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Lin S, Xue Y, Thandra S, Qi Q, Hopke PK, Thurston SW, Croft DP, Utell MJ, Rich DQ. PM 2.5 and its components and respiratory disease healthcare encounters - Unanticipated increased exposure-response relationships in recent years after environmental policies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 360:124585. [PMID: 39038774 DOI: 10.1016/j.envpol.2024.124585] [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: 04/11/2024] [Revised: 06/14/2024] [Accepted: 07/19/2024] [Indexed: 07/24/2024]
Abstract
Prior studies reported excess rates (ERs) of cardiorespiratory events associated with short-term increases in PM2.5 concentrations, despite implementation of pollution-control policies. In 2017, Federal Tier 3 light-duty vehicle regulations began, and to-date there have been no assessments of population health effects of the policy. Using the NYS Statewide Planning and Research Cooperative System (SPARCS) database, we obtained hospitalizations and ED visits with a principal diagnosis of asthma or chronic obstructive pulmonary disease (COPD) for residents living within 15 miles of six urban PM2.5 monitoring sites in NYS (2014-2019). We used a time-stratified case-crossover design and conditional logistic regression (adjusting for ambient temperature, relative humidity, and weekday) to estimate associations between PM2.5, POC (primary organic carbon), SOC (secondary organic carbon), and rates of respiratory disease hospitalizations and emergency department (ED) visits from 2014 to 2019. We evaluated demographic disparities in these relative rates and compared changes in ERs before (2014-2016) and after Tier 3 implementation (2017-2019). Each interquartile range increase in PM2.5 was associated with increased ERs of asthma or COPD hospitalizations and ED visits in the previous 7 days (ERs ranged from 1.1%-3.1%). Interquartile range increases in POC were associated with increased rates of asthma ED visits (lag days 0-6: ER = 2.1%, 95% CI = 0.7%, 3.6%). Unexpectedly, the ERs of asthma admission and ED visits associated with PM2.5, POC, and SOC were higher during 2017-2019 (after Tier 3) than 2014-2016 (before Tier-3). Chronic obstructive pulmonary disease analyses showed similar patterns. Excess Rates were higher in children (<18 years; asthma) and seniors (≥65 years; COPD), and Black, Hispanic, and NYC residents. In summary, unanticipated increases in asthma and COPD ERs after Tier-3 implementation were observed, and demographic disparities in asthma/COPD and PM2.5, POC, and SOC associations were also observed. Future work should confirm findings and investigate triggering of respiratory events by source-specific PM.
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Affiliation(s)
- Shao Lin
- Department of Environmental Health Sciences & Department of Epidemiology/Biostatistics, University at Albany, The State University of New York, Albany, NY, USA
| | - Yukang Xue
- Department of Educational and Counseling Psychology, University at Albany, The State University of New York, Albany, NY, USA
| | - Sathvik Thandra
- Department of Mathematics and Statistics, University at Albany, State University of New York, Albany, NY, USA
| | - Quan Qi
- Department of Economics, University at Albany, The State University of New York, Albany, NY, USA
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Institute for a Sustainable Environment, Clarkson University, Potsdam, NY, USA
| | - Sally W Thurston
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel P Croft
- Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, Rochester, NY, USA
| | - Mark J Utell
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, Rochester, NY, USA.
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2
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Chambliss SE, Matsui EC, Zárate RA, Zigler CM. The Role of Neighborhood Air Pollution in Disparate Racial and Ethnic Asthma Acute Care Use. Am J Respir Crit Care Med 2024; 210:178-185. [PMID: 38412262 PMCID: PMC11273303 DOI: 10.1164/rccm.202307-1185oc] [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: 07/11/2023] [Accepted: 02/27/2024] [Indexed: 02/29/2024] Open
Abstract
Rationale: The share of Black or Latinx residents in a census tract remains associated with asthma-related emergency department (ED) visit rates after controlling for socioeconomic factors. The extent to which evident disparities relate to the within-city heterogeneity of long-term air pollution exposure remains unclear. Objectives: To investigate the role of intraurban spatial variability of air pollution in asthma acute care use disparity. Methods: An administrative database was used to define census tract population-based incidence rates of asthma-related ED visits. We estimate the associations between census tract incidence rates and 1) average fine and coarse particulate matter, nitrogen dioxide (NO2), and sulfur dioxide (SO2), and 2) racial and ethnic composition using generalized linear models controlling for socioeconomic and housing covariates. We also examine for the attenuation of incidence risk ratios (IRRs) associated with race/ethnicity when controlling for air pollution exposure. Measurements and Main Results: Fine and coarse particulate matter and SO2 are all associated with census tract-level incidence rates of asthma-related ED visits, and multipollutant models show evidence of independent risk associated with coarse particulate matter and SO2. The association between census tract incidence rate and Black resident share (IRR, 1.51 [credible interval (CI), 1.48-1.54]) is attenuated by 24% when accounting for air pollution (IRR, 1.39 [CI, 1.35-1.42]), and the association with Latinx resident share (IRR, 1.11 [CI, 1.09-1.13]) is attenuated by 32% (IRR, 1.08 [CI, 1.06-1.10]). Conclusions: Neighborhood-level rates of asthma acute care use are associated with local air pollution. Controlling for air pollution attenuates associations with census tract racial/ethnic composition, suggesting that intracity variability in air pollution could contribute to neighborhood-to-neighborhood asthma morbidity disparities.
