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Feng H, Ge E, Grubic N, Liu X, Zhang H, Sun Q, Wei X, Zhou F, Huang S, Chen Y, Guo H, Li J, Zhang K, Luo M, Chen L. Coarse particulate air pollution and mortality in a multidrug-resistant tuberculosis cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174048. [PMID: 38906282 DOI: 10.1016/j.scitotenv.2024.174048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/22/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
RATIONALE The association between ambient coarse particulate matter (PM2.5-10) and mortality in multi-drug resistant tuberculosis (MDR-TB) patients has not yet been studied. The modifying effects of temperature and humidity on this association are completely unknown. OBJECTIVES To evaluate the effects of long-term PM2.5-10 exposures, and their modifications by temperature and humidity on mortality among MDR-TB patients. METHODS A Chinese cohort of 3469 MDR-TB patients was followed up from diagnosis until death, loss to follow-up, or the study's end, averaging 2567 days per patient. PM2.5-10 concentrations were derived from the difference between PM10 and PM2.5. Cox proportional hazard models estimated hazard ratios (HRs) per 3.74 μg/m3 (interquartile range, IQR) exposure to PM2.5-10 and all-cause mortality for the full cohort and individuals at distinct long-term and short-term temperature and humidity levels, adjusting for other air pollutants and potential covariates. Exposure-response relationships were quantified using smoothed splines. RESULTS Hazard ratios of 1.733 (95% CI, 1.407, 2.135) and 1.427 (1.114, 1.827) were observed for mortality in association with PM2.5-10 exposures for the full cohort under both long-term and short-term exposures to temperature and humidity. Modifying effects by temperature and humidity were heterogenous across sexes, age, treatment history, and surrounding environment measured by greenness and nighttime light levels. Nonlinear exposure-response curves suggestes a cumulative risk of PM2.5-10-related mortality starting from a low exposure concentration around 15 μg/m3. CONCLUSION Long-term exposure to PM2.5-10 poses significant harm among MDR-TB patients, with effects modified by temperature and humidity. Immediate surveillance of PM2.5-10 is crucial to mitigate the progression of MDR-TB severity, particularly due to co-exposures to air pollution and adverse weather conditions.
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Affiliation(s)
- Huiying Feng
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China.
| | - Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Nicholas Grubic
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Xin Liu
- School of Spatial Planning and Design, Hangzhou City University, China.
| | - Hui Zhang
- Guangdong Provincial Key Laboratory of Urbanization and Geo-simulation, School of Geography and Planning, Sun Yat-Sen University, Guangdong Province, China.
| | - Qiang Sun
- School of Public Health, Shandong University, China.
| | - Xiaolin Wei
- Division of Clinic Public Health, Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Fangjing Zhou
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Shanshan Huang
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China.
| | - Yuhui Chen
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Huixin Guo
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jianwei Li
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Kai Zhang
- Department of Environmental Health Science, School of Public Health, State University of New York at Albany, Rensselaer, NY 12144, United States.
| | - Ming Luo
- Guangdong Provincial Key Laboratory of Urbanization and Geo-simulation, School of Geography and Planning, Sun Yat-Sen University, Guangdong Province, China.
| | - Liang Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
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Zhang Y, He Q, Tong X, Yin P, Liu Y, Meng X, Gao Y, Shi S, Li X, Kan H, Zhou M, Li Y, Chen R. Differential associations of fine and coarse particulate air pollution with cause-specific pneumonia mortality: A nationwide, individual-level, case-crossover study. ENVIRONMENTAL RESEARCH 2024; 252:119054. [PMID: 38704007 DOI: 10.1016/j.envres.2024.119054] [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: 01/30/2024] [Revised: 03/25/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The connections between fine particulate matter (PM2.5) and coarse particulate matter (PM2.5-10) and daily mortality of viral pneumonia and bacterial pneumonia were unclear. OBJECTIVES To distinguish the connections between PM2.5 and PM2.5-10 and daily mortality due to viral pneumonia and bacterial pneumonia. METHODS Using a comprehensive national death registry encompassing all areas of mainland China, we conducted a case-crossover investigation from 2013 to 2019 at an individual level. Residential daily particle concentrations were evaluated using satellite-based models with a spatial resolution of 1 km. To analyze the data, we employed the conditional logistic regression model in conjunction with polynomial distributed lag models. RESULTS We included 221,507 pneumonia deaths in China. Every interquartile range (IQR) elevation in concentrations of PM2.5 (lag 0-2 d, 37.6 μg/m3) was associated with higher magnitude of mortality for viral pneumonia (3.03%) than bacterial pneumonia (2.14%), whereas the difference was not significant (p-value for difference = 0.38). An IQR increase in concentrations of PM2.5-10 (lag 0-2 d, 28.4 μg/m3) was also linked to higher magnitude of mortality from viral pneumonia (3.06%) compared to bacterial pneumonia (2.31%), whereas the difference was not significant (p-value for difference = 0.52). After controlling for gaseous pollutants, their effects were all stable; however, with mutual adjustment, the associations of PM2.5 remained, and those of PM2.5-10 were no longer statistically significant. Greater magnitude of associations was noted in individuals aged 75 years and above, as well as during the cold season. CONCLUSION This nationwide study presents compelling evidence that both PM2.5 and PM2.5-10 exposures could increase pneumonia mortality of viral and bacterial causes, highlighting the more robust effects of PM2.5 and somewhat higher sensitivity of viral pneumonia.
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Affiliation(s)
- Ye Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qinglin He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Xunliang Tong
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Peng Yin
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yunning Liu
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Xinyue Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Maigeng Zhou
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yanming Li
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
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Lei J, Chen R, Liu C, Zhu Y, Xue X, Jiang Y, Shi S, Gao Y, Kan H, Xuan J. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. Int J Epidemiol 2023; 52:715-726. [PMID: 37159523 DOI: 10.1093/ije/dyad056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. METHODS We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. RESULTS A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. CONCLUSIONS This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
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Affiliation(s)
- Jian Lei
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xiaowei Xue
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou, China
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He T, Jin L, Li X. On the triad of air PM pollution, pathogenic bioaerosols, and lower respiratory infection. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:1067-1077. [PMID: 34236582 PMCID: PMC8264819 DOI: 10.1007/s10653-021-01025-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/24/2021] [Indexed: 05/21/2023]
Abstract
Airborne particulate matter (PM) pollution, as a leading environmental health risk, causes millions of premature deaths globally every year. Lower respiratory infection (LRI) is a sensitive response to short-term exposure to outdoor PM pollution. The airborne transmission of etiological agents of LRI, as an important pathway for infection and morbidity, bridges the public health issues of air quality and pathogen infectivity, virulence, resistance, and others. Enormous efforts are underway to identify common pathogens and substances that are etiological agents for LRI and to understand the underlying toxicological and clinical basis of health effects by identifying mechanistic pathways. Seasonal variations and geographical disparities in the survival and infectivity of LRI pathogens are unsolved mysteries. Weather conditions in geographical areas may have a key effect, but also potentially connect LRI with short-term increases in ambient air PM pollution. Statistical associations show that short-term elevations in fine and coarse PM lead to increases in respiratory infections, but the causative agents could be chemical or microbiological and be present individually or in mixtures, and the interactions between chemical and microbiological agents remain undefined. Further investigations on high-resolution monitoring of airborne pathogens in relation to PM pollution for an integrated exposure-response assessment and mechanistic study are warranted. Improving our understanding of the spatiotemporal features of pathogenic bioaerosols and air pollutants and translating scientific evidence into effective policies is vital to reducing the health risks and devastating death toll from PM pollution.
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Affiliation(s)
- Tangtian He
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China
| | - Ling Jin
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China
| | - Xiangdong Li
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China.
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5
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Lin C, Jiang W, Gao X, He Y, Li J, Zhou C, Yang L. Attributable risk and economic burden of pneumonia among older adults admitted to hospital due to short-term exposure to airborne particulate matter: a time-stratified case-crossover study from China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:45342-45352. [PMID: 36705825 DOI: 10.1007/s11356-023-25530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
Many studies have proven the relationship between air pollutants and respiratory diseases, but few studies have assessed the impacts of air particulate matter exposure on older patients with pneumonia. This study aimed to reveal the impacts of short-term exposure to air particulate matter on the daily number of older adult patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure. We collected inpatient data from 9 city hospitals in Sichuan Province, China, from January 1, 2018, to December 31, 2019, and calculated odds ratios and 95% confidence intervals using a time-stratified case-crossover study design and an attributable risk model to calculate the economic burden due to particulate matter pollution. It was found that for every 10 μg/m3 increase in PM2.5 and PM10 concentrations, the daily number of older adult pneumonia inpatients increased by 1.5% (95% CI: 1.010-1.021) and 1.0% (95% CI: 1.006-1.014), respectively. Those 65 ~ 79 years old were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY (6.22%) and 16.03 million CNY (6.21%), respectively, with PM2.5 being the primary influencing factor. This study revealed the relationship between particulate matter pollution and pneumonia among older adults. The role of policies to limit particulate matter concentrations in reducing disease burden among older adults can be further explored.
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Affiliation(s)
- Chengwei Lin
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Wanyanhan Jiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xi Gao
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Yi He
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Jia Li
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, 250100, Shandong, China
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Zhou X, Guo M, Li Z, Yu X, Huang G, Li Z, Zhang X, Liu L. Associations between air pollutant and pneumonia and asthma requiring hospitalization among children aged under 5 years in Ningbo, 2015-2017. Front Public Health 2023; 10:1017105. [PMID: 36777770 PMCID: PMC9908005 DOI: 10.3389/fpubh.2022.1017105] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Exposure to ambient air pollutants is associated with an increased incidence of respiratory diseases such as pneumonia and asthma, especially in younger children. We investigated the relationship between rates of hospitalization of children aged under 5 years for pneumonia and asthma and the concentration of air pollutants in Ningbo between January 1, 2015 and August 29, 2017. Methods Data were obtained from the Ningbo Air Quality Data Real-time Publishing System and the big data platform of the Ningbo Health Information Center. A generalized additive model was established via logarithmic link function and utilized to evaluate the effect of pollutant concentration on lag dimension and perform sensitivity analysis. Results A total of 10,301 cases of pneumonia and 115 cases of asthma were identified over the course of this study. Results revealed that PM2.5, PM10, SO2 and NO2 were significantly associated with hospitalization for pneumonia and asthma in children under 5 years of age. For every 10-unit increase in lag03 air pollutant concentration, hospitalization for pneumonia and asthma due to PM2.5, PM10, SO2 and NO2 increased by 2.22% (95%CI: 0.64%, 3.82%), 1.94% (95%CI: 0.85%, 3.04%), 11.21% (95%CI: 4.70%, 18.10%) and 5.42% (95%CI: 3.07%, 7.82%), respectively. Discussion Adverse effects of air pollutants were found to be more severe in children aged 1 to 5 years and adverse effects due to PM2.5, PM10 and SO2 were found to be more severe in girls. Our findings underscore the need for implementation of effective public health measures to urgently improve air quality and reduce pediatric hospitalizations due to respiratory illness.
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Affiliation(s)
- Xingyuan Zhou
- Department of Pediatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Min Guo
- Department of Obstetrics, Tangshan Maternal and Child Health Care Hospital of Hebei Province, Tangshan, Hebei, China
| | - Zhifei Li
- Department of Pediatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Xiping Yu
- Department of Pediatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Gang Huang
- Department of Preventative Medicine, Medicine School of Ningbo University, Ningbo, Zhejiang, China
| | - Zhen Li
- Department of Preventative Medicine, Medicine School of Ningbo University, Ningbo, Zhejiang, China
| | - Xiaohong Zhang
- Department of Pediatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China,*Correspondence: Xiaohong Zhang ✉
| | - Liya Liu
- Department of Pediatrics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China,Liya Liu ✉
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Ünal E, Özdemir A, Khanjani N, Dastoorpoor M, Özkaya G. Air pollution and pediatric respiratory hospital admissions in Bursa, Turkey: A time series study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2767-2780. [PMID: 34641701 DOI: 10.1080/09603123.2021.1991282] [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: 05/05/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
We aimed to investigate the relation between air pollution and the number of daily hospitalizations due to pneumonia, asthma, bronchitis in children aged 0-18 in Bursa city of Turkey, between the years 2013-2018. The daily values of air pollutants (PM10, SO2, NO2, NOx, CO, and O3) from 2013 until 2018, were obtained. Adjusted Quasi-Poisson regression models including distributed lags, controlled for climate variables were used for data analysis. Increases in SO2, ozone, PMs, and nitrogen oxides were associated with pneumonia hospitalizations, increases in SO2 NOx and PMs were associated with asthma hospitalizations, and increases in SO2 and ozone were associated with bronchitis hospitalizations. Male hospitalization was related with SO2, ozone, and NOx; while female hospitalization was only related with SO2. This study showed that short-term exposure to air pollution is associated with an increased risk of pneumonia, asthma, and bronchitis hospitalization among children in Bursa.
