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Haque R, Hanson M, Shariful Islam M, Akter N, Moniruzzaman M, Alam MJ, Kamruzzaman M, Rahman M, Chisti MJ, Raqib R, Rahman SM. Pivotal relationship between heavy metal, PM 2.5 exposures and tuberculosis in Bangladeshi children: protocol paper of a case-control study. BMJ Open 2024; 14:e075010. [PMID: 38309752 PMCID: PMC10840056 DOI: 10.1136/bmjopen-2023-075010] [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: 04/24/2023] [Accepted: 01/15/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children. METHODS AND ANALYSIS As a case-control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling. ETHICS AND DISSEMINATION This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh's Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.
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Affiliation(s)
- Rehnuma Haque
- Environmental Health and WASH, Health System Population and Studies Division, International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Molly Hanson
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Md Shariful Islam
- The Department of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Nazrin Akter
- Environmental Health and WASH, Health System Population and Studies Division, International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | | | | | | | - Mahbubur Rahman
- Environmental Health and WASH, Health System Population and Studies Division, International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mohammod Jobayer Chisti
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | - Rubhana Raqib
- Immunobiology Nutrition and Toxicology Laboratory, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Syed Moshfiqur Rahman
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Luo D, Wang L, Zhang M, Martinez L, Chen S, Zhang Y, Wang W, Wu Q, Wu Y, Liu K, Xie B, Chen B. Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China. BMC Public Health 2024; 24:209. [PMID: 38233763 PMCID: PMC10795419 DOI: 10.1186/s12889-024-17644-5] [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: 01/02/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND In many areas of China, over 30% of tuberculosis cases occur among the elderly. We aimed to investigate the spatial distribution and environmental factors that predicted the occurence of tuberculosis in this group. METHODS Data were collected on notified pulmonary tuberculosis (PTB) cases aged ≥ 65 years in Zhejiang Province from 2010 to 2021. We performed spatial autocorrelation and spatial-temporal scan statistics to determine the clusters of epidemics. Spatial Durbin Model (SDM) analysis was used to identify significant environmental factors and their spatial spillover effects. RESULTS 77,405 cases of PTB among the elderly were notified, showing a decreasing trend in the notification rate. Spatial-temporal analysis showed clustering of epidemics in the western area of Zhejiang Province. The results of the SDM indicated that a one-unit increase in PM2.5 led to a 0.396% increase in the local notification rate. The annual mean temperature and precipitation had direct effects and spatial spillover effects on the rate, while complexity of the shape of the greenspace (SHAPE_AM) and SO2 had negative spatial spillover effects. CONCLUSION Targeted interventions among the elderly in Western Zhejiang may be more efficient than broad, province-wide interventions. Low annual mean temperature and high annual mean precipitation in local and neighboring areas tend to have higher PTB onset among the elderly.
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Affiliation(s)
- Dan Luo
- Department of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Luyu Wang
- School of Urban Design, Wuhan University, Hubei, Wuhan, China
| | - Mengdie Zhang
- Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Songhua Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yu Zhang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qian Wu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yonghao Wu
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China, 310058
| | - Kui Liu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
- National Centre for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Bo Xie
- School of Urban Design, Wuhan University, Hubei, Wuhan, China.
| | - Bin Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
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Katoto PDMC, Bihehe D, Brand A, Mushi R, Kusinza A, Alwood BW, van Zyl-Smit RN, Tamuzi JL, Sam-Agudu NA, Yotebieng M, Metcalfe J, Theron G, Godri Pollitt KJ, Lesosky M, Vanoirbeek J, Mortimer K, Nawrot T, Nemery B, Nachega JB. Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults. Environ Health 2024; 23:6. [PMID: 38233832 PMCID: PMC10792790 DOI: 10.1186/s12940-023-01044-0] [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: 10/04/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND In low- and middle-income countries countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection. METHODS We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 - March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB. RESULTS We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/week were more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm]. CONCLUSION Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women.