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Affiliation(s)
- Sarah E. Chambliss
- Department of Population Health
- Center for Health and Environment: Education and Research, and
| | - Elizabeth C. Matsui
- Department of Population Health
- Center for Health and Environment: Education and Research, and
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas; and
| | | | - Corwin M. Zigler
- Center for Health and Environment: Education and Research, and
- Department of Statistics and Data Sciences, The University of Texas at Austin, Austin, Texas
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3
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Wang C, Li J, Li J, Li Y, Li C, Ren L. What can be done to protect toddlers from air pollution: Current evidence. J Pediatr Nurs 2024; 76:e50-e59. [PMID: 38278746 DOI: 10.1016/j.pedn.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/28/2024]
Abstract
PROBLEM Toddlers are more prone to exposure to widely distributed air pollution and to health damage from it. However, systematic summaries of evidence on protective behaviors against air pollution for toddlers are lacking. OBJECTIVE To identify currently available evidence on protective behaviors against air pollution for toddlers. METHODS The literature retrieval was performed in selected databases, limited from 2002 to 2022. Studies meeting the following criteria were included and praised: 1) clinical practice guideline, systematic review, expert consensus, recommended practice, randomized control test (RCT) or cohort study published in Chinese or English; 2) studies reporting effects of protective behaviors against air pollution on toddlers' health outcomes or providing recommendation on these behaviors. The evidence in the included studies was extracted, synthesized and graded for evidence summary. RESULTS Studies (N = 19) were used for evidence summary development and 35 pieces of best evidence were synthesized, which were divided into three categories, including "avoiding or reducing air pollution generation", "removing existing air pollution", and "avoiding or reducing exposure to existing air pollution". CONCLUSIONS More evidence is needed to identify protective measures against outdoor air pollution and tobacco smoke. Research in the future should focus on the safety, effectiveness and feasibility of universal measures implemented in toddlers, and try to develop protective measures specific to toddlers which highlight their special nature. IMPLICATIONS The results of this study can help pediatric nurses provide individualized advice and assistance for toddlers and their families, and conduct research on the effectiveness of toddler-targeting protective behaviors more efficiently.
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Affiliation(s)
- Chongkun Wang
- School of Nursing, Peking University, Beijing, China
| | - Junying Li
- School of Nursing, Peking University, Beijing, China
| | - Jiahe Li
- School of Nursing, Peking University, Beijing, China
| | - Yuxuan Li
- School of Nursing, Peking University, Beijing, China
| | - Chunying Li
- Associate Research Librarian, Peking University Medical Library, Peking University, Beijing, China
| | - Lihua Ren
- Associate Researcher, School of Nursing, Peking University, Beijing, China.
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Wang W, Gulliver J, Beevers S, Freni Sterrantino A, Davies B, Atkinson RW, Fecht D. Short-Term Nitrogen Dioxide Exposure and Emergency Hospital Admissions for Asthma in Children: A Case-Crossover Analysis in England. J Asthma Allergy 2024; 17:349-359. [PMID: 38623450 PMCID: PMC11016460 DOI: 10.2147/jaa.s448600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/12/2024] [Indexed: 04/17/2024] Open
Abstract
Background There is an increasing body of evidence associating short-term ambient nitrogen dioxide (NO2) exposure with asthma-related hospital admissions in children. However, most studies have relied on temporally resolved exposure information, potentially ignoring the spatial variability of NO2. We aimed to investigate how daily NO2 estimates from a highly resolved spatio-temporal model are associated with the risk of emergency hospital admission for asthma in children in England. Methods We conducted a time-stratified case-crossover study including 111,766 emergency hospital admissions for asthma in children (aged 0-14 years) between 1st January 2011 and 31st December 2015 in England. Daily NO2 levels were predicted at the patients' place of residence using spatio-temporal models by combining land use data and chemical transport model estimates. Conditional logistic regression models were used to obtain the odds ratios (OR) and confidence intervals (CI) after adjusting for temperature, relative humidity, bank holidays, and influenza rates. The effect modifications by age, sex, season, area-level income deprivation, and region were explored in stratified analyses. Results For each 10 µg/m³ increase in NO2 exposure, we observed an 8% increase in asthma-related emergency admissions using a five-day moving NO2 average (mean lag 0-4) (OR 1.08, 95% CI 1.06-1.10). In the stratified analysis, we found larger effect sizes for male (OR 1.10, 95% CI 1.07-1.12) and during the cold season (OR 1.10, 95% CI 1.08-1.12). The effect estimates varied slightly by age group, area-level income deprivation, and region. Significance Short-term exposure to NO2 was significantly associated with an increased risk of asthma emergency admissions among children in England. Future guidance and policies need to consider reflecting certain proven modifications, such as using season-specific countermeasures for air pollution control, to protect the at-risk population.
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Affiliation(s)
- Weiyi Wang
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
| | - John Gulliver
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Sean Beevers
- MRC Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, London, UK
| | - Anna Freni Sterrantino
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- The Alan Turing Institute, London, UK
| | - Bethan Davies
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
| | - Richard W Atkinson
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
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5
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Zhu X, Xia Y, Wang H, Shi L, Yin H, Gu M, Yan F. PM 2.5 induced neurotoxicity through unbalancing vitamin B12 metabolism by gut microbiota disturbance. Gut Microbes 2023; 15:2267186. [PMID: 37842922 PMCID: PMC10580859 DOI: 10.1080/19490976.2023.2267186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023] Open
Abstract
Fine particulate matter (PM2.5) in the atmosphere is easily accompanied by toxic and harmful substances, causing serious harm to human health, including cognitive impairment. Vitamin B12 (VitB12) is an essential micronutrient that is synthesized by bacteria and contributes to neurotransmitter synthesis as a nutrition and signaling molecule. However, the relationship between VitB12 attenuation of cognitive impairment and intestinal microbiota regulation in PM2.5 exposure has not been elucidated. In this study, we demonstrated that PM2.5 caused behavioral defects and neuronal damage in Caenorhabditis elegans (C. elegans), along with significant gene expression changes in neurotransmitter receptors and a decrease in VitB12 content, causing behavioral defects and neuronal damage in C. elegans. Methylcobalamin (MeCbl), a VitB12 analog, alleviated PM2.5-induced neurotoxicity in C. elegans. Moreover, using in vivo and in vitro models, we discovered that long-term exposure to PM2.5 led to changes in the structure of the gut microbiota, resulting in an imbalance of the VitB12-associated metabolic pathway followed by cognitive impairment. MeCbl supplementation could increase the diversity of the bacteria, reduce harmful substance contents, and restore the concentration of short-chain fatty acids (SCFAs) and neurotransmitters to the level of the control group to some degree. Here, a new target to mitigate the harm caused by PM2.5 was discovered, supplying MeCbl for relieving intestinal and intracellular neurotransmitter disorders. Our results also provide a reference for the use of VitB12 to target the adjustment of the human intestinal microbiota to improve metabolic disorders in people exposed to PM2.5.