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Affiliation(s)
- Eda Ünal
- Department of Nursing, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Aysel Özdemir
- Department of Public Health Nursing, Bursa Uludag University, Faculty of Health Sciences, Bursa, Turkey
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Güven Özkaya
- Department of Biostatistics, Bursa Uludag University Medical Faculty, Bursa, Turkey
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Mainka A, Żak M. Synergistic or Antagonistic Health Effects of Long- and Short-Term Exposure to Ambient NO 2 and PM 2.5: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114079. [PMID: 36360958 PMCID: PMC9657687 DOI: 10.3390/ijerph192114079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 05/31/2023]
Abstract
Studies on adverse health effects associated with air pollution mostly focus on individual pollutants. However, the air is a complex medium, and thus epidemiological studies face many challenges and limitations in the multipollutant approach. NO2 and PM2.5 have been selected as both originating from combustion processes and are considered to be the main pollutants associated with traffic; moreover, both elicit oxidative stress responses. An answer to the question of whether synergistic or antagonistic health effects of combined pollutants are demonstrated by pollutants monitored in ambient air is not explicit. Among the analyzed studies, only a few revealed statistical significance. Exposure to a single pollutant (PM2.5 or NO2) was mostly associated with a small increase in non-accidental mortality (HR:1.01-1.03). PM2.5 increase of <10 µg/m3 adjusted for NO2 as well as NO2 adjusted for PM2.5 resulted in a slightly lower health risk than a single pollutant. In the case of cardiovascular heart disease, mortality evoked by exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed an antagonistic effect on health risk compared to the single pollutant. Both short- and long-term exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed a synergistic effect appearing as higher mortality from respiratory diseases.
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Bumroongkit C, Liwsrisakun C, Deesomchok A, Pothirat C, Theerakittikul T, Limsukon A, Trongtrakul K, Tajarernmuang P, Niyatiwatchanchai N, Euathrongchit J, Inchai J, Chaiwong W. Correlation of Air Pollution and Prevalence of Acute Pulmonary Embolism in Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12808. [PMID: 36232104 PMCID: PMC9566050 DOI: 10.3390/ijerph191912808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The relationship between the level of air pollution and acute pulmonary embolism (APE) has had inconsistent results. OBJECTIVE This study aimed to analyze the relationship between the high level of air pollution exposure and APE. METHODS A ten-year retrospective cohort, single-center study was performed on patients diagnosed with APE from October 2010 to December 2020. The association between air pollution and monthly APE case diagnosis was analyzed. RESULTS A total number of 696 patients was included. The effect of every 10 µg/m3 increment of particulate matters with an aerodynamic diameter < 10 µm (PM10) on total monthly APE cases (unprovoked PE and provoked PE) was increased significantly at lag 4, 5 and 6 months with adjusted RR (95% CI) of 1.06 (1.01, 1.12), p = 0.011, 1.07 (1.01, 1.13), p = 0.021 and 1.06 (1.01, 1.12), p = 0.030, respectively. Adjusted RR for APE was significantly increased for PM10 in the second tertile ((adjusted RR (95% CI) 1.76 (1.12, 2.77)), p = 0.014. CONCLUSIONS We conclude that PM10 is associated with an increased prevalence of APE cases. The policy for tighter control of air pollution in our country is needed to reduce the impact of air pollutants on people's health.
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Affiliation(s)
- Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juntima Euathrongchit
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juthamas Inchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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10
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Purves J, Hussey SJK, Corscadden L, Purser L, Hall A, Misra R, Selley L, Monks PS, Ketley JM, Andrew PW, Morrissey JA. Air pollution induces Staphylococcus aureus USA300 respiratory tract colonization mediated by specific bacterial genetic responses involving the global virulence gene regulators Agr and Sae. Environ Microbiol 2022; 24:4449-4465. [PMID: 35642645 PMCID: PMC9796851 DOI: 10.1111/1462-2920.16076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 01/07/2023]
Abstract
Exposure to particulate matter (PM), a major component of air pollution, is associated with exacerbation of chronic respiratory disease, and infectious diseases such as community-acquired pneumonia. Although PM can cause adverse health effects through direct damage to host cells, our previous study showed that PM can also impact bacterial behaviour by promoting in vivo colonization. In this study we describe the genetic mechanisms involved in the bacterial response to exposure to black carbon (BC), a constituent of PM found in most sources of air pollution. We show that Staphylococcus aureus strain USA300 LAC grown in BC prior to inoculation showed increased murine respiratory tract colonization and pulmonary invasion in vivo, as well as adhesion and invasion of human epithelial cells in vitro. Global transcriptional analysis showed that BC has a widespread effect on S. aureus transcriptional responses, altering the regulation of the major virulence gene regulators Sae and Agr and causing increased expression of genes encoding toxins, proteases and immune evasion factors. Together these data describe a previously unrecognized causative mechanism of air pollution-associated infection, in that exposure to BC can increase bacterial colonization and virulence factor expression by acting directly on the bacterium rather than via the host.
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Affiliation(s)
- Jo Purves
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
| | - Shane J. K. Hussey
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
| | - Louise Corscadden
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
| | - Lillie Purser
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
| | - Andie Hall
- Molecular Biology, Core Research LaboratoriesNatural History MuseumCromwell Road, LondonSW7 5BDUK
| | - Raju Misra
- Molecular Biology, Core Research LaboratoriesNatural History MuseumCromwell Road, LondonSW7 5BDUK
| | - Liza Selley
- MRC Toxicology UnitUniversity of CambridgeCambridgeCB2 1QRUK
| | - Paul S. Monks
- Department of ChemistryUniversity of LeicesterUniversity RoadLeicesterLE1 7RHUK
| | - Julian M. Ketley
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
| | - Peter W. Andrew
- Department of Respiratory SciencesUniversity of LeicesterUniversity Road, LeicesterLE1 9HNUK
| | - Julie A. Morrissey
- Department of GeneticsUniversity of Leicester, University RoadLeicesterLE1 7RHUK
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11
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Yang L, Yang J, Liu M, Sun X, Li T, Guo Y, Hu K, Bell ML, Cheng Q, Kan H, Liu Y, Gao H, Yao X, Gao Y. Nonlinear effect of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China: A time-series analysis. ENVIRONMENTAL RESEARCH 2022; 209:112754. [PMID: 35074347 DOI: 10.1016/j.envres.2022.112754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Many studies have illustrated adverse effects of short-term exposure to air pollution on human health, which usually assumes a linear exposure-response (E-R) function in the delineation of health effects due to air pollution. However, nonlinearity may exist in the association between air pollutant concentrations and health outcomes such as adult pneumonia hospital visits, and there is a research gap in understanding the nonlinearity. Here, we utilized both the distributed lag model (DLM) and nonlinear model (DLNM) to compare the linear and nonlinear impacts of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China. While both models show adverse effects of air pollutants on adult pneumonia hospital visits, the DLNM shows an attenuation of E-R curves at high concentrations. Moreover, the DLNM may reveal delayed health effects that may be missed in the DLM, e.g., ozone exposure and pneumonia hospital visits. With the stratified analysis of air pollutants on adult pneumonia hospital visits, both models consistently reveal that the influence of air pollutants is higher during the cold season than during the warm season. Nevertheless, they may behave differently in terms of other subgroups, such as age, gender and visit types. For instance, while no significant impact due to PM2.5 in any of the subgroups abovementioned emerges based on DLM, the results from DLNM indicate statistically significant impacts for the subgroups of elderly, female and emergency department (ED) visits. With respect to adjustment by two-pollutants, PM10 effect estimates for pneumonia hospital visits were the most robust in both DLM and DLNM, followed by NO2 and SO2 based on the DLNM. Considering the estimated health effects of air pollution relying on the assumed E-R functions, our results demonstrate that the traditional linear association assumptions may overlook some potential health risks.
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Affiliation(s)
- Lingyue Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Jiuli Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Mingyang Liu
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China
| | - Xiaohui Sun
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, 266100, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing,100021, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, 06511, USA
| | - Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200433, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huiwang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Xiaohong Yao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Yang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China.
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12
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Miyashita L, Shears R, Foley G, Semple S, Kadioglu A, Grigg J. Underground railway particulate matter and susceptibility to pneumococcal infection. EBioMedicine 2022; 80:104063. [PMID: 35598440 PMCID: PMC9127572 DOI: 10.1016/j.ebiom.2022.104063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Concentrations of particulate matter less than 10 microns (PM10) on underground railways are higher than those near urban roads. Traffic-related PM10 increases pneumococcal infection via increasing the expression of platelet-activating factor receptor (PAFR), a receptor co-opted by pneumococci to adhere to cells. To date, it is unknown whether underground railway PM10 increases pneumococcal infection. This study sought to determine the effect of London Underground (LU) PM10 on; i) pneumococcal adhesion to airway cells, and ii) susceptibility to pneumococcal disease. METHODS A549 cells and human primary airway epithelial cells were cultured with 20 µg/mL PM10 from the Bakerloo (B-PM10) and Jubilee (J-PM10) line platforms of Baker Street station. PAFR expression was assessed by flow cytometry, and pneumococcal adhesion by colony forming unit (CFU) counts. Traffic-related PM10 was collected next to a main road near the station's entrance. The PAFR blocker CV3988 and the antioxidant N-acetyl cysteine were used to assess the role of PAFR-mediated pneumococcal adhesion and oxidative stress respectively. Pneumococcal infection of mice was done after exposure to 3×80 μg doses of intranasal LU-PM10. FINDINGS In A549 cells, human primary nasal cells, and human primary bronchial epithelial cells, B-PM10 and J-PM10 increased PAFR expression and pneumococcal adhesion. Stimulated adhesion was abrogated by CV3988 and N-acetyl cysteine. Traffic-related PM10 stimulated increased adhesion compared with B-PM10. B-PM10 and J-PM10 increased lung and blood CFU and mortality in mice. Treatment of B-PM10-exposed mice with CV3988 reduced blood CFU. INTERPRETATION LU-PM10 increases pneumococcal adhesion to airway cells and susceptibility to invasive disease in mice. FUNDING The Medical College of Saint Bartholomew's Hospital Trust, and the UK Medical Research Council Programme Grant (MR/P011284/1).
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Affiliation(s)
- Lisa Miyashita
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
| | - Rebecca Shears
- The Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Gary Foley
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Scotland
| | - Aras Kadioglu
- The Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK.
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13
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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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14
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Association between Ambient Air Pollutants and Pneumonia in Wuhan, China, 2014–2017. ATMOSPHERE 2022. [DOI: 10.3390/atmos13040578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objectives: To assess associations between short-time air pollution exposure and outpatient visits for pneumonia by the distributed lag nonlinear model (DLNM). Methods: Daily outpatient visits for pneumonia and air pollutant data were collected from Wuhan Basic Medical Insurance Database in China and 10 national air quality monitoring stations in Wuhan from 2014 to 2017, respectively. Taking the first percentile of the concentration as the reference, DLNM was used to estimate the impact of moderate (50th) and high levels (99th) of pollutants on pneumonia. Results: A total of 133,882 outpatient visits were identified during the period of the study. Moderate-level (P50) fine particulate matter (PM2.5) or sulfur dioxide (SO2) and high-level nitrogen dioxide (NO2) (P99) can increase the risk of pneumonia. The maximum RR was 1.198 (95% CI: 1.094–1.311) at lag0-11, 1.304 (95% CI: 1.166–1.458) at lag0-13, and 1.286 (95% CI: 1.060–1.561) at lag0-14, respectively. Females and children had greater risks. Conclusions: Short-time PM2.5, SO2, and NO2 exposure were associated with outpatient visits for pneumonia in Wuhan, China.
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15
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Liu WY, Yi JP, Tung TH, Yan JB. Association Between the Ambient Fine Particulate Pollution and the Daily Internal Medicine Outpatient Visits in Zhoushan, China: A Time-Series Study. Front Public Health 2021; 9:749191. [PMID: 34765582 PMCID: PMC8575696 DOI: 10.3389/fpubh.2021.749191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: There has been a recent worsening of air pollution in China, which poses a huge threat to public health by inducing and promoting circulatory and respiratory diseases. This study aimed to explore the association between the concentration of air pollution and daily internal medicine outpatient visits registered for the treatment of circulatory and respiratory symptoms in Zhoushan, China using a time-series method. Methods: We validated and acquired the daily internal medicine outpatient visits records between January 1, 2014, and December 31, 2019, from the Zhoushan Center for Disease Control and Prevention in Zhejiang, China. Further, we collected the daily average records of the ambient air pollutants from the Zhoushan Environmental Monitoring Centre within the same duration. A generalized additive model with the natural splines was constructed to explore the association between the ambient air pollutants and daily internal medicine outpatient visits. Further, we conducted a lag analysis by using the distributed lag non-linear model to estimate the time-delayed effects of the air pollutants on the daily internal medicine outpatient visits. Results: A total of 2,190,258 daily internal medicine outpatient visits with a mean of 202.4 visits per day were recorded. The non-linear relationships were found among particulate matter2.5 (PM2.5), sulfur dioxide (SO2), and the daily internal medicine outpatient visits. Overall, PM2.5 was positively correlated with the daily internal medicine outpatient visits. Both ozone (O3) and SO2 had significant delayed effects on the daily internal medical outpatient numbers; however, PM2.5 only showed a short-term risk. Conclusion: Short-term exposure to PM2.5 was associated with an increase in the daily internal medicine outpatient visits for circulatory and respiratory diseases/symptoms in Zhoushan, China. SO2 and O3 were shown to induce significant effects after a concentration-dependent time lag.
