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Kuźma Ł, Dąbrowski EJ, Kurasz A, Święczkowski M, Jemielita P, Kowalewski M, Wańha W, Kralisz P, Tomaszuk-Kazberuk A, Bachórzewska-Gajewska H, Dobrzycki S, Lip GY. Effect of air pollution exposure on risk of acute coronary syndromes in Poland: a nationwide population-based study (EP-PARTICLES study). THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100910. [PMID: 38665621 PMCID: PMC11041836 DOI: 10.1016/j.lanepe.2024.100910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Background Air pollution (AP) is linked up to 20% of cardiovascular deaths. The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence. Methods We analysed short- (lags up to seven days) and mid-term (0-30 days moving average) influence of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011-2020. Data on AP concentrations were derived using GEM-AQ model. Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals. Findings Higher NO2 and PM2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3-5.7%. Increased SO2 and PM2.5 concentration triggered STEMI in the short- (SO2, PM2.5) and mid-term (PM2.5) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO2, PM2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). Interpretation There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. AP exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income. Funding National Science Center and Medical University of Bialystok, Poland.
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Affiliation(s)
- Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Emil J. Dąbrowski
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Anna Kurasz
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Michał Święczkowski
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Piotr Jemielita
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, 137 Wołoska St., Warszawa 02-507, Poland
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Centre Maastricht (CARIM), P. Debyelaan 25, Maastricht 6229 HX, the Netherlands
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, 1 Via Tricomi, Palermo 90127, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 13/15 Jagiellońska St., Bydgoszcz 85-067, Poland
| | - Wojciech Wańha
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 13/15 Jagiellońska St., Bydgoszcz 85-067, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 15 Poniatowskiego St., Katowice 40-055, Poland
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Anna Tomaszuk-Kazberuk
- Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, 14 Żurawia St., Białystok 15-540, Poland
| | - Hanna Bachórzewska-Gajewska
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Gregory Y.H. Lip
- Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, 14 Żurawia St., Białystok 15-540, Poland
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Egerton Court, 2 Rodney St, Liverpool L3 5UX, United Kingdom
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 7K, Aalborg 9220, Denmark
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Kaur G, Masket D, Reddy T, Revankar S, Satish P, Paquin A, Mulvagh S, O'Donoghue ML, Zieroth S, Farkouh M, Gulati M. Socioeconomic Disparities in Women's Cardiovascular Health in the United States and Canada. Can J Cardiol 2024; 40:1056-1068. [PMID: 38593915 DOI: 10.1016/j.cjca.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/12/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
Cardiovascular disease has been the leading cause of death in the United States and Canada for decades. Although it affects millions of people across a multitude of backgrounds, notable disparities in cardiovascular health are observed among women and become more apparent when accounting for race and socioeconomic status. Although intrinsic sex-specific physiologic differences predispose women to poorer outcomes, social determinants of health (SDOH) and biases at both the individual provider and the larger health care system levels play an equal, if not greater, role. This review examines socioeconomic disparities in women compared with men regarding cardiovascular risk factors, treatments, and outcomes. Although various at-risk subpopulations exist, we highlight the impact of SDOH in specific populations, including patients with disabilities, transgender persons, and South Asian and Indigenous populations. These groups are underrepresented in studies and experience poorer health outcomes owing to structural barriers to care. These findings emphasise the significance of understanding the interplay of different socioeconomic factors and how their stacking can negatively affect women's cardiovascular health. To address these disparities, we propose a multipronged approach to augment culturally sensitive and patient-centred care. This includes increased cardiovascular workforce diversity, inclusion of underrepresented populations into analyses of cardiovascular metrics, and greater utilisation of technology and telemedicine to improve access to health care. Achieving this goal will necessitate active participation from patients, health care administrators, physicians, and policy makers, and is imperative in closing the cardiovascular health gap for women over the coming decades.
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Affiliation(s)
- Gurleen Kaur
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Diane Masket
- Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Tina Reddy
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Shruti Revankar
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Priyanka Satish
- Ascension Texas Cardiovascular, University of Texas at Austin Dell School of Medicine, Austin, Texas, USA
| | - Amelie Paquin
- Barbra Streisand Women's Heart Center, Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA
| | - Sharon Mulvagh
- Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michelle L O'Donoghue
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shelley Zieroth
- Division of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Farkouh
- Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA.
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Xiao Y, Hu J, Chen R, Xu Y, Pan B, Gao Y, Deng Y, Li W, Kan H, Chen S. Impact of fine particulate matter on liver injury: evidence from human, mice and cells. JOURNAL OF HAZARDOUS MATERIALS 2024; 469:133958. [PMID: 38479138 DOI: 10.1016/j.jhazmat.2024.133958] [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: 01/27/2024] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND A recently discovered risk factor for chronic liver disease is ambient fine particulate matter (PM2.5). Our research aims to elucidate the effects of PM2.5 on liver injury and the potential molecular mechanisms. METHODS AND RESULTS A population-based longitudinal study involving 102,918 participants from 15 Chinese cities, using linear mixed-effect models, found that abnormal alterations in liver function were significantly associated with long-term exposure to PM2.5. The serum levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, direct bilirubin, and triglyceride increased by 2.05%, 2.04%, 0.58%, 2.99%, and 1.46% with each 10 µg/m3 increase in PM2.5. In contrast, the serum levels of total protein, albumin, and prealbumin decreased by 0.27%, 0.48%, and 2.42%, respectively. Mice underwent chronic inhalation exposure to PM2.5 experienced hepatic inflammation, steatosis and fibrosis. In vitro experiments found that hepatocytes experienced an inflammatory response and lipid metabolic dysregulation due to PM2.5, which also activated hepatic stellate cells. The down-regulation and mis-localization of polarity protein Par3 mediated PM2.5-induced liver injury. CONCLUSIONS PM2.5 exposure induced liver injury, mainly characterized by steatosis and fibrosis. The down-regulation and mis-localization of Par3 were important mechanisms of liver injury induced by PM2.5.
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Affiliation(s)
- Yalan Xiao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; NHC Key Laboratory of Glycoconjugates Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yanyi Xu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Bin Pan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab 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 Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yiran Deng
- NHC Key Laboratory of Glycoconjugates Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Wenshu Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab 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 Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; National Center for Children's Health, Children's Hospital of Fudan University, Shanghai 201102, China.
| | - She Chen
- NHC Key Laboratory of Glycoconjugates Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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Al Okla SM, Al Rasbi FAZK, Al Marhubi HS, Al Mataani SS, Al Sawai YM, Mohammed HI, Al Mamari MAS, Al Balushi SAA, Abbady AQ. The Impact of Air Pollution on Asthma Severity among Residents Living near the Main Industrial Complex in Oman: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:553. [PMID: 38791768 PMCID: PMC11121288 DOI: 10.3390/ijerph21050553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple major industrial complexes in Oman, limited knowledge regarding their impact on respiratory health is accredited. Hence, the primary objective of this study is to offer valuable insights into the respiratory health consequences of industrial air pollution in Al Batinah North. METHODS The state health clinics' records for patient visits related to asthma were collected for the timeframe spanning 2014 to 2022. Exposure was defined as the distance from the SIP, Majan Industerial Area (MIA), and Sohar Industerial Zone (SIZ) to determine high-, intermediate-, and low-exposure zones (<6 km, 6-12 km and >12 km, respectively). Exposure effect modifications by age, gender, and smoking status were also examined. RESULTS The conducted cross-sectional study of 410 patients (46.1% males and 53.9% females) living in over 17 areas around SIP revealed that 73.2% of asthmatics were under 50 years old, with severity significantly associated with closeness to the port. Risk ratios were estimated to be (RR:2.42; CI95%: 1.01-5.78), (RR:1.91; CI95%: 1.01-3.6), and (RR:1.68; CI95%: 0.92-3.09) for SIP, MIP, and SIZ areas, respectively, compared to the control area. Falaj Al Qabail (6.4 km) and Majees (6 km) had the highest number of asthma patients (N 69 and N 72) and highest percentages of severe asthma cases among these patients (28% and 24%) with significant risk ratios (RR:2.97; CI95%: 1.19-7.45 and RR:2.55; CI95%: 1.00-6.48), correspondingly. Moreover, severe asthma prevalence peaked in the 25-50 age group (RR:2.05; CI95%: 1.26-3.33), and this linkage between asthma and age was much more pronounced in males than females. Smoking and exposure to certain contaminants (dust and smoke) also increased the risk of severe asthma symptoms, but their effects were less important in the high-risk zone, suggesting much more important risk factors. A neural network model accurately predicted asthma risk (94.8% accuracy), with proximity to SIP as the most influential predictor. CONCLUSIONS This study highlights the high asthma burden near SIP, linked to port proximity, smoking, and wind direction as major risk factors. These findings inform vital public health policies to reduce air pollution and improve respiratory health in the region, prompting national policy review.
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Affiliation(s)
- Souad Mahmoud Al Okla
- College of Medicine and Health Sciences, National University of Science and Technology, P.O. Box 391, Sohar 321, Oman; (F.A.Z.K.A.R.); (H.S.A.M.); (S.S.A.M.); (Y.M.A.S.)
- Department of Biology, Faculty of Sciences, Damascus University, Damascus P.O. Box 30621, Syria
| | - Fatima Al Zahra Khamis Al Rasbi
- College of Medicine and Health Sciences, National University of Science and Technology, P.O. Box 391, Sohar 321, Oman; (F.A.Z.K.A.R.); (H.S.A.M.); (S.S.A.M.); (Y.M.A.S.)
| | - Hawida Said Al Marhubi
- College of Medicine and Health Sciences, National University of Science and Technology, P.O. Box 391, Sohar 321, Oman; (F.A.Z.K.A.R.); (H.S.A.M.); (S.S.A.M.); (Y.M.A.S.)
| | - Shima Salim Al Mataani
- College of Medicine and Health Sciences, National University of Science and Technology, P.O. Box 391, Sohar 321, Oman; (F.A.Z.K.A.R.); (H.S.A.M.); (S.S.A.M.); (Y.M.A.S.)
| | - Yusra Mohammed Al Sawai
- College of Medicine and Health Sciences, National University of Science and Technology, P.O. Box 391, Sohar 321, Oman; (F.A.Z.K.A.R.); (H.S.A.M.); (S.S.A.M.); (Y.M.A.S.)
| | - Hasa Ibrahim Mohammed
- Liwa Extended Health Center, Ministry of Health, Liwa 325, Oman; (H.I.M.); (M.A.S.A.M.)
| | | | | | - Abdul Qader Abbady
- Division of Molecular Biomedicine, Department of Molecular Biology and Biotechnology, Atomic Energy Commission of Syria (AECS), Damascus P.O. Box 6091, Syria;
- Department of Biology and Medical Science, Faculty of Pharmacy, International University for Science and Technology (IUST), Damascus, Syria
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Lin K, Wallis C, Wong EM, Edwards P, Cole A, Van Winkle L, Wexler AS. Heterogeneous deposition of regular and mentholated little cigar smoke in the lungs of Sprague-Dawley rats. Part Fibre Toxicol 2023; 20:42. [PMID: 37932763 PMCID: PMC10626780 DOI: 10.1186/s12989-023-00554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Quantifying the dose and distribution of tobacco smoke in the respiratory system is critical for understanding its toxicity, addiction potential, and health impacts. Epidemiologic studies indicate that the incidence of lung tumors varies across different lung regions, suggesting there may be a heterogeneous deposition of smoke particles leading to greater health risks in specific regions. Despite this, few studies have examined the lobar spatial distribution of inhaled particles from tobacco smoke. This gap in knowledge, coupled with the growing popularity of little cigars among youth, underscores the need for additional research with little cigars. RESULTS In our study, we analyzed the lobar deposition in rat lungs of smoke particles from combusted regular and mentholated Swisher Sweets little cigars. Twelve-week-old male and female Sprague-Dawley rats were exposed to smoke particles at a concentration of 84 ± 5 mg/m3 for 2 h, after which individual lung lobes were examined. We utilized Inductively Coupled Plasma Mass Spectrometry to quantify lobar chromium concentrations, serving as a smoke particle tracer. Our findings demonstrated an overall higher particle deposition from regular little cigars than from the mentholated ones. Higher particle deposition fraction was observed in the left and caudal lobes than other lobes. We also observed sex-based differences in the normalized deposition fractions among lobes. Animal study results were compared with the multi-path particle dosimetry (MPPD) model predictions, which showed that the model overestimated particle deposition in certain lung regions. CONCLUSIONS Our findings revealed that the particle deposition varied between different little cigar products. The results demonstrated a heterogenous deposition pattern, with higher particle deposition observed in the left and caudal lobes, especially with the mentholated little cigars. Additionally, we identified disparities between our measurements and the MPPD model. This discrepancy highlights the need to enhance the accuracy of models before extrapolating animal study results to human lung deposition. Overall, our study provides valuable insights for estimating the dose of little cigars during smoking for toxicity research.
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Affiliation(s)
- Kaisen Lin
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, 48824, USA.