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Affiliation(s)
- Xuan Zhu
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Food Safety, Zhejiang Gongshang University, Hangzhou, China
| | - Yanting Xia
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, People’s Republic of China
| | - Huanhuan Wang
- School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Laboratory animal center, Hangzhou Normal University, Hangzhou, China
| | - Lihua Shi
- Weifang Elbe Health Food Co. Ltd, Weifang, China
| | - Hongping Yin
- School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Laboratory animal center, Hangzhou Normal University, Hangzhou, China
| | - Meier Gu
- School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Laboratory animal center, Hangzhou Normal University, Hangzhou, China
| | - Fujie Yan
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
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6
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Kumar R, Mrigpuri P, Sarin R, Saini JK, Yadav R, Nagori A, Kabra SK, Mukherjee A, Yadav G. Air pollution and its effects on emergency room visits in tertiary respiratory care centers in Delhi, India. Monaldi Arch Chest Dis 2023; 94. [PMID: 36843510 DOI: 10.4081/monaldi.2023.2511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 02/28/2023] Open
Abstract
Environmental pollution has harmful effects on human health, particularly the respiratory system. We aimed to study the impact of daily ambient air pollution on daily emergency room visits for acute respiratory symptoms. This study was conducted in two tertiary respiratory care centres in Delhi, India. Daily counts of emergency room visits were collected. All patients attending the emergency room were screened for acute onset (less than 2 weeks) of respiratory symptoms and were recruited if they were staying in Delhi continuously for at least 4 weeks and having onset (≤2 weeks) of respiratory symptoms. Daily average air pollution data for the study period was obtained from four continuous ambient air quality monitoring stations. A total of 61,285 patients were screened and 11,424 were enrolled from June 2017 to February 2019. Cough and difficulty in breathing were most common respiratory symptoms. Poor air quality was observed during the months of October to December. Emergency room visits with acute respiratory symptoms significantly increased per standard deviation increase in PM10 from lag days 2-7. Increase in wheezing was primarily seen with increase in NO2. Pollutant levels have effect on acute respiratory symptoms and thus influence emergency room visits. *************************************************************** *Appendix Authors list Kamal Singhal,1 Kana Ram Jat,2 Karan Madan,3 Mohan P. George,4 Kalaivani Mani,5 Randeep Guleria,3 Ravindra Mohan Pandey,5 Rupinder Singh Dhaliwal,6 Rakesh Lodha,2 Varinder Singh1 1Department of Paediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India 2Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India 3Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India 4Department of Environment, Delhi Pollution Control Committee, Kashmere Gate, New Delhi, India 5Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India 6Department of Non-communicable Diseases, Indian Council of Medical Research, New Delhi, India.
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Affiliation(s)
- Raj Kumar
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
| | - Parul Mrigpuri
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
| | - Rohit Sarin
- Department of Pulmonary Medicine, National Institute of Tuberculosis and Respiratory Diseases, New Delhi.
| | - Jitendra Kumar Saini
- Department of Pulmonary Medicine, National Institute of Tuberculosis and Respiratory Diseases, New Delhi.
| | - Rashmi Yadav
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | | | - Sushil Kumar Kabra
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | - Arpana Mukherjee
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | - Geetika Yadav
- Department of Non-communicable Diseases, Indian Council of Medical Research, New Delhi.
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Abstract
Asthma is a chronic illness of the airways that affects approximately 300 million individuals worldwide. While it is commonly accepted that high ozone levels exacerbate asthma symptoms, the impact of low to moderate ozone levels on asthma symptoms has received little attention. The purpose of this research was to determine the relationship between hospital visits by asthma patients showing the severity of their symptoms and moderate ozone levels. Statistical analyses were performed on hospital visit big data for asthma patients in Seoul, Korea, collected between 2013 and 2017. The data set includes outpatient hospital visits (n = 17,787,982), hospital admissions (n = 215,696), and emergency department visits (n = 85,482). The frequency of hospital visits by asthma patients was evaluated in relation to low ozone levels (< 0.03 ppm) and moderate ozone levels (0.03-0.06 ppm) in the Seoul environment. In comparison to low ozone levels, moderate ozone levels resulted in a reduction in outpatient hospital visits (t = 7.052, P < .001). When ozone levels were low to moderate, there was a negative correlation between ozone levels and outpatient visits (r = -0.281, 95% CI: -0.331 to -0.228). Negative associations were also identified between ozone levels and new hospital admissions (t = 2.909, P < .01; r = -0.125, 95% CI: -0.179 to -0.070) and emergency treatments (t = 2.679, P < .01; r = -0.132, 95% CI: -0.186 to -0.076). Additionally, it was verified that moderate ozone levels one day before the visits resulted in a reduction in outpatient visits (t = 5.614, P < .001; r = -0.207, 95% CI: -0.259 to -0.153). A strong relationship was identified between moderate atmospheric ozone levels and a reduction in asthma patient hospital visits.
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Affiliation(s)
- Soyeon Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea
| | - Minhyeok Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea
- * Correspondence: School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea (e-mail: )
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Park Y, Kim SH, Kim SP, Ryu J, Yi J, Kim JY, Yoon HJ. Spatial autocorrelation may bias the risk estimation: An application of eigenvector spatial filtering on the risk of air pollutant on asthma. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:157053. [PMID: 35780885 DOI: 10.1016/j.scitotenv.2022.157053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
Air pollutants are major risk factors for respiratory diseases, particularly asthma, socially and spatially correlated. Many existing environment-asthma-related studies, however, have evaluated the impact of crude trends at the largest district level, which accounts only for temporal effects and may produce biased results with spatial autocorrelation. This study aimed to investigate how the spatial autocorrelation affects the air pollution effect estimations (sulfur dioxide [SO2], nitrogen dioxide [NO2], carbon monoxide [CO], and particulate matter [PM10]) on daily asthma emergency department (ED) visits in two metropolitan areas in Korea (Seoul Metropolitan Area [SMA] and Busan Metropolitan City, Ulsan Metropolitan City, Gyeongsangnamdo [BUG]). We applied eigenvector spatial filter (ESF) to the spatio-temporal model to remove spatial autocorrelation and distributed lag nonlinear model (DLNM) to explore nonlinear patterns between air pollutant concentration and lagged days on the three models including aggregated model (a temporal model), spatial model without ESF, and spatial model with ESF (both are spatio-temporal models). The effect of SO2 was not statistically significant for asthma ED visits in the aggregated model for SMA (cumulative relative risks [CRR] = 0.99, confidence intervals [CI]: 0.93-1.05), while the effect was statistically significant in the spatial model with ESF (CRR = 1.10, CI: 1.08-1.12). NO2 and CO were positively correlated to asthma ED visits in the spatial model without ESF (CRR = 0.84, CI: 0.81-0.86; 0.91, 0.89-0.94, respectively), but the spatial model with ESF showed significant risks (CRR = 1.21, CI: 1.18-1.24; 1.13, 1.11-1.16). Moreover, the spatial model with ESF successfully removed spatial autocorrelation (P-values for Moran's I 0.83-0.98) and demonstrated the highest model fit (McFadden's pseudo R2 0.42-0.43 for SMA and 0.26-0.27 for BUG) among the three models. Our findings demonstrate how ESF can be introduced into spatial correlation to remove bias and construct more reliable models.
