1
|
Liu Q, Yang S, Chen H. Global trends and hotspots in the study of the effects of PM2.5 on ischemic stroke. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:133. [PMID: 39198927 PMCID: PMC11360839 DOI: 10.1186/s41043-024-00622-3] [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: 06/16/2024] [Accepted: 08/14/2024] [Indexed: 09/01/2024]
Abstract
AIM The objective of this study was to visually analyse global research trends and hotspots regarding the role of PM2.5 in ischemic stroke. METHODS The Web of Science core collection database was used to search the literature on PM2.5 and ischemic stroke from 2006 to 2024. Visualization analysis was conducted using CiteSpace, VOSviewer, and an online bibliometric platform. RESULTS The analysis comprises 190 articles published between 2006 and 2024 by 1229 authors from 435 institutions in 39 countries, across 78 journals. Wellenius GA has the highest number of published and cited papers. China has the highest number of papers, while Canada has the highest citation frequency. Capital Medical University published the highest number of papers, and Harvard University had the highest citation frequency for a single paper. The study investigated the impact of PM2.5 on ischemic stroke in three phases. The first phase analysed hospitalisation rates for correlations. The second phase utilised large-scale multi-cohort data from around the world. The third phase involved studying global exposure risk through machine learning and model construction. Currently, there is limited research on the mechanisms involved, and further in-depth investigation is required. CONCLUSION This paper presents a bibliometric analysis of the research framework and hotspots concerning the effect of PM2.5 on ischemic stroke. The analysis aims to provide a comprehensive understanding of this field for researchers. It is expected that research on the effect of PM2.5 on ischemic stroke will remain an important research topic in the future.
Collapse
Affiliation(s)
- Qian Liu
- Cerebrovascular Disease Department, Gansu Provincial Hospital, No.204 West Donggang Road, Lanzhou, 730000, Gansu Province, China
- Key Laboratory of Cerebrovascular Disease of Gansu Province, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Shijie Yang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - HeCheng Chen
- Cerebrovascular Disease Department, Gansu Provincial Hospital, No.204 West Donggang Road, Lanzhou, 730000, Gansu Province, China.
- Key Laboratory of Cerebrovascular Disease of Gansu Province, Gansu Provincial Hospital, Lanzhou, Gansu, China.
| |
Collapse
|
2
|
Liang S, Chen Y, Sun X, Dong X, He G, Pu Y, Fan J, Zhong X, Chen Z, Lin Z, Ma W, Liu T. Long-term exposure to ambient ozone and cardiovascular diseases: Evidence from two national cohort studies in China. J Adv Res 2024; 62:165-173. [PMID: 37625570 PMCID: PMC11331174 DOI: 10.1016/j.jare.2023.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION The health effects of ambient ozone have been investigated in many previous studies. However, the effects of long-term exposure to ambient ozone on the incidence of cardiovascular disease (CVD) remain inconclusive. OBJECTIVES To estimate the associations of long-term exposure to maximum daily 8-hours average ozone (MDA8 O3) with the incidence of total CVD, heart disease, hypertension, and stroke. METHODS This was a prospective cohort study, and the data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS) implemented during 2011-2018 and the China Family Panel Studies (CFPS) implemented during 2010-2018. We applied a Cox proportional hazards regression model to evaluate the associations of MDA8 O3 with total CVD, heart disease, hypertension, and stroke risks, and the corresponding population-attributable fractions (PAF) attributable to MDA8 O3 were also calculated. All analyses were conducted by R software. RESULTS The mean MDA8 O3 concertation of all included participants in the CHARLS and CFPS were 51.03 part per billion (ppb) and 51.15 ppb, respectively. In the CHARLS including 18,177 participants, each 10 ppb increment in MDA8 O3 concentration was associated with a 31% increase [hazard ratio (HR) = 1.31, 95% confidence interval (CI): 1.22-1.42] in the risk of incident heart disease, and the corresponding population-attributable fractions (PAF) was 13.79% [10.12%-17.32%]. In the CFPS including 30,226 participants, each 10 ppb increment in MDA8 O3 concentration was associated with an increase in the risk of incident total CVD (1.07 [1.02-1.13]), and hypertension (1.10 [1.03-1.18]). The PAFs of total CVD, and hypertension attributable to MDA8 O3 were 3.53% [0.82%-6.16%], and 5.11% [1.73%-8.38%], respectively. Stratified analyses showed greater associations in males, urban areas, and Southern China. CONCLUSIONS Long-term exposure to MDA8 O3 may increase the incidence of CVD. Therefore, the policies that control O3 and related precursors are persistently needed.
Collapse
Affiliation(s)
- Shuru Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yumeng Chen
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan 528000, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan 523808, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518028, China
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China.
| |
Collapse
|
3
|
Koyama T, Zhao Z, Balmes JR, Calfee CS, Matthay MA, Reilly JP, Porteous MK, Diamond JM, Christie JD, Cantu E, Ware LB. Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation. J Heart Lung Transplant 2024:S1053-2498(24)01737-6. [PMID: 39019353 DOI: 10.1016/j.healun.2024.07.003] [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: 10/11/2023] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studied. We hypothesized that long-term exposure of the lung donor and recipient to high levels of ambient air pollutants would increase the risk of PGD in lung transplant recipients. METHODS Using data from 1428 lung transplant recipients and their donors enrolled in the Lung Transplant Outcomes Group observational cohort study, we evaluated the association between the development of PGD and zip-code-based estimates of long-term exposure to 6 major air pollutants (ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, particulate matter 2.5, and particulate matter 10) in both the lung donor and the lung recipient. Exposure estimates used daily EPA air pollutant monitoring data and were based on the geographic centroid of each subject's residential zip code. Associations were tested in both univariable and multivariable models controlling for known PGD risk factors. RESULTS We did not find strong associations between air pollutant exposures in either the donor or the recipient and PGD. CONCLUSIONS Exposure to ambient air pollutants, at the levels observed in this study, may not be sufficiently harmful to prime the donor lung or the recipient to develop PGD, particularly when considering the robust associations with other established PGD risk factors.
Collapse
Affiliation(s)
- Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, California
| | - Carolyn S Calfee
- Department of Medicine, University of California, San Francisco, California; Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, California
| | - Michael A Matthay
- Department of Medicine, University of California, San Francisco, California; Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, California
| | - John P Reilly
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary K Porteous
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joshua M Diamond
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason D Christie
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Translational Lung Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Edward Cantu
- Division of Cardiovascular Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lorraine B Ware
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee.
| |
Collapse
|
4
|
England E, Morris JW, Bussy C, Hancox JC, Shiels HA. The key characteristics of cardiotoxicity for the pervasive pollutant phenanthrene. JOURNAL OF HAZARDOUS MATERIALS 2024; 469:133853. [PMID: 38503207 DOI: 10.1016/j.jhazmat.2024.133853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
The key characteristic (KCs) framework has been used previously to assess the carcinogenicity and cardiotoxicity of various chemical and pharmacological agents. Here, the 12 KCs of cardiotoxicity are used to evaluate the previously reported cardiotoxicity of phenanthrene (Phe), a tricyclic polycyclic aromatic hydrocarbon (PAH), and major component of fossil fuel-derived air pollution. Phe is a semi-volatile pollutant existing in both the gas phase and particle phase through adsorption onto or into particulate matter (PM). Phe can translocate across the airways and gastrointestinal tract into the systemic circulation, enabling body-wide effects. Our evaluation based on a comprehensive literature review, indicates Phe exhibits 11 of the 12 KCs for cardiotoxicity. These include adverse effects on cardiac electromechanical performance, the vasculature and endothelium, immunomodulation and oxidative stress, and neuronal and endocrine control. Environmental agents that have similarly damaging effects on the cardiovascular system are heavily regulated and monitored, yet globally there is no air quality regulation specific for PAHs like Phe. Environmental monitoring of Phe is not the international standard with benzo[a]pyrene being frequently used as a proxy despite the two PAH species exhibiting significant differences in sources, concentration variations and toxic effects. The evidence summarised in this evaluation highlights the need to move away from proxied PAH measurements and develop a monitoring network capable of measuring Phe concentration. It also stresses the need to raise awareness amongst the medical community of the potential cardiovascular impact of PAH exposure. This will allow the production of mitigation strategies and possibly the development of new policies for the protection of the societal groups most vulnerable to cardiovascular disease.
Collapse
Affiliation(s)
- E England
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - J W Morris
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - C Bussy
- Division of Immunology, Immunity to Infection, and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - J C Hancox
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - H A Shiels
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| |
Collapse
|
5
|
Craver A, Luo J, Kibriya MG, Randorf N, Bahl K, Connellan E, Powell J, Zakin P, Jones RR, Argos M, Ho J, Kim K, Daviglus ML, Greenland P, Ahsan H, Aschebrook-Kilfoy B. Air quality and cancer risk in the All of Us Research Program. Cancer Causes Control 2024; 35:749-760. [PMID: 38145439 PMCID: PMC11045436 DOI: 10.1007/s10552-023-01823-7] [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: 01/17/2023] [Accepted: 10/31/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The NIH All of Us Research Program has enrolled over 544,000 participants across the US with unprecedented racial/ethnic diversity, offering opportunities to investigate myriad exposures and diseases. This paper aims to investigate the association between PM2.5 exposure and cancer risks. MATERIALS AND METHODS This work was performed on data from 409,876 All of Us Research Program participants using the All of Us Researcher Workbench. Cancer case ascertainment was performed using data from electronic health records and the self-reported Personal Medical History questionnaire. PM2.5 exposure was retrieved from NASA's Earth Observing System Data and Information Center and assigned using participants' 3-digit zip code prefixes. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Generalized additive models (GAMs) were used to investigate non-linear relationships. RESULTS A total of 33,387 participants and 46,176 prevalent cancer cases were ascertained from participant EHR data, while 20,297 cases were ascertained from self-reported survey data from 18,133 participants; 9,502 cancer cases were captured in both the EHR and survey data. Average PM2.5 level from 2007 to 2016 was 8.90 μg/m3 (min 2.56, max 15.05). In analysis of cancer cases from EHR, an increased odds for breast cancer (OR 1.17, 95% CI 1.09-1.25), endometrial cancer (OR 1.33, 95% CI 1.09-1.62) and ovarian cancer (OR 1.20, 95% CI 1.01-1.42) in the 4th quartile of exposure compared to the 1st. In GAM, higher PM2.5 concentration was associated with increased odds for blood cancer, bone cancer, brain cancer, breast cancer, colon and rectum cancer, endocrine system cancer, lung cancer, pancreatic cancer, prostate cancer, and thyroid cancer. CONCLUSIONS We found evidence of an association of PM2.5 with breast, ovarian, and endometrial cancers. There is little to no prior evidence in the literature on the impact of PM2.5 on risk of these cancers, warranting further investigation.
Collapse
Affiliation(s)
- Andrew Craver
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Jiajun Luo
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Muhammad G Kibriya
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Nina Randorf
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Kendall Bahl
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Elizabeth Connellan
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Johnny Powell
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Paul Zakin
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Joyce Ho
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen Kim
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Habibul Ahsan
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Briseis Aschebrook-Kilfoy
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
- Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA.
| |
Collapse
|
6
|
Strobl K, Irfan SA, Masood H, Latif N, Kurmi O. Association between PM10 exposure and risk of myocardial infarction in adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0301374. [PMID: 38691568 PMCID: PMC11062553 DOI: 10.1371/journal.pone.0301374] [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: 09/02/2023] [Accepted: 03/11/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Air pollution has several negative health effects. Particulate matter (PM) is a pollutant that is often linked to health adversities. PM2.5 (PM with an aerodynamic diameter of ≤2.5μm) exposure has been associated with negative cardiovascular (CV) outcomes. However, the impact of PM10 (PM with an aerodynamic diameter of ≤10μm) exposure is often overlooked due to its limited ability to pass the alveolar barrier. This study aims to assess the association between PM10 exposure and risk of myocardial infarction (MI) amongst adults (≥18 years of age) as this has been poorly studied. METHODS The study protocol was published on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023409796) on March 31, 2023. Literature searches were conducted on 4 databases (Ovid Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science) on January 17, 2023, for studies looking at associations between PM and MI. English studies from all time periods were assessed. Studies selected for review were time-series, case-crossover, and cohort studies which investigated the risk of MI as an outcome upon PM10 exposure. The quality of evidence was assessed using Cochrane's Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data for different risk outcomes (risk ratio (RR), odds ratio (OR), hazard ratio (HR)) and 3 lags was meta-analyzed using an inverse variance statistical analysis using a random effects model. The pooled effect sizes and the 95% confidence intervals (CIs) were reported in forest plots. RESULTS Among the 1,099 studies identified, 41 were included for review and 23 were deemed eligible for meta-analysis. Our analysis revealed that there is an increased risk (OR = 1.01; 95% CI:1.00-1.02) of MI with a 10 μg/m3 increase in PM10 after a lag 0 and lag 1 delay. CONCLUSIONS Our findings indicate that PM10 exposure is associated with an increased risk of MI. This can aid in informing environmental policy-making, personal-level preventative measures, and global public health action.