- Air Quality Research Center, University of California, Davis, Davis, CA, 95616, USA.
| | - Christopher Wallis
- Air Quality Research Center, University of California, Davis, Davis, CA, 95616, USA
| | - Emily M Wong
- Air Quality Research Center, University of California, Davis, Davis, CA, 95616, USA
| | - Patricia Edwards
- Center for Health and the Environment, University of California, Davis, Davis, CA, 95616, USA
| | - Austin Cole
- UC Davis Interdisciplinary Center for Plasma Mass Spectrometry, University of California, Davis, Davis, CA, 95616, USA
| | - Laura Van Winkle
- Department of Anatomy, Physiology and Cell Biology, University of California, Davis, Davis, CA, 95616, USA
- Center for Health and the Environment, University of California, Davis, Davis, CA, 95616, USA
| | - Anthony S Wexler
- Air Quality Research Center, University of California, Davis, Davis, CA, 95616, USA
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, 95616, USA
- Department of Civil and Environmental Engineering, University of California, Davis, Davis, CA, 95616, USA
- Department of Land, Air, and Water Resources, University of California, Davis, Davis, CA, 95616, USA
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Pei Z, Wu M, Zhu W, Pang Y, Niu Y, Zhang R, Zhang H. Associations of long-term exposure to air pollution with prevalence of pulmonary nodules: A cross-sectional study in Shijiazhuang, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115311. [PMID: 37531926 DOI: 10.1016/j.ecoenv.2023.115311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023]
Abstract
A complete understanding of the associations of ambient air pollution with prevalence of pulmonary nodule is lacking. We aimed to investigate the associations of ambient air pollutants with prevalence of pulmonary nodule. A total of 9991 health examination participants was enrolled and 3166 was elected in the final in Shijiazhuang between April 1st, 2018, and December 31st, 2018. 107 participants were diagnosed in pulmonary nodule while 3059 participants were diagnosed in non-pulmonary (named control). The individual exposure of participants was evaluation by Empirical Bayesian Kriging model according to their residential or work addresses. The pulmonary nodules were found and diagnosed by health examination through chest x-ray detection. Our results suggested that there were positive associations between prevalence of pulmonary nodules and PM2.5 (OR = 1.06, 95% CI: 1.02, 1.11) as well as O3 (OR = 1.49, 95% CI: 1.35, 1.66) levels. The platelet count (PLT) acted as the mediator of pulmonary nodules related with the PM2.5 exposure, while the neutrophil-to-lymphocyte ratio (NLR) as well as platelet-to-lymphocyte ratio (PLR) were the mediators of pulmonary nodules related with the O3 exposure. This study suggests that long-term exposure to PM2.5 and O3 may significantly associated with prevalence of pulmonary nodules, and the above associations are mediated by PLT, NLR and PLR.
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Affiliation(s)
- Zijie Pei
- Department of Thoracic Surgery, the 2nd Hospital of Hebei Medical University, Shijiazhuang 050017, PR China
| | - Mengqi Wu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Wenyuan Zhu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Yujie Niu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, PR China.
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, PR China.
| | - Helin Zhang
- Department of Thoracic Surgery, the 2nd Hospital of Hebei Medical University, Shijiazhuang 050017, PR China.
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Xu R, Huang S, Shi C, Wang R, Liu T, Li Y, Zheng Y, Lv Z, Wei J, Sun H, Liu Y. Extreme Temperature Events, Fine Particulate Matter, and Myocardial Infarction Mortality. Circulation 2023; 148:312-323. [PMID: 37486993 DOI: 10.1161/circulationaha.122.063504] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/08/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Extreme temperature events (ETEs), including heat wave and cold spell, have been linked to myocardial infarction (MI) morbidity; however, their effects on MI mortality are less clear. Although ambient fine particulate matter (PM2.5) is suggested to act synergistically with extreme temperatures on cardiovascular mortality, it remains unknown if and how ETEs and PM2.5 interact to trigger MI deaths. METHODS A time-stratified case-crossover study of 202 678 MI deaths in Jiangsu province, China, from 2015 to 2020, was conducted to investigate the association of exposure to ETEs and PM2.5 with MI mortality and evaluate their interactive effects. On the basis of ambient apparent temperature, multiple temperature thresholds and durations were used to build 12 ETE definitions. Daily ETEs and PM2.5 exposures were assessed by extracting values from validated grid datasets at each subject's geocoded residential address. Conditional logistic regression models were applied to perform exposure-response analyses and estimate relative excess odds due to interaction, proportion attributable to interaction, and synergy index. RESULTS Under different ETE definitions, the odds ratio of MI mortality associated with heat wave and cold spell ranged from 1.18 (95% CI, 1.14-1.21) to 1.74 (1.66-1.83), and 1.04 (1.02-1.06) to 1.12 (1.07-1.18), respectively. Lag 01-day exposure to PM2.5 was significantly associated with an increased odds of MI mortality, which attenuated at higher exposures. We observed a significant synergistic interaction of heat wave and PM2.5 on MI mortality (relative excess odds due to interaction >0, proportion attributable to interaction >0, and synergy index >1), which was higher, in general, for heat wave with greater intensities and longer durations. We estimated that up to 2.8% of the MI deaths were attributable to exposure to ETEs and PM2.5 at levels exceeding the interim target 3 value (37.5 μg/m3) of World Health Organization air quality guidelines. Women and older adults were more vulnerable to ETEs and PM2.5. The interactive effects of ETEs or PM2.5 on MI mortality did not vary across sex, age, or socioeconomic status. CONCLUSIONS This study provides consistent evidence that exposure to both ETEs and PM2.5 is significantly associated with an increased odds of MI mortality, especially for women and older adults, and that heat wave interacts synergistically with PM2.5 to trigger MI deaths but cold spell does not. Our findings suggest that mitigating both ETE and PM2.5 exposures may bring health cobenefits in preventing premature deaths from MI.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (S.H.)
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China (C.S.)
| | - Rui Wang
- Luohu District Chronic Disease Hospital, Shenzhen, Guangdong, China (R.W.)
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Ziquan Lv
- Central Laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (Z.L.)
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park (J.W.)
| | - Hong Sun
- Institute of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China (H.S.)
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
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Burrowes KS, Ruppage M, Lowry A, Zhao D. Sex matters: the frequently overlooked importance of considering sex in computational models. Front Physiol 2023; 14:1186646. [PMID: 37520817 PMCID: PMC10374267 DOI: 10.3389/fphys.2023.1186646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Personalised medicine and the development of a virtual human or a digital twin comprises visions of the future of medicine. To realise these innovations, an understanding of the biology and physiology of all people are required if we wish to apply these technologies at a population level. Sex differences in health and biology is one aspect that has frequently been overlooked, with young white males being seen as the "average" human being. This has not been helped by the lack of inclusion of female cells and animals in biomedical research and preclinical studies or the historic exclusion, and still low in proportion, of women in clinical trials. However, there are many known differences in health between the sexes across all scales of biology which can manifest in differences in susceptibility to diseases, symptoms in a given disease, and outcomes to a given treatment. Neglecting these important differences in the development of any health technologies could lead to adverse outcomes for both males and females. Here we highlight just some of the sex differences in the cardio-respiratory systems with the goal of raising awareness that these differences exist. We discuss modelling studies that have considered sex differences and touch on how and when to create sex-specific models. Scientific studies should ensure sex differences are included right from the study planning phase and results reported using sex as a biological variable. Computational models must have sex-specific versions to ensure a movement towards personalised medicine is realised.
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Affiliation(s)
- K. S. Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - M. Ruppage
- Department of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A. Lowry
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - D. Zhao
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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Lu YK, Liu XL, Liu YH, Chen N, Gao HY, Jin YH, Yan YX. The effects of short-term exposure to air pollution on mortality in Baotou, China, during 2015-2019. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:3387-3404. [PMID: 36322227 DOI: 10.1007/s10653-022-01419-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/27/2022] [Indexed: 06/01/2023]
Abstract
Air pollution was considered one of the main causes linked to increased morbidity and mortality around the world. This study aimed to estimate the effect of air pollutants on daily death in Baotou city of Inner Mongolia. Daily deaths data were provided by Baotou Centers for Disease Control and Prevention for the years 2015-2019 (Baotou CDC). The air pollutants, PM2.5, PM10, NO2, SO2, CO and maximum 8-h average concentrations of O3, came from the eight environmental monitoring stations in Baotou city. Time-series plots were used to exploit the trend of air pollutants at calendar time. Generalized additive model was used to estimate the effect of air pollutants on daily death. Restricted cubic spline was employed to investigate non-line relationships between air pollutants and daily death. After adjusting the meteorological factors, non-accidental daily deaths were related to PM2.5 (ER = 0.074%) and PM10 (ER = 0.023%), respectively. In stratified analysis, population aged over 65 years and females were more sensitive to air pollutants exposure and warm season might make people more susceptible to air pollutants compared with cold season. PM2.5 and PM10 increase the risk of non-accidental and cardiovascular daily death, but not respiratory daily death.
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Affiliation(s)
- Ya-Ke Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Xiao-Ling Liu
- Baotou Center for Disease Control and Prevention, Baotou, 014000, Inner Mongolia, China
| | - Yu-Hong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Hao-Yu Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Yan-Hui Jin
- Baotou Center for Disease Control and Prevention, Baotou, 014000, Inner Mongolia, China.
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, 100069, China.
- Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
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Ma X, Zhang B, Duan H, Wu H, Dong J, Guo X, Lu Z, Ma J, Xi B. Estimating future PM 2.5-attributed acute myocardial infarction incident cases under climate mitigation and population change scenarios in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 256:114893. [PMID: 37059016 DOI: 10.1016/j.ecoenv.2023.114893] [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: 01/17/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The effects of fine particulate matter (PM2.5) on acute myocardial infarction (AMI) have been widely recognized. However, no studies have comprehensively evaluated future PM2.5-attributed AMI burdens under different climate mitigation and population change scenarios. We aimed to quantify the PM2.5-AMI association and estimate the future change in PM2.5-attributed AMI incident cases under six integrated scenarios in 2030 and 2060 in Shandong Province, China. METHODS Daily AMI incident cases and air pollutant data were collected from 136 districts/counties in Shandong Province from 2017 - 2019. A two-stage analysis with a distributed lag nonlinear model was conducted to quantify the baseline PM2.5-AMI association. The future change in PM2.5-attributed AMI incident cases was estimated by combining the fitted PM2.5-AMI association with the projected daily PM2.5 concentrations under six integrated scenarios. We further analyzed the factors driving changes in PM2.5-related AMI incidence using a decomposition method. RESULTS Each 10 μg/m3 increase in PM2.5 exposure at lag05 was related to an excess risk of 1.3 % (95 % confidence intervals: 0.9 %, 1.7 %) for AMI incidence from 2017 - 2019 in Shandong Province. The estimated total PM2.5-attributed AMI incident cases would increase by 10.9-125.9 % and 6.4-244.6 % under Scenarios 1 - 3 in 2030 and 2060, whereas they would decrease by 0.9-5.2 % and 33.0-46.2 % under Scenarios 5 - 6 in 2030 and 2060, respectively. Furthermore, the percentage increases in PM2.5-attributed female cases (2030: -0.3 % to 135.1 %; 2060: -33.2 % to 321.5 %) and aging cases (2030: 15.2-171.8 %; 2060: -21.5 % to 394.2 %) would wholly exceed those in male cases (2030: -1.8 % to 133.2 %; 2060: -41.1 % to 264.3 %) and non-aging cases (2030: -41.0 % to 45.7 %; 2060: -89.5 % to -17.0 %) under six scenarios in 2030 and 2060. Population aging is the main driver of increased PM2.5-related AMI incidence under Scenarios 1 - 3 in 2030 and 2060, while improved air quality can offset these negative effects of population aging under the implementation of the carbon neutrality and 1.5 °C targets. CONCLUSION The combination of ambitious climate policies (i.e., 1.5 °C warming limits and carbon neutrality targets) with stringent clean air policies is necessary to reduce the health impacts of air pollution in Shandong Province, China, regardless of population aging.
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Affiliation(s)
- Xiaoyun Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Haiping Duan
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Han Wu
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jing Dong
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Jixiang Ma
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China.
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Święczkowski M, Dobrzycki S, Kuźma Ł. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085566. [PMID: 37107848 PMCID: PMC10139136 DOI: 10.3390/ijerph20085566] [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: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/11/2023]
Abstract
Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016-2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011-1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1-1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001-1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01-1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011-1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003-1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006-1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008-1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01-1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011-1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007-1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001-1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.
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Szabová J, Mišík O, Fučík J, Mrázová K, Mravcová L, Elcner J, Lízal F, Krzyžánek V, Mravec F. Liposomal form of erlotinib for local inhalation administration and efficiency of its transport to the lungs. Int J Pharm 2023; 634:122695. [PMID: 36758881 DOI: 10.1016/j.ijpharm.2023.122695] [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: 11/21/2022] [Revised: 01/17/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
This contribution is focused on the preparation of a liposomal drug delivery system of erlotinib resisting the nebulization process that could be used for local treatment of non-small-cell lung cancer. Liposomes with different compositions were formulated to reveal their influence on the encapsulation efficiency of erlotinib. An encapsulation efficiency higher than 98 % was achieved for all vesicles containing phosphatidic acid (d ≈ 100 nm, ζ = - 43 mV) even in the presence of polyethylene glycol (d ≈ 150 nm, ζ = - 17 mV) which decreased this value in all other formulas. The three most promising formulations were nebulized by two air-jet and two vibrating mesh nebulizers, and the aerosol deposition in lungs was calculated by tools of computational fluid and particle mechanics. According to the numerical simulations and measurements of liposomal stability, air-jet nebulizers generated larger portion of the aerosol able to penetrate deeper into the lungs, but the delivery is likely to be more efficient when the formulation is administered by Aerogen Solo vibrating mesh nebulizer because of a higher portion of intact vesicles after the nebulization. The leakage of encapsulated drug from liposomes nebulized by this nebulizer was lower than 2 % for all chosen vesicles.
