Impact of air quality on lung health: myth or reality?

Assessing the impact of mega-city construction engineering on urban livability: an explorative study of Yan'an

Yan'an City is a typical squeezed city in China and faces the challenge of limited living space. The adoption of the "Mountain Excavation and City Construction (MECC)" program was poised to elevate the city's livability. Despite the importance of megacity construction projects, few studies have examined their impact on urban livability. This study aims to fill this gap by analyzing the effects of MECC and the satisfaction characteristics of urban livability in Yan'an City, based on survey data from both old and new urban areas. Employing factor analysis and multiple linear regression, this paper assesses the influence of MECC on urban livability across different demographic groups, including age, educational background, and occupation. The empirical findings demonstrate a significant positive effect of the MECC project on urban livability. However, during categorization discussions, some respondents expressed concerns about its negative impact. The results of multiple linear regression indicate that factors such as career prospects, residential satisfaction, interpersonal relationships, and transportation level significantly influence livability (R2 = 0.607 in ND and R2 = 0.609 in OD).

Electrification of public buses in Jakarta, Indonesia: A life cycle study

Indonesia plans to mitigate the environmental emissions, particularly the carbon emissions, from the transport by replacing conventional buses with battery electric buses (BEBs). However, there are limited studies on the potential environmental benefits of BEBs and mostly focused on carbon emissions. In this study, the environmental impacts of adopting BEBs in Jakarta's public transportation system were examined using Life Cycle Assessment (LCA) to better understand its potential environmental impacts. Using LCA, the environmental impacts of BEBs were also compared with conventional buses across their life cycles, which included raw materials extraction until the end of life stages. The results showed diesel buses have generally lower environmental impacts than BEBs due to the high share of fossil fuels in the electricity generation in Indonesia. Scenario analysis showed that extending the life cycle, using different battery disposal methods, and using battery reuse could lead to higher environmental benefits in using BEBs. Among the scenarios considered in the study, prolonging the lifespan of the bus to 32 years, using electricity mix with a higher share of renewable energy and reusing the lithium-ion batteries, BEBs would have lesser environmental impact per kilometre. In particular, the particulate matter formation (PM2.5) dropped 21 %, while the overall life cycle of BEB using the highest renewable scenario showed an average of 25 % improvement compared to the baseline scenario regarding environmental impact.

The impact of air pollution on interstitial lung disease: a systematic review and meta-analysis

Introduction

There is a growing body of evidence suggesting a causal relationship between interstitial lung disease (ILD) and air pollution, both for the development of the disease, and driving disease progression. We aim to provide a comprehensive literature review of the association between air pollution, and ILD, including idiopathic pulmonary fibrosis (IPF).

Methods

We systematically searched from six online database. Two independent authors (DL and CF) selected studies and critically appraised the risk of bias using the Newcastle-Ottawa Scale (NOS). Findings are presented through a narrative synthesis and meta-analysis. Meta-analyses were performed exclusively when there was a minimum of three studies examining identical pollutant-health outcome pairs, all evaluating equivalent increments in pollutant concentration, using a random effects model.

Results

24 observational studies conducted in 13 countries or regions were identified. Pollutants under investigation encompassed ozone (O3), nitrogen dioxide (NO2), Particulate matter with diameters of 10 micrometers or less (PM10) and 2.5 micrometers or less (PM2.5), sulfur dioxide (SO2), carbon monoxide (CO), nitric oxide (NO) and nitrogen oxides (NOx). We conducted meta-analyses to assess the estimated Risk Ratios (RRs) for acute exacerbations (AE)-IPF in relation to exposure to every 10 μg/m3 increment in air pollutant concentrations, including O3, NO2, PM10, and PM2.5. The meta-analysis revealed a significant association between the increased risk of AE-IPF in PM2.5, yielding RR 1.94 (95% CI 1.30-2.90; p = 0.001). Findings across all the included studies suggest that increased exposure to air pollutants may be linked to a range of health issues in individuals with ILDs.

Conclusion

A scarcity of available studies on the air pollutants and ILD relationship underscores the imperative for further comprehensive research in this domain. The available data suggest that reducing levels of PM2.5 in the atmosphere could potentially reduce AE frequency and severity in ILD patients.

The growing impact of air quality on lung-related illness: a narrative review

Background and Objective

Poor air quality can be harmful to human well-being. There are a variety of respiratory disorders associated with toxins present within the atmosphere, such as bronchitis and asthma, which eventually lead to heart or lung complications over time. Fine particles like particulate matter 2.5 (PM2.5) accumulate in the small airways of the lung. These irritants can cause epigenetic modifications in gene regulation, leading to changes responsible for both benign and malignant lung diseases. In this review we will discuss known associations between environmental factors and pulmonary complications, consider preventative measures and offer further areas for future investigation. This review presents a summary of the literature outlining the current work done on air quality and its effects on lung-related illnesses. We discuss regional differences in air quality and consider the causes, such as manufacturing, traffic density, increase in fuel usage and natural events. We further explore disparities based on geography, race, and other social determinants.

Methods

A comprehensive literature review was performed using keywords related to air quality, pollution and lung disease within the PubMed database as well as MEDLINE and Google Scholar.

Key Content and Findings

The Clean Air Act of 1970 marked an essential transition for air quality improvement. The legislation led to decreased emissions and control measures to address atmosphere contamination. Despite these actions, poor atmospheric conditions still persist today and have become an ongoing issue. These poor conditions affect individuals living in metropolitan areas more significantly than suburban or rural areas. Pollution from industrial operations and transportation vehicles have led to increased emission outputs recently. Climate change further aggravates air quality problems by raising pollutant and allergen concentrations. The detrimental consequences of poor air quality include increased incidence of disease processes like asthma, chronic obstructive pulmonary disease (COPD) and lung cancer. To keep up with the well-being of people globally, it is important that actions be taken to battle contamination in the climate so its impact on public health can be limited.