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Affiliation(s)
- Yujin Park
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea
| | - Su Hwan Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seong Pyo Kim
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, South Korea
| | - Jiwon Ryu
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Jinyeong Yi
- Department of Health Science and Technology, Seoul National University, Seoul, South Korea
| | - Jin Youp Kim
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, South Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Hospital, Dongguk University, Goyang, Gyeonggi, South Korea
| | - Hyung-Jin Yoon
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea; Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, South Korea; Medical Big Data Research Center, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
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9
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Dąbrowiecki P, Chciałowski A, Dąbrowiecka A, Badyda A. Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105988. [PMID: 35627528 PMCID: PMC9140383 DOI: 10.3390/ijerph19105988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
Abstract
Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m3 was 1.013 (1.002–1.024) for PM10; 1.014 (1.000–1.028) for PM2.5; 1.054 (1.031–1.078) for NO2; and 1.044 for SO2 (95%CI: 0.986–1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%–8.14%) for PM10; 3.74% (0.29%–7.11%) for PM2.5; 16.4% (10.0%–21.8%) for NO2; and 2.50% (−0.75%–5.36%) for SO2. In conclusion, PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years.
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Affiliation(s)
- Piotr Dąbrowiecki
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (P.D.); (A.C.)
- Polish Federation of Asthma Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
| | - Andrzej Chciałowski
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (P.D.); (A.C.)
| | | | - Artur Badyda
- Polish Federation of Asthma Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
- Faculty of Building Services, Hydro and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland
- Correspondence:
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Huynh D, Tracy C, Thompson W, Bang F, McFaull SR, Curran J, Villeneuve PJ. Associations between meteorological factors and emergency department visits for unintentional falls during Ontario winters. Health Promot Chronic Dis Prev Can 2021; 41:401-412. [PMID: 34910897 PMCID: PMC8796965 DOI: 10.24095/hpcdp.41.12.01] [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: 11/20/2022]
Abstract
INTRODUCTION Unintentional falls are a leading cause of injury-related hospital visits among Canadians, especially seniors. While certain meteorological conditions are suspected risk factors for fall-related injuries, few studies have quantified these associations across a wider range of age groups and with population-based datasets. METHODS We applied a time-stratified case-crossover study design to characterize associations of highly-spatially-resolved meteorological factors and emergency department (ED) visits for falls, in Ontario, among those aged 5 years and older during the winter months (November to March) between 2011 and 2015. Conditional logistic models were used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) for these visits in relation to daily snowfall accumulation, including single-day lags of up to one week before the visit, and daily mean temperature on the day of the visit. Analyses were stratified by age and sex. RESULTS We identified 761 853 fall-related ED visits. The odds for these visits was increased for most days up to a week after a snowfall of 0.2 cm or greater (OR = 1.05-1.08) compared to days with no snowfall. This association was strongest among adults aged 30 to 64 years (OR = 1.16-1.19). The OR for fall-related ED visits on cold days (less than -9.4 °C) was reduced by 0.05 relative to days with an average daily temperature of 3.0 °C or higher (OR = 0.95; 95% CI: 0.94, 0.96), and this pattern was evident across all ages. There were no substantive differences in the strength of this association by sex. CONCLUSION Snowfall and warmer winter temperatures were associated with an increased risk of fall-related ED visits during Ontario winters. These findings are relevant for developing falls prevention strategies and ensuring timely treatment.
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Affiliation(s)
- David Huynh
- School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Ontario, Canada
| | - Caleigh Tracy
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Felix Bang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Jaymes Curran
- Canadian Urban Environmental Health Research Consortium, University of Victoria, Victoria, British Columbia, Canada
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Faculty of Science, Carleton University, Ottawa, Ontario, Canada
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Atmospheric pollution in the ten most populated US cities. Evidence of persistence. Heliyon 2021; 7:e08105. [PMID: 34646957 PMCID: PMC8495105 DOI: 10.1016/j.heliyon.2021.e08105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/28/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
The degree of persistence in daily PM25 and O3 in the ten most populated US cities, namely New York, Los Angeles, Chicago, Houston, Phoenix, Philadelphia, San Antonio, San Diego, Dallas and San Jose is examined in this work. We employ a methodology based on fractional integration, using the order of integration as a measure of the degree of persistence. Using data for the time period from January 1, 2019 to December 31, 2020, our results indicate that fractional integration and long memory features are both present in all the examined cases, with the integration order of the series being constrained in the (0, 1) interval. Based on this, the estimation of the coefficients for the time trend produces results which are substantially different from those obtained under the I (0) assumption.
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12
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Yu Z, Ma Y, Zhang Y, Cheng B, Feng F, Ma B, Jiao H, Zhou J. A study on the short-term effect of particulate matter pollution on hospital visits for asthma in children in Shanghai, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4123-4138. [PMID: 33774778 DOI: 10.1007/s10653-021-00888-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
Recently, particulate matter pollution has been worsening, which has been affecting the asthma visits in children. In this study, we assessed the short-term effects of PM10 and PM2.5 on asthma visits in children in Shanghai, China from January 1, 2009 and December 31, 2010, using a generalized additive model. We controlled the confounding factors, such as long-term trends, week day effect, and weather elements. The lag effects of different age subgroups (≤ 2 yr, 3-5 yr, and 6-18 yr subgroups) were performed. The results showed significant effects of PM10 and PM2.5 on asthma visits in children, though the seasonal lags varied for the three age subgroups. In general, the effect of PM2.5 on asthma visits in children was stronger and more acute than that of PM10. PM2.5 showed the highest relative risk of 1.192 at lag 0 day in summer; and PM10 showed the highest relative risk of 1.073 at lag 3 day in autumn. Overall, particulate matter pollution showed a greater effect on relatively younger children. In particular, the ≤ 2 yr subgroup showed the highest seasonal relative risk of PM10. Especially, seasonal relative risk of PM10 in autumn for the ≤ 2 yr subgroup was much higher than that for the other two subgroups. The 3-5 yr and 6-18 yr subgroups showed the highest seasonal relative risk of PM2.5 in summer and winter, respectively. But the pediatric visits data we obtained cannot reflect the true prevalence of asthma and multiple visits. Thus, selection bias may exist in our analysis.