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Affiliation(s)
- Wen-Yi Liu
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Shanghai Bluecross Medical Science Institute, Shanghai, China.,Institute for Hospital Management, Tsing Hua University, Beijing, China
| | - Jing-Ping Yi
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jian-Bo Yan
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
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16
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Qiu H, Chuang KJ, Bai CH, Fan YC, Chang TP, Yim SHL, Wong TW, Ho KF. Association of ambient ozone with pneumonia hospital admissions in Hong Kong and Taipei: A tale of two Southeast Asian cities. ENVIRONMENT INTERNATIONAL 2021; 156:106634. [PMID: 34015667 DOI: 10.1016/j.envint.2021.106634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
Ozone (O3) is a reactive oxidant exerting both inflammatory and oxidative damages to the respiratory system. With the ground-level O3 progressively increasing in the past decade, the reevaluation of the pneumonia hospitalization risk from exposure to O3 is of public health interest. We conducted an ecological time-series study to examine the city-specific association between short-term O3 exposure and pneumonia hospitalizations in Hong Kong and Taipei, respectively. We linked the daily pneumonia hospitalization count to air pollution concentrations and weather conditions according to the date of admission during 2010-2017. We applied a generalized additive distributed lag model to examine the association while adjusting for time-varying covariates. Stratified analysis by age group and the potential harvesting effect of O3 were evaluated. We observed the harvesting effects of O3 on pneumonia hospitalizations in children in both cities and adults in Taipei. The short-term effect of O3 lasted for around one week. An interquartile range (IQR) increment of daytime 8-hour mean concentration of O3 distributed over 0-6 lag days in Hong Kong (42.4 μg/m3) was associated with a 7.04% (95% CI: 5.35-8.76%) increase in hospital admissions for elderly pneumonia, while the corresponding cumulative excess risk per IQR increment of O3 in Taipei (38.7 μg/m3) was 3.41% (95% CI: 1.63-5.22%). Different O3 metrics, varying degrees of freedom for filtering the temporal trend, and three-pollutant models supported the robustness of the associations. We concluded that short-term O3 exposure was associated with pneumonia hospitalizations in the elderly population. Understanding the pneumonia hospitalization risk of O3 will help to inform public health policies in the planning of ozone control strategies and intervention measures to prevent ozone-related pneumonia in vulnerable elderly populations.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ta-Pang Chang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Steve Hung-Lam Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The Asian School of the Environment, Nanyang Technological University, Singapore
| | - Tze-Wai Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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17
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Ting MJ, Tsai YH, Chuang SP, Wang PH, Cheng SL. Is PM 2.5 associated with emergency department visits for mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease? Am J Emerg Med 2021; 50:566-573. [PMID: 34583244 DOI: 10.1016/j.ajem.2021.09.024] [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: 04/21/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) can have recurrent exacerbations and acute respiratory failure (ARF) triggered by particulate matter with a diameter of ≤2.5 μm (PM2.5). To prevent ventilator shortages, this study investigated the short-term association between PM2.5 concentration and emergency department visits (EDVs) among patients with acute exacerbation of COPD (AECOPD) requiring mechanical ventilation (MV). METHODS We conducted a time-series study to predict the PM2.5 concentration and number of ventilators needed. Daily counts of EDVs among AECOPD patients requiring ventilation from 2015 to 2019 were obtained from a hospital. Generalized linear models extending Poisson regression were used to explore the association of AECOPD with PM2.5 after controlling for the time trend, seasonal variations, and meteorological variables. RESULTS Eight hundred seventy-five AECOPD patients receiving MV were recorded, of whom 734 received noninvasive ventilation and 141 received invasive ventilatory support. EDVs for AECOPD patients with ARF significantly increased by 3.5% (95% confidence interval [CI]: 2.51%-4.42%) per 10 μg m-3 increase in PM2.5 concentration. Among seasons, PM2.5 concentration had the strongest effect on AECOPD patients with ARF in spring (<24.5 °C), with a 1.64% (95% CI: -0.56% to 3.83%) increase in admissions per 10 μg m-3 increase in same-day PM2.5 concentration. The interquartile range increase of 20 μg m-3 between winter and spring was associated with an average EDV increase of 48.66%. CONCLUSION This is the first study to predict the number of ventilators required by calculating quantitative estimates of the short-term effects of PM2.5 on EDVs for AECOPD patients with ARF. Adverse effects of PM2.5 on AECOPD patients requiring MV are evident, especially in the spring. Establishing protective standards and reducing the PM2.5 concentration to below various thresholds are urgently needed.
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Affiliation(s)
- Man-Ju Ting
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan.
| | - Ya-Hui Tsai
- Division of Pediatric Surgery, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Shih-Ping Chuang
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Ping-Huai Wang
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
| | - Shih-Lung Cheng
- Division of Chest Medicine, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
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18
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Wang X, Leng M, Liu Y, Qian ZM, Zhang J, Li Z, Sun L, Qin L, Wang C, Howard SW, Vaughn MG, Yan Y, Lin H. Different sized particles associated with all-cause and cause-specific emergency ambulance calls: A multicity time-series analysis in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 783:147060. [PMID: 34088160 DOI: 10.1016/j.scitotenv.2021.147060] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Compared with mortality and hospital admission, emergency ambulance calls (EACs) could be a more accurate outcome indicator to reflect the health effects of short-term air pollution exposure. However, such studies have been scarce, especially on a multicity scale in China. METHODS We estimated the associations of different diameter particles [i.e., inhalable particulate matter (PM10), coarse particulate matter (PMc), and fine particulate matter (PM2.5)] with EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities. We collected data on EACs and air pollution from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and overall associations. Stratified analyses were conducted to examine the effect modifications of gender, age, and season. RESULTS Significant associations of PM10 and PM2.5 with EACs were observed, while the PMc associations were positive but not statistically significant in most analyses. Specifically, each 10 μg/m3 increase in 2-day moving average concentration of PM10 was associated with a 0.25% [95% confidence interval (CI): 0.04%, 0.47%] increase in all-cause EACs, 0.13% (95% CI: -0.01%, 0.26%) in cardiovascular EACs, and 0.35% (95% CI: 0.04%, 0.66%) in respiratory EACs. The corresponding increases in daily EACs for PM2.5 were 0.30% (95% CI, 0.03%, 0.57%), 0.13% (95% CI, -0.07%, 0.33%), and 0.46% (95% CI, 0.01%, 0.92%). Season of the year also modifies the association between particulate matter pollution and EACs. CONCLUSIONS Short-term exposure to PM10 and PM2.5 were positively associated with daily all-cause and respiratory-related EACs. The associations were stronger during warm season than cold season. Our findings suggest that the most harmful fraction of particulate matter pollution is PM2.5, which has important implications for current air quality guidelines and regulations in China.
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Affiliation(s)
- Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meifang Leng
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yixuan Liu
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhengmin Min Qian
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Junguo Zhang
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ziyi Li
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Liwen Sun
- Huairou District Center for Disease Control and Prevention, Beijing, China
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Steven W Howard
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Michael G Vaughn
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Yue Yan
- Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China..
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Wang X, Xu Z, Su H, Ho HC, Song Y, Zheng H, Hossain MZ, Khan MA, Bogale D, Zhang H, Wei J, Cheng J. Ambient particulate matter (PM 1, PM 2.5, PM 10) and childhood pneumonia: The smaller particle, the greater short-term impact? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145509. [PMID: 33571778 DOI: 10.1016/j.scitotenv.2021.145509] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Smaller sizes of ambient particulate matter (PM) can be more toxic and can be breathed into lower lobes of a lung. Children are particularly vulnerable to PM air pollution because of their adverse effects on both lung functions and lung development. However, it remains unknown whether a smaller PM has a greater short-term impact on childhood pneumonia. AIMS We compared the short-term effects on childhood pneumonia from PM with aerodynamic diameters ≤1 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10), respectively. METHODS Daily time-series data (2016-2018) on pneumonia hospitalizations in children aged 0-17 years, records of air pollution (PM1, PM2.5, PM10, and gaseous pollutants), and weather conditions were obtained for Hefei, China. Effects of different PM were quantified using a quasi-Poisson generalized additive model after controlling for day of the week, holiday, seasonality and long-term time trend, and weather variables. Stratified analyses (gender, age, and season) were also performed. RESULTS For each 10 μg/m3 increase in PM1, PM2.5, and PM10 concentrations over the past three days (lag 0-2), the risk of pneumonia hospitalizations increased by 10.28% (95%CI: 5.88%-14.87%), 1.21% (95%CI: 0.34%-2.09%), and 1.10% (95%CI: 0.44%-1.76%), respectively. Additionally, both boys and girls were at risk of PM1 effects, while PM2.5 and PM10 effects were only seen in boys. Children aged ≤12 months and 1-4 years were affected by PM1, but PM2.5 and PM10 were only associated with children aged 1-4 years. Furthermore, PM1 effects were greater in autumn and winter, while greater PM2.5 and PM10 effects were evident only in autumn. CONCLUSION This study suggests a greater short-term impact on childhood pneumonia from PM1 in comparison to PM2.5 and PM10. Given the serious PM pollution in China and other rapid developing countries due to various combustions and emissions, more investigations are needed to determine the impact of different PM on childhood respiratory health.
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Affiliation(s)
- Xu Wang
- Department of Science and Education, Children's Hospital of Anhui Medical University (Anhui Provincial Children's Hospital), Hefei, Anhui, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Hong Su
- School of Public Health, Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; School of Geography and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Yimeng Song
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China; Smart Cities Research Institute, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Daniel Bogale
- College of Health Sciences, Arsi University, Asela, Ethiopia
| | - Heng Zhang
- Sir Run Run Shaw Hospital (SRRSH), affiliated with the Zhejiang University School of Medicine, Zhejiang, China
| | - Jing Wei
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
| | - Jian Cheng
- School of Public Health, Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Wang B, Yuan Q, Yang Q, Zhu L, Li T, Zhang L. Estimate hourly PM 2.5 concentrations from Himawari-8 TOA reflectance directly using geo-intelligent long short-term memory network. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 271:116327. [PMID: 33360654 DOI: 10.1016/j.envpol.2020.116327] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5) has attracted extensive attention because of its baneful influence on human health and the environment. However, the sparse distribution of PM2.5 measuring stations limits its application to public utility and scientific research, which can be remedied by satellite observations. Therefore, we developed a Geo-intelligent long short-term network (Geoi-LSTM) to estimate hourly ground-level PM2.5 concentrations in 2017 in Wuhan Urban Agglomeration (WUA). We conducted contrast experiments to verify the effectiveness of our model and explored the optimal modeling strategy. It turned out that Geoi-LSTM with TOA reflectance, meteorological conditions, and NDVI as inputs performs best. The station-based cross-validation R2, root mean squared error and mean absolute error are 0.82, 15.44 μg/m3, 10.63 μg/m3, respectively. Based on model results, we revealed spatiotemporal characteristics of PM2.5 in WUA. Generally speaking, during the day, PM2.5 concentration remained stable at a relatively high level in the morning and decreased continuously in the afternoon. While during the year, PM2.5 concentrations were highest in winter, lowest in summer, and in-between in spring and autumn. Combined with meteorological conditions, we further analyzed the whole process of a PM2.5 pollution event. Finally, we discussed the loss in removing clouds-covered pixels and compared our model with several popular models. Overall, our results can reflect hourly PM2.5 concentrations seamlessly and accurately with a spatial resolution of 5 km, which benefits PM2.5 exposure evaluations and policy regulations.
