Association between outdoor PM2.5 and prevalence of COPD: a systematic review and meta-analysis

Multiomic Signatures of Traffic-Related Air Pollution in London Reveal Potential Short-Term Perturbations in Gut Microbiome-Related Pathways

This randomized crossover study investigated the metabolic and mRNA alterations associated with exposure to high and low traffic-related air pollution (TRAP) in 50 participants who were either healthy or were diagnosed with chronic pulmonary obstructive disease (COPD) or ischemic heart disease (IHD). For the first time, this study combined transcriptomics and serum metabolomics measured in the same participants over multiple time points (2 h before, and 2 and 24 h after exposure) and over two contrasted exposure regimes to identify potential multiomic modifications linked to TRAP exposure. With a multivariate normal model, we identified 78 metabolic features and 53 mRNA features associated with at least one TRAP exposure. Nitrogen dioxide (NO2) emerged as the dominant pollutant, with 67 unique associated metabolomic features. Pathway analysis and annotation of metabolic features consistently indicated perturbations in the tryptophan metabolism associated with NO2 exposure, particularly in the gut-microbiome-associated indole pathway. Conditional multiomics networks revealed complex and intricate mechanisms associated with TRAP exposure, with some effects persisting 24 h after exposure. Our findings indicate that exposure to TRAP can alter important physiological mechanisms even after a short-term exposure of a 2 h walk. We describe for the first time a potential link between NO2 exposure and perturbation of the microbiome-related pathways.

PM2.5 exposure and lung function impairment among fiber-cement industry workers

Introduction

Numerous studies have reported respiratory impairment by exposure to fine particulate matter (PM_2.5). However, limited studies investigated its effects on fiber cement roof workers. Thus, our study evaluated the impact of PM_2.5 on pulmonary impairments among workers and its risk factors.

Design and Method

A total of 131 fiber cement roof workers have been chosen based on the inclusive criteria. Size-segregated particles were measured in the workplace of workers. Interview and spirometry tests were obtained to determine the respiratory impairments.

Result

The results showed the mean concentrations of PM_2.5 had exceeded the WHO and US-EPA standards. A quarter of workers had lung restriction, lung obstruction, and mixed. Workers are most likely to have shortness of breath and wheezing. A significant correlation was found between smoking, production workers, and a long work period with abnormal lung function. Fiber cement roof workers are significantly at risk of exposure to PM_2.5. They are most likely to acquire abnormal lung function due to PM_2.5 exposure.

Conclusion

Our study recommended the industry constantly maintain its programs. The industry should keep using the wet process to prevent dust generation and water suppression from preventing dust spread, as well as to wear respiratory protection for workers to avoid PM_2.5 exposure. We recommended as well to the industry to implement follow-up programs for workers with abnormal lung function. Further action is needed to protect the workers' occupational health in the fiber cement roof industry.

Impacts of particulate matter (PM2.5) on the health status of outdoor workers: observational evidence from Malaysia

Ambient air pollution is a significant contributor to disease burden, leading to an estimated 4.2 million premature deaths and 103.1 million disability-adjusted life years (DALYs) annually worldwide. As industrialization and urbanization surge in Asia, air pollution and its corresponding health issues follow suit. Findings on disease burden in developing countries are extremely scanty. This study aimed to determine the concentration of PM_2.5 and its impact on respiratory health of outdoor workers in Malaysia. A 2-cycled 3-month cohort study involving 440 participants was conducted. Workers' health status was assessed via (1) Total Ocular Symptom Score (TOSS), (2) Total Nasal Symptom Score (TNSS), (3) St. George's Respiratory Questionnaire (SGPQ), and (4) Asthma Control Test (ACT). The maximum PM_2.5 concentration was measured at 122.90 ± 2.07 µg/m³ during third week of August 2016. Meanwhile, the minimum concentration was measured at 57.47 ± 3.80 µg/m³ and 57.47 ± 1.64 µg/m³ during fourth week of July 2016 and first week of August 2017 respectively. Findings revealed that TOSS, TNSS, and SGPQ changes were significantly (p < 0.05) associated with the concentration of PM_2.5. Outdoor workers were more significantly (p < 0.05) affected by changes in PM_2.5 compared to indoor workers with a moderate correlation (r value ranged from 0.4 to 0.7). Ironically, no significant association was found between ACT assessment and PM_2.5. Collectively, our findings suggested that changes in the concentration of PM_2.5 threatened the respiratory health of outdoor workers. The existing policy should be strengthened and preventive measures to be enforced safeguarding health status of outdoor workers.