Conclusions

Poor air quality and recent worsening of industrial emissions have had a negative impact on lung-related illnesses. Future mitigation strategies should be taken to reduce pollution and treat diseases earlier in their course. Some of these strategies include more reliance on alternative energy sources, creation of mass transit systems and increased rates of recycling.

Assessment of Indoor Air Quality for Group-Housed Macaques (Macaca spp.)

Indoor Air Quality (IAQ) is strongly associated with animal health and wellbeing. To identify possible problems of the indoor environment of macaques (Macaca spp.), we assessed the IAQ. The temperature (°C), relative humidity (%) and concentrations of inhalable dust (mg/m3), endotoxins (EU/m3), ammonia (ppm) and fungal aerosols were measured at stationary fixed locations in indoor enclosures of group-housed rhesus (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis). In addition, the personal exposure of caretakers to inhalable dust and endotoxins was measured and evaluated. Furthermore, the air circulation was assessed with non-toxic smoke, and the number of times the macaques sneezed was recorded. The indoor temperature and relative humidity for both species were within comfortable ranges. The geometric mean (GM) ammonia, dust and endotoxin concentrations were 1.84 and 0.58 ppm, 0.07 and 0.07 mg/m3, and 24.8 and 6.44 EU/m3 in the rhesus and cynomolgus macaque units, respectively. The GM dust concentrations were significantly higher during the daytime than during the nighttime. Airborne fungi ranged between 425 and 1877 CFU/m3. Personal measurements on the caretakers showed GM dust and endotoxin concentrations of 4.2 mg/m3 and 439.0 EU/m3, respectively. The number of sneezes and the IAQ parameters were not correlated. The smoke test revealed a suboptimal air flow pattern. Although the dust, endotoxins and ammonia were revealed to be within accepted human threshold limit values (TLV), caretakers were exposed to dust and endotoxin levels exceeding existing occupational reference values.

Moraxella catarrhalis evades neutrophil oxidative stress responses providing a safer niche for nontypeable Haemophilus influenzae

Moraxella catarrhalis and nontypeable Haemophilus influenzae (NTHi) are pathogenic bacteria frequently associated with exacerbation of chronic obstructive pulmonary disease (COPD), whose hallmark is inflammatory oxidative stress. Neutrophils produce reactive oxygen species (ROS) which can boost antimicrobial response by promoting neutrophil extracellular traps (NET) and autophagy. Here, we showed that M. catarrhalis induces less ROS and NET production in differentiated HL-60 cells compared to NTHi. It is also able to actively interfere with these responses in chemically activated cells in a phagocytosis and opsonin-independent and contact-dependent manner, possibly by engaging host immunosuppressive receptors. M. catarrhalis subverts the autophagic pathway of the phagocytic cells and survives intracellularly. It also promotes the survival of NTHi which is otherwise susceptible to the host antimicrobial arsenal. In-depth understanding of the immune evasion strategies exploited by these two human pathogens could suggest medical interventions to tackle COPD and potentially other diseases in which they co-exist.

•

Mcat induces ROS and NET production to a lesser extent than NTHi in dHL-60 cells

•

Mcat interferes with ROS-related responses in chemically-activated cells

•

Mcat subverts the autophagic pathway surviving intracellularly while NTHi does not

•

Intracellular survival of NTHi is enhanced by the co-infecting bacterium Mcat

Role of Environmental Air Pollution in Chronic Rhinosinusitis

PURPOSE OF REVIEW

Chronic rhinosinusitis (CRS) is a highly prevalent disease with large social and financial burdens. The pathophysiology is multifactorial. Environmental pollutants have been suggested to play a role in the inflammatory component of the disease process.

RECENT FINDINGS

Recent work has focused on exposure to various pollutants, primarily particulate matter (PM). Exposure to environmental pollutants leads to upregulation of inflammatory markers and ciliary dysfunction at the cellular level. Mouse models suggest a role for epithelial barrier dysfunction contributing to inflammatory changes after pollutant exposure. Clinical studies support the role of pollutants contributing to disease severity in certain populations, but the role in CRS incidence or prevalence is less clear. Research is limited by the retrospective nature of most studies. This review focuses on recent advancements in our understanding of the impact of environmental pollutants in CRS, limitations of the available data, and potential opportunities for future studies.

Effects of air pollution in Spatio-temporal modeling of asthma-prone areas using a machine learning model

Industrialization and increasing urbanization have led to increased air pollution, which has a devastating effect on public health and asthma. This study aimed to model the spatial-temporal of asthma in Tehran, Iran using a machine learning model. Initially, a spatial database was created consisting of 872 locations of asthma children and six air pollution parameters, including carbon monoxide (CO), particulate matter (PM₁₀ and PM_2.5), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃) in four-seasons (spring, summer, autumn, and winter). Spatial-temporal modeling and mapping of asthma-prone areas were performed using a random forest (RF) model. For Spatio-temporal modeling and assessment, 70% and 30% of the dataset were used, respectively. The Spearman correlation and RF model findings showed that during different seasons, the PM_2.5 parameter had the most important effect on asthma occurrence in Tehran. The assessment of the Spatio-temporal modeling of asthma using the receiver operating characteristic (ROC)-area under the curve (AUC) showed an accuracy of 0.823, 0.821, 0.83, and 0.827, respectively for spring, summer, autumn, and winter. According to the results, asthma occurs more often in autumn than in other seasons.