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Affiliation(s)
- Bin Wang
- School of Geodesy and Geomatics, Wuhan University, Wuhan, China
| | - Qiangqiang Yuan
- School of Geodesy and Geomatics, Wuhan University, Wuhan, China.
| | - Qianqian Yang
- School of Geodesy and Geomatics, Wuhan University, Wuhan, China
| | - Liye Zhu
- School of Atmospheric Sciences, Sun Yat-Sen University, Guangzhou, China
| | - Tongwen Li
- School of Geospatial Engineering and Science, Sun Yat-Sen University, Guangzhou, China
| | - Liangpei Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
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Pu X, Wang L, Chen L, Pan J, Tang L, Wen J, Qiu H. Differential effects of size-specific particulate matter on lower respiratory infections in children: A multi-city time-series analysis in Sichuan, China. ENVIRONMENTAL RESEARCH 2021; 193:110581. [PMID: 33309823 DOI: 10.1016/j.envres.2020.110581] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 05/08/2023]
Abstract
Evidence on the short-term effects of size-specific particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5), ≤10 μm (PM10), and their difference (PMC) on children's Lower Respiratory Infections (LRI) is scare. This study aimed to estimate the differential effects of three size-specific PM on hospitalizations of children aged <18 years for pneumonia and bronchitis in 18 cities of southwestern China. The city-specific association was firstly estimated using the over-dispersed generalized additive model and then combined to obtain the regional average association. Further, to evaluate the robustness of the key findings, subgroup analyses and co-pollutant models were constructed. PM-related risks of LRI differed by PM fractions and cause-specific LRI. A 10 μg/m3 increment in PM2.5_lag03, PM10_lag06, and PMC_lag06 was associated with a 0.79% (95% CI: 0.29%, 1.29%), 0.77% (95% CI: 0.13%, 1.41%), and 2.33% (95% CI: 1.23%, 3.44%) increase in children's LRI hospitalizations, respectively. After adjustment for gaseous pollutants, adverse effects of the three types of size-specific PM on pneumonia hospitalizations were stable, ranging from 0.29% (95% CI: 0.05%, 0.54%) for PM2.5-2.50% (95% CI: 1.38%, 3.64%) for PMC. Additionally, PMC-related risk of bronchitis hospitalizations remained stable after adjustment for gaseous pollutants. Associations of pneumonia with PMC and PM10 in infants, bronchitis with PM2.5 in children aged 6-17 years, pneumonia and bronchitis with PM2.5, PMC, and PM10 in children aged 1-5 years were all statistical significant. Specifically, the effects of PM2.5 on LRI hospitalizations increased by age, with the highest effect of 1.72% (95%CI: 1.01%, 2.43%) in children aged 6-17 years. Our study provided evidence for short-term effects of different PM fractions on children LRI hospitalizations in Southwestern China, which will be useful for making and promoting policies on air quality standards in order to protect children's health.
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Affiliation(s)
- Xiaorong Pu
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Lina Chen
- West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jingping Pan
- Health Information Center of Sichuan Province, Chengdu, China
| | - Lei Tang
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Wen
- Glasgow College, University of Electronic Science and Technology of China, Chengdu, China
| | - Hang Qiu
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.
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Yee J, Cho YA, Yoo HJ, Yun H, Gwak HS. Short-term exposure to air pollution and hospital admission for pneumonia: a systematic review and meta-analysis. Environ Health 2021; 20:6. [PMID: 33413431 PMCID: PMC7792212 DOI: 10.1186/s12940-020-00687-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/14/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Air pollution is a major issue that poses a health threat worldwide. Although several studies investigated the adverse effects of air pollution on various diseases, few have directly demonstrated the effects on pneumonia. Therefore, we performed a systematic review and meta-analysis on the associations between short-term exposure of air pollutants and hospital admission or emergency room (ER) visit for pneumonia. METHODS A literature search was performed using PubMed, Embase, and Web of Science up to April 10, 2020. Pooled estimates were calculated as % increase with 95% confidence intervals using a random-effects model. A sensitivity analysis using the leave-one-out method and subgroup analysis by region were performed. RESULTS A total of 21 studies were included in the analysis. Every 10 μg/m3 increment in PM2.5 and PM10 resulted in a 1.0% (95% CI: 0.5-1.5) and 0.4% (95% CI: 0.2-0.6) increase in hospital admission or ER visit for pneumonia, respectively. Every 1 ppm increase of CO and 10 ppb increase of NO2, SO2, and O3 was associated with 4.2% (95% CI: 0.6-7.9), 3.2% (95% CI: 1.3-5.1), 2.4% (95% CI: - 2.0-7.1), and 0.4% (95% CI: 0-0.8) increase in pneumonia-specific hospital admission or ER visit, respectively. Except for CO, the sensitivity analyses yielded similar results, demonstrating the robustness of the results. In a subgroup analysis by region, PM2.5 increased hospital admission or ER visit for pneumonia in East Asia but not in North America. CONCLUSION By combining the inconsistent findings of several studies, this study revealed the associations between short-term exposure of air pollutants and pneumonia-specific hospital admission or ER visit, especially for PM and NO2. Based on the results, stricter intervention policies regarding air pollution and programs for protecting human respiratory health should be implemented.
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Affiliation(s)
- Jeong Yee
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
| | - Young Ah Cho
- College of Pharmacy, Gyeongsang National University, Jinju, Gyeongnam, 52828, Republic of Korea
- Mokhwa Convalescent Hospital, Jinju, Gyeongnam, 52828, Republic of Korea
| | - Hee Jeong Yoo
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
- Department of Pharmacy, National Medical Center, Seoul, 04564, Republic of Korea
| | - Hyunseo Yun
- Graduate School of Clinical Biohealth, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Hye Sun Gwak
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea.
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23
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Qiu H, Wang L, Zhou L, Pan J. Coarse particles (PM 2.5-10) and cause-specific hospitalizations in southwestern China: Association, attributable risk and economic costs. ENVIRONMENTAL RESEARCH 2020; 190:110004. [PMID: 32745536 DOI: 10.1016/j.envres.2020.110004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
The short-term morbidity effects of the coarse particle (diameter in 2.5-10 μm, PM2.5-10), as well as the corresponding morbidity burden and economic costs, remain understudied, especially in developing countries. This study aimed to examine the associations of PM2.5-10 with cause-specific hospitalizations in a multi-city setting in southwestern China and assess the attributable risk and economic costs. City-specific associations were firstly estimated using generalized additive models with quasi-poisson distribution to handle over-dispersion, and then combined to obtain the regional average association. City-specific and pooled concentration-response (C-R) associations of PM2.5-10 with cause-specific hospitalizations were also modeled. Subgroup analyses were performed by age, sex, season and region. The health and economic burden of hospitalizations for multiple outcomes due to PM2.5-10 were further evaluated. A total of 4,407,601 non-accidental hospitalizations were collected from 678 hospitals. The estimates of percentage change in hospitalizations per 10 μg/m³ increase in PM2.5-10 at lag01 was 0.68% (95%CI: 0.33%-1.03%) for non-accidental causes, 0.86% (95% CI: 0.36%-1.37%) for circulatory diseases, 1.52% (95% CI: 1.00%-2.05%) for respiratory diseases, 1.08% (95% CI: 0.47%-1.69%) for endocrine diseases, 0.66% (95% CI: 0.12%-1.21%) for nervous system diseases, and 0.84% (95% CI: 0.42%-1.25%) for genitourinary diseases, respectively. The C-R associations of PM2.5-10 with cause-specific hospitalizations suggested some evidence of nonlinearity, except for endocrine diseases. Meanwhile, the adverse effects were modified by age and season. Overall, about 0.70% (95% CI: 0.35%-1.06%) of non-accidental hospitalizations and 0.78% (95% CI: 0.38%-1.17%) of total hospitalization expenses could be attributed to PM2.5-10. The largest morbidity burden and economic costs were observed in respiratory diseases. Our findings indicate that PM2.5-10 exposure may increase the risk of hospitalizations for multiple outcomes, and account for considerable morbidity and economic burden.
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Affiliation(s)
- Hang Qiu
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.
| | - Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Zhou
- Health Information Center of Sichuan Province, Chengdu, China
| | - Jingping Pan
- Health Information Center of Sichuan Province, Chengdu, China
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24
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Pompilio A, Di Bonaventura G. Ambient air pollution and respiratory bacterial infections, a troubling association: epidemiology, underlying mechanisms, and future challenges. Crit Rev Microbiol 2020; 46:600-630. [PMID: 33059504 DOI: 10.1080/1040841x.2020.1816894] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The World Health Organization attributed more than four million premature deaths to ambient air pollution in 2016. Numerous epidemiologic studies demonstrate that acute respiratory tract infections and exacerbations of pre-existing chronic airway diseases can result from exposure to ambient (outdoor) air pollution. In this context, the atmosphere contains both chemical and microbial pollutants (bioaerosols), whose impact on human health remains unclear. Therefore, this review: summarises the findings from recent studies on the association between exposure to air pollutants-especially particulate matter and ozone-and onset or exacerbation of respiratory infections (e.g. pneumonia, cystic fibrosis lung infection, and tuberculosis); discusses the mechanisms underlying the relationship between air pollution and respiratory bacterial infections, which is necessary to define prevention and treatment strategies; demonstrates the relevance of air pollution modelling in investigating and preventing the impact of exposure to air pollutants on human health; and outlines future actions required to improve air quality and reduce morbidity and mortality related to air pollution.
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Affiliation(s)
- Arianna Pompilio
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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25
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Kim H, Yu W. Single-day and cumulative effects of ambient particulate matter exposure on emergency department visits for respiratory disease in South Korea. HONG KONG J EMERG ME 2020. [DOI: 10.1177/1024907920965305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Along with the industrialization, the air pollutants have gained more attention and studies especially about respiratory diseases were conducted. Emergency visit reflects acute aggravation of disease rather than chronic exacerbation. Objectives: The objective of this study was to evaluate the relationship between the ambient particulate matter and the emergency visits with respiratory disease in South Korea. Methods: Patients diagnosed with respiratory disease in the emergency department in 2018 were enrolled. The data of meteorological factors and air pollutants between 4 December 2017 and 31 December 2018 were acquired. Poisson regression was used with daily emergency visits as the response variable and single-day particulate matter concentration as the explanatory variable. Results: A total of 4207 patients were enrolled. In Poisson regression analysis of all respiratory diseases, the effects of [Formula: see text] and [Formula: see text] were strongest at day before 8 and 26. Age older than 65 group and chronic respiratory disease group had earlier lag effect than the all-diseases group. Cumulative effect was peaked at 14 lag day. The split point of prediction was 87 µg/m3 before 3 days for [Formula: see text] and 37 µg/m3 before 8 days for [Formula: see text]. Conclusion: The results can be used to predict the increase of emergency visits and need for medical resources when the ambient particulate matter concentration rises.
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Affiliation(s)
- Hakjung Kim
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam-si, Republic of Korea
| | - Woosung Yu
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam-si, Republic of Korea
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26
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Qiu H, Bai CH, Chuang KJ, Fan YC, Chang TP, Yim SHL, Ho KF. Association of ambient non-methane hydrocarbons exposure with respiratory hospitalizations: A time series study in Taipei, Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 729:139010. [PMID: 32361457 DOI: 10.1016/j.scitotenv.2020.139010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Ambient hydrocarbons are important precursors of ground-level ozone and secondary organic aerosol formation. However, few studies have assessed the health impact of airborne hydrocarbons. We conducted this time series ecological study to evaluate the association of short-term airborne hydrocarbons exposure with hospital admissions for respiratory diseases, while controlling for co-exposure to criteria pollutants. Taipei air pollution and weather data for the period spanning from January 2010 to December 2017 were obtained from Taiwan Air Quality Monitoring Network. Subsequently, daily pollutant concentrations were linked with daily hospital admission counts for respiratory diseases into a time series data frame. The standard generalized additive Poisson model adjusted for temporal trends, seasonal variations, weather conditions, and calendar effects, was applied to examine the short-term associations of acute airborne hydrocarbon exposure with respiratory hospital admissions. Next, the robustness of the associations was tested using two-pollutant models with further adjustment for fine particulate matter (PM2.5) and gaseous pollutants. The results demonstrated that an interquartile range increase in non-methane hydrocarbon (NMHC) exposure on lag0 day (0.15 ppm) was associated with a 0.86% (95% confidence interval: 0.37%-1.36%), 2.06% (0.77%-3.38%), and 1.25% (0.31%-2.20%) increment in all-respiratory-disease-, asthma-, and chronic-obstructive-pulmonary-disease-linked hospital admissions, respectively. The associations were robust with further adjustment for co-exposure to PM2.5 and ozone. The acute effect estimate of methane on each respiratory category was sensitive to the co-pollutant adjustment and lost statistical significance in the two-pollutant models. In conclusion, we confirmed that airborne NMHC exposure increased the risk of respiratory-disease-related hospital admissions in Taipei; this information may aid in the regulation of hydrocarbon pollution.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kai-Jen Chuang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ta-Pang Chang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Steve Hung-Lam Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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27
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Jorquera H. Ambient particulate matter in Santiago, Chile: 1989-2018: A tale of two size fractions. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2020; 258:110035. [PMID: 31929070 DOI: 10.1016/j.jenvman.2019.110035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
We have analyzed trends in ambient fine (PM2.5) and coarse (PM2.5-10) particulate matter in Santiago, Chile, for the last 30 years. PM2.5 has monotonously decreased between 67% and 72% at those sites. Trends varied between -2.0 and -2.7 (μg/m3/year) between 1989 and late 90's, and between -0.7 and -1.1 (μg/m3/year) afterwards. This slowing down is likely a consequence of fast increase of motor vehicles in the city, which have become a dominant source of ambient PM2.5. Annual ambient PM2.5 concentrations are still above 20 (μg/m3), so more regulation is needed to bring them down. Coarse particles have changed little in 30 years, decreasing between 0% and 12%; particle concentrations have evolved in a non-linear way: first increasing in 1989-1995, then decreasing until 2003, and with a flat trend afterwards. We ascribe these trends to a combination of a) public works implemented throughout the city, b) fugitive dust controls like street sweeping programs and emission offsets for PM10 and c) increasing numbers of motor vehicles in the city. Further initiatives are needed to curb down coarse particles as well. By considering interaction between trend and seasonality, we have found that ambient PM2.5 has monotonously decreased all year long at all monitoring sites with similar patterns; this is characteristic of a regional-scale pollution. For ambient PM2.5-10 trend and season have a more complex, site-specific interaction, suggesting local sources and site location in the basin are relevant in determining ambient concentrations of coarse particles. A limitation of this study is that no quantitative link between ambient concentrations trends and atmospheric emissions could be established with the analyses carried out. A strength of the study is the long period analyzed with measurements conducted with the same gravimetric methodology.