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Affiliation(s)
- Jana Szabová
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic.
| | - Ondrej Mišík
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - Jan Fučík
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic
| | - Kateřina Mrázová
- Institute of Scientific Instruments of the Czech Academy of Sciences, v.v.i, Brno, Czech Republic
| | - Ludmila Mravcová
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic
| | - Jakub Elcner
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - František Lízal
- Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
| | - Vladislav Krzyžánek
- Institute of Scientific Instruments of the Czech Academy of Sciences, v.v.i, Brno, Czech Republic
| | - Filip Mravec
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic
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Gaines B, Kloog I, Zucker I, Ifergane G, Novack V, Libruder C, Hershkovitz Y, Sheffield PE, Yitshak-Sade M. Particulate Air Pollution Exposure and Stroke among Adults in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1482. [PMID: 36674236 PMCID: PMC9860673 DOI: 10.3390/ijerph20021482] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 05/13/2023]
Abstract
Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM2.5) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel-an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014-2018. We obtained daily PM2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m3). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure-response curves were nonlinear. PM2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure-response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.
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Affiliation(s)
- Britney Gaines
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben Gurion University, Beer Sheva 8410501, Israel
| | | | - Gal Ifergane
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Neurology Department, Soroka University Medical Center, Beer Sheva 8410101, Israel
| | - Victor Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Clinical Research Center, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | | | | | - Perry E. Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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14
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Cheng B, Zhou J, Ma Y, Zhang Y, Wang H, Chen Y, Shen J, Feng F. Association between atmospheric particulate matter and emergency room visits for cerebrovascular disease in Beijing, China. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2022; 20:293-303. [PMID: 35669822 PMCID: PMC9163215 DOI: 10.1007/s40201-021-00776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 12/25/2021] [Indexed: 06/15/2023]
Abstract
PURPOSE The association between atmospheric particulate matter and emergency room visits for cerebrovascular disease were evaluated in Beijing. METHODS A generalized additive model was used to evaluate the associations between particulate matter and cerebrovascular disease, based on the daily data of meteorological elements, PM concentrations, and emergency room (ER) visits for cerebrovascular disease in Beijing from 2009 to 2012. Long-term trends and the effects of holidays, the day of the week, and confounding factors were controlled to determine the lag effect at 0-6 days. Single- and double-pollutant models were employed for different age and sex groups. RESULTS The effect of PM2.5 concentration on the number of daily ER visits for cerebrovascular disease was much stronger than that of PM10 concentration. PM2.5 and PM10 had maximum RR values of 1.096 and 1.054 at lag 6 for patients aged 61-75 years. For each inter-quartile range (IQR) increase in PM10 concentration, the maximum RR values for the total, males, females, aged 15-60 years, aged 61-75 years, and aged > 75 years were 1.024, 1.044, 1.043, 1.038, 1.054, and 1.032, respectively. For each IQR increase in PM2.5 concentration, the maximum RR values for the total, males, females, aged 15-60 years, aged 61-75 years, and aged > 75 years were 1.038, 1.064, 1.076, 1.054, 1.096, and 1.049, respectively. The RR values of the double-pollutant models were lower than those of the single-pollutant models. CONCLUSION This study showed that the effects of PM pollution on cerebrovascular disease were different among different gender and age groups, and aged 61-75 years were mostly sensitive to particulate matters. The effects of PM2.5 on cerebrovascular disease were stronger than those of PM10. Our results can provide scientific evidence for the local government to take effective measures to improve air quality and the health of residents. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40201-021-00776-w.
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Affiliation(s)
- Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Jianding Zhou
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
- Quanzhou Meteorological Bureau, Quanzhou, 362000 China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Hang Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Yan Chen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000 China
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15
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Zhang J, Wang X, Yan M, Shan A, Wang C, Yang X, Tang N. Sex Differences in Cardiovascular Risk Associated With Long-Term PM 2.5 Exposure: A Systematic Review and Meta-Analysis of Cohort Studies. Front Public Health 2022; 10:802167. [PMID: 35186842 PMCID: PMC8847390 DOI: 10.3389/fpubh.2022.802167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/11/2022] [Indexed: 12/30/2022] Open
Abstract
Background Established evidence suggests risks of developing cardiovascular disease are different by sex. However, it remains unclear whether associations of PM2.5 with cardiovascular risk are comparable between women and men. The meta-analysis aimed to examine sex differences in associations of ischemic heart disease (IHD) and stroke with long-term PM2.5 exposure. Methods PubMed, EMBASE and Cochrane Library were searched until May 2, 2021. We included cohort studies reporting sex-specific associations of long-term PM2.5 exposure (e.g., ≥1 year) with IHD and stroke. The primary analysis was to estimate relative risk (RR) of PM2.5-outcome in women and men separately, and the additional women-to-men ratio of RR (RRR) was explored to compare sex differences, using random-effect models. Results We identified 25 eligible studies with 3.6 million IHD and 1.3 million stroke cases among 63.7 million participants. A higher level of PM2.5 exposure was significantly associated with increased risk of IHD in both women (RR = 1.21; 95% CI, 1.15–1.27) and men (RR = 1.12; 95% CI, 1.07–1.17). The women-to-men RRR of IHD was 1.05 (95% CI, 1.02–1.08) per 10 μg/m3 increment in PM2.5 exposure, indicating significant excess risk of IHD in women. The significant risks of stroke associated with PM2.5 were obtained in both women (RR = 1.11; 95% CI, 1.08–1.13) and men (RR = 1.11; 95% CI, 1.07–1.14), but no significant women-to-men RRR was observed in stroke (RRR = 1.00; 95% CI, 0.96–1.04). Conclusions The study identified excess risk of IHD associated with long-term PM2.5 exposure in women. The findings would not only have repercussions on efforts to precisely evaluate the burden of IHD attributable to PM2.5, but would also provide novel clues for cardiovascular risk prevention accounting for sex-based differences.
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Affiliation(s)
- Jia Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China.,Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinyan Wang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Mengfan Yan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Chao Wang
- Department of Epidemiology and Biostatistics, Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China.,Department of Molecular Orthopaedics, Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
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Muhsin HA, Steingrimsson S, Oudin A, Åström DO, Carlsen HK. Air pollution and increased number of psychiatric emergency room visits: A case-crossover study for identifying susceptible groups. ENVIRONMENTAL RESEARCH 2022; 204:112001. [PMID: 34499892 DOI: 10.1016/j.envres.2021.112001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM10) and particulate matter 2.5 (PM2.5) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and total daily visits to the psychiatric emergency unit (PEV). Further, the aim is to identify specific risk groups who are more susceptible to the effects of air pollution exposure by studying sex, age, ongoing psychiatric follow-up and diagnoses of depression/anxiety or substance use. MATERIAL AND METHODS The sample was comprised of data from 2740 days to 81 548 PEVs at Sahlgrenska University Hospital in Gothenburg and daily mean concentrations of PM10 and PM2.5. A time-stratified case-crossover design was used to analyse associations between air pollution and PEVs. RESULTS Mean number of daily PEVs were 35 and sex distribution was even. PM exposure was associated with total PEV at lag 0 (the same day), by RR 1.016 (95% confidence interval [CI] 1.004-1.028) and RR 1.020 (95%CI 1.003-1.038) per 10 μg/m3 increase in PM10 and PM2.5, respectively. In females, PEV were increased at lag 0 and lag 1, and in males at lag 1 and lag 2. In the age-stratified analysis, PEVs significantly increased following PM exposure amongst individuals aged 35-65 years by lag 0-2 and in individuals who had contact with outpatient care at lag 0 to lag 1. There were no associations between air pollution and PEVs for any specific diagnostic group evaluated (amongst depression, anxiety and substance use disorder). CONCLUSIONS The results indicate that acute exposure to PM10 and PM2.5 may trigger acute worsening in mental health in both males and females, especially among 35-65 year old individuals. However, in subgroups of the most common psychiatric diagnoses, we did not observe statistically significant associations with PM exposure.
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Affiliation(s)
- Huda Ahmed Muhsin
- University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden.
| | - Steinn Steingrimsson
- University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden; Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Anna Oudin
- Occupational and Environmental Medicine, Dept. for Laboratory Medicine, Lund University, Lund, Sweden; Sustainable Health, Dept. for Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| | - Daniel Oudin Åström
- Occupational and Environmental Medicine, Dept. for Laboratory Medicine, Lund University, Lund, Sweden; Sustainable Health, Dept. for Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| | - Hanne Krage Carlsen
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Shin HH, Maquiling A, Thomson EM, Park IW, Stieb DM, Dehghani P. Sex-difference in air pollution-related acute circulatory and respiratory mortality and hospitalization. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150515. [PMID: 34627116 DOI: 10.1016/j.scitotenv.2021.150515] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Numerous studies have estimated adverse effects of short-term exposure to ambient air pollution on public health. Few have focused on sex-differences, and results have been inconsistent. The purpose of this study was three-fold: to identify sex-differences in air pollution-related health outcomes; to examine sex-differences by cause and season; and to examine time trends in sex-differences. METHODS Daily data were collected on circulatory- and respiratory-related mortality (for 29 years) and cause-specific hospitalization (for 17 years) with hourly concentrations of ozone (O3), nitrogen dioxide (NO2), and fine particulate matter (PM2.5). For hospitalization, more specific causes were examined: ischemic heart disease (IHD), other heart disease (OHD), cerebrovascular disease (CEV), chronic lower respiratory diseases (CLRD), and Influenza/Pneumonia (InfPn). Generalized Poisson models were applied to 24 Canadian cities, and the city-specific estimates were combined for nationwide estimates for each sex using Bayesian hierarchical models. Finally, sex-differences were tested statistically based on their interval estimates, considering the correlation between sex-specific national estimates. RESULTS Sex-differences were more frequently observed for hospitalization than mortality, respiratory than circulatory health outcomes, and warm than cold season. For hospitalization, males were at higher risk (M > F) for warm season (OHD and InfPn from O3; IHD from NO2; and InfPn from PM2.5), but F > M for cold season (CEV from O3 and OHD from NO2). For mortality, we found F > M only for circulatory diseases from ozone during the warm season. Among the above-mentioned sex-differences, three cases showed consistent time trends over the years: while M > F for OHD from O3 and IHD from NO2, F > M for OHD from NO2. CONCLUSIONS We found that sex-differences in effect of ambient air pollution varied over health outcome, cause, season and time. In particular, the consistent trends (either F > M or M > F) across 17 years provide stronger evidence of sex-differences in hospitalizations, and warrant investigation in other populations.
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Affiliation(s)
- Hwashin H Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
| | - Aubrey Maquiling
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada.
| | - In-Woo Park
- Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Dave M Stieb
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
| | - Parvin Dehghani
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
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Yan M, Xu J, Li C, Guo P, Yang X, Tang NJ. Associations between ambient air pollutants and blood pressure among children and adolescents: A systemic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 785:147279. [PMID: 33940406 DOI: 10.1016/j.scitotenv.2021.147279] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Numerous epidemiological studies have investigated the effects of short-term and long-term exposure to ambient air pollution on hypertension and blood pressure among children and adolescents. However, the results were controversial. To provide researchers reliable evidence, this meta-analysis was performed. METHODS We searched all published studies in four databases examining the effects of particulate matter (PM10, PM2.5 and PM1.0), nitrogen oxide (NO2), sulfur dioxide (SO2), ozone (O3) and carbon monoxide (CO) on hypertension and blood pressure in children and adolescents. Overall risk estimates associated with per 10 μg/m3 increase of air pollution were analyzed by a random-effect model for articles with significant heterogeneity, otherwise, a fixed-effect model was applied. Subgroup analysis was conducted for studies with significant heterogeneity. RESULTS Of 3918 identified literatures, 154 were evaluated in-depth with 15 satisfying inclusion criteria. Increased risk of hypertension was associated with long-term PM10 exposure (OR = 1.17, 95% confidence interval [CI]:1.13, 1.21). For systolic blood pressure (SBP), significant results were found for short-term PM10 (β = 0.26, 95% CI: -0.00, 0.53) exposure, long-term PM2.5 (β = 1.80, 95% CI: 0.94, 2.65) and PM10 (β = 0.50, 95% CI: 0.19, 0.81) exposure. The corresponding estimates of diastolic blood pressure (DBP) were 0.32 mmHg (95% CI: 0.19, 0.45) for short-term PM10 exposure, 1.06 mmHg (95% CI: 0.32, 1.80), 0.34 mmHg (95% CI: 0.11, 0.57) and 0.44 mmHg (95% CI: 0.25, 0.63) for long-term PM2.5, PM10 and NO2 exposure, respectively. Stratified analyses showed stronger effects of PM10 on blood pressure among studies with ≥50% boys' percentage (0.57 mmHg [95% CI: 0.44, 0.70] for SBP, 0.44 mmHg, [95% CI: 0.34, 0.54] for DBP, respectively) and articles using models to estimate exposure (0.90 mmHg [95% CI: 0.20 1.59] for SBP). CONCLUSION Ambient air pollution was associated with higher hypertension prevalence and elevated blood pressure in children and adolescents.