Traffic generated emissions alter the lung microbiota by promoting the expansion of Proteobacteria in C57Bl/6 mice placed on a high-fat diet

Air pollution has been documented to contribute to severe respiratory diseases like asthma and chronic obstructive pulmonary disorder (COPD). Although these diseases demonstrate a shift in the lung microbiota towards Proteobacteria, the effects of traffic generated emissions on lung microbiota profiles have not been well-characterized. Thus, we investigated the hypothesis that exposure to traffic-generated emissions can alter lung microbiota and immune defenses. Since a large population of the Western world consumes a diet rich in fats, we sought to investigate the synergistic effects of mixed vehicle emissions and high-fat diet consumption. We exposed 3-month-old male C57Bl/6 mice placed either on regular chow (LF) or a high-fat (HF: 45% kcal fat) diet to mixed emissions (ME: 30 µg PM/m³ gasoline engine emissions+70 µg PM/m³ diesel engine emissions) or filtered air (FA) for 6 h/d, 7 d/wk for 30 days. Levels of pulmonary immunoglobulins IgA, IgG, and IgM were analyzed by ELISA, and lung microbial profiling was done using qPCR and Illumina 16 S sequencing. We observed a significant decrease in lung IgA in the ME-exposed animals, compared to the FA-exposed animals, both fed a HF diet. Our results also revealed a significant decrease in lung IgG in the ME-exposed animals both on the LF diet and HF diet, in comparison to the FA-exposed animals. We also observed an expansion of Enterobacteriaceae belonging to the Proteobacteria phylum in the ME-exposed groups on the HF diet. Collectively, we show that the combined effects of ME and HF diet result in decreased immune surveillance and lung bacterial dysbiosis, which is of significance in lung diseases.

Urban Particulate Matters May Affect Endoplasmic Reticulum Stress and Tight Junction Disruption in Nasal Epithelial Cells

BACKGROUND

Exposure to airborne urban particulate matter (UPM) has been closely related to the development and aggravation of respiratory disease, including sinonasal disorders.

OBJECTIVE

The aims of this study were to investigate the effect of UPM on nasal epithelial tight junctions (TJs) and mucosal barrier function and delineate the underlying mechanism by using both in vitro and in vivo models.

METHODS

In this study, human nasal epithelial cells (hNECs) and BALB/c mice were exposed to UPMs. UPM 1648a and 1649 b were employed. TJ and endoplasmic reticulum (ER) stress marker expression was measured using western blot analysis and immunofluorescence. TJ integrity and nasal epithelial barrier function were evaluated by transepithelial electric resistance (TER) and paracellular flux. In addition, the effects of N-acetyl-L-cysteine (NAC) on UPM-induced nasal epithelial cells were investigated.

RESULTS

UPM significantly impaired the nasal epithelial barrier, as demonstrated by decreased protein expression of TJ and ER stress markers in human nasal epithelial cells. This finding was in parallel to reduced transepithelial electrical resistance and increased fluorescein isothiocyanate-dextran permeability. Pretreatment with NAC decreased the degree of UPM-mediated ER stress and restored nasal epithelial barrier disruption in human nasal epithelial cells (hNEC) and the nasal mucosa of experimental animals.

CONCLUSION

These data suggest that UPMs may induce nasal epithelial barrier dysfunction by targeting TJs and ER stress could be related in this process. Based on these results, we suggest that suppression of this process with an inhibitor targeting ER stress responses could represent a novel promising therapeutic target in UPM-induced sinonasal disease.

Lung damage by thoron progenies versus possible damage redemption by lung stem cells: a perspective

PURPOSE

Natural radiation is the major source of human exposure to ionizing radiation. About 52% of the total dose received from the high natural background radiations (HNBR) areas are due to inhalation dose from radon (²²²Rn)/thoron (²²⁰Rn) and their progenies. Hence, we reviewed the biological effects of ²²²Rn/²²⁰Rn and their progenies on lung tissue, and the possible role of lung stem cells in salvaging the damage caused by ²²²Rn/²²⁰Rn and their progenies.

MATERIALS AND METHOD

We have extensively reviewed articles among several hits obtained in PubMed, Scopus, and Elsevier databases with keywords 'Radon/Thoron' OR Thoron progeny/Radon progeny OR 'Thoron/Radon inhalation and lungs', and proceed for further analysis. Also, databases related to oxidative damage to lung stem cells by radiation and the repair mechanisms involved by the lung stem cells were also included.

RESULTS

Based on the existing epidemiological data on radon in residential buildings, we found that evidence exists on the association of radon induced lung carcinogenesis, but the data regarding the role of thoron induced lung damage is very limited and inconclusive. We also found that limited information has been provided based on ecological designs, leading to poor documentation of health statistics, in particular, organ-specific cancer rates. Finally, we tried to elucidate the possible mechanisms of lung injury induced by thoron inhalation and the probable role of lung stem cell toward the redemption of such oxidative damages.

CONCLUSION

Existing epidemiological data on thoron inhalation and associated health outcomes are limited and inconclusive. Further, in vivo experiments, with respect to radon/thoron inhalation dose rate ranges corresponding to the HNBR areas will be helpful in understanding the cellular and molecular effects.

Evaluation of Pollutants Along the National Road N2 in Togo using the AERMOD Dispersion Model

BACKGROUND

Air pollution has become a major problem around the world and is increasingly an issue in Togo due to increased vehicular traffic. Gaseous pollutants are released by engines and are very harmful to human health and the environment. The fuels used on the major road in Togo, the N2, are adulterated with unknown contents and are of poor quality. Many of the vehicles come from neighboring countries, such as Benin, Ghana and Nigeria.

OBJECTIVES

The present study aims to evaluate the pollution rate in Togo through the estimation of the concentrations of sulfur dioxide (SO₂), nitrogen oxides (NO_x), and particular matter (PM) on the international road, the National Road N2, in Lomé, compared to the World Health Organization's (WHO) standard limit.