Collapse
Affiliation(s)
- Kleiton Strobl
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Syed Asad Irfan
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Hassan Masood
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Noor Latif
- Faculty of Science, McMaster University, Hamilton, Canada
| | - Om Kurmi
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Faculty Research Centre for Healthcare and Communities, Coventry University, Coventry, United Kingdom
| |
Collapse
|
7
|
Wang J, Ma Y, Tang L, Li D, Xie J, Sun Y, Tian Y. Long-Term Exposure to Low Concentrations of Ambient Benzene and Mortality in a National English Cohort. Am J Respir Crit Care Med 2024; 209:987-994. [PMID: 38128545 DOI: 10.1164/rccm.202308-1440oc] [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: 08/17/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
Background: Benzene affects human health through environmental exposure in addition to occupational contact. However, few studies have examined the associations between long-term exposure to low concentrations of ambient benzene and mortality risks in nonoccupational settings.Methods: This prospective cohort study consists of 393,042 participants without stroke, myocardial infarction, or cancer at baseline from the UK Biobank. Annual average concentrations of benzene for each year during follow-up were measured using air dispersion models. The main outcomes were all-cause mortality and mortality from specific causes. Cox proportional-hazards models with time-varying exposure measurements were used to estimate the hazard ratios and 95% confidence intervals (CIs) for mortality risks. Restricted cubic spline models were used to estimate exposure-response relationships.Measurements and Main Results: With each interquartile range increase in the average annual concentration of benzene, the adjusted hazard ratios of mortality risk from all causes, cardiovascular disease, cancer, and respiratory disease were 1.26 (95% CI, 1.24-1.27), 1.24 (95% CI, 1.21-1.28), 1.27 (95% CI, 1.25-1.29), and 1.25 (95% CI, 1.20-1.30), respectively. The monotonically increasing exposure-response curves showed no threshold and plateau within the observed concentration range. Furthermore, the effect of benzene exposure on mortality persisted across different subgroups and was somewhat stronger in younger and White people (P for interaction < 0.05).Conclusions: Long-term exposure to low concentrations of ambient benzene significantly increases mortality risk in the general population. Ambient benzene represents a potential threat to public health, and further investigations are needed to support timely pollution regulation and health protection.
Collapse
Affiliation(s)
- Jianing Wang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating)
- Department of Maternal and Child Health, School of Public Health, and
| | - Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating)
- Department of Maternal and Child Health, School of Public Health, and
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating)
- Department of Maternal and Child Health, School of Public Health, and
| | - Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating)
- Department of Maternal and Child Health, School of Public Health, and
| | - Junqing Xie
- Center for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, The Botnar Research Centre, Oxford, United Kingdom; and
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating)
- Department of Maternal and Child Health, School of Public Health, and
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| |
Collapse
|
8
|
Jia W, Fu Y, Zhang N, Zhang N, Wang T, Wang Z, Zhang N, Xu J, Yang X, Zhang Q, Li C, Zhang X, Yang W, Han B, Zhang L, Tang N, Bai Z. Ambient PM 2.5-bound polycyclic aromatic hydrocarbons (PAHs) associated with pro-thrombotic biomarkers among young healthy adults: A 16 times repeated measurements panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169433. [PMID: 38128672 DOI: 10.1016/j.scitotenv.2023.169433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Studies have shown that the cardio/cerebrovascular toxicity of ambient PM2.5 is related to its bound polycyclic aromatic hydrocarbons (PAHs). Currently, only a few studies have reported the relationship between PM2.5-bound PAHs and promoted blood coagulation and thrombosis, but there isn't a consistent conclusion. Therefore, we conducted a prospective panel study to investigate the association. Thirty-three young healthy adults participated in sixteen repeated visits from 2014 to 2018 in Tianjin, China. During each visit, three pro-thrombotic biomarkers: ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin motif 13), D-dimer and Myeloperoxidase (MPO) were measured. Before each visit, ambient PM2.5 samples were daily collected for one week. Sixteen PAHs were determined using Gas Chromatography-Mass Spectrometer, and the positive matrix factorization (PMF) model was applied to identify the sources. Linear mixed-effects models were fitted to investigate the associations between PM2.5-bound PAHs exposure and the biomarkers. Thirteen time-metrics were defined to identify significant time points of PM2.5-bound PAHs' effects. We observed that the increase of PM2.5-bound PAHs exposure was significantly associated with reduced ADAMTS13, elevated D-dimer and MPO. At lag0, each 5.7 ng/m3 increase in Benzo[j]fluoranthene and per 3.4 ng/m3 increase Dibenz[a,h]anthracene could make a maximum change of -19.08 % in ADAMTS13 and 132.60 % in D-dimer. Additionally, per 16.43 ng/m3 increase in Chrysene could lead to a maximum elevation of 32.14 % in MPO at lag4. The PM2.5-bound PAHs often triggered more significant changes at lag 3,4 and 6. The ambient PM2.5-bound PAHs originated from six sources: coal combustion (43.10 %), biomass combustion (20.77 %), diesel emission (14.78 %), gasoline emission (10.95 %), industrial emission (7.58 %), and cooking emission (2.83 %). The greatest contributors to alterations in ADAMTS13, D-dimer and MPO are industrial emission (-48.43 %), biomass combustion (470.32 %) and diesel emission (13.14 %) at lag4. Our findings indicated that short-term exposure to ambient PM2.5-bound PAHs can induce alterations of pro-thrombotic biomarkers among healthy adults.
Collapse
Affiliation(s)
- Wenhui Jia
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Yucong Fu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Nan Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Ningyu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Tong Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Zhiyu Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Nan Zhang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Qiang Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Wen Yang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| |
Collapse
|
9
|
Guo LH, Lin LZ, Zhou Y, Jalaludin B, Morawska L, Dharmage SC, Knibbs LD, Huang GF, Chen DH, Ma H, Gao M, Heinrich J, Zhou P, Gui ZH, Chu C, Liu RQ, Dong GH. Global, regional, and national burden of ischemic heart disease attributable to ambient PM 2.5 from 1990 to 2019: An analysis for the global burden of disease study 2019. ENVIRONMENTAL RESEARCH 2024; 241:117635. [PMID: 37972813 DOI: 10.1016/j.envres.2023.117635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/28/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
Information on the spatio-temporal patterns of the burden of ischemic heart disease (IHD) caused by ambient ambient fine particulate matter (PM2.5) in the global level is needed to prioritize the control of ambient air pollution and prevent the burden of IHD. The Global Burden of Disease Study (GBD) 2019 provides data on IHD attributable to ambient PM2.5. The IHD burden and mortality attributable to ambient PM2.5 were analyzed by year, age, gender, socio-demographic index (SDI) level, geographical region and country. Estimated annual percentage change (EAPC) was calculated to estimate the temporal trends of age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) from 1990 to 2019. Globally, the ASMR and ASDR for ambient PM2.5-related IHD tended to level off generally, with EAPC of -0.03 (95% CI: -0.06, 0.12) and 0.3 (95% CI: 0.22, 0.37), respectively. In the past 30 years, there were obvious differences in the trend of burden change among different regions. A highest increased burden was estimated in low-middle SDI region (EAPC of ASMR: 3.73 [95% CI: 3.56, 3.9], EAPC of ASDR: 3.83 [95% CI: 3.64, 4.02]). In contrast, the burden in high SDI region (EAPC of ASMR: -4.48 [95% CI: -4.6, -4.35], EAPC of ASDR: -3.98 [95% CI: -4.12, -3.85]) has declined most significantly. Moreover, this burden was higher among men and older populations. EAPCs of the ASMR (R = -0.776, p < 0.001) and ASDR (R = -0.781, p < 0.001) of this burden had significant negative correlations with the countries' SDI level. In summary, although trends in the global burden of IHD attributable to ambient PM2.5 are stabilizing, but this burden has shifted from high SDI countries to middle and low SDI countries, especially among men and elderly populations. To reduce this burden, the air pollution management prevention need to be further strengthened, especially among males, older populations, and middle and low SDI countries.
Collapse
Affiliation(s)
- Li-Hao Guo
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China.
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW, 2037, Australia; Ingham Institute for Applied Medial Research, Liverpool, NSW, 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW, 2052, Australia.
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Luke D Knibbs
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.
| | - Guo-Feng Huang
- 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.
| | - 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.
| | - 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.
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong, China.
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, 80336, Germany.
| | - Peien Zhou
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, CB2 1TN, UK.
| | - Zhao-Huan Gui
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Chu Chu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Ru-Qing Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| |
Collapse
|
10
|
Wang Q, Cao J. Atmospheric PM 2.5 exposure and risk of ischemic heart disease: A systematic review and meta-analysis of observational studies. Perfusion 2024; 39:210-222. [PMID: 36342821 DOI: 10.1177/02676591221131485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Fine particulate matter <2.5 μm in diameter (PM2.5) has been validated to associate with cardiovascular diseases (CVD) incidence and mortality. So far, no study has quantitatively evaluated the relationship between the atmospheric PM2.5 exposure and ischemic heart disease (IHD). We conducted a meta-analysis to illustrate the relationship between PM2.5 and IHD. Published articles were systematically searched (until June 2022) from PubMed, EMBASE, Cochrane Library. A random-effect model was performed to summarize the total relative risks (RRs) and 95% confidence intervals (CIs). Meta-analysis was performed using Stata 12.0 software. A total of 28 studies among 23 cohorts (23.38 million individuals and 256256 IHD cases) were included. With PM2.5 increasing 10 μg/m3, the total RRs of IHD incidence and mortality were 1.07 (95% CI: 0.99-1.17), 1.21 (95% CI: 1.15-1.28), respectively. In sub-analyses, our study revealed that the combined RRs of exposure to PM2.5 on IHD mortality in Asian and European population [1.11 (95% CI: 0.93-1.33); 1.06 (95% CI: 1.02-1.11)] were much lower compared with American and Canadian people [1.27 (95% CI: 1.17-1.37); 1.30 (95% CI: 1.24-1.35)]. Furthermore, study duration, size and some adjustments were related with the total RR. Our findings indicated that exposure of an increase in the concentration of atmospheric PM2.5 may increase the risk of IHD incidence and mortality. Further evidence is needed to confirmed the association.
Collapse
Affiliation(s)
- Qingli Wang
- Department of Cardiology, Yancheng Clinical College of Xuzhou Medical University, Yancheng, China
| | - Jingyan Cao
- Department of Cardiology, Yancheng Clinical College of Xuzhou Medical University, Yancheng, China
| |
Collapse
|
11
|
Ma Y, Zhang J, Li D, Tang L, Li Y, Cui F, Wang J, Wen C, Yang J, Tian Y. Genetic Susceptibility Modifies Relationships Between Air Pollutants and Stroke Risk: A Large Cohort Study. Stroke 2024; 55:113-121. [PMID: 38134266 DOI: 10.1161/strokeaha.123.044284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The extent to which genetic susceptibility modifies the associations between air pollutants and the risk of incident stroke is still unclear. This study was designed to investigate the separate and joint associations of long-term exposure to air pollutants and genetic susceptibility on stroke risk. METHODS The participants of this study were recruited by the UK Biobank between 2006 and 2010. These participants were followed up from the enrollment until the occurrence of stroke events or censoring of data. Hazard ratios (HRs) and 95% CIs for stroke events associated with long-term exposure to air pollutants were estimated by fitting both crude and adjusted Cox proportional hazards models. Additionally, the polygenic risk score was calculated to estimate whether the polygenic risk score modifies the associations between exposure to air pollutants and incident stroke. RESULTS A total of 502 480 subjects were included in this study. After exclusion, 452 196 participants were taken into the final analysis. During a median follow-up time of 11.7 years, 11 334 stroke events were observed, with a mean age of 61.60 years, and men accounted for 56.2% of the total cases. Long-term exposures to particulate matter with an aerodynamic diameter smaller than 2.5 µm (adjusted HR, 1.70 [95% CI, 1.43-2.03]) or particulate matter with an aerodynamic diameter smaller than 10 µm (adjusted HR, 1.50 [95% CI, 1.36-1.66]), nitrogen dioxide (adjusted HR, 1.10 [95% CI, 1.07-1.12]), and nitrogen oxide (adjusted HR, 1.04 [95% CI, 1.02-1.05]) were pronouncedly associated with increased risk of stroke. Meanwhile, participants with high genetic risk and exposure to high air pollutants had ≈45% (31%, 61%; particulate matter with an aerodynamic diameter smaller than 2.5 µm), 48% (33%, 65%; particulate matter with an aerodynamic diameter smaller than 10 µm), 51% (35%, 69%; nitrogen dioxide), and 39% (25%, 55%; nitrogen oxide) higher risk of stroke compared with those with low genetic risk and exposure to low air pollutants, respectively. Of note, we observed additive and multiplicative interactions between genetic susceptibility and air pollutants on stroke events. CONCLUSIONS Chronic exposure to air pollutants was associated with an increased risk of stroke, especially in populations at high genetic risk.
Collapse
Affiliation(s)
- Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Zhang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital (J.Z., J.Y.)
- Institute of Cardiovascular Diseases, China Three Gorges University, Yichang (J.Z., J.Y.)
- Hubei Clinical Research Center for Ischemic Cardiovascular Disease, Yichang, China (J.Z., J.Y.)
| | - Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yimeng Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT (Y.L.)
| | - Feipeng Cui
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianing Wang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Wen
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan, China (C.W.)
| | - Jian Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital (J.Z., J.Y.)
- Institute of Cardiovascular Diseases, China Three Gorges University, Yichang (J.Z., J.Y.)
- Hubei Clinical Research Center for Ischemic Cardiovascular Disease, Yichang, China (J.Z., J.Y.)