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Affiliation(s)
- Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Ji Zhou
- Key Laboratory of Meteorology and Health in Shanghai, Shanghai, 200030, China
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13
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Yadav R, Nagori A, Mukherjee A, Singh V, Lodha R, Kabra SK, Yadav G, Saini JK, Singhal KK, Jat KR, Madan K, George MP, Mani K, Mrigpuri P, Kumar R, Guleria R, Pandey RM, Sarin R, Dhaliwal RS. Effects of ambient air pollution on emergency room visits of children for acute respiratory symptoms in Delhi, India. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:45853-45866. [PMID: 33881691 DOI: 10.1007/s11356-021-13600-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
The present study explored the association between daily ambient air pollution and daily emergency room (ER) visits due to acute respiratory symptoms in children of Delhi. The daily counts of ER visits (ERV) of children (≤15 years) having acute respiratory symptoms were obtained from two hospitals of Delhi for 21 months. Simultaneously, data on daily concentrations of particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) and weather variables were provided by the Delhi Pollution Control Committee. K-means clustering with time-series approach and multi-pollutant generalized additive models with Poisson link function was used to estimate the 0-6-day lagged change in daily ER visits with the change in multiple pollutants levels. Out of 1,32,029 children screened, 19,120 eligible children having acute respiratory symptoms for ≤2 weeks and residing in Delhi for the past 4 weeks were enrolled. There was a 29% and 21% increase in ERVs among children on high and moderate level pollution cluster days, respectively, compared to low pollution cluster days on the same day and previous 1-6 days of exposure to air pollutants. There was percentage increase (95% CI) 1.50% (0.76, 2.25) in ERVs for acute respiratory symptoms for 10 μg/m3 increase of NO2 on previous day 1, 46.78% (21.01, 78.05) for 10 μg/m3 of CO on previous day 3, and 13.15% (9.95, 16.45) for 10 μg/m3 of SO2 on same day of exposure. An increase in the daily ER visits of children for acute respiratory symptoms was observed after increase in daily ambient air pollution levels in Delhi.
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Affiliation(s)
- Rashmi Yadav
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Aditya Nagori
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, 110007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Aparna Mukherjee
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Varinder Singh
- Kalawati Saran Children Hospital and Lady Harding Medical College, New Delhi, ,110001, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sushil Kumar Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Geetika Yadav
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Jitendra Kumar Saini
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India
| | - Kamal Kumar Singhal
- Kalawati Saran Children Hospital and Lady Harding Medical College, New Delhi, ,110001, India
| | - Kana Ram Jat
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Karan Madan
- Pulmonology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 10029, India
| | - Mohan P George
- Delhi Pollution Control Committee, Kashmere Gate, New Delhi, 110006, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Parul Mrigpuri
- Vallabhbhai Patel Chest Institute, New Delhi, 110007, India
| | - Raj Kumar
- Vallabhbhai Patel Chest Institute, New Delhi, 110007, India
| | - Randeep Guleria
- Pulmonology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, 10029, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rohit Sarin
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India
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Kassam S, Serrano-Lomelin J, Hicks A, Crawford S, Bakal JA, Ospina MB. Geography as a Determinant of Health: Health Services Utilization of Pediatric Respiratory Illness in a Canadian Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8347. [PMID: 34444093 PMCID: PMC8392806 DOI: 10.3390/ijerph18168347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/03/2022]
Abstract
Respiratory diseases contribute to high healthcare utilization rates among children. Although social inequalities play a major role in these conditions, little is known about the impact of geography as a determinant of health, particularly with regard to the difference between rural and urban centers. A regional geographic analysis was conducted using health repository data on singleton births between 2005 and 2010 in Alberta, Canada. Data were aggregated according to regional health sub-zones in the province and standardized prevalence ratios (SPRs) were determined for eight respiratory diseases (asthma, influenza, bronchitis, bronchiolitis, croup, pneumonia, and other upper and other lower respiratory tract infections). The results indicate that there are higher rates of healthcare utilization in northern compared to southern regions and in rural and remote regions compared to urban ones, after accounting for both material and social deprivation. Geography plays a role in discrepancies of healthcare utilization for pediatric respiratory diseases, and this can be used to inform the provision of health services and resource allocation across various regions.