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Affiliation(s)
- Patrick D M C Katoto
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- Office of the President and CEO, South African Medical Research Council, Cape Town, South Africa.
- Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Dieudonné Bihehe
- Department of Internal Medicine, Université Evangélique en Afrique, Bukavu, DR, Congo
| | - Amanda Brand
- Centre for Evidence-Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Raymond Mushi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Aline Kusinza
- Department of Medicine, Division of Pulmonology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Brian W Alwood
- Department of Medicine, Division of Pulmonology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Richard N van Zyl-Smit
- Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Jacques L Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marcel Yotebieng
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
| | - John Metcalfe
- Division of Pulmonary and Critical Care Medicine, Trauma Center, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA
| | - Grant Theron
- South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, NRF-DST Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT, USA
| | - Maia Lesosky
- Division of epidemiology and Biostatistics, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jeroen Vanoirbeek
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Tim Nawrot
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Centre of Environmental Health, University of Hasselt, Hasselt, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jean B Nachega
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA.
- Department of Medicine, Center for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- Department of Epidemiology and Center for Global Health, Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, 130 DeSoto St., Room A522 Crabtree Hall, Pittsburgh, 15260, PA, USA.
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Katoto PDMC, Bihehe D, Brand A, Mushi R, Kusinza A, Alwood BW, van Zyl-Smit RN, Tamuzi JL, Sam-Agudu NA, Yotebieng M, Metcalfe J, Theron G, Godri Pollitt KJ, Lesosky M, Vanoirbeek J, Mortimer K, Nawrot T, Nemery B, Nachega JB. Household Air Pollution and Risk of Pulmonary Tuberculosis in HIV-Infected Adults. RESEARCH SQUARE 2023:rs.3.rs-3410503. [PMID: 37886487 PMCID: PMC10602081 DOI: 10.21203/rs.3.rs-3410503/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background In developing countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection. Methods We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 - March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB. Results We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/weekwere more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm]. Conclusion Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - John Metcalfe
- Zuckerberg San Francisco General Hospital, University of California
| | - Grant Theron
- NRF-DST Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University
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Huang K, Hu CY, Yang XY, Zhang Y, Wang XQ, Zhang KD, Li YQ, Wang J, Yu WJ, Cheng X, Cao JY, Zhang T, Kan XH, Zhang XJ. Contributions of ambient temperature and relative humidity to the risk of tuberculosis admissions: A multicity study in Central China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156272. [PMID: 35644395 DOI: 10.1016/j.scitotenv.2022.156272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As a communicable disease and major public health issue, many studies have quantified the associations between tuberculosis (TB) and meteorological factors with inconsistent results. The purpose of this multicenter study was to characterize the associations between ambient temperature, humidity and the risk of TB hospitalizations and to investigate potential heterogeneity. METHOD Data on daily hospitalizations for TB, meteorological factors and ambient air pollutants for 16 cities in Anhui Province were collected from 2015 to 2020. A distributed lag nonlinear model (DLNM) was performed to obtain the estimates of meteorological-TB relationships by cities. Then, we used the multivariate meta-regression model to pool the city-specific estimates with air pollution, demographic indicators, medical resource and latitude as potential modifiers to explore the sources of heterogeneity. Finally, we divided the whole province into three regions to validate the meteorological-TB relationships by regions. RESULTS The overall pooled temperature-TB association presented an approximate S-shaped curve, with relative risk (RR) peaking at 5 °C (RR = 1.536, 95% CI: 1.303-1.811) compared to the reference temperature (27 °C). Lag-response curve suggested that low temperature exposure increased the risk of TB hospitalizations at lag 0 and 1 day (lag0 day: RR = 1.136, 95% CI: 1.048-1.231, lag1 day: RR = 1.052, 95% CI: 1.023-1.082). However, the overall exposure-response curve between relative humidity and TB showed almost horizontal line with reference relative humidity to 78%. The residual heterogeneity ranged from 27.1% to 36.9%, with air pollution, latitude and medical resource explained the largest proportion. CONCLUSION We found that low temperature exposure is associated with an acute increased risk of TB hospitalizations in Anhui Province. The association between temperature and TB admission varies depending on air pollution, latitude, and medical resources. Since the effect of short-term exposure to humidity is not significant, further studies are supposed to focus on the long-term effect of humidity.