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
12
|
Liu N, Deng Q, Hu P, Chang J, Li Y, Zhang Y, Su Y, Liu J, Long Y. Associations between urban exposome and recurrence risk among survivors of acute myocardial infarction in Beijing, China. ENVIRONMENTAL RESEARCH 2023; 238:117267. [PMID: 37776939 PMCID: PMC7615203 DOI: 10.1016/j.envres.2023.117267] [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: 05/22/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Few previous studies have investigated the impacts of coexposure to multiple urban environmental factors on the prognosis of acute myocardial infarction (AMI) events. This study aimed to evaluate the associations between the urban exposome and AMI recurrence. We used data from 88,509 AMI patients from a large cohort obtained from the Beijing Cardiovascular Disease Surveillance System between 2013 and 2019. Twenty-six types of urban exposures were assessed within 300-m, 500-m, and 1000-m buffers of patients' home addresses in the baseline and cumulative average levels. We used the Cox proportional hazard model along with the Elastic Net (ENET) algorithm to estimate the hazard ratios (HRs) of recurrent AMI per interquartile range increase in each selected urban exposure. The increased risk of AMI recurrence was significantly associated with lower urban function diversity in the 500-m buffer, longer distance to subway stations and higher PM2.5 for both baseline and cumulative average exposure. The cumulative averages of two urban factors, including the distance to parks, and the density of fruit and vegetable shops in the 1000-m buffer, were also identified as significant factors affecting the risk of AMI recurrence. These findings can help improve the urban design for promoting human cardiovascular health.
Collapse
Affiliation(s)
- Ningrui Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Yan Li
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuyang Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuwei Su
- School of Architecture, Tsinghua University, Beijing, China; School of Urban Design, Wuhan University, Wuhan, China
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China.
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China; Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing, China.
| |
Collapse
|
13
|
Wang Y, Qiu X, Wei Y, Schwartz JD. Long-Term Exposure to Ambient PM 2.5 and Hospitalizations for Myocardial Infarction Among US Residents: A Difference-in-Differences Analysis. J Am Heart Assoc 2023; 12:e029428. [PMID: 37702054 PMCID: PMC10547266 DOI: 10.1161/jaha.123.029428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023]
Abstract
Background Air pollution has been recognized as an untraditional risk factor for myocardial infarction (MI). However, the MI risk attributable to long-term exposure to fine particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) is unclear, especially in younger populations, and few studies have represented the general population or had power to examine comorbidities. Methods and Results We applied the difference-in-differences approach to estimate the relationship between annual PM2.5 exposure and hospitalizations for MI among US residents and further identified potential susceptible subpopulations. All hospital admissions for MI in 10 US states over the period 2002 to 2016 were obtained from the Healthcare Cost and Utilization Project State Inpatient Database. In total, 1 914 684 MI hospital admissions from 8106 zip codes were included in this study. We observed a 1.35% (95% CI, 1.11-1.59) increase in MI hospitalization rate for 1-μg/m3 increase in annual PM2.5 exposure. The estimate was robust to adjustment for surface pressure, relative humidity, and copollutants. In the population exposed to ≤12 μg/m3, there was a larger increment of 2.17% (95% CI, 1.79-2.56) in hospitalization rate associated with 1-μg/m3 increase in PM2.5. Young people (0-34 years of age) and elderly people (≥75 years of age) were the 2 most susceptible age groups. Residents living in more densely populated or poorer areas and individuals with comorbidities were observed to be at a greater risk. Conclusions This study indicates long-term residential exposure to PM2.5 could increase risk of MI among the general US population, people with comorbidities, and poorer individuals. The association persists below current standards.
Collapse
Affiliation(s)
- Yichen Wang
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Xinye Qiu
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Yaguang Wei
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Joel D. Schwartz
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
| |
Collapse
|
14
|
Alahmad B, Khraishah H, Althalji K, Borchert W, Al-Mulla F, Koutrakis P. Connections Between Air Pollution, Climate Change, and Cardiovascular Health. Can J Cardiol 2023; 39:1182-1190. [PMID: 37030516 PMCID: PMC11097327 DOI: 10.1016/j.cjca.2023.03.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
Globally, more people die from cardiovascular disease than any other cause. Climate change, through amplified environmental exposures, will promote and contribute to many noncommunicable diseases, including cardiovascular disease. Air pollution, too, is responsible for millions of deaths from cardiovascular disease each year. Although they may appear to be independent, interchangeable relationships and bidirectional cause-and-effect arrows between climate change and air pollution can eventually lead to poor cardiovascular health. In this topical review, we show that climate change and air pollution worsen each other, leading to several ecosystem-mediated effects. We highlight how increases in hot climates as a result of climate change have increased the risk of major air pollution events such as severe wildfires and dust storms. In addition, we show how altered atmospheric chemistry and changing patterns of weather conditions can promote the formation and accumulation of air pollutants: a phenomenon known as the climate penalty. We demonstrate these amplified environmental exposures and their associations to adverse cardiovascular health outcomes. The community of health professionals-and cardiologists, in particular-cannot afford to overlook the risks that climate change and air pollution bring to the public's health.
Collapse
Affiliation(s)
- Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Environmental and Occupational Health Department, College of Public Health, Kuwait University, Kuwait City, Kuwait; Dasman Diabetes Institute (DDI), Kuwait City, Kuwait.
| | - Haitham Khraishah
- Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Khalid Althalji
- Jaber Alahmad Hospital, Ministry of Health, Kuwait City, Kuwait
| | - William Borchert
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Fahd Al-Mulla
- Dasman Diabetes Institute (DDI), Kuwait City, Kuwait
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
15
|
Yuan Y, Wang K, Sun HZ, Zhan Y, Yang Z, Hu K, Zhang Y. Excess mortality associated with high ozone exposure: A national cohort study in China. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2023; 15:100241. [PMID: 36761466 PMCID: PMC9905662 DOI: 10.1016/j.ese.2023.100241] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 05/24/2023]
Abstract
Emerging epidemiological studies suggest that long-term ozone (O3) exposure may increase the risk of mortality, while pre-existing evidence is mixed and has been generated predominantly in North America and Europe. In this study, we investigated the impact of long-term O3 exposure on all-cause mortality in a national cohort in China. A dynamic cohort of 20882 participants aged ≥40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study. A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season (April-September) O3 exposure. The annual average level of participant exposure to warm-season O3 concentrations was 100 μg m-3 (range: 61-142 μg m-3). An increase of 10 μg m-3 in O3 was associated with a hazard ratio (HR) of 1.18 (95% confidence interval [CI]: 1.13-1.23) for all-cause mortality. Compared with the first exposure quartile of O3, HRs of mortality associated with the second, third, and highest exposure quartiles were 1.09 (95% CI: 0.95-1.25), 1.02 (95% CI: 0.88-1.19), and 1.56 (95% CI: 1.34-1.82), respectively. A J-shaped concentration-response association was observed, revealing a non-significant increase in risk below a concentration of approximately 110 μg m-3. Low-temperature-exposure residents had a higher risk of mortality associated with long-term O3 exposure. This study expands current epidemiological evidence from China and reveals that high-concentration O3 exposure curtails the long-term survival of middle-aged and older adults.
Collapse
Affiliation(s)
- Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
- Department of Earth Sciences, University of Cambridge, Cambridge, CB2 3EQ, UK
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| |
Collapse
|
16
|
Huang W, Zhou Y, Chen X, Zeng X, Knibbs LD, Zhang Y, Jalaludin B, Dharmage SC, Morawska L, Guo Y, Yang X, Zhang L, Shan A, Chen J, Wang T, Heinrich J, Gao M, Lin L, Xiao X, Zhou P, Yu Y, Tang N, Dong G. Individual and joint associations of long-term exposure to air pollutants and cardiopulmonary mortality: a 22-year cohort study in Northern China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100776. [PMID: 37547049 PMCID: PMC10398602 DOI: 10.1016/j.lanwpc.2023.100776] [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: 12/05/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 08/08/2023]
Abstract
Background Evidence on the associations between long-term exposure to multiple air pollutants and cardiopulmonary mortality is limited, especially for developing regions with higher pollutant levels. We aimed to characterise the individual and joint (multi-pollutant) associations of long-term exposure to air pollutants with cardiopulmonary mortality, and to identify air pollutant that primarily contributes to the mortality risk. Methods We followed 37,442 participants with a mean age of 43.5 years in four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) from January 1998 to December 2019. Annual particulate matter (PM) with diameters ≤2.5 μm (PM2.5), ≤10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were estimated using daily average values from satellite-derived machine learning models and monitoring stations. Time-varying Cox proportional hazards model was used to evaluate the individual association between air pollutants and mortality from non-accidental causes, cardiovascular diseases (CVDs), non-malignant respiratory diseases (RDs) and lung cancer, accounting for demographic and socioeconomic factors. Effect modifications by age, sex, income and education level were also examined. Quantile-based g-Computation integrated with time-to-event data was additionally applied to evaluate the co-effects and the relative weight of contributions for air pollutants. Findings During 785,807 person-years of follow-up, 5812 (15.5%) died from non-accidental causes, among which 2932 (7.8%) were from all CVDs, 479 (1.3%) from non-malignant RDs, and 552 (1.4%) from lung cancer. Long-term exposure to PM10 (mean [baseline]: 136.5 μg/m3), PM2.5 (mean [baseline]: 70.2 μg/m3), SO2 (mean [baseline]: 113.0 μg/m3) and NO2 (mean [baseline]: 39.2 μg/m3) were adversely and consistently associated with all mortality outcomes. A 10 μg/m3 increase in PM2.5 was associated with higher mortality from non-accidental causes (hazard ratio 1.20; 95% confidence interval 1.17-1.23), CVDs (1.23; 1.19-1.28), non-malignant RDs (1.37; 1.25-1.49) and lung cancer (1.14; 1.05-1.23). A monotonically increasing curve with linear or supra-linear shape with no evidence of a threshold was observed for the exposure-response relationship of mortality with individual or joint exposure to air pollutants. PM2.5 consistently contributed most to the elevated mortality risks related to air pollutant mixture, followed by SO2 or PM10. Interpretation There was a strong and positive association of long-term individual and joint exposure to PM10, PM2.5, SO2, and NO2 with mortalities from non-accidental causes, CVDs, non-malignant RDs and lung cancer in high-exposure settings, with PM2.5 potentially being the main contributor. The shapes of associations were consistent with a linear or supra-linear exposure-response relationship, with no lower threshold observed within the range of concentrations in this study. Funding National Key Research and Development Program of China, the China Scholarship Council, the National Natural Science Foundation of China, Natural Science Foundation of Guangdong Province.
Collapse
Affiliation(s)
- Wenzhong Huang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xiaowen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Luke D. Knibbs
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, NSW 2006, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Yunting Zhang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW 2037, Australia
- Ingham Institute for Applied Medial Research, Liverpool, NSW 2170, Australia
- School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tong Wang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich 80336, Germany
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
| | - Lizi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peien Zhou
- Department of Public Health & Primary Care, University of Cambridge, Cambridge CB2 1TN, United Kingdom
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| |
Collapse
|
17
|
Manojkumar N, Srimuruganandam B. Spatio-temporal health benefits attributable to PM 2.5 reduction in an Indian city. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:552-562. [PMID: 35187985 DOI: 10.1080/09603123.2022.2040959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Fine particulate matter (PM2.5) is linked with a wide spectrum of human health effects and has the highest contribution to total air pollution mortality. This study aims to quantify health benefits of reducing PM2.5 concentration to World Health Organization standard (annual mean = 10 µg m-3) for various health endpoints during 2011-2019 period using AirQ+ and BenMAP-CE software packages. Intraurban assessment in Vellore city, India was done by estimating health benefits at ward level. Both software packages estimated annual average all-cause, ischemic heart disease, stroke, and chronic obstructive pulmonary disease health benefits in the range of 919-945, 175-234, 70-152, and 99-175 cases at city level and 15-16, 3-4, 1-3, and 2-3 cases at ward level, respectively. Sensitivity analysis showed that relative risk had a large influence on health benefit estimates. Present study results will play a crucial role in the future air quality and public health policies of Vellore city.