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Affiliation(s)
- Shehzad Kassam
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Jesus Serrano-Lomelin
- Department of Obstetrics & Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada;
| | - Anne Hicks
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Susan Crawford
- Alberta Perinatal Health Program, Alberta Health Services, Edmonton, AB T2N 2T9, Canada;
| | - Jeffrey A. Bakal
- Provincial Research Data Services, Alberta Health Services, Edmonton, AB T6G 2C8, Canada;
| | - Maria B. Ospina
- Department of Obstetrics & Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada;
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15
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Hou X, Huang H, Hu H, Wang D, Sun B, Zhang XD. Short-term exposure to ambient air pollution and hospital visits for IgE-mediated allergy: A time-stratified case-crossover study in southern China from 2012 to 2019. EClinicalMedicine 2021; 37:100949. [PMID: 34386741 PMCID: PMC8343265 DOI: 10.1016/j.eclinm.2021.100949] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Because of the limited epidemiological evidence on the association between acute air pollutants and allergy, there is a need to investigate this association, especially between the short-term exposure to air pollution and the serum Immunoglobulin E (IgE)-mediated allergy. METHODS A total of 39,569 IgE test results and demographic characteristics were obtained in the First Affiliated Hospital of Guangzhou Medical University between August 2012 and September 2019. Ninety-nine specific allergens were tested according to clinical diagnosis. The logistic regression was used to assess the effects of CO, NO2 and PM2.5 exposure on the risk of sensitization to specific inhalant/food allergens. Generalized additive models with multivariate adjustments were utilized to model the exposure-response relationship. Stratified analyses were performed to estimate the reliability of correlations in various subgroups. FINDINGS Single-pollutant models indicate that the 3-day moving average (lag2-4) of CO, PM2.5 or NO2 is associated with the increased risk for allergic diseases related to specific inhaled allergens. In multi-pollutant models, the adjusted Odds Ratio (OR) 95% (Confidence Interval, CI) increases by 8% (95% CI, 2%-15%) for per increment of 0.2 mg/m3 in CO levels, and rises by 8% (95% CI, 2%-13%) for each increase of 16.3 μg/m3 in PM2.5 concentration. The associations are stronger in youngsters (<18, years) but not significantly different by gender. Particularly, a significantly stronger association between PM2.5 exposure and hospital visits for inhaled allergy is observed in patients who are exposed to lower concentration of SO2 (<10.333 μg/m3) and higher levels of NO2 (≥42.0 μg/m3), as well as patients enrolled after 2017. INTERPRETATION The short-term exposure to CO/PM2.5 increases the number of hospital visits for IgE-mediated allergy, especially for the sensitization to specific inhalant allergens. Therefore, to prevent inhaled allergies, the public policy for controlling air pollution needs to be considered seriously. FUNDING This study was supported by the University of Macau (grant numbers: FHS-CRDA-029-002-2017 and MYRG2018-00,071-FHS) as well as the Science and Technology Development Fund, Macau SAR (File no. 0004/2019/AFJ and 0011/2019/AKP). This work was also supported by the National Natural Science Foundation of China (81,871,736), the National Key Technology R&D Program (2018YFC1311902), the Guangdong Science and Technology Foundation (2019B030316028), the Guangzhou Municipal Health Foundation (20191A011073), and the Guangzhou Science and Technology Foundation (201,804,020,043).
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Affiliation(s)
- Xiangqing Hou
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangdong, China
| | - Haisheng Hu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangdong, China
| | - Dandan Wang
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangdong, China
- Corresponding author.
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16
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Source-specific contributions of particulate matter to asthma-related pediatric emergency department utilization. Health Inf Sci Syst 2021; 9:12. [PMID: 33786161 DOI: 10.1007/s13755-021-00141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/23/2021] [Indexed: 10/21/2022] Open
Abstract
Ambient particulate matter smaller than 2.5 μm (PM2.5) is associated with different chronic diseases. It is crucial to identify the sources of ambient particulate matter to reduce the impact on health. Still, only a few studies have been linked with specific ambient particulate matter sources. In this study, we estimated the contributions of sources of PM2.5 and examined their association with daily asthma hospital utilization in Cincinnati, Ohio, USA. We used a model-based clustering method to group days with similar source-specific contributions into six distinct clusters. Specifically, elevated PM2.5 concentrations occurring on days characterized by low coal combustion contributions showed a significantly reduced risk of hospital utilization for asthma (rate ratio: 0.86, 95% CI: [0.77, 0.95]) compared to other clusters. Reducing coal combustion contribution to PM2.5 levels could be an effective intervention for lowering asthma-related hospital utilization. Supplementary Information The online version contains supplementary material available at 10.1007/s13755-021-00141-z.
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17
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Satia I, Adatia A, Yaqoob S, Greene JM, O'Byrne PM, Killian KJ, Johnston N. Emergency department visits and hospitalisations for asthma, COPD and respiratory tract infections: what is the role of respiratory viruses, and return to school in September, January and March? ERJ Open Res 2020; 6:00593-2020. [PMID: 33263068 PMCID: PMC7682724 DOI: 10.1183/23120541.00593-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background Asthma exacerbations increase in September coinciding with children returning to school. The aim of this study was to investigate whether this occurs 1) for COPD and respiratory tract infections (RTIs); 2) after school resumes in January and March; and 3) identify which viruses may be responsible. Methods Emergency department (ED) visits and admissions for asthma, COPD and RTIs and the prevalence of viruses in Ontario, Canada were analysed daily between 2003 and 2013. ED visits and admissions were provided by the Canadian Institute for Health Information. Viral prevalence was obtained from the Centre for Immunisation and Respiratory Infectious Diseases. Results ED visits and admissions rates demonstrated a biphasic pattern. Lowest rates occurred in July and August and the highest rates in September for asthma, and after December for COPD and RTI. The increase in rates for 30 days before and after school return in September was greatest for children with asthma <15 years (2.4–2.6×). Event rates fell after school return in January for all three conditions ranging from 10–25%, and no change followed March break for asthma and COPD. Human rhinovirus was prevalent in summer with a modest relationship to asthma rates in September. The prevalence of respiratory syncytial virus, influenza A and coronavirus was associated with sustained event rates for COPD and RTIs. Conclusions Asthma, COPD and RTIs increase in September but do not occur after return to school in January and March. Human rhinovirus is associated with ED visits and admissions only in September. Asthma, COPD and RTIs increase in September but do not occur after return to school in January and March. Human RV is associated with ED visits and admissions only in September.https://bit.ly/3jEy168
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Affiliation(s)
- Imran Satia
- McMaster University, Department of Medicine, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
| | - Adil Adatia
- McMaster University, Department of Medicine, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
| | - Sarah Yaqoob
- McMaster University, Department of Medicine, Hamilton, Canada
| | | | - Paul M O'Byrne
- McMaster University, Department of Medicine, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
| | | | - Neil Johnston
- McMaster University, Department of Medicine, Hamilton, Canada.,Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
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Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134846. [PMID: 32640508 PMCID: PMC7370127 DOI: 10.3390/ijerph17134846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/16/2022]
Abstract
Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities. This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas. A time-stratified case-crossover study was conducted using the hospitalization data from a children’s hospital and the air pollution data, including particulate matter 2.5 (PM2.5) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014. A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature. We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014. The single-pollutant models showed that PM2.5 concentration had a significant positive effect on risk for hospital readmissions (OR = 1.082, 95% CI = 1.008–1.162, p = 0.030). In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1.023, 95% CI = 1.001–1.045, p = 0.042) and PM2.5 concentrations (OR = 1.080, 95% CI = 1.005–1.161, p = 0.036). The effects of ambient air pollutants on hospital readmissions varied by age and season. Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients.