METHODS

The simulations of pollutant concentration were performed using the Industrial Source Complex Short Term Version 3 model, which is included in the United States Environmental Protection Agency Regulatory Model (USEPA) AERMOD View software. The meteorological averages data were obtained from the local station near the National Road N2 in Togo in 2018. Hourly averages were calculated according to the European Monitoring Evaluation Programme/European Environmental Agency air pollutant emission inventory guidebook 2016 and were processed using AERMET View and a terrain pre-processor, AERMAP. For the model, the sources of pollution were the vehicles traveling on the road segment. The source was a line volume with 20 m of width and 2 m of height. The estimation methodology covered exhaust emissions of NO_x, SO₂ and PM contained in the fuel.

RESULTS

The simulations provided average hourly, daily and annual concentrations of the different pollutants: 71.91 μg/m³, 42.41 μg/m³,11.23 μg/m³ for SO₂; 16.78 μg/m³, 9.89 μg/m³, 2.46 μg/m³ for NO_x and below the detection limit, 0.62 μg/m³, 0.15 μg/m³ for PM, respectively. These results indicate that on the National Road N2 in Togo, the concentrations of SO₂ were high compared to those of NO_x and PM. The daily average concentration of SO₂ was twice the permissible limits set by the WHO.

CONCLUSIONS

Emissions obtained from the AERMOD for NO_x and PM were less than the permissible limits set by the WHO, while the rate of SO₂ was twice the permissible limit. The fuels used on this road were very rich in sulfur. The sulfur level in fuels must be monitored by stakeholders in Togo.

COMPETING INTERESTS

The authors declare no competing financial interests.

Host, Gender, and Early-Life Factors as Risks for Chronic Obstructive Pulmonary Disease

Although smoking results in lung pathology in many, still not all smokers develop chronic obstructive pulmonary disease (COPD). Roughly a quarter of patients with COPD have never smoked. An understanding of both host and environmental factors beyond smoking that contribute to disease development remain critical to understanding disease prevention and ultimately effectively intervene. In this article, we summarize host factors, including genetics and gender, as well as early-life events that contribute to the development of COPD.

Nanodomains in cardiopulmonary disorders and the impact of air pollution

Air pollution is a major environmental threat and each year about 7 million people reported to die as a result of air pollution. Consequently, exposure to air pollution is linked to increased morbidity and mortality world-wide. Diesel automotive engines are a major source of urban air pollution in the western societies encompassing particulate matter and diesel exhaust particles (DEP). Air pollution is envisioned as primary cause for cardiovascular dysfunction, such as ischemic heart disease, cardiac dysrhythmias, heart failure, cerebrovascular disease and stroke. Air pollution also causes lung dysfunction, such as chronic obstructive pulmonary disease (COPD), asthma, idiopathic pulmonary fibrosis (IPF), and specifically exacerbations of these diseases. DEP induces inflammation and reactive oxygen species production ultimately leading to mitochondrial dysfunction. DEP impair structural cell function and initiate the epithelial-to-mesenchymal transition, a process leading to dysfunction in endothelial as well as epithelial barrier, hamper tissue repair and eventually leading to fibrosis. Targeting cyclic adenosine monophosphate (cAMP) has been implicated to alleviate cardiopulmonary dysfunction, even more intriguingly cAMP seems to emerge as a potent regulator of mitochondrial metabolism. We propose that targeting of the mitochondrial cAMP nanodomain bear the therapeutic potential to diminish air pollutant — particularly DEP — induced decline in cardiopulmonary function.

Lagging and Flagging: Air Pollution, Shale Gas Exploration and the Interaction of Policy, Science, Ethics and Environmental Justice in England

The science on the effects of global climate change and air pollution on morbidity and mortality is clear and debate now centres around the scale and precise contributions of particular pollutants. Sufficient data existed in recent decades to support the adoption of precautionary public health policies relating to fossil fuels including shale exploration. Yet air quality and related public health impacts linked to ethical and environmental justice elements are often marginalized or missing in planning and associated decision making. Industry and government policies and practices, laws and planning regulations lagged well behind the science in the United Kingdom. This paper explores the reasons for this and what shaped some of those policies. Why did shale gas policies in England fail to fully address public health priorities and neglect ethical and environmental justice concerns. To answer this question, an interdisciplinary analysis is needed informed by a theoretical framework of how air pollution and climate change are largely discounted in the complex realpolitik of policy and regulation for shale gas development in England. Sources, including official government, regulatory and planning documents, as well as industry and scientific publications are examined and benchmarked against the science and ethical and environmental justice criteria. Further, our typology illustrates how the process works drawing on an analysis of official policy documents and statements on planning and regulatory oversight of shale exploration in England, and material from industry and their consultants relating to proposed shale oil and gas development. Currently the oil, gas and chemical industries in England continue to dominate and influence energy and feedstock-related policy making to the detriment of ethical and environmental justice decision making with significant consequences for public health.

Association of air pollutants, airborne occupational exposures, and chronic rhinosinusitis disease severity

BACKGROUND

Previous work has shown that chronic rhinosinusitis (CRS) severity may be associated with particulate matter 2.5 (PM_2.5 ) and black carbon (BC) in CRS patients without nasal polyps (CRSsNP). Data regarding occupational exposures, however, are lacking. We assessed the impact of PM_2.5 , BC, as well as occupational airborne exposure on CRS disease severity.

METHODS

Patients with CRS with nasal polyps (CRSwNP), CRSsNP, and aspirin-exacerbated respiratory disease (AERD) were identified from an institutionwide database. Spatial modeling from 37 pollutant monitoring sites in Allegheny County was used to estimate exposures. Patient occupations using the 2010 Standard Occupation Classification (SOC10) and airborne occupation exposures to vapors, gases, dusts, fumes, fibers and mists (VGDFFiM) or diesel fumes were recorded. Disease severity was measured by modified Lund-Mackay score (LMS), systemic corticosteroid therapy, and incidence of functional endoscopic sinus surgery (FESS).