Collapse
Affiliation(s)
- N Manojkumar
- School of Civil Engineering, Vellore Institute of Technology, Vellore, India
| | - B Srimuruganandam
- School of Civil Engineering, Vellore Institute of Technology, Vellore, India
| |
Collapse
|
18
|
Poulsen AH, Sørensen M, Hvidtfeldt UA, Christensen JH, Brandt J, Frohn LM, Ketzel M, Andersen C, Raaschou-Nielsen O. Source-Specific Air Pollution Including Ultrafine Particles and Risk of Myocardial Infarction: A Nationwide Cohort Study from Denmark. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:57010. [PMID: 37235386 DOI: 10.1289/ehp10556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Air pollution is negatively associated with cardiovascular health. Impediments to efficient regulation include lack of knowledge about which sources of air pollution contributes most to health burden and few studies on effects of the potentially more potent ultrafine particles (UFP). OBJECTIVE The authors aimed to investigate myocardial infarction (MI) morbidity and specific types and sources of air pollution. METHODS We identified all persons living in Denmark in the period 2005-2017, age >50 y and never diagnosed with MI. We quantified 5-y running time-weighted mean concentrations of air pollution at residencies, both total and apportioned to traffic and nontraffic sources. We evaluated particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5), <0.1μm (UFP), elemental carbon (EC), and nitrogen dioxide (NO2). We used Cox proportional hazards models, with adjustment for time-varying exposures, and personal and area-level demographic and socioeconomic covariates from high-quality administrative registers. RESULTS In this nationwide cohort of 1,964,702 persons (with 18 million person-years of follow-up and 71,285 cases of MI), UFP and PM2.5 were associated with increased risk of MI with hazard ratios (HRs) per interquartile range (IQR) of 1.040 [95% confidence interval (CI): 1.025, 1.055] and 1.053 (95% CI: 1.035, 1.071), respectively. HRs per IQR of UFP and PM2.5 from nontraffic sources were similar to the total (1.034 and 1.051), whereas HRs for UFP and PM2.5 from traffic sources were smaller (1.011 and 1.011). The HR for EC from traffic sources was 1.013 (95% CI: 1.003, 1.023). NO2 from nontraffic sources was associated with MI (HR=1.048; 95% CI: 1.034, 1.062) but not from traffic sources. In general, nontraffic sources contributed more to total air pollution levels than national traffic sources. CONCLUSIONS PM2.5 and UFP from traffic and nontraffic sources were associated with increased risk of MI, with nontraffic sources being the dominant source of exposure and morbidity. https://doi.org/10.1289/EHP10556.
Collapse
Affiliation(s)
- Aslak Harbo Poulsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ulla Arthur Hvidtfeldt
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate (Interdisciplinary Centre for Climate Change), Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate (Interdisciplinary Centre for Climate Change), Aarhus University, Roskilde, Denmark
| | - Lise Marie Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate (Interdisciplinary Centre for Climate Change), Aarhus University, Roskilde, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research, Department of Civil and Environmental Engineering, University of Surrey, Guildford, UK
| | - Christopher Andersen
- iClimate (Interdisciplinary Centre for Climate Change), Aarhus University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- iClimate (Interdisciplinary Centre for Climate Change), Aarhus University, Roskilde, Denmark
| |
Collapse
|
19
|
Poulsen AH, Sørensen M, Hvidtfeldt UA, Frohn LM, Ketzel M, Christensen JH, Brandt J, Massling A, Khan J, Lassen CF, Raaschou-Nielsen O. Air pollution and myocardial infarction; effect modification by sociodemographic and environmental factors. A cohort study from Denmark. ENVIRONMENTAL RESEARCH 2023; 229:115905. [PMID: 37086881 DOI: 10.1016/j.envres.2023.115905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
Air pollution is associated with increased risk of myocardial infarction (MI), but it is unresolved to what extent the association is modified by factors such as socioeconomic status, comorbidities, financial stress, residential green space, or road traffic noise. We formed a cohort of all (n = 1,964,702) Danes, aged 50-85 years, with 65,311 cases of MI during the followed-up period 2005-2017. For all participants we established residential five-year running average exposure to particulate matter <2.5 μm (PM2.5), ultrafine particles (UFP, <0.1 μm), elemental carbon (EC) and nitrogen dioxide (NO2). We evaluated risk in population strata, using Aalen additive hazards models to estimate absolute risk and Cox proportional hazards models to estimate relative risk of MI with 95% confidence intervals (CI). PM2.5 and the other pollutant were associated with MI. Lower education and lower income were associated with higher absolute risks of MI from air pollution, whereas no clear effect modification was apparent for relative risk estimates. For example, 5 μg/m3 higher PM2.5 was associated with HR for MI of 1.16 (95% CI: 1.10-1.22) among those with only mandatory education and 1.13 (95% CI: 1.03-1.24) among those with long education. The corresponding rate differences per 100,000 person years were 243 (95% CI: 216-271) and 358 (95% CI: 338-379), respectively. Higher level of comorbidity was consistently across all four pollutants associated with both higher absolute and relative risk of MI. In conclusion, people with comorbid conditions or of lower SES appeared more vulnerable to long-term exposure to air pollution and more cases of MI may be prevented by focused interventions in these groups.
Collapse
Affiliation(s)
- Aslak Harbo Poulsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
| | - Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, 4000, Roskilde, Denmark
| | - Ulla A Hvidtfeldt
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; iClimate - Interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, UK
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; iClimate - Interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; iClimate - Interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Andreas Massling
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Christina Funch Lassen
- Centre of Social Medicine, University Hospital Bispebjerg-Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Ole Raaschou-Nielsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| |
Collapse
|
20
|
Xia Y, Liu Z, Hu B, Rangarajan S, Ah Tse L, Li Y, Wang J, Hu L, Wang Y, Xiang Q, Lin Y, Han G, Yusuf S, Li W. Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China). ENVIRONMENT INTERNATIONAL 2023; 174:107829. [PMID: 36934571 DOI: 10.1016/j.envint.2023.107829] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is lacking. This study aimed to investigate the associations between long-term exposure to ambient fine particulate matter<2.5 µm (PM2.5) concentrations and the risk of incidence and mortality of CVD in a large cohort study from 115 communities. METHODS In this cohort study, we followed 42 160 adults aged 35-75 years at baseline who enrolled in the Prospective Urban and Rural Epidemiology Study conducted in China (PURE-China) between 2005 and 2009 with ambient PM2.5 estimates, and followed up until August 2021. Cox proportional hazards frailty models were used to estimate the associations between long-term mean outdoor PM2.5 concentrations and CVD events, CVD mortality, and all-cause mortality. FINDINGS During a median follow-up period of 11.8 years, we documented 2 190 deaths, including 732 CVD deaths. There were 4 559 (10.8 %) of 42 160 participants who experienced incident total CVD, among them there were 861 myocardial infarctions (MI) and 2 338 S. The 3-year median concentration of ambient PM2.5 before the cohort commencement was 52.7 µg/m3 (interquartile range [IQR] 30.3-74.6). In full adjusted model, a 10 µg/m3 increase in PM2.5 was associated with a hazard ratio (HR) of 1.12 (95 % CI 1.11-1.14) for major CVD and 1.03 (95 % CI 1.01-1.05) for all-cause mortality. Besides, long-term PM2.5 concentrations had a significantly positive gradient association with total CVD and a similar pattern of associations with other CVD outcomes was observed. INTERPRETATION This study demonstrated that long-term ambient PM2.5 concentrations is positively associated with increased risks of CVD in adults aged 35-70 years from China. This finding reinforces the need for policymakers to adopt more effective strategies to improve air quality.
Collapse
Affiliation(s)
- Yanjie Xia
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiguang Liu
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Bo Hu
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lap Ah Tse
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yang Li
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junying Wang
- Balingqiao Community Health Service Center, Xinghualing District, Taiyuan, Shanxi Province, China
| | - Lihua Hu
- Nanchang County Center for Disease Control and Prevention, Nanchang, Jiangxi Province, China
| | - Yang Wang
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Quanyong Xiang
- Centers for Disease Control and Prevention in Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Yang Lin
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Guoliang Han
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Wei Li
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
21
|
Abstract
Despite recent advances in treatment and prevention, stroke remains a leading cause of morbidity and mortality. There is a critical need to identify novel modifiable risk factors for disease, including environmental agents. A body of evidence has accumulated suggesting that elevated levels of ambient air pollutants may not only trigger cerebrovascular events in susceptible people (short-term exposures) but also increase the risk of future events (long-term average exposures). This review assesses the updated evidence for both short and long-term exposure to ambient air pollution as a risk factor for stroke incidence and outcomes. It discusses the potential pathophysiologic mechanisms and makes recommendations to mitigate exposure on a personal and community level. The evidence indicates that reduction in air pollutant concentrations represent a significant population-level opportunity to reduce risk of cerebrovascular disease.
Collapse
Affiliation(s)
- Erin R Kulick
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA (E.R.K.)
| | - Joel D Kaufman
- Department of Medicine, University of Washington, Seattle (J.D.K., C.S.)
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle (J.D.K., C.S.)
- Department of Epidemiology, University of Washington, Seattle (J.D.K.)
| | - Coralynn Sack
- Department of Medicine, University of Washington, Seattle (J.D.K., C.S.)
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle (J.D.K., C.S.)
| |
Collapse
|
22
|
Wang X, Wang T, Hua J, Cai M, Qian Z, Wang C, Li H, McMillin SE, Aaron HE, Xie C, Lin H. Histological types of lung cancer attributable to fine particulate, smoking, and genetic susceptibility. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159890. [PMID: 36334679 DOI: 10.1016/j.scitotenv.2022.159890] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/07/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5), smoking, and genetic factors are associated with lung cancer. However, the relationship between PM2.5, smoking and subtypes of lung cancer remains unclear. Moreover, it is unclear whether genetic risk modifies the impact of PM2.5 and smoking on incident lung cancer. METHODS A total of 298,069 participants from the UK Biobank study without lung cancer at baseline were included in this study. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated using multivariable Cox proportional models for the association of lung cancer and its subtypes with PM2.5, smoking, and genetic risk. Potential gene-smoking or gene-PM2.5 interactions were also estimated. We further estimated population attributable fractions for incident lung cancer. RESULTS During 10.4 years of follow-up, 1683 incident lung cancer cases were identified. Our analysis found that genetic variants, smoking, and PM2.5 were significantly associated with incident lung cancer. For different histological types of lung cancer, the HRs for squamous cell lung carcinoma associated with PM2.5 (per 5 μg/m3 increment) and current smoking were 2.76 (95 % CI: 1.72, 4.42, p < 0.001) and 48.64 (95 % CI: 27.96, 84.61, p < 0.001), while the HRs for lung adenocarcinoma were 1.59 (95 % CI: 1.13, 2.23, p < 0.001) and 9.89 (95 % CI: 7.91, 12.36, p < 0.001), respectively. We further found that participants with high levels of PM2.5 pollution and high genetic risk had the highest risk of incident lung cancer (HR = 1.81, 95 % CI: 1.39, 2.35, p < 0.001), while the interaction between PM2.5 and genetic risk was not statistically significant. We observed that the population attributable fractions of lung cancer attributable to current smoking and high PM2.5 exposure were estimated to be 67.45 % and 17.59 %. CONCLUSION Genetic susceptibility, smoking, and PM2.5 are important risk factors for lung cancer. Both smoking and PM2.5 are more closely associated with an elevated risk of squamous cell lung cancer.
Collapse
Affiliation(s)
- Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, China
| | - Tingting Wang
- Department of Public Health, Faculty of Medicine, Macau University of Science and Technology, China
| | - Junjie Hua
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, China
| | | | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Chuanbo Xie
- Cancer Prevention Center, Sun Yat-sen University Cancer Center, China; State Key Laboratory of Oncology in South China, China; Collaborative Innovation Center for Cancer Medicine, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, China.
| |
Collapse
|
23
|
Min KD, Kim SY, Cho SI. Ambient PM 2.5 exposures could increase risk of tuberculosis recurrence. Environ Health Prev Med 2023; 28:48. [PMID: 37648454 PMCID: PMC10480611 DOI: 10.1265/ehpm.23-00131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The effect of ambient PM2.5 on the incidence of tuberculosis (TB) has been investigated in epidemiological studies. However, they did not separately study new and relapsed TB infection and focused on relatively short-term effects of PM2.5. In this regard, we examined the associations of long-term PM2.5 exposures with both new and relapsed TB incidences in South Korea, where the disease burden of TB is greatest among high-income countries. METHODS An area-level ecological study of 250 districts was conducted from 2015 to 2019. Age- and sex-standardized TB incidence ratios for each district and year were used as outcome variables, and their associations with PM2.5 concentrations for one to five-year average were examined. Negative binomial regression models incorporating spatiotemporal autocorrelation were employed using integrated nested Laplace approximations. Stratified analyses were conducted by type of TB (total, new, and relapsed cases). RESULTS Districts with higher PM2.5 concentrations tended to have significantly higher TB recurrence rate. The relative risks per 10 µg/m3 PM2.5 increase were 1.218 (95% credible interval 1.051-1.411), 1.260 (1.039-1.527) and 1.473 (1.015-2.137) using the two, three and five-year average PM2.5 exposures, respectively. CONCLUSIONS The results imply that interventions for reducing air pollution might help prevent TB recurrence.
Collapse
Affiliation(s)
- Kyung-Duk Min
- College of Veterinary Medicine, Chungbuk National University
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center
| | - Sung-il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University
| |
Collapse
|
24
|
Shi W, Zhang T, Li Y, Huang Y, Luo L. Association between household air pollution from solid fuel use and risk of chronic diseases and their multimorbidity among Chinese adults. ENVIRONMENT INTERNATIONAL 2022; 170:107635. [PMID: 36413929 DOI: 10.1016/j.envint.2022.107635] [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: 08/13/2022] [Revised: 10/21/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Given the increasing burden of chronic conditions, multimorbidity is now a priority for public health systems worldwide. However, the relationship between household air pollution (HAP) exposure with multimorbidity remains unclear. METHODS We used three waves data (2011, 2013, and 2015) including 19,295 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, to investigate the association between HAP exposure from solid fuel use for heating and cooking with the risk of chronic multimorbidity. Multimorbidity was defined as the coexistence of two or more of 15 chronic diseases (hypertension, diabetes, dyslipidemia, heart disease, stroke, cardiovascular disease, chronic lung disease, asthma, kidney disease, liver disease, digestive disease, cancer, psychiatric disease, memory-related disease, and arthritis). Multiple logistic regression investigated the association between solid fuel use for heating and cooking, separately or simultaneously, with the risk of multimorbidity. Poisson regression with quasi-likelihood estimation explored whether solid fuel exposure could increase the number of morbidities. Stratified analyses and sensitivity analyses examined the effect modification and robustness of the association. RESULTS Of the 19,295 participants (mean age: 58.9 years), 40.9 % have multimorbidity. Compared with participants who used clean fuels for heating and cooking, the risk was higher in mixed fuel (adjusted odds ratio, aOR = 1.26, 95 %CI:1.16-1.36) and solid fuel users (aOR = 1.81, 1.67-1.98) separately. HAP from solid fuel use was positively associated with an increased number of morbidities (adjusted β = 0.329, 0.290 to 0.368), after controlling for confounders. Those living in a one-story building, with poor household cleanliness have a higher risk of multimorbidity. No significant modifications of those associations by the socio-demographic and behaviour characteristics was observed. CONCLUSIONS HAP from solid fuel use is associated with a high risk of chronic multimorbidity in Chinese adults. Our findings provide important implications for reducing chronic disease burden by restricting solid fuel use.