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Yu HR, Lin CHR, Tsai JH, Hsieh YT, Tsai TA, Tsai CK, Lee YC, Liu TY, Tsai CM, Chen CC, Chang CH, Hsu TY, Niu CK. A Multifactorial Evaluation of the Effects of Air Pollution and Meteorological Factors on Asthma Exacerbation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114010. [PMID: 32512940 PMCID: PMC7313451 DOI: 10.3390/ijerph17114010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 01/05/2023]
Abstract
In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO2; NO2; O3; CO; PM2.5; PM10) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered.
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Affiliation(s)
- Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kaohsiung 83301, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Correspondence: ; Tel.: +886-7-5252000 (ext. 4339); Fax: +886-7-5254-301
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan;
- PhD Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung 80737, Taiwan
| | - Yun-Ting Hsieh
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Ti-An Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chang-Ku Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Yi-Chen Lee
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Ta-Yu Liu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Min Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Cheng Chen
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Hao Chang
- Department of Respiratory Therapy, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Te-Yao Hsu
- Department of Obstetrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Chen-Kuang Niu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
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20
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Feng J, Cavallero S, Hsiai T, Li R. Impact of air pollution on intestinal redox lipidome and microbiome. Free Radic Biol Med 2020; 151:99-110. [PMID: 31904545 DOI: 10.1016/j.freeradbiomed.2019.12.044] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/29/2019] [Accepted: 12/30/2019] [Indexed: 12/20/2022]
Abstract
Air pollution is a rising public health issue worldwide. Cumulative epidemiological and experimental studies have shown that exposure to air pollution such as particulate matter (PM) is linked with increased hospital admissions and all-cause mortality. While previous studies on air pollution mostly focused on the respiratory and cardiovascular effects, emerging evidence supports a significant impact of air pollution on the gastrointestinal (GI) system. The gut is exposed to PM as most of the inhaled particles are removed from the lungs to the GI tract via mucociliary clearance. Ingestion of contaminated food and water is another common source of GI tract exposure to pollutants. Recent studies have associated air pollution with intestinal diseases, including appendicitis, colorectal cancer, and inflammatory bowel disease. In addition to the liver and adipose tissue, intestine is an important organ system for lipid metabolism, and the intestinal redox lipids might be tightly associated with the intestinal and systematic inflammation. The gut microbiota modulates lipid metabolism and contributes to the initiation and development of intestinal disease including inflammatory bowel disease. Recent data support microbiome implication in air pollution-mediated intestinal and systematic effects. In this review, the associations between air pollution and intestinal diseases, and the alterations of intestinal lipidome and gut microbiome by air pollution are highlighted. The potential mechanistic aspects underlying air pollution-mediated intestinal pathology will also be discussed.
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Affiliation(s)
- Juan Feng
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, Guangdong, China
| | - Susana Cavallero
- Department of Medicine, University of California, Los Angeles, CA, USA
| | - Tzung Hsiai
- Department of Medicine, University of California, Los Angeles, CA, USA; Department of Bioengineering, University of California, Los Angeles, CA, USA; West Los Angeles Healthcare System, USA; Medical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Rongsong Li
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, Guangdong, China.
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21
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Lu P, Zhang Y, Lin J, Xia G, Zhang W, Knibbs LD, Morgan GG, Jalaludin B, Marks G, Abramson M, Li S, Guo Y. Multi-city study on air pollution and hospital outpatient visits for asthma in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 257:113638. [PMID: 31812526 DOI: 10.1016/j.envpol.2019.113638] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The proportion of asthma patients with mild to moderate exacerbations is far greater than the number who experience episodes that are severe enough to require emergency room visits or hospital admission. However the routinely collected data from hospitals is absent in the past. OBJECTIVE To evaluate associations between short-term exposures to air pollutants and hospital outpatient visits for asthma in China. METHODS We obtained data for 143,057 asthma outpatient visits from the largest hospitals in 17 Chinese cities, between Jan 01 2013 and Dec 31 2015. We used daily concentrations of air pollutants measured by the China National Environmental Monitoring Centre. We used a time-stratified case-crossover design, and fitted conditional logistic regression models to determine the associations. RESULTS Particulate matter ≤10μm in diameter (PM10) and nitrogen dioxide (NO2) were associated with increased risks of hospital outpatient visits for asthma on the same day, while the effects were delayed for particulate matter ≤2.5μm in diameter (PM2.5) and sulphur dioxide (SO2). For the cumulative effect model at lag05 days, 10 μg/m3 increase in air pollutants concentrations were correlated with hospital outpatient visits for asthma with odds ratios (ORs) and 95% confidence intervals 1.004 (1.000-1.008) for PM2.5, 1.005 (1.002-1.008) for PM10, 1.030 (1.021-1.040) for NO2, and 1.015 (1.008-1.021) for SO2. Almost one in nine (10.9%; 7.7, 13.9%) hospital outpatient visits for asthma were attributable to NO2. CONCLUSION Short-term exposures to PM2.5, PM10, NO2 and SO2 were associated with hospital outpatient visits for asthma in China.
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Affiliation(s)
- Peng Lu
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Jiangtao Lin
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China.