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Affiliation(s)
- Mengfan Yan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Jiahui Xu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Chaokang Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Pengyi Guo
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
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Flow Structure and Particle Deposition Analyses for Optimization of a Pressurized Metered Dose Inhaler (pMDI) in a Model of Tracheobronchial Airway. Eur J Pharm Sci 2021; 164:105911. [PMID: 34129919 DOI: 10.1016/j.ejps.2021.105911] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 01/13/2023]
Abstract
Inhalation therapy plays an important role in management or treatment of respiratory diseases such asthma and chronic obstructive pulmonary diseases (COPDs). For decades, pressurized metered dose inhalers (pMDIs) have been the most popular and prescribed drug delivery devices for inhalation therapy. The main objectives of the present computational work are to study flow structure inside a pMDI, as well as transport and deposition of micron-sized particles in a model of human tracheobronchial airways and their dependence on inhalation air flow rate and characteristic pMDI parameters. The upper airway geometry, which includes the extrathoracic region, trachea, and bronchial airways up to the fourth generation in some branches, was constructed based on computed tomography (CT) images of an adult healthy female. Computational fluid dynamics (CFD) simulation was employed using the k-ω model with low-Reynolds number (LRN) corrections to accomplish the objectives. The deposition results of the present study were verified with the in vitro deposition data of our previous investigation on pulmonary drug delivery using a hollow replica of the same airway geometry as used for CFD modeling. It was found that the flow structure inside the pMDI and extrathoracic region strongly depends on inhalation flow rate and geometry of the inhaler. In addition, regional aerosol deposition patterns were investigated at four inhalation flow rates between 30 and 120 L/min and for 60 L/min yielding highest deposition fractions of 24.4% and 3.1% for the extrathoracic region (EX) and the trachea, respectively. It was also revealed that particle deposition was larger in the right branches of the bronchial airways (right lung) than the left branches (left lung) for all of the considered cases. Also, optimization of spray characteristics showed that the optimum values for initial spray velocity, spray cone angle and spray duration were 100 m/s, 10° and 0.1 sec, respectively. Moreover, spray cone angle, more than any other of the investigated pMDI parameters can change the deposition pattern of inhaled particles in the airway model. In conclusion, the present investigation provides a validated CFD model for particle deposition and new insights into the relevance of flow structure for deposition of pMDI-emitted pharmaceutical aerosols in the upper respiratory tract.
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Abstract
Ventilation and mechanics of breathing are an integral part of respiratory physiology that directly affect aerosol transport and deposition in the lung. Although natural breathing pattern varies widely among individuals, breathing pattern is controllable, and by using an appropriate breathing pattern, aerosol deposition can be substantially modified for desired purposes. Effects of breathing pattern have been investigated under carefully controlled inhalation conditions covering a wide range of tidal volumes (VT) and breathing frequencies (f) or respiratory times (T = 1/f). The studies have shown that lung deposition can increase or decrease as much as two times by changing the breathing pattern. Specific functional relationships have been found between lung deposition and breathing pattern parameters such that lung deposition can be estimated for any given breathing pattern. Both VT and T have shown strong effects on lung deposition, but their influence is variable depending on particle size, particularly, ultrafine vs. micron-sized particles. VT is more influential than T for micron-sized particles whereas VT and T are equally influential for ultrafine particles. Although effects of lung morphology are difficult to study systematically, comparison between normals and patients with obstructive airway disease has shown that lung deposition is closely related with the degree of airways obstruction and can be 2-3 times greater in patients with obstructive airway disease compared to normals. Thus, breathing pattern and the status of airways obstruction should be carefully considered in designing aerosol delivery and estimating deposition dose.
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Affiliation(s)
- Chong S Kim
- Senior Research Scientist, Public Health and Integrated Tocxicology Division, Center for Public Health and Environmental Effects, U.S. Environmental Protection Agency, Reserach Triangle Park, North Carolina, USA
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21
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Debela SA, Sheriff I, Debela EA, Sesay MT, Tolcha A, Tengbe MS. Assessment of Perceptions and Cancer Risks of Workers at a Polychlorinated Biphenyl-Contaminated Hotspot in Ethiopia. J Health Pollut 2021; 11:210609. [PMID: 34267996 PMCID: PMC8276727 DOI: 10.5696/2156-9614-11.30.210609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) are synthetic and persistent toxic chemicals with a high potential to bioaccumulate in human tissue. There is no existing literature on workers' perceptions and occupational cancer risk due to exposure to PCBs in Ethiopia. OBJECTIVES The aim of the present study was to assess workers' perceptions of occupational health and safety measures of PCB management and to evaluate the cancer risk posed by PCBs to workers handling these chemicals in Ethiopia. METHODS A total of 264 questionnaires were administered to workers at the study area to obtain information about PCB management. A mathematical model adopted from the United States Environmental Protection Agency (USEPA) was used to assess the potential cancer risk of people working in PCB-contaminated areas. RESULTS The results showed that the majority of the workers had little knowledge of safe PCB management practices. Furthermore, 82.6% had not received training on chemical management and occupational health and safety protocols. The association between respondents' responses on the impact of PCBs to the use of personal protective equipment was statistically significant (p <0.005). Accidental ingestion, dermal contact and inhalation exposure pathways were considered in assessing the cancer risk of people working in these areas. The estimated cancer risk for PCBs via dermal contact was higher than for the accidental ingestion and inhalation pathways. The health risk associated with dermal contact was 73.8-times higher than the inhalation exposure route. Workers at the oil tanker and oil barrel area and swampy site are at higher risk of cancer via dermal contact at the 95th centile (879 and 2316 workers per million due to PCB exposure, respectively). However, there is very low cancer risk at the staff residence and garden area via the inhalation route. CONCLUSIONS Training programs would help improve the knowledge of workers in the area of occupational health and safety of chemical handling. Further studies on PCBs in the exposed workers will provide information on their blood sera PCB levels and consequently identify potential health impacts. PARTICIPANT CONSENT Obtained. ETHICS APPROVAL Ethics approval was obtained from the Research Ethics Review Committee of Adama Hospital Medical College, Adama, Ethiopia. COMPETING INTERESTS The authors declare no competing financial interests.
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Affiliation(s)
- Sisay Abebe Debela
- Department of Public Health, College of Health Science, Selale University, Fiche, Ethiopia
| | - Ishmail Sheriff
- Department of Public Health, College of Human Resource Development, 8 Black Street Drive, off Alusine Kala Drive, Magbenteh, Makeni; Sierra Leone
| | - Endashaw Abebe Debela
- Department of Internal Medicine, School of Medicine, Adama Hospital Medical College, Adama, Ethiopia
| | - Musa Titus Sesay
- Department of Environmental Engineering, School of Environmental Science and Engineering, Suzhou University of Science and Technology, Suzhou, Jiangsu Province; People's Republic of China
| | - Alemu Tolcha
- Department of Environmental Health, College of Medicine and Health Science, Hawassa University, Hawassa Ethiopia
| | - Michaela Sia Tengbe
- Department of Environmental Science and Engineering, School of Environment and Safety Engineering, Jiangsu University, Zhenjiang City, Jiangsu Province; People's Republic of China
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Khosravi A, Rajabi HR, Vakhshoori M, Rabiei K, Hosseini SM, Mansouri A, Roghani-Dehkordi F, Najafian J, Rahimi M, Jafari-Koshki T, Sadeghian B, Shishehforoush M, Lahijanzadeh A, Taheri M, Sarrafzadegan N. Association between ambient fine particulate matter with blood pressure levels among Iranian individuals admitted for cardiac and respiratory diseases: Data from CAPACITY study. ARYA ATHEROSCLEROSIS 2021; 16:178-184. [PMID: 33598038 PMCID: PMC7867310 DOI: 10.22122/arya.v16i4.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The relation between air pollution and cardiovascular diseases (CVDs) risk factors, especially blood pressure (BP) levels, has been less frequently assessed. The aim of this study was evaluating the association between air pollutants of less than 2.5 µm [particulate matter (PM2.5)] and BP indices among individuals admitted with CVDs and pulmonary diseases. METHODS This cross-sectional study was in context of air pollution associated with hospitalization and mortality of CVDs and respiratory diseases (CAPACITY) study. Data of 792 Iranian patients referring to two hospitals in Isfahan, Iran, for cardiovascular or respiratory problems from March 2011 to March 2012 were used for analysis. BP indices including systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were obtained from patients’ medical forms and mean PM2.5 concentrations during 24 hours prior to admission of each patient were obtained from Isfahan Department of Environment (DOE). RESULTS Mean ± standard deviation (SD) of participants’ age were 62.5 ± 15.9 years. All BP indices on admission were significantly higher in women compared with men. Adjustment of all potential confounders including age, sex, temperature, wind speed, and dew point revealed that increasing one quartile in PM2.5 concentrations had been associated with 1.98 mmHg raising in SBP at the time of admission [95% confidence interval (CI) = 0.41-3.54, P = 0.010]. Women with cardiac diseases had higher all BP indices with increased PM2.5 concentration [SBP: β: 4.30, 95% CI = 0.90-7.70, P = 0.010; DBP: β: 1.89, 95% CI = 0.09-3.69, P = 0.040; MAP: β: 3.09, 95% CI = 0.68-5.51, P= 0.010, respectively). CONCLUSION Our findings suggest that increasing PM2.5 concentration has been positively associated with raising SBP in total population and all BP indices among women with cardiac problems at admission time. Several comprehensive studies are required for confirming these relations.
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Affiliation(s)
- Alireza Khosravi
- Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Rajabi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrbod Vakhshoori
- General Practitioner, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Katayoun Rabiei
- General Practitioner, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mohsen Hosseini
- Professor, Department of Biostatics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asieh Mansouri
- Assistant Professor, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Roghani-Dehkordi
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Najafian
- Associate Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Rahimi
- Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tohid Jafari-Koshki
- Molecular Medicine Research Center, Department of Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Sadeghian
- Central Laboratory and Air Pollution Monitoring, Isfahan Province Environmental Monitoring Center, Isfahan Department of Environment, Isfahan, Iran
| | | | | | - Marzieh Taheri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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das Neves J, Sverdlov Arzi R, Sosnik A. Molecular and cellular cues governing nanomaterial-mucosae interactions: from nanomedicine to nanotoxicology. Chem Soc Rev 2021; 49:5058-5100. [PMID: 32538405 DOI: 10.1039/c8cs00948a] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mucosal tissues constitute the largest interface between the body and the surrounding environment and they regulate the access of molecules, supramolecular structures, particulate matter, and pathogens into it. All mucosae are characterized by an outer mucus layer that protects the underlying cells from physicochemical, biological and mechanical insults, a mono-layered or stratified epithelium that forms tight junctions and controls the selective transport of solutes across it and associated lymphoid tissues that play a sentinel role. Mucus is a gel-like material comprised mainly of the glycoprotein mucin and water and it displays both hydrophilic and hydrophobic domains, a net negative charge, and high porosity and pore interconnectivity, providing an efficient barrier for the absorption of therapeutic agents. To prolong the residence time, absorption and bioavailability of a broad spectrum of active compounds upon mucosal administration, mucus-penetrating and mucoadhesive particles have been designed by tuning the chemical composition, the size, the density, and the surface properties. The benefits of utilizing nanomaterials that interact intimately with mucosae by different mechanisms in the nanomedicine field have been extensively reported. To ensure the safety of these nanosystems, their compatibility is evaluated in vitro and in vivo in preclinical and clinical trials. Conversely, there is a growing concern about the toxicity of nanomaterials dispersed in air and water effluents that unintentionally come into contact with the airways and the gastrointestinal tract. Thus, deep understanding of the key nanomaterial properties that govern the interplay with mucus and tissues is crucial for the rational design of more efficient drug delivery nanosystems (nanomedicine) and to anticipate the fate and side-effects of nanoparticulate matter upon acute or chronic exposure (nanotoxicology). This review initially overviews the complex structural features of mucosal tissues, including the structure of mucus, the epithelial barrier, the mucosal-associated lymphatic tissues and microbiota. Then, the most relevant investigations attempting to identify and validate the key particle features that govern nanomaterial-mucosa interactions and that are relevant in both nanomedicine and nanotoxicology are discussed in a holistic manner. Finally, the most popular experimental techniques and the incipient use of mathematical and computational models to characterize these interactions are described.