Collapse
Affiliation(s)
- Wenming Shi
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Tiantian Zhang
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
| | - Yongzhen Li
- Children's Hospital of Fudan University, Shanghai 201100, China
| | - Yonggang Huang
- Department of Blood Transfusion, Tongling People's Hospital, Tongling 244000, Anhui, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai 200032, China; Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| |
Collapse
|
25
|
Byun G, Choi Y, Kim S, Lee JT. Long-term exposure to ambient ozone and mortality in a population-based cohort of South Korea: Considering for an alternative exposure time metric. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 314:120300. [PMID: 36181930 DOI: 10.1016/j.envpol.2022.120300] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Studies on the health effects of long-term ozone exposure remain limited with mixed results. One potential source of this inconsistency is the difference in exposure time metrics. This study aimed to investigate the association between long-term exposure to ambient ozone and mortality in South Korea, using different exposure metrics. We also examined whether heterogeneity between previous studies was due to the different exposure metrics. The study population comprised 179,806 participants from the National Health Insurance Service-National Sample Cohort (2002-2015) residing in seven major cities in South Korea. Several ozone exposure metrics (year-round 24-h, year-round 8-h, warm-season 24-h, and warm-season 8-h) were calculated. Time-varying Cox proportional hazards models were used to estimate the association between ozone and all-cause and cause-specific mortalities. Random-effect meta-analysis and meta-regression analysis were performed to pool the effect estimates of previous studies and examine whether the exposure metric can explain the between-study heterogeneity. The hazard ratios (HRs) per 10 ppb increment in year-round 24-h ozone for all-cause (HR, 1.18; 95% CI, 1.07-1.29) and circulatory (HR, 1.52; 95% CI, 1.25-1.84) mortality were higher than those of the other metrics. Year-round 8-h ozone exhibited the largest association with respiratory mortality (HR, 1.43; 95% CI, 1.04-1.96). A meta-analysis of 29 previous studies and the present study showed the largest HR for all-cause mortality from studies using year-round 8-h exposure (HR, 1.014; 95% CI, 0.994-1.033). The exposure metric was significantly associated with effect estimates in the multivariable meta-regression model. In conclusion, in the population-based cohort in South Korea, we found positive associations between several long-term ozone exposure metrics and mortality. The different ozone exposure metrics exhibited heterogeneous effect estimates. A year-round 24-h average ozone metric also could be considered an alternative long-term standard for ozone.
Collapse
Affiliation(s)
- Garam Byun
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Yongsoo Choi
- Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Sera Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
| |
Collapse
|
26
|
Ma T, Yazdi MD, Schwartz J, Réquia WJ, Di Q, Wei Y, Chang HH, Vaccarino V, Liu P, Shi L. Long-term air pollution exposure and incident stroke in American older adults: A national cohort study. GLOBAL EPIDEMIOLOGY 2022; 4:100073. [PMID: 36644436 PMCID: PMC9838077 DOI: 10.1016/j.gloepi.2022.100073] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/19/2023] Open
Abstract
Aims Stroke is a leading cause of death and disability for Americans, and growing evidence suggests that air pollution may play an important role. To facilitate pollution control efforts, the National Academy of Sciences and the World Health Organization have prioritized determining which air pollutants are most toxic. However, evidence is limited for the simultaneous effects of multiple air pollutants on stroke. Methods and results We constructed a nationwide population-based cohort study, using the Medicare Chronic Conditions Warehouse (2000-2017) and high-resolution air pollution data, to investigate the impact of long-term exposure to ambient PM2.5, NO2, and ground-level O3 on incident stroke. Hazard ratios (HR) for stroke incidence were estimated using single-, bi-, and tri-pollutant Cox proportional hazards models. We identified ~2.2 million incident stroke cases among 17,443,900 fee-for-service Medicare beneficiaries. Per interquartile range (IQR) increase in the annual average PM2.5 (3.7 μg/m3), NO2 (12.4 ppb), and warm-season O3 (6.5 ppb) one-year prior to diagnosis, the HRs were 1.022 (95% CI: 1.017-1.028), 1.060 (95% CI: 1.054-1.065), and 1.021 (95% CI: 1.017-1.024), respectively, from the tri-pollutant model. There was strong evidence of linearity in concentration-response relationships for all three air pollutants in single-pollutant models. This linear relationship remained robust for NO2 and O3 in tri-pollutant models while the effect of PM2.5 attenuated at the lower end of concentrations. Conclusion Using a large nationwide cohort, our study suggests that long-term exposure to PM2.5, NO2, and O3 may independently increase the risk of stroke among the US elderly, among which traffic-related air pollution plays a particularly crucial role.
Collapse
Affiliation(s)
- Tszshan Ma
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Weeberb J. Réquia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Pengfei Liu
- School of Earth and Atmospheric Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
27
|
Sabayan B. Primary Prevention of Ischemic Stroke. Semin Neurol 2022; 42:571-582. [PMID: 36395819 DOI: 10.1055/s-0042-1758703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Ischemic stroke is by far the most common type of cerebrovascular event and remains a major cause of death and disability globally. Despite advancements in acute stroke care, primary prevention is still the most cost-effective approach in reducing the burden of ischemic stroke. The two main strategies for primary stroke prevention include population-wide versus high-risk group interventions. Interventions such as increasing access to primary care, regulation of salt and sugar contents in processed foods, public education, and campaigns to control cerebrovascular risk factors are examples of population-wide interventions. High-risk group interventions, on the other hand, focus on recognition of individuals at risk and aim to modify risk factors in a timely and multifaceted manner. This article provides an overview on conventional modifiable risk factors for ischemic stroke and highlights the emerging risk factors and approaches for high-risk group identification and treatment.
Collapse
Affiliation(s)
- Behnam Sabayan
- Department of Neurology, HealthPartners Neuroscience Center, St. Paul, Minnesota.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
28
|
Liu C, Chan KH, Lv J, Lam H, Newell K, Meng X, Liu Y, Chen R, Kartsonaki C, Wright N, Du H, Yang L, Chen Y, Guo Y, Pei P, Yu C, Shen H, Wu T, Kan H, Chen Z, Li L. Long-Term Exposure to Ambient Fine Particulate Matter and Incidence of Major Cardiovascular Diseases: A Prospective Study of 0.5 Million Adults in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:13200-13211. [PMID: 36044001 PMCID: PMC9494741 DOI: 10.1021/acs.est.2c03084] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Few cohort studies explored the long-term effects of ambient fine particulate matter (PM2.5) on incidence of cardiovascular diseases (CVDs), especially in countries with higher levels of air pollution. We aimed to evaluate the association between long-term exposure to PM2.5 and incidence of CVD in China. We performed a prospective cohort study in ten regions that recruited 512,689 adults during 2004-2008, with follow-up until 2017. Annual PM2.5 concentrations were estimated using a satellite-based model with national coverage and 1 x 1 km spatial resolution. Time-varying Cox proportional hazard regression models were used to estimate hazard ratios (HRs) for all-cause and cause-specific CVDs associated with PM2.5, adjusting for conventional covariates. During 5.08 million person-years of follow-up, 148,030 incident cases of CVD were identified. Long-term exposure to PM2.5 showed positive and linear association with incidence of CVD, without a threshold below any concentration. The adjusted HRs per 10 μg/m3 increase in PM2.5 was 1.04 (95%CI: 1.02, 1.07) for total CVD. The risk estimates differed between certain population subgroups, with greater HRs in men, in household with higher income, and in people using unclean heating fuels. This prospective study of large Chinese population provided essential epidemiological evidence for CVD incident risk associated with PM2.5.
Collapse
Affiliation(s)
- Cong Liu
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Ka Hung Chan
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
- Oxford
British Heart Foundation Center of Research Excellence, University of Oxford, Oxford OX3 7LF, UK
| | - Jun Lv
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
- Key Laboratory
of Molecular Cardiovascular Sciences (Peking University), Ministry
of Education, Beijing 100191, China
| | - Hubert Lam
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Katherine Newell
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Xia Meng
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Yang Liu
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Renjie Chen
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Christiana Kartsonaki
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Neil Wright
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Huaidong Du
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Ling Yang
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Yiping Chen
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Yu Guo
- Fuwai
Hospital Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Pei Pei
- Fuwai
Hospital Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Canqing Yu
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
| | - Hongbing Shen
- Department
of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tangchun Wu
- School
of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Haidong Kan
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Zhengming Chen
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
- MRC
Population Health Research Unit, Nuffield Department of Population
Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Liming Li
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
| | | |
Collapse
|
29
|
Impacts of Outdoor Particulate Matter Exposure on the Incidence of Lung Cancer and Mortality. Medicina (B Aires) 2022; 58:medicina58091159. [PMID: 36143834 PMCID: PMC9501799 DOI: 10.3390/medicina58091159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 01/03/2023] Open
Abstract
Background and objectives: Long-term exposure to air pollution has been associated with lung cancer. This study aimed to evaluate the relative risk (RR) and hazard ratio (HR) of lung cancers and the prognostic implication of outdoor particulate matter (PM) pollution using a meta-analysis. Materials and Methods: We performed the meta-analysis using 19 eligible studies and evaluated the PMs, dividing into PM smaller than 2.5 µm (PM2.5) and PM smaller than 10 µm (PM10). In addition, subgroup analyses, based on the increment of PM exposure, location, sex, smoking history, and tumor histology, were performed. Results: Lung cancer was significantly increased by exposure to PM2.5 (RR 1.172, 95% confidence interval (CI) 1.002–1.371), but not PM10 exposure. However, there was no significant correlation between PM10 exposure and the incidence of lung cancers (RR 1.062, 95% CI 0.932–1.210). The all-cause and lung-cancer-specific mortalities were significantly increased by PM2.5 exposure (HR 1.1.43, 95% CI 1.011–1.291 and HR 1.144, 95% CI 1.002–1.307, respectively). However, PM10 exposure significantly increased the all-cause mortality, but not the lung-cancer-specific mortality. The lung-cancer-specific mortality was significantly increased by PM10 per 12.1 μg/m3 increment and in the Europe area. Conclusions: PM2.5 significantly increased lung cancer and the all-cause and lung-cancer-specific mortalities, whereas PM10 did not increase lung cancer or lung-cancer-specific mortality. However, PM10 increased the all-cause mortality and the PM10 per 12.1 μg/m3 increment and PM10 in the Europe area may increase the lung-cancer-specific mortality.
Collapse
|
30
|
Prueitt RL, Li W, Edwards L, Zhou J, Goodman JE. Systematic review of the association between long-term exposure to fine particulate matter and mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1647-1685. [PMID: 33849343 DOI: 10.1080/09603123.2021.1901864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
We used a transparent systematic review framework based on best practices for evaluating study quality and integrating evidence to conduct a review of the available epidemiology studies evaluating associations between long-term exposure to ambient concentrations of PM2.5 and mortality (all-cause and non-accidental) conducted in North America. We found that while there is some consistency across studies for reporting positive associations, these associations are weak and several important methodological issues have led to uncertainties with regard to the evidence from these studies, including potential confounding by measured and unmeasured factors, exposue measurement error, and model misspecification. These uncertainties provide a plausible, alternative explanation to causality for the weakly positive findings across studies. Using a causality framework that incorporates best practices for making causal determinations, we concluded that the evidence for a causal relationship between long-term exposure to ambient PM2.5 concentrations and mortality from these studies is inadequate.