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Affiliation(s)
- Héctor Jorquera
- Departamento de Ingeniería Química y Bioprocesos, Pontificia Universidad Católica de Chile, Avda. Vicuña Mackenna 4860, Santiago, 7820436, Chile; Centro de Desarrollo Urbano Sustentable, Santiago, Chile.
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28
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Tian Y, Wu Y, Liu H, Si Y, Wu Y, Wang X, Wang M, Wu J, Chen L, Wei C, Wu T, Gao P, Hu Y. The impact of ambient ozone pollution on pneumonia: A nationwide time-series analysis. ENVIRONMENT INTERNATIONAL 2020; 136:105498. [PMID: 31991238 DOI: 10.1016/j.envint.2020.105498] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/03/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
Few large multicity studies have assessed acute effect of tropospheric ozone pollution on pneumonia risk. We aimed to examine the relation between day-to-day changes in ozone concentrations and hospital admissions for pneumonia in China. We conducted a national time-series study in 184 major Chinese cities from 2014 to 2017. City-specific relation between ozone concentrations and pneumonia admissions was evaluated using an over-dispersed generalized additive model. Random-effects meta-analysis was conducted to pool the city-specific estimates. Two-pollutant models were fitted to test the robustness of the relations. We also investigated potential effect modifiers. Overall, we observed increased admissions for pneumonia associated with ozone exposure. The national-average estimates per 10-μg/m3 increase in ozone were 0.14% (95% CI: 0.03%-0.25%) at lag 0 day in the whole year, 0.30% (95% CI: 0.17%-0.43%) at lag 0 day in the warm season, and 0.20% (95% CI: 0.05%-0.34%) at lag 1 day in the cool season. Two-pollutant models indicated that the ozone effects were not confounded by PM2.5, SO2, NO2 or CO. The association between ozone and pneumonia was stronger in the elderly. Ozone levels and gross domestic product per capita reduced the effects of ozone, and smoking enhanced the effects of ozone. In conclusion, we estimated an increase in daily pneumonia admissions associated with ozone exposure in China. As the first national study in China to report acute effect of ozone on pneumonia hospitalizations, our findings are incredibly meaningful in terms of both ozone pollution related policy development and pneumonia prevention.
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Affiliation(s)
- Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan, China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Yaqin Si
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China; Beijing HealthCom Data Technology Co. Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071 Beijing, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Libo Chen
- Beijing HealthCom Data Technology Co. Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071 Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology Co. Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071 Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China; Key Laboratory of Molecular Cardiovascular (Peking University), Ministry of Education, Beijing, China.
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No. 38 Xueyuan Road, 100191 Beijing, China.
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Shears RK, Jacques LC, Naylor G, Miyashita L, Khandaker S, Lebre F, Lavelle EC, Grigg J, French N, Neill DR, Kadioglu A. Exposure to diesel exhaust particles increases susceptibility to invasive pneumococcal disease. J Allergy Clin Immunol 2020; 145:1272-1284.e6. [PMID: 31983527 PMCID: PMC7154500 DOI: 10.1016/j.jaci.2019.11.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The World Health Organization estimates that air pollution is responsible for 7 million deaths per annum, with 7% of these attributable to pneumonia. Many of these fatalities have been linked to exposure to high levels of airborne particulates, such as diesel exhaust particles (DEPs). OBJECTIVES We sought to determine whether exposure to DEPs could promote the progression of asymptomatic nasopharyngeal carriage of Streptococcus pneumoniae to invasive pneumococcal disease. METHODS We used mouse models and in vitro assays to provide a mechanistic understanding of the link between DEP exposure and pneumococcal disease risk, and we confirmed our findings by using induced sputum macrophages isolated from healthy human volunteers. RESULTS We demonstrate that inhaled exposure to DEPs disrupts asymptomatic nasopharyngeal carriage of S pneumoniae in mice, leading to dissemination to lungs and blood. Pneumococci are transported from the nasopharynx to the lungs following exposure to DEPs, leading to increased proinflammatory cytokine production, reduced phagocytic function of alveolar macrophages, and consequently, increased pneumococcal loads within the lungs and translocation into blood. These findings were confirmed by using DEP-exposed induced sputum macrophages isolated from healthy volunteers, demonstrating that impaired innate immune mechanisms following DEP exposure are also at play in humans. CONCLUSION Lung inhaled DEPs increase susceptibility to pneumococcal disease by leading to loss of immunological control of pneumococcal colonisation, increased inflammation, tissue damage, and systemic bacterial dissemination.
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Affiliation(s)
- Rebecca K Shears
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Laura C Jacques
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Georgia Naylor
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Lisa Miyashita
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Shadia Khandaker
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Filipa Lebre
- Adjuvant Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Ed C Lavelle
- Adjuvant Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Neil French
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Daniel R Neill
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Microbial Evolution, Genomics and Adaptation Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Aras Kadioglu
- Bacterial Pathogenesis and Immunity Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
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A Preliminary Attempt at the Identification and Financial Estimation of the Negative Health Effects of Urban and Industrial Air Pollution Based on the Agglomeration of Gdańsk. SUSTAINABILITY 2019. [DOI: 10.3390/su12010042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article marks the first attempt on Polish and European scale to identify the relationship between urban and industrial air pollution and the health conditions of urban populations, while also estimating the financial burden of incidence rates among urban populations for diseases selected in the course of this study as having a causal relation with such incidence. This paper presents the findings of a pilot study based on general regression models, intended to explore air pollutants with a statistically relevant impact on the incidence of selected diseases within the Agglomeration of Gdańsk in the years 2010–2018. In discussing the city’s industrial functions, the study takes into consideration the existence within its limits of a large port that services thousands of ships every year, contributing substantially to the volume of emissions (mainly NOx and PM) to the air. The causes considered include the impact of air pollution, seasonality, land- and sea-based emissions, as well as their mutual interactions. All of the factors and their interactions have a significant impact (p ≤ 0.05) on the incidence of selected diseases in the long term (9 years). The source data were obtained from the Polish National Health Fund (NFZ), the Agency for Regional Monitoring of Atmosphere in the Agglomeration of Gdańsk (ARMAAG), the Chief Inspectorate of Environmental Protection (GIOŚ), and the Port of Gdańsk Harbourmaster. The study used 60 variables representing the diseases, classified into 19 groups. The resulting findings were used to formulate a methodology for estimating the financial burden of the negative health effects of air pollution for the agglomeration, and will be utilized as a reference point for further research in selected regions of Poland.
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Tian Y, Liu H, Wu Y, Si Y, Li M, Wu Y, Wang X, Wang M, Chen L, Wei C, Wu T, Gao P, Hu Y. Ambient particulate matter pollution and adult hospital admissions for pneumonia in urban China: A national time series analysis for 2014 through 2017. PLoS Med 2019; 16:e1003010. [PMID: 31891579 PMCID: PMC6938337 DOI: 10.1371/journal.pmed.1003010] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 12/04/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The effects of ambient particulate matter (PM) pollution on pneumonia in adults are inconclusive, and few scientific data on a national scale have been generated in low- or middle-income countries, despite their much higher PM concentrations. We aimed to examine the association between PM levels and hospital admissions for pneumonia in Chinese adults. METHODS AND FINDINGS A nationwide time series study was conducted in China between 2014 and 2017. Information on daily hospital admissions for pneumonia for 2014-2017 was collected from the database of Urban Employee Basic Medical Insurance (UEBMI), which covers 282.93 million adults. Associations of PM concentrations and hospital admissions for pneumonia were estimated for each city using a quasi-Poisson regression model controlling for time trend, temperature, relative humidity, day of the week, and public holiday and then pooled by random-effects meta-analysis. Meta-regression models were used to investigate potential effect modifiers, including cities' annual-average air pollutants concentrations, temperature, relative humidity, gross domestic product (GDP) per capita, and coverage rates by the UEBMI. More than 4.2 million pneumonia admissions were identified in 184 Chinese cities during the study period. Short-term elevations in PM concentrations were associated with increased pneumonia admissions. At the national level, a 10-μg/m3 increase in 3-day moving average (lag 0-2) concentrations of PM2.5 (PM ≤2.5 μm in aerodynamic diameter) and PM10 (PM ≤10 μm in aerodynamic diameter) was associated with 0.31% (95% confidence interval [CI] 0.15%-0.46%, P < 0.001) and 0.19% (0.11%-0.30%, P < 0.001) increases in hospital admissions for pneumonia, respectively. The effects of PM10 were stronger in cities with higher temperatures (percentage increase, 0.031%; 95% CI 0.003%-0.058%; P = 0.026) and relative humidity (percentage increase, 0.011%; 95% CI 0%-0.022%; P = 0.045), as well as in the elderly (percentage increase, 0.10% [95% CI 0.02%-0.19%] for people aged 18-64 years versus 0.32% [95% CI 0.22%-0.39%] for people aged ≥75 years; P < 0.001). The main limitation of the present study was the unavailability of data on individual exposure to PM pollution. CONCLUSIONS Our findings suggest that there are significant short-term associations between ambient PM levels and increased hospital admissions for pneumonia in Chinese adults. These findings support the rationale that further limiting PM concentrations in China may be an effective strategy to reduce pneumonia-related hospital admissions.
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Affiliation(s)
- Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Medical Informatics Center, Peking University, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yaqin Si
- Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Libo Chen
- Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Molecular Cardiovascular (Peking University), Ministry of Education, Beijing, China
- * E-mail: (YH); (PG)
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Medical Informatics Center, Peking University, Beijing, China
- * E-mail: (YH); (PG)
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Cheng CY, Cheng SY, Chen CC, Pan HY, Wu KH, Cheng FJ. Ambient air pollution is associated with pediatric pneumonia: a time-stratified case-crossover study in an urban area. Environ Health 2019; 18:77. [PMID: 31462279 PMCID: PMC6714311 DOI: 10.1186/s12940-019-0520-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 08/22/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Pneumonia, the leading reason underlying childhood deaths, may be triggered or exacerbated by air pollution. To date, only a few studies have examined the association of air pollution with emergency department (ED) visits for pediatric pneumonia, with inconsistent results. Therefore, we aimed to elucidate the impact of short-term exposure to particulate matter (PM) and other air pollutants on the incidence of ED visits for pediatric pneumonia. METHODS PM2.5, PM10, and other air pollutant levels were measured at 11 air quality-monitoring stations in Kaohsiung City, Taiwan, between 2008 and 2014. Further, we extracted the medical records of non-trauma patients aged ≤17 years and who had visited an ED with the principal diagnosis of pneumonia. A time-stratified case-crossover study design was employed to determine the hazard effect of air pollution in a total of 4024 patients. RESULTS The single-pollutant model suggested that per interquartile range increment in PM2.5, PM10, nitrogen dioxide (NO2), and sulfur dioxide (SO2) on 3 days before the event increased the odds of pediatric pneumonia by 14.0% [95% confidence interval (CI), 5.1-23.8%], 10.9% (95% CI, 2.4-20.0%), 14.1% (95% CI, 5.0-24.1%), and 4.5% (95% CI, 0.8-8.4%), respectively. In two-pollutant models, PM2.5 and NO2 were significant after adjusting for PM10 and SO2. Subgroup analyses showed that older children (aged ≥4 years) were more susceptible to PM2.5 (interaction p = 0.024) and children were more susceptible to NO2 during warm days (≥26.5 °C, interaction p = 0.011). CONCLUSIONS Short-term exposure to PM2.5 and NO2 possibly plays an important role in pediatric pneumonia in Kaohsiung, Taiwan. Older children are more susceptible to PM2.5, and all children are more susceptible to NO2 during warm days.