Outdoor air quality and human health: An overview of reviews of observational studies

The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NO_X, NO₂, O₃, PM₁₀, PM_2.5, and SO₂ and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM_2.5, PM₁₀, NO₂, and SO₂ concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM_2.5, PM₁₀, O₃, NO₂, and SO₂ concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.

Nicotinamide Mononucleotide and Coenzyme Q10 Protects Fibroblast Senescence Induced by Particulate Matter Preconditioned Mast Cells

Particulate matter (PM) pollutants impose a certain degree of destruction and toxicity to the skin. Mast cells in the skin dermis could be activated by PMs that diffuse across the blood vessel after being inhaled. Mast cell degranulation in the dermis provides a kind of inflammatory insult to local fibroblasts. In this study, we evaluated human dermal fibroblast responses to conditioned medium from KU812 cells primed with PM. We found that PM promoted the production of proinflammatory cytokines in mast cells and that the cell secretome induced reactive oxygen species and mitochondrial reactive oxygen species production in dermal fibroblasts. Nicotinamide mononucleotide or coenzyme Q10 alleviated the generation of excessive ROS and mitochondrial ROS induced by the conditioned medium from PM-activated KU812 cells. PM-conditioned medium treatment increased the NF-κB expression in dermal fibroblasts, whereas NMN or Q10 inhibited p65 upregulation by PM. The reduced sirtuin 1 (SIRT 1) and nuclear factor erythroid 2-related Factor 2 (Nrf2) expression induced by PM-conditioned medium was reversed by NMN or Q10 in HDFs. Moreover, NMN or Q10 attenuated the expression of senescent β-galactosidase induced by PM-conditioned KU812 cell medium. These findings suggest that NMN or Q10 ameliorates PM-induced inflammation by improving the cellular oxidative status, suppressing proinflammatory NF-κB, and promoting the levels of the antioxidant and anti-inflammatory regulators Nrf2 and SIRT1 in HDFs. The present observations help to understand the factors that affect HDFs in the dermal microenvironment and the therapeutic role of NMN and Q10 as suppressors of skin aging.

Association of PM2.5 and PM10 with Acute Exacerbation of Chronic Obstructive Pulmonary Disease at lag0 to lag7: A Systematic Review and Meta-Analysis

This study aimed to conduct a meta-analysis to investigate whether short-term exposure to fine (PM_2.5) and coarse (PM₁₀) particulate matter was associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalization, emergency room visit, and outpatient visit at different lag values. PubMed, Embase, and the Cochrane Library were searched for relevant papers published up to March 2021. For studies reporting results per 1-µg/m³ increase in PM_2.5, the results were recalculated as per 10-µg/m³ increase. We manually calculated the RRs for these two studies and transferred the RRs to estimate 10 µg/m³ increases in PM_2.5. Automation tools were initially used to remove ineligible studies. Two reviewers independently screened the remaining records and retrieved reports. Twenty-six studies (28 datasets; 7,018,419 patients) were included. There was a significant association between PM_2.5 and AECOPD events on lag0 (ES = 1.01, 95%CI: 1.01-1.02, p < 0.001; I²=88.6%, P_{heterogeneity}<0.001), lag1 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I²=82.5%, P_{heterogeneity}<0.001), lag2 (ES = 1.01, 95%CI: 1.01-1.01, p < 0.001; I²=90.6%, P_{heterogeneity}<0.001), lag3 (ES = 1.01, 95%CI: 1.00-1.01, p < 0.001; I²=88.9%, P_{heterogeneity}<0.001), lag4 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I²=83.7%, P_{heterogeneity}<0.001), and lag7 (ES = 1.00, 95%CI: 1.00-1.00, p < 0.001; I²=0.0%, P_{heterogeneity}=0.743). The subgroup analyses showed that PM_2.5 influenced the rates of hospitalization, emergency room visits, and outpatient visits. Similar trends were observed with PM₁₀. The risk of AECOPD events (hospitalization, emergency room visit, and outpatient visit) was significantly increased with a 10-µg/m³ increment in PM_2.5 and PM₁₀ from lag0 to lag7.List Of Abbreviations: particulate matter (PM_2.5 and PM₁₀); acute exacerbation of chronic obstructive pulmonary disease (AECOPD); Chronic obstructive pulmonary disease (COPD); Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); Effect sizes [48]; confidence intervals (CIs).