Collapse
|
31
|
Niu Y, Zhou Y, Chen R, Yin P, Meng X, Wang W, Liu C, Ji JS, Qiu Y, Kan H, Zhou M. Long-term exposure to ozone and cardiovascular mortality in China: a nationwide cohort study. Lancet Planet Health 2022; 6:e496-e503. [PMID: 35709807 DOI: 10.1016/s2542-5196(22)00093-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The evidence for a causal relationship between long-term ozone exposure and cardiovascular mortality is inconclusive, and most published data are from high-income countries. We aimed to investigate the association between long-term exposure to ozone and cardiovascular mortality in China, the most populous middle-income country. METHODS We did a nationwide cohort study comprising Chinese adults aged 18 years and older from the 2010-11 China Chronic Disease and Risk Factors Surveillance project; participants were followed up until Dec 31, 2018, or the date of death. Data on participants' deaths were obtained through linkage to the Disease Surveillance Point system, a national death registration database. Residential ozone exposure was estimated with a previously developed random forest model. We applied stratified Cox proportional hazards models to estimate the associations of ozone with mortality due to overall cardiovascular diseases, ischaemic heart disease, and stroke. The models were stratified by age and sex and adjusted for a set of individual-level and regional covariates. Warm-season average ozone concentration for the previous 1-3 years was added as a time-varying variable. We also did subgroup analyses by age, sex, level of education, smoking status, urban or rural residence, and geographical region. FINDINGS Data were analysed for 96 955 participants. The warm-season average ozone concentration during the follow-up period was 89·7 μg/m3 (SD 14·4). In the fully adjusted models, we observed significant and positive associations between ozone and mortality from overall cardiovascular diseases (hazard ratio [HR] 1·093 [95% CI 1·046-1·142] per 10 μg/m3 increase in warm-season ozone concentrations), ischaemic heart disease (1·184 [1·099-1·276] per 10 μg/m3 increase in warm-season ozone concentrations), and stroke (1·063 [1·002- 1·128] per 10 μg/m3 increase in warm-season ozone concentrations). After adjusting for fine particulate matter, the associations with overall cardiovascular disease and ischaemic heart disease mortality were almost unchanged, whereas the association with stroke mortality lost statistical significance. The association of long-term ozone exposure with cardiovascular mortality was more prominent in people aged 65 years and older than in those younger than 65 years. We did not find any effect modification of sex, level of education, smoking status, urban or rural residence, and geographical region. We observed an almost linear exposure-response relationship between ozone and cardiovascular mortality. INTERPRETATION This study is, to the best of our knowledge, the first nationwide cohort study to show that long-term ozone exposure contributes to elevated risks of cardiovascular mortality, particularly from ischaemic heart disease, in a middle-income setting. The exposure-response function generated from this study could potentially inform future air quality standard revisions and environmental health impact assessments. FUNDING National Natural Science Foundation of China.
Collapse
Affiliation(s)
- Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yuchang Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China; Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Yang Qiu
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
32
|
Khosravipour M, Safari-Faramani R, Rajati F, Omidi F. The long-term effect of exposure to respirable particulate matter on the incidence of myocardial infarction: a systematic review and meta-analysis study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:42347-42371. [PMID: 35355187 DOI: 10.1007/s11356-022-18986-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
Although several studies have investigated the long-term association of respirable particulate matter (PM ≤ 10 µm) with the incidence of myocardial infarction (MI), this association is inconclusive or even contradictory. This systematic review and meta-analysis study aimed to quantify the long-term effect of exposure to respirable PM on the incidence of MI. To find relevant publications, online databases, including Scopus, PubMed, and Web of Science, were searched on October 10, 2021. A random-effect model was used to calculate the pooled hazard ratio (HR) and 95% confidence interval (95% CI) of MI across studies. Heterogeneity was presented with reporting I2 index. Of 4591 records found in the primary searching, the number of 24 prospective cohort studies with more than 70 million participants was included. The pooled HR (95% CI) of MI per 1 µg/m3 increment of respirable PM was estimated as 1.01 (1.00, 1.01). Subgroup analyses according to aerodynamic diameter of PM showed an only significant stronger risk of MI per 1 µg/m3 increase in PM with aerodynamic diameter < 2.5 µm (HR = 1.01, 95% CI = 1.00, 1.01). No sex difference was found in the association of respirable PM with MI incidence. There was only a significant association among studies defined MI as ICD-10: I21 code (HR = 1.01, 95% CI = 1.00, 1.01) and studies defined MI as ICD-10: I21-22 (HR = 1.02, 95% CI = 1.00, 1.04). No significant publication bias was observed across studies. In conclusion, this study confirms a significant association between long-term exposure to respirable PM air pollution and development of MI.
Collapse
Affiliation(s)
- Masoud Khosravipour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Fariborz Omidi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
33
|
Short-Term Effects of Low-Level Ambient Air NO 2 on the Risk of Incident Stroke in Enshi City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116683. [PMID: 35682266 PMCID: PMC9180296 DOI: 10.3390/ijerph19116683] [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: 04/12/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022]
Abstract
Previous studies found that exposure to ambient nitrogen dioxide (NO2) was associated with an increased risk of incident stroke, but few studies have been conducted for relatively low NO2 pollution areas. In this study, the short-term effects of NO2 on the risk of incident stroke in a relatively low-pollution area, Enshi city of Hubei Province, China, were investigated through time-series analysis. Daily air-pollution data, meteorological data, and stroke incidence data of residents in Enshi city from 1 January 2015 to 31 December 2018 were collected. A time-series analysis using a generalised additive model (GAM) based on Poisson distribution was applied to explore the short-term effects of low-level NO2 exposure on the risk of incident stroke and stroke subtypes, as well as possible age, sex, and seasonal differences behind the effects. In the GAM model, potential confounding factors, such as public holidays, day of the week, long-term trends, and meteorological factors (temperature and relative humidity), were controlled. A total of 9122 stroke incident cases were included during the study period. We found that NO2 had statistically significant effects on the incidence of stroke and ischemic stroke, estimated by excess risk (ER) of 0.37% (95% CI: 0.04–0.70%) and 0.58% (95% CI: 0.18–0.98%), respectively. For the cumulative lag effects, the NO2 still had a statistically significant effect on incident ischemic stroke, estimated by ER of 0.61% (95% CI: 0.01–1.21%). The two-pollutant model showed that the effects of NO2 on incident total stroke were still statistically significant after adjusting for other air pollutants (PM2.5, PM10, SO2, CO, and O3). In addition, the effects of NO2 exposure on incident stroke were statistically significant in elderly (ER = 0.75%; 95% CI: 0.11–1.40%), males (ER = 0.47%; 95% CI: 0.05–0.89%) and cold season (ER = 0.83%; 95% CI: 0.15–1.51%) subgroups. Our study showed that, as commonly observed in high-pollution areas, short-term exposure to low-level NO2 was associated with an increased risk of incident stroke, including ischemic stroke. Males and elderly people were more vulnerable to the effects of NO2, and the adverse effects might be promoted in the cold season.
Collapse
|
34
|
Modified Inverse Distance Weighting Interpolation for Particulate Matter Estimation and Mapping. ATMOSPHERE 2022. [DOI: 10.3390/atmos13050846] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Various studies are currently underway on PM (Particulate Matter) monitoring in view of the importance of air quality in public health management. Spatial interpolation has been used to estimate PM concentrations due to that it can overcome the shortcomings of station-based PM monitoring and provide spatially continuous information. However, PM is affected by a combination of several factors, and interpolation that only considers the spatial relationship between monitoring stations is limited in ensuring accuracy. Additionally, relatively accurate results may be obtained in the case of interpolation by using external drifts, but the methods have a disadvantage in that they require additional data and preprocessing. This study proposes a modified IDW (Inverse Distance Weighting) that allows more accurate estimations of PM based on the sole use of measurements. The proposed method improves the accuracy of the PM estimation based on weight correction according to the importance of each known point. Use of the proposed method on PM10 and PM2.5 in the Seoul-Gyeonggi region in South Korea led to an improved accuracy compared with IDW, kriging, and linear triangular interpolation. In particular, the proposed method showed relatively high accuracy compared to conventional methods in the case of a relatively large PM estimation error.
Collapse
|
35
|
Sun HZ, Yu P, Lan C, Wan MW, Hickman S, Murulitharan J, Shen H, Yuan L, Guo Y, Archibald AT. Cohort-based long-term ozone exposure-associated mortality risks with adjusted metrics: A systematic review and meta-analysis. Innovation (N Y) 2022; 3:100246. [PMID: 35519514 PMCID: PMC9065904 DOI: 10.1016/j.xinn.2022.100246] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/16/2022] [Indexed: 11/30/2022] Open
Abstract
Long-term ozone (O3) exposure may lead to non-communicable diseases and increase mortality risk. However, cohort-based studies are relatively rare, and inconsistent exposure metrics impair the credibility of epidemiological evidence synthetization. To provide more accurate meta-estimations, this study updates existing systematic reviews by including recent studies and summarizing the quantitative associations between O3 exposure and cause-specific mortality risks, based on unified exposure metrics. Cross-metric conversion factors were estimated linearly by decadal observations during 1990-2019. The Hunter-Schmidt random-effects estimator was applied to pool the relative risks. A total of 25 studies involving 226,453,067 participants (14 unique cohorts covering 99,855,611 participants) were included in the systematic review. After linearly unifying the inconsistent O3 exposure metrics , the pooled relative risks associated with every 10 nmol mol-1 (ppbV) incremental O3 exposure, by mean of the warm-season daily maximum 8-h average metric, were as follows: 1.014 with 95% confidence interval (CI) ranging 1.009-1.019 for all-cause mortality; 1.025 (95% CI: 1.010-1.040) for respiratory mortality; 1.056 (95% CI: 1.029-1.084) for COPD mortality; 1.019 (95% CI: 1.004-1.035) for cardiovascular mortality; and 1.074 (95% CI: 1.054-1.093) for congestive heart failure mortality. Insignificant mortality risk associations were found for ischemic heart disease, cerebrovascular diseases, and lung cancer. Adjustment for exposure metrics laid a solid foundation for multi-study meta-analysis, and widening coverage of surface O3 observations is expected to strengthen the cross-metric conversion in the future. Ever-growing numbers of epidemiological studies supported the evidence for considerable cardiopulmonary hazards and all-cause mortality risks from long-term O3 exposure. However, evidence of long-term O3 exposure-associated health effects was still scarce, so more relevant studies are needed to cover more populations with regional diversity.
Collapse
Affiliation(s)
- Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Changxin Lan
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing 100191, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Michelle W.L. Wan
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Sebastian Hickman
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Jayaprakash Murulitharan
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Huizhong Shen
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Le Yuan
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Alexander T. Archibald
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- National Centre for Atmospheric Science, Cambridge CB2 1EW, UK
| |
Collapse
|
36
|
Feng Y, Wei J, Hu M, Xu C, Li T, Wang J, Chen W. Lagged Effects of Exposure to Air Pollutants on the Risk of Pulmonary Tuberculosis in a Highly Polluted Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5752. [PMID: 35565147 PMCID: PMC9106023 DOI: 10.3390/ijerph19095752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/24/2022] [Accepted: 05/07/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Although significant correlations have been observed between air pollutants and the development of pulmonary tuberculosis (PTB) in many developed countries, data are scarce for developing and highly polluted regions. METHOD A combined Poisson generalized linear regression-distributed lag nonlinear model was used to determine the associations between long-term exposure (2005-2017) to air pollutants and the risk of PTB in the Beijing-Tianjin-Hebei region. RESULTS The monthly PTB cases exhibited a fluctuating downward trend. For each 10 μg/m3 increase in concentration, the maximum lag-specific risk and cumulative relative risk (RR) were 1.011 (95% confidence interval (CI): 1.0091.012, lag: 3 months) and 1.042 (1.036-1.048, 5 months) for PM2.5, and 1.023 (1.015-1.031, 0 months) and 1.041 (1.026-1.055, 2 months) for NO2. The risk of PTB was negatively correlated with O3 exposure, and the minimum lag-specific risk and cumulative RR were 0.991 (95% CI: 0.987-0.994, lag: 0 months) and 0.974 (0.968-0.981, 4 months), respectively. No age-dependent effects were observed. CONCLUSIONS Our results revealed potential associations between outdoor exposure to PM2.5, NO2, and O3 and the risk of PTB. Further research should explore the corresponding interactions and potential mechanisms.
Collapse
Affiliation(s)
- Yuqing Feng
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA;
| | - Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing 210023, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
| | - Tao Li
- Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
| | - Wei Chen
- Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| |
Collapse
|
37
|
Guo C, Yu T, Bo Y, Lin C, Chang LY, Wong MCS, Yu Z, Lau AKH, Tam T, Lao XQ. Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults. Epidemiology 2022; 33:309-317. [PMID: 35067568 DOI: 10.1097/ede.0000000000001464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5. METHODS We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes. RESULTS This study identified 14,627 deaths and had a total of 5 million person-years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%-35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results. CONCLUSION Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation.