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Affiliation(s)
- Chi-Yung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Shih-Yu Cheng
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
- Department of Emergency Medicine, Yunlin Chang Gung Memorial Hospital, No. 1500, Gongye Rd, Mailiao Township, Yunlin County, 638, Taiwan
| | - Chien-Chih Chen
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Kuan-Han Wu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan.
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan.
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Liu J, Li Y, Li J, Liu Y, Tao N, Song W, Cui L, Li H. Association between ambient PM 2.5 and children's hospital admissions for respiratory diseases in Jinan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:24112-24120. [PMID: 31228058 DOI: 10.1007/s11356-019-05644-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/30/2019] [Indexed: 05/12/2023]
Abstract
To determine the association between daily air pollution and the hospital admissions for respiratory diseases in children aged from 0 to 17 years in Jinan, China. Generalized linear models were used to explore the acute effects of ambient fine particulate matter (PM2.5) on the children's hospital admissions for respiratory diseases. We evaluated the lag associations (including lag 0 to lag 3, lag 01, and lag 03) between daily PM2.5 and the number of children's hospital admissions for respiratory diseases, and stratified by gender, age group (baby group: age 0-1 years; child group: age 1-5 years; student group: age 6-17 years), and cause-specific disease (including upper infection, pneumonia, and acute bronchitis) during 2011-2015. PM2.5 had significant positive impacts on the number of children's hospital admissions for respiratory disease. The results showed that per 10 μg/m3 increase of PM2.5 at lag 1 was associated with an increase in total and male hospital admissions of 0.23% (95% CI, 0.02%-0.45%) and 0.32% (95% CI, 0.04%-0.06%). The corresponding risk of the student group (age 6-17 years) hospital admissions was increased 0.90% (95% CI, 0.39%-1.42%) at lag 1 day. The corresponding risk of the upper infection was increased 0.96% (95% CI, 0.37-1.55%) at lag 1 day. Males and student groups (age 6-17 years) were more vulnerable to PM2.5 exposure. Upper infection admission was identified as the sensitive disease for children. It is a better way to reduce children's outdoor activities to avoid health effects when the air pollution increases.
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Affiliation(s)
- Jinyue Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, 250062, Shandong, China
| | - Yifan Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
| | - Jun Li
- Pediatric Intensive Care Unit, Jinan Children's Hospital, Jinan, 250022, Shandong, China
| | - Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
| | - Ningning Tao
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Wanmei Song
- School of medicine, Shandong University, Jinan, 250000, Shandong, China
| | - Liangliang Cui
- Department of Environmental Health, Jinan Municipal Center for Disease Control and Prevention, Jinan, 250021, Shandong, China.
| | - Huaichen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, 250062, Shandong, China.
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Association Between Ambient Air Pollution Exposure and Spontaneous Pneumothorax Occurrence. Epidemiology 2019; 30 Suppl 1:S48-S56. [PMID: 31181006 DOI: 10.1097/ede.0000000000001013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Spontaneous pneumothorax is hypothesized to be associated with air pollution exposure based on pathophysiological mechanisms involving airway inflammation. Therefore, we analyzed the association between daily concentrations of air pollutants [sulfur dioxide, nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), particulate matter (PM) less than 2.5 μm in diameter (PM2.5), PM less than 10 μm in diameter (PM10), and coarse PM (PM10-2.5)] and the number of spontaneous pneumothorax-related hospital visits. METHODS We analyzed a subset of data from the National Health Insurance Service-National Sample Cohort, a nationally representative dynamic cohort based on health insurance claims data in Korea. Using time series analysis with the Poisson generalized additive model, we evaluated hospital visit data of over 100,000 male cohort members residing in Seoul from 2007 to 2010. RESULTS We identified 516 hospital visits due to spontaneous pneumothorax. In a single-pollutant model, an interquartile range increase of PM and CO exposure at lag day 1 was associated with spontaneous pneumothorax hospital visits (relative risk, 95% confidence interval: PM2.5: 1.10 (1.01, 1.21); PM10: 1.09 (1.01, 1.18); PM10-2.5: 1.06 (1.00, 1.12); CO: 1.11 (1.01, 1.23)). For lag day 2, NO2 and PM exposure was associated with pneumothorax hospital visits (NO2: 1.15 (1.01, 1.32); PM10: 1.10 (1.02, 1.18); PM10-2.5: 1.07 (1.02, 1.13)). In a multipollutant model, the association was consistent for PM. CONCLUSION The number of hospital visits due to spontaneous pneumothorax increased with air pollution exposure, especially with PM. Our finding suggests that air pollution is a possible predisposing factor for spontaneous pneumothorax.
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Abstract
RATIONALE The relationship between air pollution and pneumonia is poorly understood. OBJECTIVES To examine relationships between short-term air pollution exposure and number and severity of pneumonia cases along the Wasatch Front in Utah, a region with periodic high levels of outdoor air pollution. METHODS We applied time-stratified case-crossover analyses with distributed lag to patients presenting to seven emergency departments with pneumonia over a 2-year period. We compared levels of particulate matter less than or equal to 2.5 μm in aerodynamic diameter, nitrogen dioxide, and ozone at patient residences with emergency department cases, hospitalizations, objectively defined severe pneumonia, and mortality. We calculated direct cost impacts of particulate matter less than or equal to 2.5 μm in aerodynamic diameter reduction. RESULTS We evaluated 4,336 pneumonia cases in seven hospitals. Among adults aged 65 years and older, we found consistently positive associations between particulate matter less than or equal to 2.5 μm in aerodynamic diameter within 6 days of presentation and instances of pneumonia (Lag Day 1 adjusted odds ratio, 1.35 per 10 μg/m3 over 12 μg/m3; 95% confidence interval, 1.16-1.57), severe pneumonia (Lag Day 1 adjusted odds ratio, 1.38; 95% confidence interval, 1.06-1.80), and inpatient mortality (Lag Day 5 adjusted odds ratio, 1.50; 95% confidence interval, 1.03-2.16). Smaller associations were found between nitrogen dioxide exposure and pneumonia occurrence, severity, and inpatient and 30-day mortality. Ozone exposure was modestly associated with increased instance and severity of pneumonia in younger adults. Particulate matter less than or equal to 2.5 μm in aerodynamic diameter and nitrogen dioxide effects were greatest in colder months, and ozone effects were greatest in warmer months. Reduction of particulate matter less than or equal to 2.5 μm in aerodynamic diameter levels to less than 12.0 mg/m3 could prevent 76-112 cases of pneumonia per year in these hospitals serving approximately half of the Wasatch Front's population, reducing direct medical facility costs by $807,000 annually. CONCLUSIONS Among older adults, short-term ambient particulate matter less than or equal to 2.5 μm in aerodynamic diameter exposure is associated with more emergency department visits and hospitalizations for pneumonia, severe pneumonia, increased mortality, and increased healthcare costs. Nitrogen dioxide and ozone modestly increase pneumonia risk and illness severity.
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Ge E, Lai K, Xiao X, Luo M, Fang Z, Zeng Y, Ju H, Zhong N. Differential effects of size-specific particulate matter on emergency department visits for respiratory and cardiovascular diseases in Guangzhou, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 243:336-345. [PMID: 30196203 DOI: 10.1016/j.envpol.2018.08.068] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Studies differentiating the cardiorespiratory morbidity effects of PM2.5, PM10, and PM2.5∼10 (i.e. coarse PM or PMc) are still limited and inconsistent. OBJECTIVE To estimate the acute, cumulative, and harvesting effects of exposure to the three size-specific PM on cardiorespiratory morbidity, and their concentration-response relations. METHODS A total of 6,727,439 emergency department (ED) visits were collected from 16 public teaching hospitals in Guangzhou, from January 1st 2012 to December 31st 2015, among which over 2.1 million were asthma, COPD, pneumonia, respiratory tract infection (RTI), hypertension, stroke, and coronary heart disease (CHD). Distributed lag non-linear models (DLNM) was used to estimate the associations between the three size-specific PM and ED visits for the cardiovascular diseases. Long-term trends, seasonality, influenza epidemics, meteorological factors, and other gas pollutants, including SO2, NO2, and O3, were adjusted. We stratified the analyses by gender and age. RESULTS Elevated PM2.5 and PM10 were significantly associated with increased ED visits for pneumonia, RTI, and CHD at both lag0 and lag0-3. A 10 μg/m3 increment of PMc (at lag0-14) was estimated to increase ED visits for pneumonia by 6.32% (95% CI, 4.19, 8.49) and for RTI by 4.72% (95% CI, 3.81, 5.63), respectively. PMc showed stronger cumulative effects on asthma in children than elderly. We observed significant harvesting effects (i.e. morbidity displacements) of the three size-specific PM on respiratory but very little on cardiovascular ED visits. The concentration-response curves suggested non-linear relations between exposures to the three different sizes of PM and respiratory morbidity. CONCLUSIONS Overall, the three size-specific PM demonstrated distinct acute and cumulative effects on the cardiorespiratory diseases. PM2.5 and PMc would have significant effects on pneumonia and RTI. Strategies should be considered to further reduce levels of ambient PM2.5 and PMc.
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Affiliation(s)
- Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Guangzhou Institute of Respiratory Health, Guangdong Province, China.
| | - Kefang Lai
- Guangzhou Institute of Respiratory Health, Guangdong Province, China.
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan Province, China.
| | - Ming Luo
- School of Geography and Planning, Sun Yat-Sen University, Guangdong Province, China.
| | - Zhangfu Fang
- Guangzhou Institute of Respiratory Health, Guangdong Province, China.
| | - Yanjun Zeng
- Guangzhou Environmental Monitoring Center Station, Guangdong Province, China.
| | - Hong Ju
- Guangzhou Environmental Monitoring Center Station, Guangdong Province, China.
| | - Nanshan Zhong
- Guangzhou Institute of Respiratory Health, Guangdong Province, China.
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Ran J, Qiu H, Sun S, Yang A, Tian L. Are ambient volatile organic compounds environmental stressors for heart failure? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 242:1810-1816. [PMID: 30077408 DOI: 10.1016/j.envpol.2018.07.086] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Numerous epidemiological studies have indicated the adverse cardiovascular effects of air pollution on heart failure (HF) risk. However, little data are available directly evaluating the association of ambient volatile organic compounds (VOCs) with HF risk. We aimed to estimate the short-term effects of ambient VOCs on HF emergency hospitalizations in Hong Kong and to evaluate whether the associations were modified by sex and age. METHODS We collected the daily VOCs concentrations from the Hong Kong Environmental Protection Department between April 2011 to December 2014. HF emergency hospital admission data were obtained from the Hospital Authority of Hong Kong. Generalized additive model (GAM) integrated with the distributed lag model (DLM) was used to estimate the excess risks of HF emergency hospitalizations with ambient concentrations of each VOCs groups - alkane, alkene, alkyne, benzene and substituted benzene. RESULTS We observed short-term effects of alkyne and benzene on an increased risk of HF emergency hospitalizations. The cumulative effect over 0-6 lag days (dlm0-6) for an IQR increment of alkyne (1.17 ppb) was associated with 4.2% (95% CI: 1.18%-7.26%) increases of HF emergency hospitalizations, while the corresponding effect estimate over dlm0-2 for benzene per IQR (0.43 ppb) was 2.7% (95% CI: 0.39%-5.04%). Each VOCs groups was significantly associated with HF emergency hospitalizations in men. CONCLUSIONS Ambient volatile organic compounds, particularly alkyne and benzene, were associated with increased risks of heart failure in the Hong Kong population.
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Affiliation(s)
- Jinjun Ran
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
| | - Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Aimin Yang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China.
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Qiu H, Pun VC, Tian L. Short-term effects of fine and coarse particles on deaths in Hong Kong elderly population: An analysis of mortality displacement. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 241:148-154. [PMID: 29804047 DOI: 10.1016/j.envpol.2018.05.056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND While numerous studies worldwide have evaluated the short-term associations of fine and coarse particulate matter (PM) air pollution with mortality and morbidity, these studies may be susceptible to short-term harvesting effect. We aimed to investigate the short-term association between mortality and PM with aerodynamic diameter less than 2.5 μm (PM2.5) and those between 2.5 and 10 μm (PMc) within a month prior to death, and assess the mortality displacement by PM2.5 and PMc among elderly population in Hong Kong. METHODS We obtained air pollution data from January 2011 to December 2015 from Environmental Protection Department, and daily cause-specific mortality data from Census and Statistical Department of Hong Kong. We performed generalized additive distributed lag model to examine the acute, delayed and long-lasting effects of PM2.5 and PMc within one month on mortality. RESULTS We observed a statistically significant association of PM2.5 and PMc exposure over lags 0-6 days with all natural mortality and cardio-respiratory mortality. The overall cumulative effect of PM2.5 over 0-30 lag days was 3.44% (95% CI: 0.30-6.67%) increase in all natural mortality and 6.90% (95% CI: 0.58-13.61%) increase of circulatory mortality, which suggested the absence of mortality displacement by PM2.5. On the other hand, no significant cumulative association with mortality was found for PMc over 0-30 lag exposure window, and thus mortality displacement by PMc cannot be ruled out. Findings remained robust in various sensitivity analyses. CONCLUSIONS We found adverse effect of both PM2.5 and PMc exposure within one week prior to death. While there was no evidence of mortality displacement in the association of PM2.5 exposure over one month prior with all natural and circulatory mortality, mortality displacement by PMc cannot be ruled out. PM2.5 may contribute more to the longer term effect of particulate matter than PMc.
