and obesity rates, poverty, education and greenness, modify the long-term PM2.5-mortality association. RESULTS We found an association between long-term PM2.5 and survival (hazard ratio = 1.2; 95% confidence interval [CI]: 1.1, 1.3 per 10 μg/m increase in the annual PM2.5 average concentrations). We observed elevated estimates in the Southeastern, South and Northwestern US (hazard ratio = 1.9; 95% CI: 1.7, 2.2, and 1.4; 95% CI: 1.2, 1.7, and 1.4; 95% CI: 1.1, 1.9, respectively). We observed a higher association between long-term PM2.5 exposure and mortality in warmer cities. Furthermore, we observed increasing estimates with increasing obesity rates, %residents and families in poverty, %black residents and %population without a high school degree, and lower effects with increasing median household income and %white residents. CONCLUSIONS To the best of our knowledge, this is the first study to assess modification by temperature and community-level characteristics on the long-term PM2.5-survival association. Our findings suggest that living in cities with high temperatures and low socio economic status (SES) is associated with higher effect estimates.
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Okeahialam BN. The Cold Dusty Harmattan: A Season of Anguish for Cardiologists and Patients. ENVIRONMENTAL HEALTH INSIGHTS 2016; 10:143-146. [PMID: 27594787 PMCID: PMC5004994 DOI: 10.4137/ehi.s38350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 05/30/2023]
Abstract
Human health and disease often demonstrate seasonal patterns. Knowledge of these aspects aids anticipation and planning. Numerous studies have shown that hypertension and cardiovascular diseases demonstrate a seasonal pattern. The Harmattan, the cold dusty season in Sub-Saharan Africa, is the season of greatest concern in this regard. In this commentary, the author draws on his and other researchers' studies to explain the grounds for onset and worsening of existing cardiovascular diseases. As implied in the title, it is a season that puts great strain on the cardiologist and the health system, as well as greater disease burden on the patient. This should be taken into consideration in planning and pooling of resources for effective patient management and mitigation of impact of disease.
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Davis RE, McGregor GR, Enfield KB. Humidity: A review and primer on atmospheric moisture and human health. ENVIRONMENTAL RESEARCH 2016; 144:106-116. [PMID: 26599589 DOI: 10.1016/j.envres.2015.10.014] [Citation(s) in RCA: 177] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 05/18/2023]
Abstract
Research examining associations between weather and human health frequently includes the effects of atmospheric humidity. A large number of humidity variables have been developed for numerous purposes, but little guidance is available to health researchers regarding appropriate variable selection. We examine a suite of commonly used humidity variables and summarize both the medical and biometeorological literature on associations between humidity and human health. As an example of the importance of humidity variable selection, we correlate numerous hourly humidity variables to daily respiratory syncytial virus isolates in Singapore from 1992 to 1994. Most water-vapor mass based variables (specific humidity, absolute humidity, mixing ratio, dewpoint temperature, vapor pressure) exhibit comparable correlations. Variables that include a thermal component (relative humidity, dewpoint depression, saturation vapor pressure) exhibit strong diurnality and seasonality. Humidity variable selection must be dictated by the underlying research question. Despite being the most commonly used humidity variable, relative humidity should be used sparingly and avoided in cases when the proximity to saturation is not medically relevant. Care must be taken in averaging certain humidity variables daily or seasonally to avoid statistical biasing associated with variables that are inherently diurnal through their relationship to temperature.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, 291 McCormick Road, Charlottesville, VA 22904-4123, USA.
| | - Glenn R McGregor
- Department of Geography, Durham University, Durham DH1 3LE, United Kingdom.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Basagaña X. The Sagrada Familia splines. J Epidemiol Community Health 2015; 69:1033-4. [PMID: 25954022 DOI: 10.1136/jech-2015-205672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Xavier Basagaña
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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