RESULTS

Two hundred thirty-four patients were included (CRSwNP, n = 113; CRSsNP, n = 96; AERD, n = 25). The prevalence of AERD among those with CRSwNP was 18%. Patients exposed to VGDFFiM or diesel fumes required higher steroid doses vs nonexposed patients (p = 0.015 and p = 0.03, respectively); patients with VGDFFiM levels >5% were more likely to undergo FESS vs nonexposed patients (p = 0.0378). There was no difference in PM_2.5 and BC with regard to disease severity and FESS between CRSwNP, CRSsNP, and AERD patients. Steroid use was significantly higher in CRSwNP and AERD vs CRSsNP (p = 0.001). LMS was significantly higher in AERD as compared with CRSwNP and CRSsNP (p = 0.001).

CONCLUSION

Occupational airborne exposure to VGDFFiM correlated with increased prevalence of FESS and need for corticosteroids in CRS patients. There was no difference in PM_2.5 and BC levels and disease severity outcome measures between CRS subtypes in this subset.

Vehicle Ammonia Emissions Measured in An Urban Environment in Sydney, Australia, Using Open Path Fourier Transform Infra-Red Spectroscopy

Airborne particulate matter (PM) is a major health risk in urban settings. Ammonia (NH3) from vehicle exhaust is an under-recognised ingredient in the formation of inorganic PM and there remains a shortage of data to properly quantify the role of NH3 from vehicles in PM formation. An Open-path Fourier transform infra-red (OP-FTIR) spectrometer measured atmospheric NH3, carbon monoxide (CO) and carbon dioxide (CO2) at high temporal resolution (5 min) in Western Sydney over 11 months. The oxides of nitrogen (NO2 and NO; NOx) and sulphur dioxide (SO2) were measured at an adjacent air quality monitoring station. NH3 levels were maxima in the morning and evening coincident with peak traffic. During peak traffic NH3:CO ratio ranged from 0.018 to 0.022 ppbv:ppbv. Results were compared with the Greater Metropolitan Region 2008 (GMR2008) emissions inventory. Measured NH3:CO was higher during peak traffic times than the GMR2008 emissions estimates, indicating an underestimation of vehicle NH3 emissions in the inventory. Measurements also indicated the urban atmosphere was NH3 rich for the formation of ammonium sulphate ((NH4)2SO4) particulate was SO2 limited while the formation of ammonium nitrate (NH4NO3) was NH3 limited. Any reduction in NOx emissions with improved catalytic converter efficiency will be accompanied by an increase in NH3 production and potentially with an increase in NH4NO3 particulate.

Lung alveolar tissue destruction and protein citrullination in diesel exhaust-exposed mouse lungs

Humanity faces an increasing impact of air pollution worldwide, including threats to human health. Air pollutants prompt and promote chronic inflammation, tumourigenesis, autoimmune and other destructive processes in the human body. Post-translational modification of proteins, for example citrullination, results from damaging attacks of pollutants, including smoking, air pollution and others, rendering host tissues immunogenic. Citrullinated proteins and citrullinating enzymes, deiminases, are more prevalent in patients with COPD and correlate with ongoing inflammation and oxidative stress. In this study, we installed an in-house-designed diesel exhaust delivery and cannabidiol vaporization system where mice were exposed to relevant, urban traffic-related levels of diesel exhaust for 14 days and assessed integrity of alveolar tissue, gene expression shifts and changes in protein content in the lungs and other tissues of exposed mice. Systemic presence of modified proteins was also tested. The protective effect of phytocannabinoids was investigated as well. Data obtained in our study show subacute effects of diesel exhaust on mouse lung integrity and protein content. Emphysematous changes are documented in exposed mouse lungs. In parallel, increased levels of citrulline were detected in the alveolar lung tissue and peripheral blood of exposed mice. Pre-treatment with vaporized cannabidiol ameliorated some damaging effects. Results reported hereby provide new insights into subacute lung tissue changes that follow diesel exhaust exposure and suggest possible dietary and/or other therapeutic interventions for maintaining lung health and healthy ageing.

Critical review of long-term ozone exposure and asthma development

Asthma, a chronic respiratory disorder with complex etiology and various phenotypes, is a considerable public health concern in the USA and worldwide. While there is evidence suggesting ambient ozone exposure may exacerbate asthma, information regarding the potential role of ozone in asthma development is more limited. Thus, we conducted a critical review of observational epidemiology studies to determine whether long-term ambient ozone exposure is a risk factor for asthma development. We identified 14 relevant studies; 11 evaluated asthma development in children, while three studies, based on a single cohort, assessed this outcome in adults. Studies of childhood asthma and long-term ozone exposure - including exposure in utero, during the first year of life and during early childhood - reported inconsistent findings, which were further weakened by critical methodological limitations in statistical analyses and in exposure and outcome assessments, such as exposure measurement error and a lack of adjustment for key confounders. For adult-onset asthma, long-term ozone exposure was associated with an increased risk in men but not women. In addition to considerable uncertainties due to potential exposure measurement error and a lack of adjustment for key confounders, this study has limited generalizability to the US general population. While experimental evidence indicates that it may be biologically plausible that long-term ozone exposure could contribute to asthma development, it does not provide insight regarding an established mode of action. Future research is needed to address the uncertainties regarding the role of long-term ambient ozone exposure in asthma development.