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Affiliation(s)
- Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vivian C Pun
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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Wang X, Zhang L, Yao Z, Ai S, Qian ZM, Wang H, BeLue R, Liu T, Xiao J, Li X, Zeng W, Ma W, Lin H. Ambient coarse particulate pollution and mortality in three Chinese cities: Association and attributable mortality burden. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 628-629:1037-1042. [PMID: 30045528 DOI: 10.1016/j.scitotenv.2018.02.100] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 01/25/2018] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
The short-term mortality effects of ambient fine particulate matter air pollution have been widely investigated in China. However, the associations between day-to-day variation in ambient coarse particles pollution (PMc) and mortality, as well as the corresponding mortality burden, remain understudied. We estimated the short-term PMc-mortality association in three Chinese cities of the Pearl River Delta (PRD) region during the period of 2013-16. The city-specific association was first estimated using generalized additive models and then combined to obtain the overall effect estimates. We further estimated PMc related attributable fraction and attributable mortality. Our study found a significant association between PMc and mortality. Each 10μg/m3 increase of a current day's PMc was associated with a 1.37% (95% CI: 0.55%, 2.22%) increase in total mortality, a 1.63% increase (95% CI: 0.31%, 2.98%) in cardiovascular mortality, and a 0.97% increase (95% CI: -0.17%, 2.13%) in respiratory mortality in the three cities. We estimated that 0.37% (95% CI: 0.14%, 0.61%) and 2.72% (95% CI: 1.03%, 4.50%) of total mortalities were attributable to PMc by using China's standards and WHO's air quality guidelines as references-corresponding to 1394 (95% CI: 528, 2291) and 10,305 (95% CI: 3884, 17,000) attributable premature mortalities in the three cities, respectively. This study suggests that ambient coarse particulate pollution might be one important risk factor of total, cardiovascular, and respiratory mortality, as well as account for substantial mortality burdens in the three Chinese cities of the PRD.
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Affiliation(s)
- Xiaojie Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Lingli Zhang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Zhenjiang Yao
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Siqi Ai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Min Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Hao Wang
- The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou 510310, China
| | - Rhonda BeLue
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Hualiang Lin
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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40
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Fan Z, Pun VC, Chen XC, Hong Q, Tian L, Ho SSH, Lee SC, Tse LA, Ho KF. Personal exposure to fine particles (PM 2.5) and respiratory inflammation of common residents in Hong Kong. ENVIRONMENTAL RESEARCH 2018; 164:24-31. [PMID: 29462750 DOI: 10.1016/j.envres.2018.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/15/2018] [Accepted: 02/08/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND Given the lack of research on the personal exposure to fine particles (PM2.5) in Hong Kong, we examined the association between short-term personal exposure to PM2.5 and their constituents and inflammation in exhaled breath in a sample of healthy adult residents. METHOD Forty-six participants underwent personal PM2.5 monitoring for averagely 6 days to obtain 276 samples. Fractional exhaled nitric oxide (FeNO), a biomarker of inflammation in exhaled breath, was measured at the end of each 24-h personal monitoring. PM2.5 chemical constituents, including organic carbon, elemental carbon, 16 polycyclic aromatic hydrocarbons (PAHs), and 6 phthalate esters, were speciated from the personal samples collected. A mixed-effects model was used to estimate the association of PM2.5 and their constituents with FeNO. The comparison was also made with parallel analyses using ambient concentrations. RESULTS Personal exposures to PM2.5 (28.1 ± 23.3 μg/m3) were higher than the ambient levels (13.3 ± 6.4 μg/m3) monitored by stations. The composition profile and personal-to-ambient concentration ratio varied among subjects with different occupations. An interquartile range (IQR) change in personal exposure to PM2.5 was positively associated with 12.8% increase in FeNO (95% confidence interval, CI: 5.5-20.7%), while nil association was found for ambient PM2.5. Among the constituents measured, only the carcinogenic PAHs were significantly associated with 12% increase in FeNO responses (95% CI, 0.0-25.6%). CONCLUSION In conclusion, our study provides the first understanding about personal exposure to PM2.5 and possible sources in Hong Kong. The results also showed that personal exposure to PM2.5 and c-PAHs were linked to increased FeNO levels among healthy adults.
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Affiliation(s)
- Zhanlan Fan
- The Jockey Club School of Public Healthh and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian C Pun
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Xiao-Cui Chen
- The Jockey Club School of Public Healthh and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Environment, energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Qiu Hong
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Steven Sai-Hang Ho
- Key Laboratory of Aerosol Chemistry and Physics, SKLLQG, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710075, China
| | - Shun-Cheng Lee
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lap Ah Tse
- The Jockey Club School of Public Healthh and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kin-Fai Ho
- The Jockey Club School of Public Healthh and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Environment, energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China.
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Audureau É, Simon-Deckers A, Franco-Montoya ML, Annangi B, Kermanizadeh A, Boczkowski J, Lanone S. Substantial modification of the gene expression profile following exposure of macrophages to welding-related nanoparticles. Sci Rep 2018; 8:8554. [PMID: 29867105 PMCID: PMC5986907 DOI: 10.1038/s41598-018-26988-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 05/21/2018] [Indexed: 11/09/2022] Open
Abstract
Anthropic nanoparticles (NP) are increasingly produced and emitted, with accompanying concerns for human health. Currently there is no global understanding as to the exact mechanistics of NP toxicity, as the traditional nanotoxicological approaches only provide a restricted overview. To address this issue, we performed an in-depth transcriptomic analysis of human macrophages exposed to a panel of welding-related metal oxide NP that we previously identified in welders lungs (Fe2O3, Fe3O4, MnFe2O4 and CrOOH NP). Utilizing the specified analysis criteria (|fold change| ≥1.5, p ≤ 0.001), a total of 2164 genes were identified to be differentially expressed after THP-1 macrophage exposure to the different NP. Performing Gene Ontology enrichment analysis, for cellular content, biological processes and Swiss-Prot/Protein Information Resource keywords the data show for the first time a profound modification of gene differential expression in response to the different NP, among which MnFe2O4 NP were the most potent to induce THP-1 macrophage activation. The transcriptomic analysis utilized in the study, provides novel insights into mechanisms that could contribute to NP-induced adverse effects and support the need for widened approaches to supplement existing knowledge of the processes underlying NP toxicity which would have not been possible using traditional nanotoxicological studies.
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Affiliation(s)
- Étienne Audureau
- Université Paris Est-Créteil, DHU A-TVB, IRMB- EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Créteil, F-94010, France.,AP-HP, Hôpital Henri-Mondor, Service de Santé Publique, Créteil, F-94010, France
| | | | | | | | - Ali Kermanizadeh
- INSERM, U955, Equipe 4, Créteil, F-94000, France.,University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Jorge Boczkowski
- INSERM, U955, Equipe 4, Créteil, F-94000, France.,Université Paris Est-Créteil, Faculté de Médecine, Créteil, F-94000, France.,DHU A-TVB, Service d'explorations fonctionnelles respiratoires, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Créteil, F-94000, France
| | - Sophie Lanone
- INSERM, U955, Equipe 4, Créteil, F-94000, France. .,Université Paris Est-Créteil, Faculté de Médecine, Créteil, F-94000, France.
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Ho HC, Wong MS, Yang L, Shi W, Yang J, Bilal M, Chan TC. Spatiotemporal influence of temperature, air quality, and urban environment on cause-specific mortality during hazy days. ENVIRONMENT INTERNATIONAL 2018; 112:10-22. [PMID: 29245038 DOI: 10.1016/j.envint.2017.12.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 06/07/2023]
Abstract
Haze is an extreme weather event that can severely increase air pollution exposure, resulting in higher burdens on human health. Few studies have explored the health effects of haze, and none have investigated the spatiotemporal interaction between temperature, air quality and urban environment that may exacerbate the adverse health effects of haze. We investigated the spatiotemporal pattern of haze effects and explored the additional effects of temperature, air pollution and urban environment on the short-term mortality risk during hazy days. We applied a Poisson regression model to daily mortality data from 2007 through 2014, to analyze the short-term mortality risk during haze events in Hong Kong. We evaluated the adverse effect on five types of cause-specific mortality after four types of haze event. We also analyzed the additional effect contributed by the spatial variability of urban environment on each type of cause-specific mortality during a specific haze event. A regular hazy day (lag 0) has higher all-cause mortality risk than a day without haze (odds ratio: 1.029 [1.009, 1.049]). We have also observed high mortality risks associated with mental disorders and diseases of the nervous system during hazy days. In addition, extreme weather and air quality contributed to haze-related mortality, while cold weather and higher ground-level ozone had stronger influences on mortality risk. Areas with a high-density environment, lower vegetation, higher anthropogenic heat, and higher PM2.5 featured stronger effects of haze on mortality than the others. A combined influence of haze, extreme weather/air quality, and urban environment can result in extremely high mortality due to mental/behavioral disorders or diseases of the nervous system. In conclusion, we developed a data-driven technique to analyze the effects of haze on mortality. Our results target the specific dates and areas with higher mortality during haze events, which can be used for development of health warning protocols/systems.
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Affiliation(s)
- Hung Chak Ho
- Department of Land Surveying and Geo-Informatics, the Hong Kong Polytechnic University, Hong Kong; Research Institute for Sustainable Urban Development, the Hong Kong Polytechnic University, Hong Kong
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, the Hong Kong Polytechnic University, Hong Kong; Research Institute for Sustainable Urban Development, the Hong Kong Polytechnic University, Hong Kong.
| | - Lin Yang
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong
| | - Wenzhong Shi
- Department of Land Surveying and Geo-Informatics, the Hong Kong Polytechnic University, Hong Kong; Research Institute for Sustainable Urban Development, the Hong Kong Polytechnic University, Hong Kong
| | - Jinxin Yang
- Department of Land Surveying and Geo-Informatics, the Hong Kong Polytechnic University, Hong Kong; Research Institute for Sustainable Urban Development, the Hong Kong Polytechnic University, Hong Kong
| | - Muhammad Bilal
- Department of Land Surveying and Geo-Informatics, the Hong Kong Polytechnic University, Hong Kong; Research Institute for Sustainable Urban Development, the Hong Kong Polytechnic University, Hong Kong; School of Marine Sciences, Nanjing University of Information Science & Technology, Nanjing 210044, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan
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Tian Y, Xiang X, Juan J, Song J, Cao Y, Huang C, Li M, Hu Y. Short-term effects of ambient fine particulate matter pollution on hospital visits for chronic obstructive pulmonary disease in Beijing, China. Environ Health 2018; 17:21. [PMID: 29482552 PMCID: PMC6389038 DOI: 10.1186/s12940-018-0369-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/20/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Little is known about the effect of ambient fine particulate matter (PM2.5) on chronic obstructive pulmonary disease (COPD) in China. The objective of this study was to explore the short-term effects of PM2.5 on outpatient and inpatient visits for COPD in Beijing, China. METHODS A total of 3,503,313 outpatient visits and 126,982 inpatient visits for COPD between January 1, 2010, and June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to estimate the percentage change with 95% confidence interval (CI) in hospital visits for COPD in relation to an interquartile range (IQR) (90.8 μg/m3) increase in PM2.5 concentrations. RESULTS Short-term exposure to PM2.5 was significantly associated with increased use of COPD-related health services. There were clear exposure-response associations of PM2.5 with COPD outpatient and inpatient visits. An IQR increase in the concurrent day PM2.5 concentrations was significantly associated with a 2.38% (95% CI, 2.22%-2.53%) and 6.03% (95% CI, 5.19%-6.87%) increase in daily outpatient visits and inpatient visits, respectively. Elderly people were more sensitive to the adverse effects. The estimated risk was higher during the warm season compared to the cool season. CONCLUSIONS Short-term exposure to PM2.5 was associated with increased risk of hospital visits for COPD. Our findings contributed to the limited evidence concerning the effects of ambient PM2.5 on COPD morbidity in developing countries.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Chao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
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Guo P, Feng W, Zheng M, Lv J, Wang L, Liu J, Zhang Y, Luo G, Zhang Y, Deng C, Shi T, Liu P, Zhang L. Short-term associations of ambient air pollution and cause-specific emergency department visits in Guangzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 613-614:306-313. [PMID: 28917169 DOI: 10.1016/j.scitotenv.2017.09.102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/23/2017] [Accepted: 09/11/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Evidence of association of ambient air pollution with cause-specific emergency department visits in China is still limited. This study aimed to investigate short-term associations between exposures to air pollutants and daily cause-specific emergency department visits using a large-scale multicenter database involving a total of 65 sentinel hospitals in Guangzhou, the most densely-populated city in south China, during 2013-2015. MATERIAL AND METHODS We obtained data on 162,771 emergency department visits from 65 hospitals from the Emergency Medical Command Center in Guangzhou between January 1, 2013 and December 31, 2015. Daily air pollution data on particulate matter (PM) of aerodynamic diameter<10 and 2.5μm (PM10, and PM2.5, respectively), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3) were collected from the Daily Quality Report of the Guangzhou Environmental Protection Bureau during the study period. Visits for neurologic, respiratory and circulatory diseases were assessed in relation to air pollutants using Poisson generalized additive models. RESULTS Mean daily number of emergency department visits for neurologic, respiratory and circulatory diseases was 89, 24 and 35, respectively. After adjustment for other pollutants (PM2.5, PM10, NO2 and O3), meteorological factors and time-varying confounders, a 7.98-μg/m3 (interquartile range) increment in 2-day moving average of same-day and previous-day SO2 concentrations was associated with the statistically significant increase of 4.89% (95% confidence interval: 2.86, 6.95) in neurologic emergency department visits; elevation in SO2 level (per 7.98μg/m3) was linked to a 5.19% (95% confidence interval: 2.03, 8.44) increase in circulatory emergency department visits. Most positive links were seen during the cold season. CONCLUSIONS The results of this study contribute to the evidence of the significant associations between SO2 and specific neurologic and circulatory conditions, and also provide insight into the planning of clinical services and emergency contingency response for air pollution exposures in Guangzhou.