Long-term PM2.5 exposure and various health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies

Adverse effects from exposure to particulate matter <2.5 μm in diameter (PM_2.5) on health-related outcomes have been found in a range of experimental and epidemiological studies. This study aimed to assess the significance, validity, and reliability of the relationship between long-term PM_2.5 exposure and various health outcomes. The Embase, PubMed, Web of Science, CNKI, WANFANG, VIP, and SinoMed databases and reference lists of the retrieved review articles were searched to obtain meta-analysis and systematic reviews focusing on PM_2.5-related outcomes as of August 31, 2021. Random-/fixed-effects models were applied to estimate summary effect size and 95% confidence intervals (CIs). The quality of included meta-analyses was evaluated based on the AMSTAR 2 tool. Small-study effect and excess significance bias studies were conducted to further assess the associations. Registered PROSPERO number: CRD42020200606. This included 24 articles involving 71 associations between PM_2.5 exposure and the health outcomes. The evidence for the positive association of 10 μg/m³ increments of long-term exposure to PM_2.5 and stroke incidence in Europe was convincing (effect size = 1.07, 95% CI: 1.05-1.10). There was evidence that was highly suggestive of a positive association between 10 μg/m³ increments of long-term exposure to PM_2.5 and the following health-related outcomes: mortality of lung cancer (effect size = 1.11, 95% CI: 1.08-1.13) and Alzheimer's disease (effect size = 4.79, 95% CI: 2.79-8.21). There was highly suggestive evidence that chronic obstructive pulmonary disease risk is positively associated with higher long-term PM_2.5 exposure versus lower long-term PM_2.5 exposure (effect size = 2.32, 95% CI: 1.88-2.86). In conclusion, the positive association of long-term exposure to PM_2.5 and stroke incidence in Europe was convincing. Given the validity of numerous associations of long-term exposure to PM_2.5 and health-related outcomes is subject to biases, more robust evidence is urgently needed.

Characterization and exposure assessment of household fine particulate matter pollution in China

Household fine particulate matter (PM_2.5 ) pollution greatly impacts residents' health. To explore the current national situation of household PM_2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household-weighted mean concentration of household PM_2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m³ . HPL in the rural area (164.3 ± 104.5 μg/m³ ) was higher than that in the urban area (123.9 ± 122.3 μg/m³ ). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM_2.5 among school-age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently.

The effects of traffic-related air pollutants on chronic obstructive pulmonary disease in the community-based general population

Background

Previous studies have shown inconsistent results regarding the impact of traffic pollution on the prevalence of chronic obstructive pulmonary disease (COPD). Therefore, using frequency matching and propensity scores, we explored the association between traffic pollution and COPD in a cohort of 8284 residents in a major agricultural county in Taiwan.

Methods

All subjects completed a structured questionnaire interview and health checkups. Subjects with COPD were identified using Taiwan National Health Insurance Research Databases. A hybrid kriging/LUR model was used to identify levels of traffic-related air pollutants (PM_2.5 and O₃). Multiple logistic regression models were used to calculate the prevalence ratios (PRs) of COPD and evaluate the role played by traffic-related indices between air pollutants and COPD. The distributed lag nonlinear model was applied in the analysis; we excluded current or ever smokers to perform the sensitivity analysis.