A general method for evaluating the effects of air pollutants on lung cancer prevalence

It is widely accepted that some air pollutants are related to lung cancer prevalence. An effective method is proposed to quantitatively evaluate the effects of air pollutants and the interactions between them. The method consisted of three parts: data decomposition, comparable data generation and relationship inference. Firstly, very limited monitoring data published by Geographic Information System were applied to calculate the inhalable air pollution of relatively massive patient samples. Then the investigated area was partitioned into a number of districts, and the comparable data containing air pollutant concentrations and lung cancer prevalence in all districts were generated. Finally, the relationships between pollutants and lung cancer prevalence were concluded by an information fusion tool: Choquet integral. As an example, the proposed method was applied in the investigation of air pollution in Tianjin, China. Overall, SO₂, O₃ and PM_2.5 were the top three factors for lung cancer. And there was obvious positive interaction between O₃ and PM_2.5 and negative interaction among SO₂, O₃ and PM₁₀. The effect of SO₂ on men was larger than on women. O₃ and SO₂ were the most important factors for the adenocarcinoma and squamous cell carcinoma, respectively. The effect of SO₂ or NO₂ on squamous cell carcinoma is obviously larger than that on adenocarcinoma, while the effect of O₃ or PM_2.5 on adenocarcinoma is obviously larger than that on squamous cell carcinoma. The results provide important suggestions for management of pollutants and improvement of environmental quality. The proposed method without any parameter is general and easily realized, and it sets the foundation for further researches in other cities/countries. Implications: For total lung cancer prevalence, male and female lung cancer prevalence, and adenocarcinoma and squamous cell carcinoma prevalence, the proposed method not only quantify the effect of single pollutant (SO₂, NO₂, CO, O₃, PM_2.5, and PM₁₀) but also reveals the correlations between different pollutants such as positive interaction or negative interaction. The proposed method without any geographic predictor and parameter is much easier to realize, and it sets the foundation for further research in other cities/countries. The study results provide important suggestions for the targeted management of different pollutants and the improvement of human lung health.

The position paper of the Polish Society of Allergology on climate changes, natural disasters and allergy and asthma

The observed global climate change is an indisputable cause of the increased frequency of extreme weather events and related natural disasters. This phenomenon is observed all over the world including Poland. Moreover, Polish citizens as tourists are also exposed to climate phenomena that do not occur in our climate zone. Extreme weather events and related disasters can have a significant impact on people with allergic diseases, including asthma. These effects may be associated with the exposure to air pollution, allergens, and specific microclimate conditions. Under the auspices of the Polish Society of Allergology, experts in the field of environmental allergy prepared a statement on climate changes, natural disasters and allergy and asthma to reduce the risk of adverse health events provoked by climate and weather factors. The guidelines contain the description of the factors related to climate changes and natural disasters affecting the course of allergic diseases, the specific microclimate conditions and the recommendations of the Polish Society of Allergology for vulnerable population, patients suffering from asthma and allergy diseases, allergologists and authorities in the event of climate and weather hazards.

The association between pollutant levels and asthma-related emergency department visits in the Bronx after the World Trade Center attacks

Objective: To examine the potential impact of the World Trade Center (WTC) attacks on asthma-related emergency department visits (AREDV) in the New York City borough of the Bronx. Methods: We obtained daily nitrogen dioxide (NO₂), sulfur dioxide (SO₂) and ozone (O₃) values from the National Climatic Data Center's collection station in the Bronx from 1999 and 2002, a year before and after the WTC attacks. We compared daily AREDV and pollutant levels between 1999 and 2002 using the Wilcoxon signed rank sum test. We considered each season separately due to seasonal variations of AREDV and pollutants. We then used multiple linear regression models to assess the relationships between the changes in AREDV and the changes in pollutants from 1999 to 2002 in each season. Results: There were statistically significant increases from 1999 to 2002 in the daily NO₂ in the summer. Significant increases for daily SO₂ and O₃ values from 1999 to 2002 occurred in all seasons. Significant increases occurred in daily AREDV values in the spring and fall. Multiple linear regression analyses showed that increases in the daily O₃ values were significantly associated with increases in AREDV from 1999 to 2002 in the summer season. Conclusion: We observed a possible association between the WTC attacks and significant increases in O₃ and SO₂ for all seasons, and NO₂ for the summer. AREDV significantly increased following the WTC attacks. Increases in daily O₃ values were significantly associated with increases in AREDV in the summer season.

Role of Oxidative Stress in the Pathology and Management of Human Tuberculosis

Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, is the leading cause of mortality worldwide due to a single infectious agent. The pathogen spreads primarily via aerosols and especially infects the alveolar macrophages in the lungs. The lung has evolved various biological mechanisms, including oxidative stress (OS) responses, to counteract TB infection. M. tuberculosis infection triggers the generation of reactive oxygen species by host phagocytic cells (primarily macrophages). The development of resistance to commonly prescribed antibiotics poses a challenge to treat TB; this commonly manifests as multidrug resistant tuberculosis (MDR-TB). OS and antioxidant defense mechanisms play key roles during TB infection and treatment. For instance, several established first-/second-line antitubercle antibiotics are administered in an inactive form and subsequently transformed into their active form by components of the OS responses of both host (nitric oxide, S-oxidation) and pathogen (catalase/peroxidase enzyme, EthA). Additionally, M. tuberculosis has developed mechanisms to survive high OS burden in the host, including the increased bacterial NADH/NAD⁺ ratio and enhanced intracellular survival (Eis) protein, peroxiredoxin, superoxide dismutases, and catalases. Here, we review the interplay between lung OS and its effects on both activation of antitubercle antibiotics and the strategies employed by M. tuberculosis that are essential for survival of both drug-susceptible and drug-resistant bacterial subtypes. We then outline potential new therapies that are based on combining standard antitubercular antibiotics with adjuvant agents that could limit the ability of M. tuberculosis to counter the host's OS response.

Effects of Exposure to New Car Interiors in Patients With Asthma and Allergic Rhinitis

Rationale

Vehicle interiors are an important microenvironment for atopic subjects. This study evaluated the subjective and objective physiologic and clinical effects of exposing subjects with asthma and allergic rhinitis to new 2017 Mercedes vehicles during 90-minute rides.

Methods

Ten adult asthmatics with allergic rhinitis were assessed before and 45 and 90 minutes into rides in a 2017 Mercedes-Benz S-Class sedan and GLE-Class SUV on 2 separate days. Assessments included spirometry, fractional exhaled nitric oxide, peak nasal inspiratory flow, asthma symptom scores, and physical examinations.