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Affiliation(s)
- José das Neves
- i3S - Instituto de Investigação e Inovação em Saúde & INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Roni Sverdlov Arzi
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
| | - Alejandro Sosnik
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
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Sui X, Zhang J, Zhang Q, Sun S, Lei R, Zhang C, Cheng H, Ding L, Ding R, Xiao C, Li X, Cao J. The short-term effect of PM 2.5/O 3 on daily mortality from 2013 to 2018 in Hefei, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:153-169. [PMID: 32785823 DOI: 10.1007/s10653-020-00689-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
This research intends to explore the short-term impacts of PM2.5/O3 on daily death in Hefei from 2013 to 2018. Data on daily death of Hefei residents, meteorological factors, and air pollutants were collected from Jan 1, 2013, to Dec 31, 2018. The correlation between PM2.5/O3 and daily death in Hefei during the research period was studied by time series analysis. From 2013 to 2018, there were 61,683 non-accidental deaths, including 27,431 cardiovascular deaths, 5587 respiratory deaths, 20,921 malignant tumor deaths, and 1674 diabetes deaths, in Hefei. Annual mean concentrations of PM2.5, PM10, NO2, SO2, CO, and O3 in Hefei were 66.18, 92.37, 39.75, 15.39, 930, and 79.08 μg m-3, respectively. An increase of 10 μg m-3 in PM2.5 was related with 0.53% (95% CI 0.31-0.75%), 0.93% (95% CI 0.60-1.26%), 0.90% and (95% CI 0.23-1.57%) increase in non-accidental, cardiovascular and respiratory diseases mortality, respectively. The association between ozone and mortality was not significant. In cold seasons, PM2.5 had a stronger effect on the deaths resulting from non-accidental, cardiovascular, and respiratory diseases. The effect of O3 on deaths was not significantly different between the cold season and the warm season. Women and the elders (over 65 years) were at high risk of being affected by PM2.5/O3. Short-term exposure to PM2.5 was positively correlated with increased deaths due to non-accidental, cardiovascular and respiratory diseases in Hefei. Females and elders were more vulnerable to PM2.5/O3 exposure. No significant associations were observed between ozone and deaths from non-accidental, cardiovascular, respiratory, malignant tumors, and diabetes diseases.
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Affiliation(s)
- Xinmiao Sui
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Junqing Zhang
- Hefei Centre for Disease Control and Prevention of Anhui, Hefei, Anhui, China
| | - Qi Zhang
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shu Sun
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ruoqian Lei
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chao Zhang
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Han Cheng
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liu Ding
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Changchun Xiao
- Hefei Centre for Disease Control and Prevention of Anhui, Hefei, Anhui, China
| | - Xiaoru Li
- Hefei Centre for Disease Control and Prevention of Anhui, Hefei, Anhui, China
| | - Jiyu Cao
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Hu J, Fu H, Shen H, Teng CG, Yang W, Yang HB, Liu F. Does underweight amplify the relationship between short-term particulate matter exposure and blood pressure in children and adolescents: a large cross-sectional study in a metropolis of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:42449-42459. [PMID: 32710354 DOI: 10.1007/s11356-020-10215-2] [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: 03/21/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
Overweight/obesity modified the effects of ambient particulate matter (PM) exposure on blood pressure (BP). This study aims to assess whether interaction of underweight and short-term PM exposure on BP exists in Chinese children. A cross-sectional analysis including 144,513 children aged 6 to 17 years in 2016 Health Promotion Program for Children and Adolescents of Suzhou, China, was performed. Daily concentrations of inhalable PM (PM10) and fine PM (PM2.5) were extracted from air monitoring stations close to students' schools. We applied generalized linear mixed-effects models to estimate the interactions. Estimated changes (95% confidence intervals (CIs)) of systolic BP (SBP), diastolic BP (DBP), and odds ratios (ORs) (95% CIs) for prevalence of HBP were calculated. Significant interactions between PM and underweight on BP and prevalence of high BP (HBP) were observed. For example, at lag 6, the ORs (95% CIs) for HBP by each 10 μg/m3 changes of PM2.5 were 1.066 (1.039, 1.093) and 1.036 (1.028, 1.043) among underweight and normal weight subjects, respectively; these values for PM10 were 1.048 (1.031, 1.065) and 1.025 (1.021, 1.030). At lag 5, the increases of SBP for PM2.5 were 0.32 (95% CI 0.22, 0.43) mmHg and 0.23 (95% CI 0.29, 0.26) mmHg, while changes of DBP were 0.27 (95% CI 0.18, 0.35) mmHg and 0.19 (95% CI 0.16, 0.21) mmHg among underweight and normal weight subjects, respectively. Stratified analyses demonstrated that these interactions were only obtained in males. Effects of short-term PM exposure on BP and prevalence of HBP are enhanced in underweight children and adolescents.
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Affiliation(s)
- Jia Hu
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China.
| | - Han Fu
- Xi'an Center for Disease Control and Prevention, Xi'an, 710054, Shaanxi, China
| | - Hui Shen
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China
| | - Chen-Gang Teng
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China
| | - Wei Yang
- School of Community Health Sciences, University of Nevada, Reno, NV, 89154, USA
| | - Hai-Bing Yang
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China
| | - Fang Liu
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China.
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Christou S, Chatziathanasiou T, Angeli S, Koullapis P, Stylianou F, Sznitman J, Guo HH, Kassinos SC. Anatomical variability in the upper tracheobronchial tree: sex-based differences and implications for personalized inhalation therapies. J Appl Physiol (1985) 2020; 130:678-707. [PMID: 33180641 DOI: 10.1152/japplphysiol.00144.2020] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The morphometry of the large conducting airways is presumed to have a strong effect on the regional deposition of inhaled aerosol particles. Nevertheless, sex-based differences have not been fully quantified and are still largely ignored in designing inhalation therapies. To this end, we retrospectively analyzed high-resolution computed tomography scans for 185 individuals (90 women, 95 men) in the age range of 12-89 yr to determine airway luminal areas, airway lengths, and bifurcation angles. Only subjects free of chronic airway disease were considered. In men, luminal areas of the upper conducting airways were, on average, ∼30%-50% larger when compared with those in women, with the largest differences found in the trachea (289.72 ± 54.25 vs. 193.50 ± 42.37 mm2 for men and women, respectively). The ratio of the largest luminal area in men to the smallest luminal area in women (in any given segment) ranged between 4.5 and 8.6, the largest differences being found in the lobar bronchi. Sex-based differences were minor in the case of bifurcation angles (e.g., average main bifurcation angle: 93.04 ± 9.58° vs. 91.03 ± 9.81° for men and women, respectively), but large intersubject variability was found irrespective of sex (e.g., range of main bifurcation angle: 65.04°-122.01° vs. 69.46°-113.94° for men and women, respectively). Bronchial segments were shorter by ∼5%-20% in women relative to men, the largest differences being located in the upper lobes. False discovery rate analysis revealed statistically significant associations among morphometric measures of the right lung in women (but not in men), suggesting two phenotypes among women that we attribute to the smaller female thoracic volume.NEW & NOTEWORTHY We found significant sex-based morphometric differences in the central airways of healthy men and women that were only mildly attenuated in subsets matched for lung volume. Lumen areas were significantly larger in men (∼30%-50%). Large variability (∼75%-87%) in airway bifurcation angles (60°-122°) was found irrespective of sex. The branching pattern of the right main and right upper bronchi in women (but not in men) follows two phenotypes modulated by lung volume.
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Affiliation(s)
- Simoni Christou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Thanasis Chatziathanasiou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | | | - Pantelis Koullapis
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Fotos Stylianou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Haiwei Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Stavros C Kassinos
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
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Häussermann S, Sommerer K, Scheuch G. Regional Lung Deposition: In Vivo Data. J Aerosol Med Pulm Drug Deliv 2020; 33:291-299. [PMID: 33021414 DOI: 10.1089/jamp.2020.29032.sh] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The method section of this chapter on in vivo regional lung deposition highlights a nonradioactive method to measure regional deposition, which uses a photometer to quantify inhaled and exhaled particles and in that way is able to estimate the lung region from which the particles are exhaled and to what amount. The radioactive methods cover the measurement of clearance of the deposited particles as well as different imaging techniques to determine regional deposition. The result section reviews in vivo trials in human subjects. It also addresses different parameters that influence the regional deposition in the lungs: particle size, inhalation maneuver, carrier gas, disease, and inhalation device. All of these factors can affect regional deposition significantly. By choosing specific values of these parameters, it should be feasible to target different regions of the lungs for the therapy of different diseases.
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Abstract
Modeling particle deposition in the human lung requires information about the morphology of the lung in terms of simple geometric units, e.g., characterizing bronchial airways by straight cylindrical tubes. Five different regional deposition models are discussed in this section with respect to morphometric lung models and related mathematical modeling techniques: 1) one-dimensional cross-section or "trumpet" model, 2) deterministic symmetric generation or "single-path" model, 3) deterministic asymmetric generation or "multiple-path" model, 4) stochastic asymmetric generation or "multiple-path" model, and 5) single-path computational fluid and particle dynamics (CFPD) model. Current deposition models can predict the following regional deposition quantities relevant for the administration of medical aerosols: 1) regional bronchial and alveolar deposition, 2) generational lung deposition, 3) lobar deposition, 4) generational lobar deposition, and 5) generational surface deposition. Although deposition fractions predicted by the different models depend on the selection of a specific morphometric lung model and a specific set of analytical deposition equations, all models predict the same trends as functions of particle diameter and breathing parameters. In general, the overall agreement between the modeling predictions obtained by the various deposition models and the available experimental evidence indicates that current deposition models correctly predict regional and generational deposition.
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Affiliation(s)
- Werner Hofmann
- Department of Chemistry and Physics of Materials, University of Salzburg, Salzburg, Austria
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Douafer H, Andrieu V, Brunel JM. Scope and limitations on aerosol drug delivery for the treatment of infectious respiratory diseases. J Control Release 2020; 325:276-292. [PMID: 32652109 DOI: 10.1016/j.jconrel.2020.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 01/24/2023]
Abstract
The rise of antimicrobial resistance has created an urgent need for the development of new methods for antibiotics delivery to patients with pulmonary infections in order to mainly increase the effectiveness of the drugs administration, to minimize the risk of emergence of resistant strains, and to prevent patients reinfection. Since bacterial resistance is often related to antibiotic concentration, their pulmonary administration could eradicate strains resistant to the same drug at the concentration achieved through the systemic circulation. Pulmonary administration offers several advantages; it directly targets the site of the infection which allows the inhaled dose of the drug to be reduced compared to that administered orally or parenterally while keeping the same local effect. The review article is made with an objective to compile information about various existing modern technologies developed to provide greater patient compliance and reduce the undesirable side effect of the drugs. In conclusion, aerosol antibiotic delivery appears as one of the best technologies for the treatment of pulmonary infectious diseases and able to limit the systemic adverse effects related to the high drug dose and to make life easier for the patients.
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Affiliation(s)
- Hana Douafer
- Aix Marseille Univ, INSERM, SSA, MCT, 13385 Marseille, France
| | - Véronique Andrieu
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, 13385 Marseille, France
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Leemans G, Belmans D, Van Holsbeke C, Kushnarev V, Sugget J, Ides K, Vissers D, De Backer W. A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1261-1268. [PMID: 32581531 PMCID: PMC7280059 DOI: 10.2147/copd.s242191] [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: 12/13/2019] [Accepted: 05/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) patients are prone to suffer from chronic bronchitis, which ultimately affects their quality of life and overall prognosis. Oscillating positive expiratory pressure (oPEP) devices are designed to aid in the mucus clearance by generating positive pressure pulses in the airways. The main aim of this study was to analyze the impact of a specific oPEP device - Aerobika® - on top of standard of care medication in COPD patients' lung dynamics and drug deposition. Patients and Methods In this single-arm pilot study, patients were assessed using standard spirometry tests and functional respiratory imaging (FRI) before and after a period of 15±3 days of using the oPEP device twice daily (before their standard medication). Results The utilization of the oPEP device led to a significant increase of 2.88% in specific airway volume after two weeks (1.44 (SE: 0.18) vs 1.48 (SE: 0.19); 95% CI = [0.03%,5.81%]; p=0.048). Moreover, the internal airflow distribution (IAD) was affected by the treatment: patients' changes ranged from -6.74% to 4.51%. Furthermore, IAD changes at the lower lobes were also directly correlated with variations in forced expiratory volume in one second and peak expiratory flow; conversely, IAD changes at the upper lobes were inversely correlated with these clinical parameters. Interestingly, this change in IAD was significantly correlated with changes in lobar drug deposition (r 2=0.30, p<0.001). Conclusion Our results support that the Aerobika device utilization leads to an improved airflow, which in turn causes a shift in IAD and impacts the drug deposition patterns of the concomitant medication in patients with COPD.
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Affiliation(s)
- Glenn Leemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium.,FLUIDDA nv, Antwerp, Kontich, Belgium
| | | | | | | | - Jason Sugget
- Trudell Medical International, London, Ontario, Canada
| | - Kris Ides
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
| | - Wilfried De Backer
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
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Comparison of Two Models to Estimate Deposition of Fungi and Bacteria in the Human Respiratory Tract. ATMOSPHERE 2020. [DOI: 10.3390/atmos11060561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Understanding the deposition of bioaerosols in the respiratory system may help determine the risk of disease; however, measuring deposition fraction in-situ is difficult. Computational models provide estimates of particle deposition fraction for given breathing and particle parameters; however, these models traditionally have not focused on bioaerosols. We calculated deposition fractions in an average-sized adult with a new bioaerosol-specific lung deposition model, BAIL, and with two multiple-path models for three different breathing scenarios: “default” (subject sitting upright and breathing nasally), “light exercise”, and “mouth breathing”. Within each scenario, breathing parameters and bioaerosol characteristics were kept the same across all three models. BAIL generally calculated a higher deposition fraction in the extrathoracic (ET) region and a lower deposition fraction in the alveolar region than the multiple-path models. Deposition fractions in the tracheobronchial region were similar among the three models; total deposition fraction patterns tended to be driven by the ET deposition fraction, with BAIL resulting in higher deposition in some scenarios. The difference between deposition fractions calculated by BAIL and other models depended on particle size, with BAIL generally indicating lower total deposition for bacteria-sized bioaerosols. We conclude that BAIL predicts somewhat lower deposition and, potentially, reduced risk of illness from smaller bioaerosols that cause illness due to deposition in the alveolar region. On the other hand, it suggests higher deposition in the ET region, especially for light exercise and mouth-breathing scenarios. Additional comparisons between the models for other breathing scenarios, people’s age, and different bioaerosol particles will help improve our understanding of bioaerosol deposition.