Collapse
Affiliation(s)
- Cui Guo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Yacong Bo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Martin C S Wong
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- The School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical Colleges, Beijing, China
- The School of Public Health, The Peking University, Beijing, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Henan, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong
| | - Xiang Qian Lao
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
| |
Collapse
|
38
|
Heo S, Son JY, Lim CC, Fong KC, Choi HM, Hernandez-Ramirez RU, Nyhan K, Dhillon PK, Kapoor S, Prabhakaran D, Spiegelman D, Bell ML. Effect modification by sex for associations of fine particulate matter (PM 2.5) with cardiovascular mortality, hospitalization, and emergency room visits: systematic review and meta-analysis. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2022; 17:053006. [PMID: 35662857 PMCID: PMC9162078 DOI: 10.1088/1748-9326/ac6cfb] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Particulate matter with aerodynamic diameter no larger than 2.5 μm (PM2.5) has been linked to cardiovascular diseases (CVDs) but evidence for vulnerability by sex remains unclear. We performed systematic review and meta-analysis to synthesize the state of scientific evidence on whether cardiovascular risks from PM2.5 differ for men compared to women. The databases Pubmed, Scopus, Embase, and GreenFILE were searched for studies published Jan. 1995 to Feb. 2020. Observational studies conducting subgroup analysis by sex for impacts of short-term or long-term exposure to PM2.5 on target CVDs were included. Data were independently extracted in duplicate and pooled with random-effects meta-regression. Risk ratios (RRs) for long-term exposure and percent changes in outcomes for short-term exposure were calculated per 10 μg/m3 PM2.5 increase. Quality of evidence of risk differences by sex was rated following Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 12,502 articles were screened, with 61 meeting inclusion criteria. An additional 32 studies were added from citation chaining. RRs of all CVD mortality for long-term PM2.5 for men and women were the same (1.14; 95% CI: 1.09, 1.22) indicating no statistically different risks. Men and women did not have statistically different risks of daily CVD mortality, hospitalizations from all CVD, ischemic heart disease, cardiac arrest, acute myocardial infarction, and heart failure from short-term PM2.5 exposure (difference in % change in risk per 10 μg/m3 PM2.5: 0.04 (95% CI, -0.42 to 0.51); -0.05 (-0.47 to 0.38); 0.17 (-0.90, 1.24); 1.42 (-1.06, 3.97); 1.33 (-0.05, 2.73); and -0.48 (-1.94, 1.01), respectively). Analysis using GRADE found low or very low quality of evidence for sex differences for PM2.5-CVD risks. In conclusion, this meta-analysis and quality of evidence assessment of current observational studies found very limited evidence of the effect modification by sex for effects of PM2.5 on CVD outcomes in adults, which can inform clinical approaches and policies.
Collapse
Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, United States of America
| | - Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, United States of America
| | - Chris C Lim
- School of the Environment, Yale University, New Haven, CT, United States of America
- Community, Environment & Policy Department, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, United States of America
| | - Kelvin C Fong
- School of the Environment, Yale University, New Haven, CT, United States of America
| | - Hayon Michelle Choi
- School of the Environment, Yale University, New Haven, CT, United States of America
| | - Raul U Hernandez-Ramirez
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Kate Nyhan
- Harvey Cushing / John Hay Whitney Medical Library, Yale School of Public Health, Yale University, New Haven, CT, United States of America
- Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | | | | | - Dorairaj Prabhakaran
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
| | - Donna Spiegelman
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, United States of America
| |
Collapse
|
39
|
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.
Collapse
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
| |
Collapse
|
40
|
Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction. Environ Epidemiol 2022; 6:e200. [PMID: 35434462 PMCID: PMC9005250 DOI: 10.1097/ee9.0000000000000200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/29/2022] [Indexed: 11/26/2022] Open
Abstract
Fine particulate matter (PM2.5) is a known risk factor for cardiovascular disease (CVD). Neighborhood walkability and greenness may also be associated with CVD, but there is limited evidence on their joint or interacting effects with PM2.5.
Collapse
|
41
|
Li YJ, Takeda K, Yamamoto M, Kawada T. Potential of NRF2 Pathway in Preventing Developmental and Reproductive Toxicity of Fine Particles. FRONTIERS IN TOXICOLOGY 2022; 3:710225. [PMID: 35295150 PMCID: PMC8915851 DOI: 10.3389/ftox.2021.710225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 08/27/2021] [Indexed: 12/13/2022] Open
Abstract
Air pollution is associated with significant adverse health effects. Recent studies support the idea that inhalation of fine particles can instigate extrapulmonary effects on the cardiovascular system through several pathways. The systemic transfer of ultrafine particles (UFPs) or soluble particle components (organic compounds and metals) is of particular concern. An integral role of reactive oxygen species (ROS)-dependent pathways has been suggested in systemic inflammatory responses and vascular dysfunction at the molecular level. Accumulating lines of evidence suggest that fine particles affect fetal development, giving rise to low birth weight and a reduction in fetal growth, and also affect the immune, cardiovascular, and central nervous systems. Oxidative stress plays an important role in fine particles toxicity; pre-treatment with antioxidants partially suppresses the developmental toxicity of fine particles. On the other hand, Nuclear factor erythroid-derived 2-like 2 (Nfe2l2), also known as NRF2, is a transcription factor essential for inducible and/or constitutive expression of phase II and antioxidant enzymes. Studies using Nrf2-knockout mice revealed that NRF2 dysfunction is intimately involved in the pathogenesis of various human diseases. Multiple single nucleotide polymorphisms (SNPs) have been detected in human NRF2 locus. An NRF2 gene SNP (−617C > A; rs6721961), located in the upstream promoter region, affects the transcriptional level of NRF2 and thereby the protein level and downstream gene expression. It has been reported that the SNP-617 is associated with various diseases. The onset and exacerbation of the diseases are regulated by genetic predisposition and environmental factors; some people live in the air-polluted environment but are not affected and remain healthy, suggesting the presence of individual differences in the susceptibility to air pollutants. NRF2 polymorphisms may also be associated with the fetal effects of fine particles exposure. Screening high-risk pregnant women genetically susceptible to oxidative stress and prevention by antioxidant interventions to protect fetal development in air-polluted areas should be considered. This article reviews the recent advances in our understanding of the fetal health effects of fine particles and describes potential chemoprevention via the NRF2 pathway to prevent the developmental and reproductive toxicity of fine particles.
Collapse
Affiliation(s)
- Ying-Ji Li
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | - Ken Takeda
- Faculty of Pharmaceutical Sciences, Sanyo-onoda City University, Sanyo-Onoda, Japan
| | - Masayuki Yamamoto
- Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
42
|
Olaniyan T, Pinault L, Li C, van Donkelaar A, Meng J, Martin RV, Hystad P, Robichaud A, Ménard R, Tjepkema M, Bai L, Kwong JC, Lavigne E, Burnett RT, Chen H. Ambient air pollution and the risk of acute myocardial infarction and stroke: A national cohort study. ENVIRONMENTAL RESEARCH 2022; 204:111975. [PMID: 34478722 DOI: 10.1016/j.envres.2021.111975] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 05/07/2023]
Abstract
We used a large national cohort in Canada to assess the incidence of acute myocardial infarction (AMI) and stroke hospitalizations in association with long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). The study population comprised 2.7 million respondents from the 2006 Canadian Census Health and Environment Cohort (CanCHEC), followed for incident hospitalizations of AMI or stroke between 2006 and 2016. We estimated 10-year moving average estimates of PM2.5, NO2, and O3, annually. We used Cox proportional hazards models to examine the associations adjusting for various covariates. For AMI, each interquartile range (IQR) increase in exposure was found to be associated with a hazard ratio of 1.026 (95% CI: 1.007-1.046) for PM2.5, 1.025 (95% CI: 1.001-1.050) for NO2, and 1.062 (95% CI: 1.041-1.084) for O3, respectively. Similarly, for stroke, an IQR increase in exposure was associated with a hazard ratio of 1.078 (95% CI: 1.052-1.105) for PM2.5, 0.995 (95% CI: 0.965-1.030) for NO2, and 1.055 (95% CI: 1.028-1.082) for O3, respectively. We found consistent evidence of positive associations between long-term exposures to PM2.5, and O3, and to a lesser degree NO2, with incident AMI and stroke hospitalizations.
Collapse
Affiliation(s)
- Toyib Olaniyan
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Lauren Pinault
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Chi Li
- Department of Chemistry, University of California, Berkeley, CA, 94720, United States.
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada; Department of Energy, Environment & Chemical Engineering, Washington University in St Louis, St Louis, MO, 63130, United States.
| | - Jun Meng
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada.
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada; Department of Energy, Environment & Chemical Engineering, Washington University in St Louis, St Louis, MO, 63130, United States.
| | - Perry Hystad
- School of Biological & Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, United States.
| | - Alain Robichaud
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, Québec, H9P 1J3, Canada.
| | - Richard Ménard
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, Québec, H9P 1J3, Canada.
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Li Bai
- ICES, Toronto, Ontario, M4N 3M5, Canada.
| | - Jeffrey C Kwong
- ICES, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario, M5G 1V5, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, K1A 0L4, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada.
| | - Richard T Burnett
- Institute of Health Metrics & Evaluation, University of Washington, Seattle, WA, 98121, United States; Population Studies Division, Environmental Health and Research Bureau, Health Canada, Ottawa, Ontario K1A 0T6, Canada.
| | - Hong Chen
- ICES, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario, M5G 1V5, Canada; Population Studies Division, Environmental Health and Research Bureau, Health Canada, Ottawa, Ontario K1A 0T6, Canada.
| |
Collapse
|
43
|
Choi G, Kim Y, Shin G, Bae S. Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2494. [PMID: 35270187 PMCID: PMC8909340 DOI: 10.3390/ijerph19052494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023]
Abstract
We sought to estimate the lifetime healthcare costs and outcomes associated with the exposure to the escalated concentration of fine particulate matter (particle size < 2.5 μm, PM2.5) among adult Korean women. We adapted a previously developed Markov model, and a hypothetical cohort composed of Korean women was exposed to either a standard (15 μg/m3) or increased (25 μg/m3) concentration of PM2.5. The time horizon of the analysis was 60 years, and the cycle length was 1 year. The outcomes were presented as direct healthcare costs and quality-adjusted life years (QALYs), and costs were discounted annually at 5%. Deterministic and probabilistic sensitivity analyses were performed. The model estimated that when the exposure concentration was increased by 10 μg/m3, the lifetime healthcare cost increased by USD 9309, which is an 11.3% increase compared to the standard concentration group. Women exposed to a higher concentration of PM2.5 were predicted to live 30.64 QALYs, compared to 32.08 QALYs for women who were exposed to the standard concentration of PM2.5. The tendency of a higher cost and shorter QALYs at increased exposure was consistent across a broad range of sensitivity analyses. The negative impact of PM2.5 was higher on cost than on QALYs and accelerated as the exposure time increased, emphasizing the importance of early intervention.
Collapse
Affiliation(s)
- Gyeyoung Choi
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
| | - Yujeong Kim
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
- Korean Health Insurance Review & Assessment Service, Wonju 26465, Korea
| | - Gyeongseon Shin
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
| | - SeungJin Bae
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
| |
Collapse
|
44
|
Simões F, Bouveyron C, Piga D, Borel D, Descombes S, Paquis-Flucklinger V, Levraut J, Gibelin P, Bottini S. Cardiac dyspnea risk zones in the South of France identified by geo-pollution trends study. Sci Rep 2022; 12:1900. [PMID: 35115629 PMCID: PMC8813995 DOI: 10.1038/s41598-022-05827-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
The incidence of cardiac dyspnea (CD) and the distribution of pollution in the south of France suggests that environmental pollution may have a role in disease triggering. CD is a hallmark symptom of heart failure leading to reduced ability to function and engage in activities of daily living. To show the impact of short-term pollution exposure on the increment of CD emergency room visits, we collected pollutants and climate measurements on a daily basis and 43,400 events of CD in the Région Sud from 2013 to 2018. We used a distributed lag non-linear model (DLNM) to assess the association between air pollution and CD events. We divided the region in 357 zones to reconciliate environmental and emergency room visits data. We applied the DLNM on the entire region, on zones grouped by pollution trends and on singular zones. Each pollutant has a significant effect on triggering CD. Depending on the pollutant, we identified four shapes of exposure curves to describe the impact of pollution on CD events: early and late effect for NO2; U-shape and rainbow-shape (or inverted U) for O3; all the four shapes for PM10. In the biggest cities, O3 has the most significant association along with the PM10. In the west side, a delayed effect triggered by PM10 was found. Zones along the main highway are mostly affected by NO2 pollution with an increase of the association for a period up to 9 days after the pollution peak. Our results can be used by local authorities to set up specific prevention policies, public alerts that adapt to the different zones and support public health prediction-making. We developed a user-friendly web application called Health, Environment in PACA Region Tool (HEART) to collect our results. HEART will allow citizens, researchers and local authorities to monitor the impact of pollution trends on local public health.
Collapse
Affiliation(s)
- Fanny Simões
- Center of Modeling, Simulation and Interactions, Université Côte d'Azur, 151 Route de Saint Antoine de Ginestiere, 06200, Nice, France
| | - Charles Bouveyron
- Inria, CNRS, Laboratoire JA Dieudonné, Maasai Research Team, Université Côté d'Azur, Nice, France
| | | | | | - Stéphane Descombes
- Inria, CNRS, Laboratoire JA Dieudonné, Université Côté d'Azur, Nice, France
| | | | - Jaques Levraut
- Département Hospitalo-Universitaire de Médecine d'Urgence, Nice, France
| | - Pierre Gibelin
- Faculté de Médicine, Université Côte d'Azur, Nice, France
| | - Silvia Bottini
- Center of Modeling, Simulation and Interactions, Université Côte d'Azur, 151 Route de Saint Antoine de Ginestiere, 06200, Nice, France.
| |
Collapse
|
45
|
Liu Z, Xu P, Gong F, Tan Y, Han J, Tian L, Yan J, Li K, Xi Z, Liu X. Altered lipidomic profiles in lung and serum of rat after sub-chronic exposure to ozone. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150630. [PMID: 34597571 DOI: 10.1016/j.scitotenv.2021.150630] [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: 07/20/2021] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Ozone (O) exposure not only causes lung injury and lung inflammation but also changes blood composition. Previous studies have mainly focused on inflammatory processes and metabolic diseases caused by acute or chronic ozone exposure. However, the effect of ozone on lipid expression profiles remains unclear. This study aimed to investigate the lipidomic changes in lung tissue and serum of rats after ozone exposure for three months and explore the lipid metabolic pathway involved in an ozone-induced injury. Based on the non-targeted lipidomic analysis platform of the UPLC Orbitrap mass spectrometry system, we found that sub-chronic exposure to ozone significantly changed the characteristics of lipid metabolism in lungs and serum of rats. First, the variation in sphingomyelin (SM) and triglyceride (TG) levels in the lung and serum after O3 exposure are shown. SM decreased in both tissues, while TG decreased in the lungs and increased in the serum. Further, the effect of ozone on glycerophospholipids in the lung and serum was completely different. Phosphatidylethanolamine (PE), phosphatidylserine (PS), and phosphatidylinositol (PI) were the major glycerophospholipids whose levels were altered in the lung, while phosphatidylglycerol (PG), phosphatidic acid (PA), and phosphatidylcholine (PC) levels changed dramatically in the serum. Third, after O3 exposure, the level of monogalactosyldiacylglycerol (MGDG), mainly MGDG (43, 11), a saccharolipid, declined significantly and uniquely in the serum. These results suggested that sub-chronic O3 exposure may play a role in the development of several diseases through perturbation of lipidomic profiles in the lungs and blood. In addition, changes in the lipids of the lung and blood may induce or exacerbate respiratory diseases.