Results

Of the 10 subjects, 6 were women, mean age was 32 years, and 6 and 4 were using chronic asthma controllers or intranasal corticosteroids, respectively. None of the subjects had worsening of asthma or rhinitis symptoms during the rides. There were no statistically significant changes from baseline in forced expiratory volume in 1 second, forced expiratory volume in 1 second:forced vital capacity ratio, forced expiratory flow at 25%-75% of vital capacity, fractional exhaled nitric oxide, or peak nasal inspiratory flow at 45 or 90 minutes into the rides with either Mercedes vehicle (all P values > .1 using generalized linear mixed model).

Conclusion

The interior environment of the tested Mercedes vehicles did not cause changes in subjective or objective measures of asthma and allergic rhinitis. We suggest that this model system can be used to test other vehicles for putatively adverse effects on patients with allergic respiratory disorders.

The in vivo and in vitro approaches for establishing a link between advanced glycation end products and lung cancer

Advanced glycation end products (AGEs) are directly related to third aging-associated diseases, such as cardiovascular diseases, arteriosclerosis, and neurodegeneration. Likewise, these irreversible and nonenzymatic products have been reported to be involved in the progression of malignant cancers. In general, aging-associated diseases and the initiation of cancer have been subjects of interest for several years. Few studies on the role of AGEs in cancer have been performed on cell lines. Moreover, past investigations in the field of glycation biology still lack the knowledge of in vivo and in vitro approaches for cancer cells. Accordingly, we aimed to focus on and establish a link between cancer and glycation with respect to all the possible AGEs. In our study, the levels of carboxymethyllysine (CML) increased by 50.94% in an animal model of glycation, whereas in an animal model of cancer, the contents of CML increased by 45.94% compared with their negative controls. Similarly, fluorescent AGEs were also examined and were found to be increased by 65.3% and 58.63% in the animal models of glycation and cancer, respectively, compared with the control subjects. The protein carbonyl contents were also found to be enhanced in the animal models of glycation and cancer. In our study, the levels of reactive oxygen species were also found to be significantly increased in the in vitro model of cancer cells as compared with the controls. Such an initial breakthrough indicated that AGEs were present in the serum of the animal models of cancer and glycation.

The effect of urban particulate matter on cultured human nasal fibroblasts

BACKGROUND

Exposure to urban particulate matter (UPM) has been linked to aggravation of various health problems. Although the effects of UPM on the lower respiratory tract have been extensively studied, more research is required on the impact of UPM on the upper respiratory tract and the underlying mechanisms. Thus, we investigated the cytotoxic effects of UPM on cultured human nasal fibroblasts, the underlying signaling pathways involved, and changes in cytokine levels.

METHODS

Human turbinate tissue specimens were collected during partial turbinectomies performed on 6 patients, and then cultured. The effect of UPM on nasal fibroblast viability was explored. Real-time reverse transcription-polymerase chain reaction was used to measure the mRNA levels of genes encoding cytokines and chemokines (interleukin [IL]-4, IL-6, IL-8, and tumor necrosis factor-α) before and after 24 hours of UPM treatment. Enzyme-linked immunosorbent assays were employed to measure IL-6 and IL-8 levels. The status of the p38 and nuclear factor (NF)-κB signaling pathways was analyzed by Western blotting.

RESULTS

UPM reduced cell viability in a dose-dependent manner and increased IL-6 and IL-8 expression at both the mRNA and protein levels. UPM induced the phosphorylation of p38 and NF-κB p65; inhibitors of the actions of these proteins repressed phosphorylation and the expression of IL-6 and IL-8.

CONCLUSION

UPM induced IL-6 and IL-8 expression by fibroblasts via p38 and NF-κB classical signaling, suggesting that UPM can induce or aggravate allergic and/or chronic rhinitis.

Investigating the environmental quality deterioration and human health hazard caused by heating emissions

By analyzing the status quo of the district heating energy consumption and air quality in China, it was found that with the environmental quality degradation, the previous assessment method using energy efficiency as the index cannot consider the impact on the environmental quality and human health simultaneously. Hence, to analyze the environmental quality deterioration and human health hazard due to the heating emissions, a novel assessment method was proposed and can be used to guide the improvement strategies. In this study, based on the quantitative influence of the heating emissions, urban population density and pollution duration, heating impact index (HII) as a new comprehensive evaluation index was introduced. It can be used to assess the urgency of the heating improvement in the studied regions. To estimate the air pollution status quo caused by heating emissions, 66 main heating cities in China were selected as the studied objects. The results showed that the calculated average heating emission-contributed air quality index (AQI) was 45% and polluted time percentage was 39%. The industrial emissions in 19 cities were the main reason to deteriorate the environmental quality during the heating season. While in the remaining 47 cities (71.2% of total studied cities), heating emissions dominated the deterioration of environmental quality. Subsequently, the cities with HII larger than 0.1 were divided into six levels to provide a guide for the Chinese government and relevant departments to improve the heating system and reduce human health hazard. This study can also be used as a reference for other polluted cities to investigate the environmental quality deterioration and human health hazard degrees due to the heating emissions.

Air pollutants may be environmental risk factors in chronic rhinosinusitis disease progression

BACKGROUND

Little is known about the role of environmental exposures in the pathophysiology of chronic rhinosinusitis (CRS). In this study, we measured the impact of air pollutants (particulate matter 2.5 [PM_2.5 ] and black carbon [BC]) on CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP).

METHODS

Spatial modeling from pollutant monitoring sites was used to estimate exposures surrounding residences for patients meeting inclusion criteria (total patients, n = 234; CRSsNP, n = 96; CRSwNP, n = 138). Disease severity outcome measures included modified Lund-Mackay score (LMS), systemic steroids, number of functional endoscopic sinus surgeries (FESS), and 22-item Sino-Nasal Outcome Test (SNOT-22) score. PM_2.5 and BC exposures were correlated with outcome measures.