Results

Increased PRs of COPD per SD increment of PM_2.5 were 1.10 (95% CI 1.05–1.15) and 1.25 (95% CI 1.13–1.40) in the population with age and sex matching as well as propensity-score matching, respectively. The results of the sensitivity analysis were similar between the single and two pollutant models. PM_2.5 concentrations were significantly associated with traffic flow including sedans, buses, and trucks (p < 0.01). The higher road area and the higher PM_2.5 concentrations near the subject’s residence correlated with a greater risk of developing COPD (p for interaction < 0.01).

Conclusions

Our results suggest that long-term exposure to traffic-related air pollution may be positively associated with the prevalence of COPD.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12931-021-01812-x.

Vulnerability and Burden of All-Cause Mortality Associated with Particulate Air Pollution during COVID-19 Pandemic: A Nationwide Observed Study in Italy

BACKGROUND

Limited evidence is available on the health effects of particulate matter (PM including PM2.5 with an aerodynamic diameter ≤ 2.5 μm; PM10, ≤ 10 μm; PM2.5-10, 2.5-10 μm) during the pandemic of COVID-19 in Italy. The aims of the study were to examine the associations between all-cause mortality and PM in the pandemic period and compare them to the normal periods (2015-2019).

METHODS

We collected daily data regarding all-cause mortality (stratified by age and gender), and PM concentrations for 107 Italian provinces from 1 January 2015 to 31 May 2020. A time-stratified case-cross design with the distributed lag non-linear model was used to examine the association between PM and all-cause mortality. We also compared the counts and fractions of death attributable to PM in two periods.

RESULTS

Italy saw an increase in daily death counts while slight decreases in PM concentrations in pandemic period. Each 10 µg/m3 increase in PM was associated with much higher increase in daily all-cause mortality during the pandemic period compared to the same months during 2015-2019 (increased mortality rate: 7.24% (95%CI: 4.84%, 9.70%) versus 1.69% (95%CI: 1.12%, 2.25%) for PM2.5; 3.45% (95%CI: 2.58%, 4.34%) versus 1.11% (95%CI: 0.79%, 1.42%) for PM10; 4.25% (95%CI: 2.99%, 5.52%) versus 1.76% (95%CI: 1.14%, 2.38%) for PM2.5-10). The counts and fractions of deaths attributable to PM were higher in 2020 for PM2.5 (attributable death counts: 20,062 versus 3927 per year in 2015-2019; attributable fractions: 10.2% versus 2.4%), PM10 (15,112 versus 3999; 7.7% versus 2.5%), and PM2.5-10 (7193 versus 2303; 3.7% versus 1.4%).

CONCLUSION

COVID-19 pandemic increased the vulnerability and excess cases of all-cause mortality associated with short-term exposure to PM2.5, PM2.5-10, and PM10 in Italy, despite a decline in air pollution level.

Health Impact of Air Pollution from Shipping in the Baltic Sea: Effects of Different Spatial Resolutions in Sweden

In 2015, stricter regulations to reduce sulfur dioxide emissions and particulate air pollution from shipping were implemented in the Baltic Sea. We investigated the effects on population exposure to particles <2.5 µm (PM_2.5) from shipping and estimated related morbidity and mortality in Sweden’s 21 counties at different spatial resolutions. We used a regional model to estimate exposure in Sweden and a city-scale model for Gothenburg. Effects of PM_2.5 exposure on total mortality, ischemic heart disease, and stroke were estimated using exposure–response functions from the literature and combining them into disability-adjusted life years (DALYS). PM_2.5 exposure from shipping in Gothenburg decreased by 7% (1.6 to 1.5 µg/m³) using the city-scale model, and 35% (0.5 to 0.3 µg/m³) using the regional model. Different population resolutions had no effects on population exposures. In the city-scale model, annual premature deaths due to shipping PM_2.5 dropped from 97 with the high-sulfur scenario to 90 in the low-sulfur scenario, and in the regional model from 32 to 21. In Sweden, DALYs lost due to PM_2.5 from Baltic Sea shipping decreased from approximately 5700 to 4200. In conclusion, sulfur emission restrictions for shipping had positive effects on health, but the model resolution affects estimations.