Collapse
Affiliation(s)
- Zhiyuan Liu
- Tianjin University of Sport, Tianjin 301617, China; Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Pengfei Xu
- Tianjin University of Sport, Tianjin 301617, China; Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Fuxu Gong
- Tianjin University of Sport, Tianjin 301617, China; Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Yizhe Tan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Jie Han
- Tianjin University of Sport, Tianjin 301617, China; Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Lei Tian
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Jun Yan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Kang Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Zhuge Xi
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China.
| | - Xiaohua Liu
- Tianjin University of Sport, Tianjin 301617, China; Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China.
| |
Collapse
|
46
|
Chio CP, Lo WC, Tsuang BJ, Hu CC, Ku KC, Wang YS, Chen YJ, Lin HH, Chan CC. County-Wide Mortality Assessments Attributable to PM 2.5 Emissions from Coal Consumption in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1599. [PMID: 35162624 PMCID: PMC8835574 DOI: 10.3390/ijerph19031599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 12/10/2022]
Abstract
Over one-third of energy is generated from coal consumption in Taiwan. In order to estimate the health impact assessment attributable to PM2.5 concentrations emitted from coal consumption in Taiwan. We applied a Gaussian trajectory transfer-coefficient model to obtain county-wide PM2.5 exposures from coal consumption, which includes coal-fired power plants and combined heat and power plants. Next, we calculated the mortality burden attributable to PM2.5 emitted by coal consumption using the comparative risk assessment framework developed by the Global Burden of Disease study. Based on county-level data, the average PM2.5 emissions from coal-fired plants in Taiwan was estimated at 2.03 ± 1.29 (range: 0.32-5.64) μg/m3. With PM2.5 increments greater than 0.1 μg/m3, there were as many as 16 counties and 66 air quality monitoring stations affected by coal-fired plants and 6 counties and 18 monitoring stations affected by combined heat and power plants. The maximum distances affected by coal-fired and combined heat and power plants were 272 km and 157 km, respectively. Our findings show that more counties were affected by coal-fired plants than by combined heat and power plants with significant increments of PM2.5 emissions. We estimated that 359.6 (95% CI: 334.8-384.9) annual adult deaths and 124.4 (95% CI: 116.4-132.3) annual premature deaths were attributable to PM2.5 emitted by coal-fired plants in Taiwan. Even in six counties without power plants, there were 75.8 (95% CI: 60.1-91.5) deaths and 25.8 (95%CI: 20.7-30.9) premature deaths annually attributable to PM2.5 emitted from neighboring coal-fired plants. This study presents a precise and effective integrated approach for assessing air pollution and the health impacts of coal-fired and combined heat and power plants.
Collapse
Affiliation(s)
- Chia-Pin Chio
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei 10055, Taiwan;
- Institute of Environmental and Occupational Health Science, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
| | - Wei-Cheng Lo
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10055, Taiwan; (W.-C.L.); (C.-C.H.)
- Institute of Statistical Science, Academia Sinica, Taipei 11529, Taiwan
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| | - Ben-Jei Tsuang
- Department of Environmental Engineering, Innovation and Development Center of Sustainable Agriculture (IDCSA), National Chung-Hsing University, Taichung 40227, Taiwan; (B.-J.T.); (K.-C.K.); (Y.-S.W.)
| | - Chieh-Chun Hu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10055, Taiwan; (W.-C.L.); (C.-C.H.)
| | - Kai-Chen Ku
- Department of Environmental Engineering, Innovation and Development Center of Sustainable Agriculture (IDCSA), National Chung-Hsing University, Taichung 40227, Taiwan; (B.-J.T.); (K.-C.K.); (Y.-S.W.)
| | - Yi-Sheng Wang
- Department of Environmental Engineering, Innovation and Development Center of Sustainable Agriculture (IDCSA), National Chung-Hsing University, Taichung 40227, Taiwan; (B.-J.T.); (K.-C.K.); (Y.-S.W.)
| | | | - Hsien-Ho Lin
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei 10055, Taiwan;
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10055, Taiwan; (W.-C.L.); (C.-C.H.)
| | - Chang-Chuan Chan
- Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei 10055, Taiwan;
- Institute of Environmental and Occupational Health Science, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
| |
Collapse
|
47
|
Li H, Deng W, Small R, Schwartz J, Liu J, Shi L. Health effects of air pollutant mixtures on overall mortality among the elderly population using Bayesian kernel machine regression (BKMR). CHEMOSPHERE 2022; 286:131566. [PMID: 34293557 PMCID: PMC8578302 DOI: 10.1016/j.chemosphere.2021.131566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/02/2021] [Accepted: 07/14/2021] [Indexed: 05/19/2023]
Abstract
It is well documented that fine particles matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) are associated with a range of adverse health outcomes. However, most epidemiologic studies have focused on understanding their additive effects, despite that individuals are exposed to multiple air pollutants simultaneously that are likely correlated with each other. Therefore, we applied a novel method - Bayesian Kernel machine regression (BKMR) and conducted a population-based cohort study to assess the individual and joint effect of air pollutant mixtures (PM2.5, O3, and NO2) on all-cause mortality among the Medicare population in 15 cities with 656 different ZIP codes in the southeastern US. The results suggest a strong association between pollutant mixture and all-cause mortality, mainly driven by PM2.5. The positive association of PM2.5 with mortality appears stronger at lower percentiles of other pollutants. An interquartile range change in PM2.5 concentration was associated with a significant increase in mortality of 1.7 (95% CI: 0.5, 2.9), 1.6 (95% CI: 0.4, 2.7) and 1.4 (95% CI: 0.1, 2.6) standard deviations (SD) when O3 and NO2 were set at the 25th, 50th, and 75th percentiles, respectively. BKMR analysis did not identify statistically significant interactions among PM2.5, O3, and NO2. However, since the small sub-population might weaken the study power, additional studies (in larger sample size and other regions in the US) are in need to reinforce the current finding.
Collapse
Affiliation(s)
- Haomin Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Wenying Deng
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Raphael Small
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jeremiah Liu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| |
Collapse
|
48
|
Xu Y, Chen JT, Holland I, Yanosky JD, Liao D, Coull BA, Wang D, Rexrode K, Whitsel EA, Wellenius GA, Laden F, Hart JE. Analysis of long- and medium-term particulate matter exposures and stroke in the US-based Health Professionals Follow-up Study. Environ Epidemiol 2021; 5:e178. [PMID: 34909558 PMCID: PMC8663831 DOI: 10.1097/ee9.0000000000000178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Stroke is a leading cause of mortality worldwide, and air pollution is the third largest contributor to global stroke burden. Existing studies investigating the association between long-term exposure to particulate matter (PM) and stroke incidence have been mixed and very little is known about the associations with medium-term exposures. Therefore, we wanted to evaluate these associations in an cohort of male health professionals. METHODS We assessed the association of PM exposures in the previous 1 and 12 months with incident total, ischemic, and hemorrhagic stroke in 49,603 men in the prospective US-based Health Professionals' Follow-up Study 1988-2007. We used spatiotemporal prediction models to estimate monthly PM less than 10 (PM10) and less than 2.5 (PM2.5), and PM2.5-10 at all mailing addresses. We used time-varying Cox proportional hazards models adjusted for potential confounders based on previous literature to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each 10-μg/m3 increase in exposure in the preceding 1 and 12 months. We explored possible effect modification by age, obesity, smoking, aspirin use, diet quality, physical activity, diabetes, and Census region. RESULTS We observed 1,467 cases of incident stroke. Average levels of 12-month PM10, PM2.5-10, and PM2.5 were 20.7, 8.4, and 12.3 µg/m3, respectively. In multivariable adjusted models, we did not observe consistent associations between PM and overall or ischemic stroke. There was a suggestion of increased risk of hemorrhagic stroke (12-month PM10 multivariable HR: 1.13 [0.86, 1.48]; PM2.5-10: 1.12 [0.78, 1.62]; PM2.5:1.17 [0.76, 1.81], all per 10 µg/m3). There was little evidence of effect modification. CONCLUSIONS We observed only weak evidence of an association between long-term exposure to PM and risks of overall incident stroke. There was a suggestion of increasing hemorrhagic stroke risk.
Collapse
Affiliation(s)
- Yenan Xu
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Jarvis T. Chen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Brent A. Coull
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
| | - Dong Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Kathryn Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
49
|
Pala K, Aykac N, Yasin Y. Premature deaths attributable to long-term exposure to PM 2.5 in Turkey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:51940-51947. [PMID: 33993451 DOI: 10.1007/s11356-021-13923-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
This research aims to reveal the premature deaths caused by long-term exposure to PM2.5 in 2018 in Turkey utilizing the AirQ+ program developed by the World Health Organization. Calculation of yearly average PM2.5 concentration in provinces, acreage of provinces, and the mortality rate of the at-risk population was the data required for the operation of the AirQ+ program. With the help of the AirQ+ program, the results revealed that a total of 44,617 people (95% CI 29.882-57.709) died prematurely due to sustained exposure to PM2.5 in Turkey in 2018. The highest estimated mortality proportion attributable to PM2.5 pollution was in the provinces of Igdir and Kahramanmaras. The highest estimated number of mortality cases per 100,000 population attributable to PM2.5 pollution was in the provinces of Manisa and Afyonkarahisar. This research points out that reaching the PM2.5 limits specified by the WHO could have prevented 44,617 premature deaths in the year 2018 in Turkey.
Collapse
Affiliation(s)
- Kayihan Pala
- Department of Public Health, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Nilufer Aykac
- Department of Pulmonary Medicine, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Yesim Yasin
- School of Medicine, Department of Public Health, Acibadem Mehmet Ali Aydinlar University, Icerenkoy mah. Kayisdagi cad. No: 32 34684 Atasehir, Istanbul, Turkey.
| |
Collapse
|
50
|
Cai L, Yang J, Cosky E, Xin R, Geng X, Ding Y. Enhanced Cerebral Microbleeds by Long-Term Air Pollution Exposure in Spontaneously Hypertensive Rats. Neurol Res 2021; 44:196-205. [PMID: 34461819 DOI: 10.1080/01616412.2021.1968705] [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: 10/20/2022]
Abstract
BACKGROUND Cerebral microbleeds (CMBs) are associated with a high risk for stroke . The present study determined whether long-term exposure to PM2.5 results in progressive worsening of CMBs and induction of systemic inflammation and microvascular oxidative stress. METHODS Sixteen male Spontaneously hypertensive rats (SHR) and eight Wistar-Kyoto (WKY) rats were exposed to either filtered air or PM2.5 for 12 months. To detect CMBs, rats were imaged using a 7-T MRI. To determine systemic inflammation and oxidative stress, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), as well as reactive oxygen species (ROS), NADPH activity and its subunits p22/47/67phox & gp91phox were measured. RESULTS During the exposure period, the mean daily concentration of PM2.5 was 59.2 ± 1.0 μg/m3. PM2.5 exposure significantly increased the incidence of CMBs compared to the PM2.5 (-) group (37.5% vs 12.5% incidence rate, p < 0.001). Animals exposed to PM2.5 also had significantly increased systolic blood pressures (SBPs) at 3 months (173 ± 5 vs 157 ± 5 mmHg, p < 0.05), 6 months (218 ± 6 vs 193 ± 7 mmHg, p < 0.01), 9 months (222 ± 6 vs 203 ± 8 mmHg, p < 0.05), and 12 months (231 ± 4 vs 207 ± 5 mmHg, p = 0.01). Additionally, there were significant elevations in IL-6, MCP-1, and TNF-α in the exposed group. Furthermore, PM2.5 significantly increased NOX activity and protein levels of gp91phox and p22/47/67phox. CONCLUSION In the SHR model, long-term exposure to PM2.5 worsened CMBs, increased SBPs, induced systemic inflammation and oxidative stress. Therefore, PM2.5 is potentially a controllable risk factor that promotes CMBs in certain patients, such as those with hypertension.
Collapse
Affiliation(s)
- Lipeng Cai
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jianjie Yang
- Department of Pathology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Eric Cosky
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ruiqiang Xin
- Department of Medical Imaging, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Yuchuan Ding
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|