RESULTS

Mean PM_2.5 and BC findings were not significantly different between CRSwNP and CRSsNP patients or patients with and without asthma. Among those with CRSsNP, PM_2.5 was significantly associated with undergoing FESS. For each unit increase in PM_2.5 , there was a 1.89-fold increased risk in the proportion of CRSsNP patients who required further surgery (p = 0.015). This association was not identified in CRSwNP patients (p = 0.445). BC was also significantly associated with SNOT-22 score in the CRSsNP group. For each 0.1-unit increase in BC, there was a 7.97-unit increase in SNOT-22 (p = 0.008). A similar, although not significant, increase in SNOT-22 was found with increasing BC in the CRSwNP group (p = 0.728).

CONCLUSION

Air pollutants correlate with CRS symptom severity that may be influenced by exposure levels, with a more pronounced impact on CRSsNP patients. This study is the first to demonstrate the possible role of inhalant pollutants in CRS phenotypes, addressing a critical knowledge gap in environmental risk factors for disease progression.

The Interactive Roles of Lipopolysaccharides and dsRNA/Viruses on Respiratory Epithelial Cells and Dendritic Cells in Allergic Respiratory Disorders: The Hygiene Hypothesis

The original hygiene hypothesis declares "more infections in early childhood protect against later atopy". According to the hygiene hypothesis, the increased incidence of allergic disorders in developed countries is explained by the decrease of infections. Epithelial cells and dendritic cells play key roles in bridging the innate and adaptive immune systems. Among the various pattern-recognition receptor systems of epithelial cells and dendritic cells, including toll-like receptors (TLRs), nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs) and others, TLRs are the key systems of immune response regulation. In humans, TLRs consist of TLR1 to TLR10. They regulate cellular responses through engagement with TLR ligands, e.g., lipopolysaccharides (LPS) acts through TLR4 and dsRNA acts through TLR3, but there are certain common components between these two TLR pathways. dsRNA activates epithelial cells and dendritic cells in different directions, resulting in allergy-related Th2-skewing tendency in epithelial cells, and Th1-skewing tendency in dendritic cells. The Th2-skewing effect by stimulation of dsRNA on epithelial cells could be suppressed by the presence of LPS above some threshold. When LPS level decreases, the Th2-skewing effect increases. It may be via these interrelated networks and related factors that LPS modifies the allergic responses and provides a plausible mechanism of the hygiene hypothesis. Several hygiene hypothesis-related phenomena, seemingly conflicting, are also discussed in this review, along with their proposed mechanisms.

Exposure scenario: Another important factor determining the toxic effects of PM2.5 and possible mechanisms involved

Worsening air pollution is a serious threat to public health in many urban and heavily industrialized areas. Particle size and chemical composition are well known determinants of the pathological response to air pollution. In addition, pathological responses may depend on the exposure profile (or scenario) of air pollution. For instance, we previously demonstrated that repeated exposure to low levels of fine airborne particulate matter (PM2.5) induced distinct epigenetic changes compared to acute high-doses exposure. In the present study, we evaluated the differential pathological responses of BEAS-2B human bronchial epithelial cells to two distinct PM2.5 exposure scenarios: 24-h exposure to high-doses PM2.5 (0, 6, 12, 24, 48, 96 μg/cm²) and 10 days' repeated exposure to low levels of PM2.5 (0, 1.5, 3, 6 μg/cm²). Acute exposure to high concentrations of PM2.5 caused ROS burst, marked DNA damage, dysfunction of the endoplasmic reticulum (ER) stress response, autophagy and necrotic cell death. In contrast, repeated low levels of PM2.5 led to sustained low-grade ROS accumulation, milder DNA damage, ER stress/unfolded protein response (UPR), S-phase arrest, apoptosis, and autophagy. Notably, most cells surviving repeated low-level exposure showed a series of abnormal adaptive responses, such as inhibition of mitochondria biogenesis and epigenetic dysregulation. These results indicate that different PM2.5 exposure scenarios induce distinct forms cytotoxicity and adaptive response. In addition to particle size and chemical composition, exposure scenario may be a critical factor determining the toxic health effects of PM2.5.

Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m³ increase in nitrogen dioxide (NO₂) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m³ increase in PM₁₀). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.

Diesel Exhaust Particles Upregulate Interleukins IL-6 and IL-8 in Nasal Fibroblasts

Background

Diesel exhaust particles (DEP) are a major source of air pollution. Nasal fibroblasts are known to produce various cytokines and chemokines. The aim of this study was to evaluate DEP-induced cytokines and chemokines in nasal fibroblasts and to identify the signaling pathway involved.

Methods

A cytokine and chemokine array performed after stimulation of nasal fibroblasts with DEP revealed that levels of IL-6 and IL-8 were increased most significantly among various cytokines and chemokines. RT—PCR and ELISA were used to determine the mRNA and protein expression levels of IL-6 and IL-8. Signaling pathways of p-38, Akt, and NF-κB were analyzed by western blotting, luciferase assay, and ELISA. Organ cultures of nasal interior turbinate were also developed to demonstrate the ex vivo effect of DEP on the expression of IL-6 and IL-8 and the associated signaling pathway.

Results

DEP increased the expressions of IL-6 and IL-8 in nasal fibroblasts at mRNA and protein levels. DEP induced phosphorylation of p38, Akt, and NF-κB, whereas inhibitors of p38, Akt, and NF-κB blocked these phophorylations and the expressions of IL-6 and IL-8. These findings were also observed in ex vivo organ culture of nasal inferior turbinate.

Conclusions

DEP induces expression of IL-6 and IL-8 via p38, Akt, and NF-κB signaling pathways in nasal fibroblasts. This finding suggests that air pollution might induce or aggravate allergic rhinitis or chronic rhinosinusitis.