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Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jiayun Lv
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Li Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Ju Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yanhong Zhang
- Shantou University Medical College, Shantou 515041, China
| | - Gangfeng Luo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yanting Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Changyu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Tongxing Shi
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Pengda Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Lin Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
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Nhung NTT, Schindler C, Dien TM, Probst-Hensch N, Perez L, Künzli N. Acute effects of ambient air pollution on lower respiratory infections in Hanoi children: An eight-year time series study. ENVIRONMENT INTERNATIONAL 2018; 110:139-148. [PMID: 29128032 DOI: 10.1016/j.envint.2017.10.024] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 10/26/2017] [Accepted: 10/28/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND Lower respiratory diseases are the most frequent causes of hospital admission in children worldwide, particularly in developing countries. Daily levels of air pollution are associated with lower respiratory diseases, as documented in many time-series studies. However, investigations in low-and-middle-income countries, such as Vietnam, remain sparse. OBJECTIVE This study investigated the short-term association of ambient air pollution with daily counts of hospital admissions due to pneumonia, bronchitis and asthma among children aged 0-17 in Hanoi, Vietnam. We explored the impact of age, gender and season on these associations. METHODS Daily ambient air pollution concentrations and hospital admission counts were extracted from electronic databases received from authorities in Hanoi for the years 2007-2014. The associations between outdoor air pollution levels and hospital admissions were estimated for time lags of zero up to seven days using Quasi-Poisson regression models, adjusted for seasonal variations, meteorological variables, holidays, influenza epidemics and day of week. RESULTS All ambient air pollutants were positively associated with pneumonia hospitalizations. Significant associations were found for most pollutants except for ozone and sulfur dioxide in children aged 0-17. Increments of an interquartile range (21.9μg/m3) in the 7-day-average level of NO2 were associated with a 6.1% (95%CI 2.5% to 9.8%) increase in pneumonia hospitalizations. These associations remained stable in two-pollutant models. All pollutants other than CO were positively associated with hospitalizations for bronchitis and asthma. Associations were weaker in infants than in children aged 1-5. CONCLUSION Strong associations between hospital admissions for lower respiratory infections and daily levels of air pollution confirm the need to adopt sustainable clean air policies in Vietnam to protect children's health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Nhung NTT, Amini H, Schindler C, Kutlar Joss M, Dien TM, Probst-Hensch N, Perez L, Künzli N. Short-term association between ambient air pollution and pneumonia in children: A systematic review and meta-analysis of time-series and case-crossover studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:1000-1008. [PMID: 28763933 DOI: 10.1016/j.envpol.2017.07.063] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 05/22/2023]
Abstract
Ambient air pollution has been associated with respiratory diseases in children. However, its effects on pediatric pneumonia have not been meta-analyzed. We conducted a systematic review and meta-analysis of the short-term association between ambient air pollution and hospitalization of children due to pneumonia. We searched the Web of Science and PubMed for indexed publications up to January 2017. Pollutant-specific excess risk percentage (ER%) and confidence intervals (CI) were estimated using random effect models for particulate matter (PM) with diameter ≤ 10 (PM10) and ≤2.5 μm (PM2.5), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). Results were further stratified by subgroups (children under five, emergency visits versus hospital admissions, income level of study location, and exposure period). Seventeen studies were included in the meta-analysis. The ER% per 10 μg/m3 increase of pollutants was 1.5% (95% CI: 0.6%-2.4%) for PM10 and 1.8% (95% CI: 0.5%-3.1%) for PM2.5. The corresponding values per 10 ppb increment of gaseous pollutants were 2.9% (95% CI: 0.4%-5.3%) for SO2, 1.7% (95% CI: 0.5%-2.8%) for O3, and 1.4% (95% CI: 0.4%-2.4%) for NO2. ER% per 1000 ppb increment of CO was 0.9% (95% CI: 0.0%-1.9%). Associations were not substantially different between subgroups. This meta-analysis shows a positive association between daily levels of ambient air pollution markers and hospitalization of children due to pneumonia. However, lack of studies from low-and middle-income countries limits the quantitative generalizability given that susceptibilities to the adverse effects of air pollution may be different in those populations. The meta-regression in our analysis further demonstrated a strong effect of country income level on heterogeneity.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Heresh Amini
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Meltem Kutlar Joss
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tran Minh Dien
- Vietnam National Children's Hospital, Dong Da, Hanoi, Viet Nam
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Spatial variation of pneumonia hospitalization risk in Twin Cities metro area, Minnesota. Epidemiol Infect 2017; 145:3274-3283. [PMID: 29039282 DOI: 10.1017/s0950268817002291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Fine resolution spatial variability in pneumonia hospitalization may identify correlates with socioeconomic, demographic and environmental factors. We performed a retrospective study within the Fairview Health System network of Minnesota. Patients 2 months of age and older hospitalized with pneumonia between 2011 and 2015 were geocoded to their census block group, and pneumonia hospitalization risk was analyzed in relation to socioeconomic, demographic and environmental factors. Spatial analyses were performed using Esri's ArcGIS software, and multivariate Poisson regression was used. Hospital encounters of 17 840 patients were included in the analysis. Multivariate Poisson regression identified several significant associations, including a 40% increased risk of pneumonia hospitalization among census block groups with large, compared with small, populations of ⩾65 years, a 56% increased risk among census block groups in the bottom (first) quartile of median household income compared to the top (fourth) quartile, a 44% higher risk in the fourth quartile of average nitrogen dioxide emissions compared with the first quartile, and a 47% higher risk in the fourth quartile of average annual solar insolation compared to the first quartile. After adjusting for income, moving from the first to the second quartile of the race/ethnic diversity index resulted in a 21% significantly increased risk of pneumonia hospitalization. In conclusion, the risk of pneumonia hospitalization at the census-block level is associated with age, income, race/ethnic diversity index, air quality, and solar insolation, and varies by region-specific factors. Identifying correlates using fine spatial analysis provides opportunities for targeted prevention and control.
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Guo P, Wang Y, Feng W, Wu J, Fu C, Deng H, Huang J, Wang L, Zheng M, Liu H. Ambient Air Pollution and Risk for Ischemic Stroke: A Short-Term Exposure Assessment in South China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091091. [PMID: 28930181 PMCID: PMC5615628 DOI: 10.3390/ijerph14091091] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 02/07/2023]
Abstract
Data on the association between air pollution and risk of ischemic stroke in China are still limited. This study aimed to investigate the association between short-term exposure to ambient air pollution and risk of ischemic strokes in Guangzhou, the most densely-populated city in south China, using a large-scale multicenter database of stroke hospital admissions. Daily counts of ischemic stroke admissions over the study years 2013-2015 were obtained from the Guangzhou Cardiovascular and Cerebrovascular Disease Event Surveillance System. Daily particulate matter <2.5 μm in diameter (PM2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and meteorological data were collected. The associations between air pollutants and hospital admissions for stroke were examined using relative risks (RRs) and their corresponding 95% confidence intervals (CIs) based on time-series Poisson regression models, adjusting for temperature, public holiday, day of week, and temporal trends in stroke. Ischemic stroke admissions increased from 27,532 to 35,279 through 2013 to 2015, increasing by 28.14%. Parameter estimates for NO₂ exposure were robust regardless of the model used. The association between same-day NO₂ (RR = 1.0509, 95% CI: 1.0353-1.0668) exposure and stroke risk was significant when accounting for other air pollutants, day of the week, public holidays, temperature, and temporal trends in stroke events. Overall, we observed a borderline significant association between NO₂ exposure modeled as an averaged lag effect and ischemic stroke risk. This study provides data on air pollution exposures and stroke risk, and contributes to better planning of clinical services and emergency contingency response for stroke.
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Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Yulin Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Jiagang Wu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Chuanxi Fu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
| | - Jun Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China.
| | - Li Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Huazhang Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
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Mannucci PM, Franchini M. Health Effects of Ambient Air Pollution in Developing Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091048. [PMID: 28895888 PMCID: PMC5615585 DOI: 10.3390/ijerph14091048] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/26/2017] [Accepted: 09/09/2017] [Indexed: 02/08/2023]
Abstract
The deleterious effects of ambient air pollution on human health have been consistently documented by many epidemiologic studies worldwide, and it has been calculated that globally at least seven million deaths are annually attributable to the effects of air pollution. The major air pollutants emitted into the atmosphere by a number of natural processes and human activities include nitrogen oxides, volatile organic compounds, and particulate matter. In addition to the poor ambient air quality, there is increasing evidence that indoor air pollution also poses a serious threat to human health, especially in low-income countries that still use biomass fuels as an energy resource. This review summarizes the current knowledge on ambient air pollution in financially deprived populations.
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Affiliation(s)
- Pier Mannuccio Mannucci
- Scientific Direction, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, 20100 Milan, Italy.
| | - Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, 46100 Mantova, Italy.
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50
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Nguyen NTT, Dien TM, Schindler C, Lien NTB, Probst-Hensch N, Lan VTH, Künzli N, Perez L. Childhood hospitalisation and related deaths in Hanoi, Vietnam: a tertiary hospital database analysis from 2007 to 2014. BMJ Open 2017; 7:e015260. [PMID: 28760788 PMCID: PMC5642783 DOI: 10.1136/bmjopen-2016-015260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe hospital admission and emergency visit rates and potential risk factors of prolonged hospitalisation and death among children in Hanoi. STUDY DESIGN A retrospective study reviewed 212 216 hospitalisation records of children (aged 0-17) who attended the Vietnam National Children's Hospital in Hanoi between 2007 and 2014. Four indicators were analysed and reported: (1) rate of emergency hospital visits, (2) rate of hospitalisation, (3) length of hospital stay and (4) number of deaths. The risk of prolonged hospitalisation was investigated using Cox proportion hazard, and the risk of death was investigated through logistic regressions. RESULTS During 2007-2014, the average annual rate of emergency visits was 2.2 per 1000 children and the rate of hospital admissions was 13.8 per 1000 children. The annual rates for infants increased significantly by 3.9 per 1000 children during 2012-2014 for emergency visits and 25.1 per 1000 children during 2009-2014 for hospital admissions. Digestive diseases (32.0%) and injuries (30.2%) were common causes of emergency visits, whereas respiratory diseases (37.7%) and bacterial and parasitic infections (19.8%) accounted for most hospital admissions. Patients with mental and behavioural disorders remained in the hospital the longest (median=12 days). Morbidities related to the perinatal period dominated mortality causes (32.5% of deaths among those admitted to the hospital. Among the respiratory diseases, pneumonia was the leading cause of both prolonged hospitalisation and death. CONCLUSIONS Preventable health problems, such as common bacterial infections and respiratory diseases, were the primary causes of hospital admissions in Vietnam.
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Affiliation(s)
- Nhung T T Nguyen
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nguyen T B Lien
- Surgical Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Vu T H Lan
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Laura Perez
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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