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Wang YY, Li Q, Guo Y, Zhou H, Wang QM, Shen HP, Zhang YP, Yan DH, Li S, Chen G, Zhou S, He Y, Yang Y, Peng ZQ, Wang HJ, Ma X. Long-term exposure to airborne particulate matter of 1 μm or less and blood pressure in healthy young adults: A national study with 1.2 million pregnancy planners. ENVIRONMENTAL RESEARCH 2020; 184:109113. [PMID: 32199315 DOI: 10.1016/j.envres.2020.109113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 06/10/2023]
Abstract
No evidence exists concerning the effect of airborne particulate matter of 1 μm or less (PM1) on blood pressure of young adults planning for pregnancy. We collected health examination information of about 1.2 million couples (aged 18-45 years) from a national birth cohort in China from Jan 1, 2013 to Oct 1, 2014 and matched their home address to daily PM1 and PM2.5 concentrations, which were predicted by remote sensing information. Generalized additive mixed models were used to analyze associations between long-term exposure to PM and blood pressure, after controlling for individual factors. A 10 μg/m3 increase in PM1 was associated with increased systolic blood pressure (SBP) for 0.26 (95%CI: 0.24, 0.29) mmHg in females and 0.29 (95%CI: 0.26, 0.31) mmHg in males, respectively. PM1 was also associated with increased DBP for 0.22 (95%CI: 0.20, 0.23) mmHg in females and 0.17 (95%CI: 0.15, 0.19) mmHg in males, respectively. Similar effects on blood pressure were found for PM2.5, meanwhile, the effect of PM2.5 on SBP increased with the scale of PM1 included in PM2.5 (p for interaction term <0.01). In summary, long-term exposure to PM1 as well as PM2.5 was associated with increased SBP and DBP of Chinese young adults planning for pregnancy.
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Affiliation(s)
- Yuan-Yuan Wang
- National Research Institute for Family Planning, Beijing, China; National Center for Human Genetic Resources, Beijing, China
| | - Qin Li
- National Center for Human Genetic Resources, Beijing, China; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hong Zhou
- National Center for Human Genetic Resources, Beijing, China; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Qiao-Mei Wang
- Department of Maternal and Child Health, National Health Commission of the PR China, Beijing, China
| | - Hai-Ping Shen
- Department of Maternal and Child Health, National Health Commission of the PR China, Beijing, China
| | - Yi-Ping Zhang
- Department of Maternal and Child Health, National Health Commission of the PR China, Beijing, China
| | - Dong-Hai Yan
- Department of Maternal and Child Health, National Health Commission of the PR China, Beijing, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
| | - Zuo-Qi Peng
- National Research Institute for Family Planning, Beijing, China
| | - Hai-Jun Wang
- National Center for Human Genetic Resources, Beijing, China; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China; National Center for Human Genetic Resources, Beijing, China.
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Effect of ambient air pollution exposure on renal dysfunction among hospitalized patients in Shanghai, China. Public Health 2020; 181:196-201. [PMID: 32092559 DOI: 10.1016/j.puhe.2020.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/20/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We investigated whether long-term ambient air pollutants (AAP) exposure was associated with estimated glomerular filtration rate (eGFR) among hospitalized patients living in urban areas of Shanghai, China. STUDY DESIGN This was a cross-sectional observational study. METHODS A total of 3622 newly hospitalized inpatients were investigated from October 2014 to May 2015. The prior year's average exposure to particulate matter (PM) of each participant was estimated using the Kriging interpolation method of ArcGIS. The estimated eGFR was calculated according to the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Both generalized linear and logistic regression models were applied to assess the associations between AAP and renal function. RESULTS One-year PM10 exposure was associated with lower eGFR; each standard deviation (SD) increase in PM10 was significantly associated with the increased prevalence of CKD [adjusted odds ratio (OR) 1.11; 95% confidence interval (CI): 1.02, 1.21], and lower eGFR by -0.40 (95%CI: -0.80, -0.01) ml/min/1.73 m2. Moreover, the effect of PM10 was significantly greater in people over 65 years old. CONCLUSION Our results supported that exposure to ambient PM10 increased the risk of CKD and negatively affected renal function among Chinese adults.
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Jiao A, Xiang Q, Ding Z, Cao J, Ho HC, Chen D, Cheng J, Yang Z, Zhang F, Yu Y, Zhang Y. Short-term impacts of ambient fine particulate matter on emergency department visits: Comparative analysis of three exposure metrics. CHEMOSPHERE 2020; 241:125012. [PMID: 31606575 DOI: 10.1016/j.chemosphere.2019.125012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/15/2019] [Accepted: 09/29/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Research argued that daily excessive concentration hours (DECH) could be more informative through accounting for within-day variations, when assessing population-level exposure to ambient fine particle (PM2.5). However, few studies have comparatively investigated PM2.5-associated risks using DECH and two common metrics of daily mean and hourly peak concentration. METHODS We collected daily records of all-cause emergency department visits (EDVs) and hourly data on air pollutants and meteorological factors from Shenzhen, China, 2015-2018. According to guidelines proposed by the World Health Organization, DECH was calculated by summing up daily concentrations exceeding 25 μg/m3. Based on time-stratified case-crossover design, we adopted conditional logistic regression models to assess short-term attributable risks of EDVs associated with PM2.5 using three exposure metrics. RESULTS DECH and daily average of PM2.5 strongly elevated risks of EDVs, while less evident associations were observed using hourly peak metric. Estimated excess relative risks at lag 0 day were 0.56% (95% confidence interval [CI]: 0.21 to 0.91), 0.69% (95% CI: 0.25 to 1.13) and 0.37% (95% CI: 0.02 to 0.76), respectively, associated with an interquartile range increase in DECH (420.2 μg/m3), 24-h average (24.9 μg/m3) and hourly peak concentration (38 μg/m3). More emergency visits could be attributed to DECH than daily mean PM2.5, with attributable fractions of 2.02% (95% CI: 1.42 to 2.61) and 1.09% (95% CI: 0.69 to 1.49), respectively. CONCLUSIONS This study added evidence for increased risk of EDVs associated with exposure to ambient PM2.5. DECH was a potential alternative exposure metric for PM2.5 assessment, which may have implications for future revision of air quality standards.
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Affiliation(s)
- Anqi Jiao
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China; Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China
| | - Jiguo Cao
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Dieyi Chen
- Department of Global Health, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4059, Australia
| | - Zhiming Yang
- Donlinks School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083, China
| | - Faxue Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, 442000, China.
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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Clergé A, Le Goff J, Lopez C, Ledauphin J, Delépée R. Oxy-PAHs: occurrence in the environment and potential genotoxic/mutagenic risk assessment for human health. Crit Rev Toxicol 2019; 49:302-328. [DOI: 10.1080/10408444.2019.1605333] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Adeline Clergé
- Normandie Univ, UNICAEN, UNIROUEN, ABTE, Caen Cedex, France
- Comprehensive Cancer Center François Baclesse, UNICANCER, Caen Cedex, France
| | | | - Claire Lopez
- Normandie Univ, UNICAEN, UNIROUEN, ABTE, Caen Cedex, France
| | | | - Raphaël Delépée
- Normandie Univ, UNICAEN, UNIROUEN, ABTE, Caen Cedex, France
- Comprehensive Cancer Center François Baclesse, UNICANCER, Caen Cedex, France
- Normandie Univ, UNICAEN, PRISMM core facility, SF4206 ICORE, CCC F. Baclesse, Caen, France
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Qu Y, Pan Y, Niu H, He Y, Li M, Li L, Liu J, Li B. Short-term effects of fine particulate matter on non-accidental and circulatory diseases mortality: A time series study among the elder in Changchun. PLoS One 2018; 13:e0209793. [PMID: 30596713 PMCID: PMC6312390 DOI: 10.1371/journal.pone.0209793] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/11/2018] [Indexed: 12/26/2022] Open
Abstract
Background and objectives Fine particulate matter (PM2.5, particulate matter with an aerodynamic diameter less than or equal to 2.5 μm) has multiple adverse effects on human health, especially on the respiratory and circulatory system. The purpose of this study was to evaluate the short-term effect of PM2.5 on the mortality risk of non-accidental and circulatory diseases, and to explore the potential effect modification by sex, education and death location. Methods We collected daily mortality counts of Changchun (China) residents, daily meteorology and air pollution data, from January 1, 2014, to January 1, 2017. We focused on the elderly (≥65 years old) population who died from non-accidental causes and circulatory diseases, and stratified them by sex, education, and death location. A generalized additive Poisson regression model (GAM) was used to analyse the impact of air pollutants on mortality. We fit single pollutant models to examine PM2.5 effects with different lag structures of single-day (distributed lag:lag0-lag3) and multi-day (moving average lag: lag01-lag03). To test the sensitivity of the model, a multi-pollutant model was established when the PM2.5 effect was strongest. Results In the single pollutant models, an increment of PM2.5 by 10 μg/m3 at lag0-3 was associated with a 0.385% (95% CI: 0.069% to 0.702%) increase in daily non-accidental mortality and a 0.442% (95% CI: 0.038% to 0.848%) increase in daily circulatory disease mortality. NO2 (lag1) and O3 (lag0, lag1, lag2, lag01,lag02, lag03) were associated with daily non-accidental death and NO2 (lag1, lag3, lag03) and O3 (lag0, lag1, lag01,lag02, lag03) were associated with daily circulatory disease mortality. In the co-pollutant models, the risk estimates for PM2.5 changed slightly. The excess mortality risk of non-accidental and circulatory diseases was higher for women, people with low education, and died outside hospital. Conclusions We found that short-term exposure to PM2.5 increased the mortality risk of non-accidental and circulatory diseases among the elderly in Changchun. Women, people with low education and died outside hospital are more susceptible to PM2.5. NO2 and O3 were also associated with an increase in mortality from non-accidental and circulatory diseases and the O3 is a high effect.
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Affiliation(s)
- Yangming Qu
- Key Laboratory of Zoonosis Research, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yang Pan
- Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Huikun Niu
- Key Laboratory of Zoonosis Research, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yinghua He
- Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Meiqi Li
- Key Laboratory of Zoonosis Research, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lu Li
- Key Laboratory of Zoonosis Research, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jianwei Liu
- Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China
| | - Bo Li
- Key Laboratory of Zoonosis Research, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- * E-mail:
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Hu K, Guo Y, Hu D, Du R, Yang X, Zhong J, Fei F, Chen F, Chen G, Zhao Q, Yang J, Zhang Y, Chen Q, Ye T, Li S, Qi J. Mortality burden attributable to PM 1 in Zhejiang province, China. ENVIRONMENT INTERNATIONAL 2018; 121:515-522. [PMID: 30292144 DOI: 10.1016/j.envint.2018.09.033] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND Limited evidence is available on the health effects of particulate matter with an aerodynamic diameter of <1 μm (PM1), mainly due to the lack of its ground measurement worldwide. OBJECTIVES To identify and examine the mortality risks and mortality burdens associated with PM1, PM2.5, and PM10 in Zhejiang province, China. METHODS We collected daily data regarding all-cause (stratified by age and gender), cardiovascular, stroke, respiratory, and chronic obstructive pulmonary disease (COPD) mortality, and PM1, PM2.5, and PM10, from 11 cities in Zhejiang province, China during 2013 and 2017. We used a quasi-Poisson regression model to estimate city-specific associations between mortality and PM concentrations. Then we used a random-effect meta-analysis to pool the provincial estimates. To show the mortality burdens of PM1, PM2.5, and PM10, we calculated the mortality fractions and deaths attributable to these PMs. RESULTS Daily concentrations of PM1, PM2.5, and PM10 ranged between 0-199 μg/m3, 0-218 μg/m3, and 0-254 μg/m3, respectively; Mortality effects were significant in lag 0-2 days. The relative risks for all-cause mortality were 1.0064 (95% CI: 1.0034, 1.0094), 1.0061 (95% CI: 1.0034, 1.0089), and 1.0060 (95% CI: 1.0038, 1.0083) associated with a 10 μg/m3 increase in PM1, PM2.5, and PM10, respectively. Age- and gender-stratified analysis shows that elderly people (aged 65+) and females are more sensitive to PMs. The mortality fractions of all-cause mortality were estimated to be 2.39% (95% CI: 1.28, 3.48) attributable to PM1, 2.53% (95% CI: 1.42, 3.63) attributable to PM2.5, and 3.08% (95% CI: 1.95, 4.19) attributable to PM10. The ratios of attributable cause-specific deaths for PM1/PM2.5, PM1/PM10, and PM2.5/PM10 were higher than the ratios of their respective concentrations. CONCLUSIONS PM1, PM2.5 and PM10 are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM1 accounts for the vast majority of short-term PM2.5- and PM10-induced mortality. Our analyses support the notion that smaller size fractions of PM have a more toxic mortality impacts, which suggests to develop strategies to prevent and control PM1 in China, such as to foster strict regulations for automobile and industrial emissions.