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Affiliation(s)
- Kai Huang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xi-Yao Yang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xin-Qiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Kang-Di Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ying-Qing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Wen-Jie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xin Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ji-Yu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China
| | - Tao Zhang
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China
| | - Xiao-Hong Kan
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China; Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei 230022, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
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Hu B, Wang Y, Wang Z, He X, Wang L, Yuan D, He Y, Jin T, He S. Association of SLC11A1 Polymorphisms With Tuberculosis Susceptibility in the Chinese Han Population. Front Genet 2022; 13:899124. [PMID: 35938025 PMCID: PMC9352942 DOI: 10.3389/fgene.2022.899124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
Tuberculosis (TB) is an important health issue in the world. Although the relation of SLC11A1 polymorphisms with TB risk has been extensively studied, it has not been reported in the northwest Chinese Han population. Therefore, this study aimed to investigate the relationships between five polymorphisms in or near the SLC11A1 gene and susceptibility to TB. The Agena MassARRAY platform was conducted for genotyping from 510 TB patients and 508 healthy controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed through logistic regression adjustment age and gender to assess the relationships between polymorphisms and TB risk. Our results identified that rs7608307 was related to increased TB risk in males (CT vs. CC: OR = 1.69, 95%CI: 1.12–2.56, p = 0.013; CT-TT vs. CC: OR = 1.61, 95%CI: 1.08–2.41, p = 0.020) and age ≤41 group (CT vs. CC: OR = 1.66, 95%CI: 1.04–2.65, p = 0.035), respectively. The SNP rs13062 was associated with the TB risk both in males (p = 0.012) and age >41 group (p = 0.021). In addition, we observed that the CC genotype of rs4674301 was correlated with increased TB risk in females (p = 0.043). Our results demonstrated the relationships between polymorphisms (rs7608307, rs4674301, and rs13062) in or near the SLC11A1 gene and age- and sex-specific TB risk in the northwest Chinese Han population.
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Affiliation(s)
- Baoping Hu
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
- Department of Anesthesiology, The Affiliated Hospital of Xizang Minzu University, Xianyang, China
| | - Yuhe Wang
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
- Department of Clinical Laboratory, The Affiliated Hospital of Xizang Minzu University, Xianyang, China
| | - Zhongtao Wang
- Department of Infectious Diseases, General Hospital of Tibet Military Command, Lhasa, China
| | - Xue He
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Li Wang
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Dongya Yuan
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Yongjun He
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Tianbo Jin
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
- *Correspondence: Tianbo Jin, , Shumei He,
| | - Shumei He
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
- Engineering Research Center of Tibetan Medicine Detection Technology, Ministry of Education, Xianyang, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
- *Correspondence: Tianbo Jin, , Shumei He,
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Keswani A, Akselrod H, Anenberg SC. Health and Clinical Impacts of Air Pollution and Linkages with Climate Change. NEJM EVIDENCE 2022; 1:EVIDra2200068. [PMID: 38319260 DOI: 10.1056/evidra2200068] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Air Pollution Impacts and Climate Change LinksAs part of the NEJM Group series on climate change, Keswani and colleagues review the linkages between climate change and air pollution and suggest strategies that clinicians may use to mitigate the adverse health impacts of air pollution.
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Affiliation(s)
- Anjeni Keswani
- Division of Allergy/Immunology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Hana Akselrod
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Susan C Anenberg
- George Washington University Milken Institute School of Public Health, Washington, DC
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