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Affiliation(s)
- Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Deyun Hu
- Hangzhou Meteorological Service, Hangzhou 310051, China
| | - Rongguang Du
- Hangzhou Meteorological Service, Hangzhou 310051, China
| | - Xuchao Yang
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA.
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou 310008, China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Qian Chen
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Tingting Ye
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Jiaguo Qi
- Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA
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Rangaraj N, Pailla SR, Sampathi S. Insight into pulmonary drug delivery: Mechanism of drug deposition to device characterization and regulatory requirements. Pulm Pharmacol Ther 2018; 54:1-21. [PMID: 30447295 DOI: 10.1016/j.pupt.2018.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/09/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Nagarjun Rangaraj
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India
| | - Sravanthi Reddy Pailla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India
| | - Sunitha Sampathi
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-HYD), Balanagar, Telangana, 500037, India.
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Zeng W, Zhang Y, Wang L, Wei Y, Lu R, Xia J, Chai B, Liang X. Ambient fine particulate pollution and daily morbidity of stroke in Chengdu, China. PLoS One 2018; 13:e0206836. [PMID: 30399151 PMCID: PMC6219788 DOI: 10.1371/journal.pone.0206836] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 10/18/2018] [Indexed: 01/04/2023] Open
Abstract
Introduction Association has been reported between ambient fine particulate matter (PM) and adverse outcomes of cerebrovascular events. However, it remains unclear that whether short-term exposure to PM relates to stroke and the lag of health effects. This triggers us to examine the relationship between PM and population stroke morbidity in Chengdu. Methods The daily average concentration of atmospheric pollutants and meteorological factors and daily morbidity of stroke in Chengdu (2013–2015) were collected. Based on time series analysis-generalized additive models (GAM), single-pollutant, two-pollutant and multi-pollutant model were established. The effects of atmospheric PM2.5 (defined as PM less than 2.5μm in aerodynamic diameter), PMc(defined as PM less than 10μm and more than 2.5μm in aerodynamic diameter) and PM10 (defined as PM less than 10μm in aerodynamic diameter) concentration on the daily mortality of stroke were analyzed, respectively. Results The three-year mean concentrations of PM2.5, PMc and PM10 for air pollutants were 75.9, 43.9 and 119.7 μg/m3, respectively. PM2.5 on the current day (lag0) and with a moving average of 0–1 days were significantly associated with the increasing risk of stroke morbidity, and PM2.5 with a lag of 0–1 days had greater association, whereas for PMc and PM10 there were no significant association observed. In our study, every 10μg/m3 increase of PM2.5 was associated with 0.69% percent change in stroke morbidity (95%CI: 0.01~1.38). For females, every 10μg/m3 increase of PM2.5 contributes to 0.80% percent change of onset. And for the group of age less than 65, we observed 0.78% higher risk every 10μg/m3 increase of PM2.5. Conclusions These findings suggest that short-term exposure to PM2.5 within 1 day is associated with the onset of stroke, and the younger people (age<65) and females are more sensitive than older people and males.
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Affiliation(s)
- Wei Zeng
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Yingcong Zhang
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China.,Chengdu High-tech Zone Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Liang Wang
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Yonglan Wei
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Rong Lu
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Jinjie Xia
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Bing Chai
- Chengdu Tianfu New Area Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
| | - Xian Liang
- Chengdu Center for Diseases Control and Prevention, Chengdu, Sichuan, P.R. China
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Vilas Boas DS, Matsuda M, Toffoletto O, Garcia MLB, Saldiva PHN, Marquezini MV. Workers of São Paulo city, Brazil, exposed to air pollution: Assessment of genotoxicity. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2018; 834:18-24. [DOI: 10.1016/j.mrgentox.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
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Zhong P, Huang S, Zhang X, Wu S, Zhu Y, Li Y, Ma L. Individual-level modifiers of the acute effects of air pollution on mortality in Wuhan, China. Glob Health Res Policy 2018; 3:27. [PMID: 30214944 PMCID: PMC6131956 DOI: 10.1186/s41256-018-0080-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Ambient air pollution has posed negative effects on human health. Individual-level factors may modify this effect, but previous studies have controversial conclusions, and evidence is lacking especially in developing countries. This study aims to examine the modifying effects of sex, age, and education level of individuals on the associated between daily mortality and air pollutants, including particulate matter < 10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2). Methods Time-series analysis was conducted to investigate the acute effects of the air pollution on daily mortality from January 2002 to December 2010 in Wuhan, China. Generalized Additive Models (GAM) were used to examine the association stratified by sex for non-accidental, cardiovascular, and respiratory mortality. For non-accidental mortality, stratified analysis was also conducted by age and educational level. Results Outdoor air pollution was associated with daily non-accidental and cardiovascular mortality. An increase of 10 μg/m3 in a 2-day average concentration of PM10, SO2, and NO2 was corresponding to the increase in non-accidental mortality of 0.29% (95%CI: 0.06–0.53%), 1.22% (95%CI: 0.77–1.67%) and 1.60% (95%CI: 1.00–2.19%), respectively. The effects of air pollution were faster in females than males. The magnitude of the estimates was higher for females with low education, aged 65–75 years for PM10 and < 65 years for SO2. To be more specific, we observed that per 10 μg/m3 increase in SO2 was association with increases in non-accidental mortality of 2.03% (95%CI: 1.38–2.67) for all females and 3.10% (95%CI: 2.05–4.16) for females with low education. Conclusion Females and people with low-education are more susceptible to the effect of air pollution, which would provide a sound scientific basis for determination of air pollution standards.
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Affiliation(s)
- Peirong Zhong
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Shichun Huang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Xiaotong Zhang
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Simin Wu
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Yaohui Zhu
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Yang Li
- Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Hongshan District, Wuhan, 430079 China
| | - Lu Ma
- 1Department of Healthcare Management, School of Health Sciences, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071 China.,3Global Health Institute, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan City, 430071 China
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Park SW, Kim BG, Kim JW, Park JW, Kim JI. A cross-sectional study on the pulmonary function of residents in two urban areas with different PM 10 concentrations: data from the fourth Korea national health and nutrition examination survey (KNHANES) 2007-2009. Ann Occup Environ Med 2018; 30:47. [PMID: 30026954 PMCID: PMC6048902 DOI: 10.1186/s40557-018-0258-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background The present study aims to compare the pulmonary function of residents of Seoul special city (Seoul) and Jeju special self-governing province including Jeju city and Seogwipo city (Jeju), characterized by vastly different annual average airborne particulate matter with an aerodynamic diameter less ≤10 μm (PM10) concentrations, with the annual average PM10 concentration in Seoul being significantly higher than that in Jeju. Methods This cross-sectional study analyzed the pulmonary function test results and sociodemographic data of Korean adults ≥19 years of age derived from the 4th KNHANES, 2007–2009. A total of 830 individuals residing in Seoul or Jeju were included in this study. T-tests were used to analyze predicted values of forced expiratory volume in 1 sec (FEV1p), predicted values of forced vital capacity (FVCp) and FEV1/FVC ratio (FEV1/FVC), as dependent variables, to examine the differences in the subjects’ pulmonary function according to the city of residence. Stratified analysis was then performed to adjust for variables potentially affecting pulmonary function. The analysis was performed on subjects as a group and also following stratification according to sex and other variables. Results Seoul residents had a significantly lower FVCp than that of the Jeju residents (difference: 3.48%, p = 0.002). FEV1p, FVCp and FEV1/FVC of male Seoul residents were significantly lower than those of male Jeju residents (difference: 6.99, 5.11% and 0.03, respectively; p < 0.001, p = 0.001, p = 0.001). In male subjects, statistically significant results were obtained even after adjusting the influence of other variables through stratified analysis. Conclusion The present analysis was based on cross-sectional data collected at one point in time. Therefore, unlike longitudinal studies, it does not establish a clear causal association between the variables. Nevertheless, this study found that pulmonary function among subjects residing in Seoul was significantly decreased compared to that of subjects residing in Jeju.
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Affiliation(s)
- Si Woo Park
- Department of Occupational & Environmental Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Byoung Gwon Kim
- Department of Occupational & Environmental Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Jung Woo Kim
- Department of Occupational & Environmental Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Jung Woo Park
- Department of Occupational & Environmental Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Jung Il Kim
- Department of Occupational & Environmental Medicine, College of Medicine, Dong-A University, Busan, South Korea
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Yang BY, Qian ZM, Vaughn MG, Howard SW, Pemberton JP, Ma H, Chen DH, Hu LW, Zeng XW, Zhang C, Tian YP, Nian M, Xiao X, Dong GH. Overweight modifies the association between long-term ambient air pollution and prehypertension in Chinese adults: the 33 Communities Chinese Health Study. Environ Health 2018; 17:57. [PMID: 29954383 PMCID: PMC6022431 DOI: 10.1186/s12940-018-0401-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Research regarding the interaction of ambient air pollution and overweight on prehypertension is scarce. We aimed to test whether overweight modifies the association between long-term exposure to ambient air pollution and prehypertension in Chinese adults. METHODS A total of 16,188 Chinese adults, aged 18-74 years old, from 33 communities in 3 Northeastern Chinese cities were evaluated. Three-year average levels of particles with an aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxides (SO2), nitrogen dioxides (NO2), and ozone (O3) were calculated at monitoring stations. Generalized additive models and 2-level regression analyses were applied. RESULTS We observed significant interactions between air pollutants and overweight on prehypertension and blood pressure. The associations of PM10, SO2, NO2, and O3 with prehypertension were significant among overweight participants (Prevalence Rate Ratios (PRRs) per interquartile range (IQR) of air pollutants: 1.14-1.20), but not among normal weight participants (PRRs: 0.98-1.04). PM10, SO2, and O3 were significantly associated with systolic blood pressure (SBP), and the magnitudes of these associations were higher among overweight adults (increases in SBP per IQR of air pollutants: 1.82-4.53 mmHg) than those among normal weight adults (increases in SBP: 0.42-0.61 mmHg). For diastolic blood pressure (DBP), significant associations were mainly observed in overweight participants (increases in DBP: 0.80-1.63 mmHg). Further stratified analyses showed that all these interactions were stronger in women, the older, and participants living in areas with lower income levels or higher population density. CONCLUSIONS Being overweight may enhance the effects of ambient air pollution on prehypertension and blood pressure in Chinese adults.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Zhengmin Min Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, 63104 USA
| | - Michael G. Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, 63104 USA
| | - Steven W. Howard
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - John Phillip Pemberton
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, 63104 USA
| | - Huimin Ma
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640 China
| | - Duo-Hong Chen
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, 510308 China
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Chuan Zhang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Yan-Peng Tian
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Min Nian
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Xiang Xiao
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment; Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 People’s Republic of China
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Liang H, Qiu H, Tian L. Short-term effects of fine particulate matter on acute myocardial infraction mortality and years of life lost: A time series study in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:558-563. [PMID: 28988091 DOI: 10.1016/j.scitotenv.2017.09.266] [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: 07/31/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Previous studies have applied years of life lost (YLL) as a complementary indicator to assess the short-term effect of the air pollution on the health burden from all-cause mortality, but sparsely focused on individual diseases such as acute myocardial infraction (AMI). In this study, we aimed to conduct a time-series analysis to evaluate short-term effects of fine particulate matter (PM2.5) on mortality and YLL from AMI in Hong Kong from 2011 to 2015, and explore the potential effect modifiers including sex and age by subgroup analysis. We applied generalized additive Poisson and Gaussian regression model for daily death count and YLL, respectively. We found that 10μg/m3 increment in concentration of PM2.5 lasting for two days (lag01) was associated with a 2.35% (95% CI 0.38% to 4.36%) increase in daily mortality count and a 1.69 (95% CI 0.01 to 3.37) years increase in YLL from AMI. The association between PM2.5 and AMI mortality count was stronger among women and older people than men and young people, respectively. We concluded that acute exposure to PM2.5 may increase the risk of mortality and YLL from AMI in Hong Kong and this effect can be modified by age and gender. These findings add to the evidence base for public health policy formulation and resource allocation.
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Affiliation(s)
- Haiqing Liang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
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Soulele K, Macheras P, Karalis V. On the pharmacokinetics of two inhaled budesonide/formoterol combinations in asthma patients using modeling approaches. Pulm Pharmacol Ther 2017; 48:168-178. [PMID: 29223508 DOI: 10.1016/j.pupt.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/27/2017] [Accepted: 12/05/2017] [Indexed: 11/26/2022]
Abstract
Dry powder inhalers containing the budesonide/formoterol combination have currently a well-established position among other inhaled products. Even though their efficacy mainly depends on the local concentrations of the drug they deliver within the lungs, their safety profile is directly related to their total systemic exposure. The aim of the present investigation was to explore the absorption and disposition kinetics of the budesonide/formoterol combination delivered via two different dry powder inhalers in asthma patients. Plasma concentration-time data were obtained from a single-dose, crossover bioequivalence study in asthma patients. Non-compartmental and population compartmental approaches were applied to the available datasets. The non-compartmental analysis allowed for an initial characterization of the primary pharmacokinetic (PK) parameters of the two inhaled drugs and subsequently the bioequivalence assessment of the two different dry powder inhalers. The population pharmacokinetic analysis further explored the complex absorption and disposition characteristics of the two drugs. In case of inhaled FOR, a five-compartment PK model including an enterohepatic re-circulation process was developed. For inhaled BUD, the incorporation of two parallel first-order absorption rate constants (fast and slow) for lung absorption in a two-compartment PK model emphasized the importance of pulmonary anatomical features and underlying physiological processes during model development. The role of potential covariates on the variability of the PK parameters was also investigated.
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Affiliation(s)
- K Soulele
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 157 84 Athens, Greece.
| | - P Macheras
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 157 84 Athens, Greece; Pharma-Informatics Unit of Research & Innovation Center ATHENA, 151 25 Maroussi, Greece.
| | - V Karalis
- Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 157 84 Athens, Greece; Institute of Applied and Computational Mathematics (IACM), Foundation of Research and Technology Hellas (FORTH), Greece.
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Morélot-Panzini C, O'Donnell CR, Lansing RW, Schwartzstein RM, Banzett RB. Aerosol furosemide for dyspnea: Controlled delivery does not improve effectiveness. Respir Physiol Neurobiol 2017; 247:146-155. [PMID: 29031573 DOI: 10.1016/j.resp.2017.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 01/23/2023]
Abstract
Aerosolized furosemide has been shown to relieve dyspnea; nevertheless, all published studies have shown great variability in response. This dyspnea relief is thought to result from the stimulation of slowly adapting pulmonary stretch receptors simulating larger tidal volume. We hypothesized that better control over aerosol administration would produce more consistent dyspnea relief; we used a clinical ventilator to control inspiratory flow and tidal volume. Twelve healthy volunteers inhaled furosemide (40mg) or placebo in a double blind, randomized, crossover study. Breathing Discomfort was induced by hypercapnia during constrained ventilation before and after treatment. Both treatments reduced breathing discomfort by 20% full scale. Effectiveness of aerosol furosemide treatment was weakly correlated with larger tidal volume. Response to inhaled furosemide was inversely correlated to furosemide blood level, suggesting that variation among subjects in the fate of deposited drug may determine effectiveness. We conclude that control of aerosol delivery conditions does not improve consistency of treatment effect; we cannot, however, rule out placebo effect.
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Affiliation(s)
- Capucine Morélot-Panzini
- Pulmonary Division, Beth Israel Deaconess MC, Boston, MA, 02215, USA; Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, F-75013, Paris, France.
| | - Carl R O'Donnell
- Pulmonary Division, Beth Israel Deaconess MC, Boston, MA, 02215, USA; Harvard Med School, Boston, MA, 02115, USA
| | - Robert W Lansing
- Pulmonary Division, Beth Israel Deaconess MC, Boston, MA, 02215, USA
| | - Richard M Schwartzstein
- Pulmonary Division, Beth Israel Deaconess MC, Boston, MA, 02215, USA; Harvard Med School, Boston, MA, 02115, USA
| | - Robert B Banzett
- Pulmonary Division, Beth Israel Deaconess MC, Boston, MA, 02215, USA; Harvard Med School, Boston, MA, 02115, USA
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Stockfelt L, Andersson EM, Molnár P, Gidhagen L, Segersson D, Rosengren A, Barregard L, Sallsten G. Long-term effects of total and source-specific particulate air pollution on incident cardiovascular disease in Gothenburg, Sweden. ENVIRONMENTAL RESEARCH 2017; 158:61-71. [PMID: 28600978 DOI: 10.1016/j.envres.2017.05.036] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/25/2017] [Accepted: 05/28/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND AIMS Long-term exposure to air pollution increases cardiopulmonary morbidity and mortality, but it is not clear which components of air pollution are the most harmful, nor which time window of exposure is most relevant. Further studies at low exposure levels have also been called for. We analyzed two Swedish cohorts to investigate the effects of total and source-specific particulate matter (PM) on incident cardiovascular disease for different time windows of exposure. METHODS Two cohorts initially recruited to study predictors of cardiovascular disease (the PPS cohort and the GOT-MONICA cohort) were followed from 1990 to 2011. We collected data on residential addresses and assigned each individual yearly total and source-specific PM and Nitrogen Oxides (NOx) exposures based on dispersion models. Using multivariable Cox regression models with time-dependent exposure, we studied the association between three different time windows (lag 0, lag 1-5, and exposure at study start) of residential PM and NOx exposure, and incidence of ischemic heart disease, stroke, heart failure and atrial fibrillation. RESULTS AND DISCUSSION During the study period, there were 2266 new-onset cases of ischemic heart disease, 1391 of stroke, 925 of heart failure and 1712 of atrial fibrillation. The majority of cases were in the PPS cohort, where participants were older. Exposure levels during the study period were moderate (median: 13µg/m3 for PM10 and 9µg/m3 for PM2.5), and similar in both cohorts. Road traffic and residential heating were the largest local sources of PM air pollution, and long distance transportation the largest PM source in total. In the PPS cohort, there were positive associations between PM in the last five years and both ischemic heart disease (HR: 1.24 [95% CI: 0.98-1.59] per 10µg/m3 of PM10, and HR: 1.38 [95% CI: 1.08-1.77] per 5µg/m3 of PM2.5) and heart failure. In the GOT-MONICA cohort, there were positive but generally non-significant associations between PM and stroke (HR: 1.48 [95% CI: 0.88-2.49] per 10µg/m3 of PM10, and HR: 1.50 [95% CI: 0.90-2.51] per 5µg/m3 of PM2.5, in the last five years). Effect estimates were stronger for women, non-smokers, and higher socioeconomic classes. Exposure in the last five years seemed to be more strongly associated with outcomes than other exposure time windows. Associations between source-specific PM air pollution and outcomes were mixed and generally weak. High correlations between the main pollutants limited the use of multi-pollutant models. CONCLUSIONS The main PM air pollutants were associated with ischemic heart disease and stroke (in women) at the relatively low exposure levels in Gothenburg, Sweden. The associations tended to be stronger for women than for men, for non-smokers than for smokers, and for higher socioeconomic classes than for lower. The associations could not be attributed to a specific PM source or type, and differed somewhat between the two cohorts. The results of this study confirm that further efforts to reduce air pollution exposure should be undertaken in Sweden to reduce the negative health effects in the general population.
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Affiliation(s)
- Leo Stockfelt
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Eva M Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Molnár
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Gidhagen
- Swedish Meteorological and Hydrological Institute, Sweden
| | | | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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Yang BY, Qian ZM, Vaughn MG, Nelson EJ, Dharmage SC, Heinrich J, Lin S, Lawrence WR, Ma H, Chen DH, Hu LW, Zeng XW, Xu SL, Zhang C, Dong GH. Is prehypertension more strongly associated with long-term ambient air pollution exposure than hypertension? Findings from the 33 Communities Chinese Health Study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 229:696-704. [PMID: 28711568 DOI: 10.1016/j.envpol.2017.07.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/05/2017] [Indexed: 06/07/2023]
Abstract
Numerous studies have evaluated the effects of long-term exposure to ambient air pollution on hypertension. However, little information exists regarding its effects on prehypertension, a very common, but understudied cardiovascular indicator. We evaluated data from 24,845 adults (ages 18-74 years) living in three Northeastern Chinese cities in 2009. Blood pressure (BP) was measured by trained observers using a standardized mercuric-column sphygmomanometer. Three-year (from 2006 to 2008) average concentrations of particles with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were calculated using data from monitoring stations. Effects were analyzed using generalized additive models and two-level regression analyses, controlling for covariates. We found positive associations of all pollutants with prehypertension (e.g. odds ratio (OR) was 1.17 (95% confidence interval (CI), 1.09-1.25) per interquartile range (IQR) of PM10) in a fully adjusted model, as compared to normotensive participants. These associations were stronger than associations with hypertension (e.g. OR was 1.03 (95% CI, 1.00, 1.07) per IQR of PM10). We have also found positive associations of all studied pollutants with systolic and diastolic BP: e.g., associations with PM10 per IQR were 1.24 mmHg (95% CI, 1.03-1.45) for systolic BP and 0.47 mmHg (95% CI, 0.33-0.61) for diastolic BP. Further, we observed that associations with BP were stronger in women and in older participants (systolic BP only). In conclusion, long-term exposure to ambient air pollution was more strongly associated with prehypertension than with hypertension, especially among females and the elderly. Thus, interventions to reduce air pollution are of great significance for preventing future cardiovascular events, particularly among individuals with prehypertension.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Erik J Nelson
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405, USA
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic 3052, Australia
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilian University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen 80336, Germany
| | - Shao Lin
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York, New York 12144-3445, USA
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York, New York 12144-3445, USA
| | - Huimin Ma
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China
| | - Duo-Hong Chen
- Department of Air Quality Forecasting and Early Warning, Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou 510308, China
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shu-Li Xu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Chuan Zhang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Dugernier J, Hesse M, Jumetz T, Bialais E, Roeseler J, Depoortere V, Michotte JB, Wittebole X, Ehrmann S, Laterre PF, Jamar F, Reychler G. Aerosol Delivery with Two Nebulizers Through High-Flow Nasal Cannula: A Randomized Cross-Over Single-Photon Emission Computed Tomography-Computed Tomography Study. J Aerosol Med Pulm Drug Deliv 2017; 30:349-358. [PMID: 28463044 DOI: 10.1089/jamp.2017.1366] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND High-flow nasal cannula use is developing in ICUs. The aim of this study was to compare aerosol efficiency by using two nebulizers through a high-flow nasal cannula: the most commonly used jet nebulizer (JN) and a more efficient vibrating-mesh nebulizer (VN). METHODS Aerosol delivery of diethylenetriaminepentaacetic acid labeled with technetium-99m (4 mCi/4 mL) to the lungs by using a VN (Aerogen Solo®; Aerogen Ltd., Galway, Ireland) and a constant-output JN (Opti-Mist Plus Nebulizer®; ConvaTec, Bridgewater, NJ) through a high-flow nasal cannula (Optiflow®; Fisher & Paykel, New Zealand) was compared in six healthy subjects. Flow rate was set at 30 L/min through the heated humidified circuit. Pulmonary and extrapulmonary deposition was measured by single-photon emission computed tomography combined with a low-dose computed tomographic scan and by planar scintigraphy. RESULTS Lung deposition was only 3.6 (2.1-4.4) and 1 (0.7-2)% of the nominal dose with the VN and the JN, respectively (p < 0.05). The JN showed higher retained doses than the VN. However, both nebulizers were associated with substantial deposition in the single limb circuit, the humidification chamber, and the nasal cannula [58.2 (51.6-61.6)% of the nominal dose with the VN versus 19.2 (15.8-22.9)% of the nominal dose with the JN, p < 0.05] and in the upper respiratory tract [17.6 (13.4-27.9)% of the nominal dose with the VN and 8.6 (6.0-11.0)% of the nominal dose with the JN, p < 0.05], especially in the nasal cavity. CONCLUSIONS In the specific conditions of the study, pulmonary drug delivery through the high-flow nasal cannula is about 1%-4% of the initial amount of drugs placed in the nebulizer, despite the higher efficiency of the VN as compared with the JN.
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Affiliation(s)
- Jonathan Dugernier
- 1 Institut de Recherche Expérimentale et Clinique (IREC), Pneumologie, ORL and Dermatologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,2 Soins Intensifs, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,3 Médecine Physique, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Michel Hesse
- 4 Médecine Nucléaire, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | | | - Emilie Bialais
- 1 Institut de Recherche Expérimentale et Clinique (IREC), Pneumologie, ORL and Dermatologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,2 Soins Intensifs, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,3 Médecine Physique, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Jean Roeseler
- 2 Soins Intensifs, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Virginie Depoortere
- 4 Médecine Nucléaire, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Jean-Bernard Michotte
- 5 Haute Ecole de Santé Vaud, Filière Physiothérapie, University of Applied Sciences and Arts Western Switzerland , Lausanne, Switzerland
| | - Xavier Wittebole
- 2 Soins Intensifs, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Stephan Ehrmann
- 6 Université François Rabelais , Tours, France .,7 INSERM, Centre d'étude des Pathologies Respiratoires , Tours, France .,8 CHRU de Tours, Réanimation Polyvalente , Tours, France
| | | | - François Jamar
- 4 Médecine Nucléaire, Cliniques Universitaires Saint-Luc , Brussels, Belgium
| | - Gregory Reychler
- 1 Institut de Recherche Expérimentale et Clinique (IREC), Pneumologie, ORL and Dermatologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,3 Médecine Physique, Cliniques Universitaires Saint-Luc , Brussels, Belgium .,9 Pneumologie, Cliniques Universitaires Saint-Luc , Brussels, Belgium
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A Systematic Review of Global Desert Dust and Associated Human Health Effects. ATMOSPHERE 2016. [DOI: 10.3390/atmos7120158] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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