| | - Guoxin Xia
- School of Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Wenyi Zhang
- Center for Disease Surveillance and Research, Institute for Disease Control and Prevention of Chinese People's Liberation Army, Beijing, China
| | - Luke D Knibbs
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Geoffrey G Morgan
- School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Guy Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Yuming Guo
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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22
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Ohyama M, Nakajima T, Minejima C, Azuma K, Oka K, Itano Y, Kudo S, Takenaka N. Association between indoor nitrous acid, outdoor nitrogen dioxide, and asthma attacks: results of a pilot study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:632-642. [PMID: 30585082 DOI: 10.1080/09603123.2018.1559924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/13/2018] [Indexed: 06/09/2023]
Abstract
The association between nitrogen dioxide (NO2) and asthma has been investigated. However, conventional NO2 assays measure nitrous acid (HONO) as NO2. In this pilot epidemiological observational study, we assessed exposure to indoor HONO and some air pollutants in pediatric asthma patients and examined possible association between exposure and asthma symptoms. Indoor HONO and nitric oxide (NO), which are primarily generated by the combustion of certain substances, were significantly associated with asthma attacks in 2010. In 2010, indoor HONO was closely correlated with indoor NO than with outdoor NO2. Conversely, in 2012, indoor HONO was closely correlated with outdoor NO2 and NO than with indoor NO2 and NO. Outdoor NO2 was significantly associated with asthma attacks in 2012. Our results highlight the need for further epidemiological studies of the association between indoor HONO and asthma symptoms using multivariate analyses to examine the role of NO2 in asthma symptoms. Abbreviations: CXCL1: the chemokine (C-X-C motif) ligand 1; EP: the entire study period; FP: the first half of study period; HONO: nitrous acid; NO: nitric oxide; NO2: nitrogen dioxide; OH radical: hydroxyl radical; SP: the second half of study period; TNF-α: tumor necrosis factor-α; US EPA: United States Environmental Protection Agency; WHO: World Health Organization.
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Affiliation(s)
- Masayuki Ohyama
- Department of Environmental Health, Osaka Institute of Public Health , Osaka , Japan
| | - Takae Nakajima
- Department of Environmental Health, Osaka Institute of Public Health , Osaka , Japan
| | - Chika Minejima
- Department of Natural Sciences, College of Liberal Arts, International Christian University , Mitaka , Japan
| | - Kenichi Azuma
- Department of Environmental Medicine and Behavioural Science, Faculty of medicine Kindai University , Osaka-sayama , Japan
| | - Kenji Oka
- Department of Research, Institute of Environment, Agriculture and Fisheries, Osaka Prefectural Government , Osaka , Japan
| | - Yasuyuki Itano
- Osaka City Research Center of Environmental Science , Osaka , Japan
| | - Shouichiro Kudo
- Department of Applied Chemistry, Graduate School of Engineering, Osaka Prefecture University , Sakai , Japan
| | - Norimichi Takenaka
- Department of Applied Chemistry, Graduate School of Engineering, Osaka Prefecture University , Sakai , Japan
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23
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Zhang T, Zheng Y, Gao Y, Zhao T, Guo S, Yang L, Shi Y, Zhou L, Ye L. Exposure to PM 2.5 affects blood lipid levels in asthmatic rats through notch signaling pathway. Lipids Health Dis 2019; 18:160. [PMID: 31391046 PMCID: PMC6686462 DOI: 10.1186/s12944-019-1102-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 08/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies have confirmed atmospheric PM2.5 could affect asthma, and dyslipidemia may be related to pathogenesis of asthma. Recent studies show Notch ligands had lipid combination domains which are responsible for regulating lipid levels. However, the effect of PM2.5 on asthmatic rats' lipid levels and the role of Notch signaling pathway is unclear. METHODS Rats were treat with ovalbumin (OVA) to establish asthma models. Notch signaling pathway inhibitor (DAPT) was injected intraperitoneally. Asthmatic and healthy rats were exposed to different concentrations of PM2.5. Lung tissues were collected and the expression of Hes1 protein was detected by Western Blot. Blood samples were collected to detect the serum lipid levels. RESULTS Hes1 expression levels in healthy and asthma pathway inhibition groups were lower than those in control groups. Compared with control group, rats exposed to PM2.5 in middle and high dose, the levels of TG and TC were decreased. Similar results were observed after exposure to the same concentration of PM2.5 in asthmatic rats. Rats, which were exposed to PM2.5 after being established the asthma model successfully, could exhibit more significant dyslipidemia than those with direct exposure. After Notch signaling pathway inhibited, TC and LDL in asthma pathway inhibition group were lower than those in healthy group. CONCLUSIONS PM2.5 can affect the lipid levels of asthmatic rats through the Notch signaling pathway.
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Affiliation(s)
- Tianrong Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Yan Zheng
- The Department of Cadre ward, the first Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Yizhen Gao
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Tianyang Zhao
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Shuangyu Guo
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Liwei Yang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Yanbin Shi
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Liting Zhou
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China.
| | - Lin Ye
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China.
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24
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Pratt JR, Gan RW, Ford B, Brey S, Pierce JR, Fischer EV, Magzamen S. A national burden assessment of estimated pediatric asthma emergency department visits that may be attributed to elevated ozone levels associated with the presence of smoke. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:269. [PMID: 31254073 DOI: 10.1007/s10661-019-7420-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 03/20/2019] [Indexed: 05/27/2023]
Abstract
Asthma is the most common pediatric disease in the USA. It has been consistently demonstrated that asthma symptoms are exacerbated by exposure to ozone. Ozone (O3) is a secondary pollutant produced when volatile organic compounds (VOCs) are oxidized in the atmosphere in the presence of nitrogen oxides (NOx). At ground level, elevated ozone is typically formed as a result of human activities. However, wildfires represent an additional source of ozone precursors. Recent evidence suggests that smoke can increase ozone concentrations. We estimated the number of excess asthma-related emergency department (ED) visits in children with asthma that may be attributed to elevated ozone associated with smoke (EOAS) in the USA. We conducted a quantitative burden assessment (BA) using a Monte Carlo approach to estimate the median number of excess pediatric asthma ED visits that may be attributed to EOAS among children with asthma in the continental USA between 2005 and 2014, as well as 95% confidence bounds (95% CB). We estimated that a median of 2403 (95% CB 235-5382) pediatric asthma ED visits could be attributed to EOAS exposure between 2005 and 2014 in the continental USA. Furthermore, the impact of EOAS on estimated asthma ED visits was greatest in the eastern half of the continental USA. We found a significant increase in pediatric asthma ED visits that may be attributed to exposure to EOAS. EOAS may have a measurable negative impact on children with asthma in the USA.
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Affiliation(s)
- Jacob R Pratt
- Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Ryan W Gan
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA
| | - Bonne Ford
- Department of Atmospheric Sciences, Colorado State University, Fort Collins, CO, USA
| | - Steven Brey
- Department of Atmospheric Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jeffrey R Pierce
- Department of Atmospheric Sciences, Colorado State University, Fort Collins, CO, USA
| | - Emily V Fischer
- Department of Atmospheric Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sheryl Magzamen
- Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA.
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA.
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25
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Zhang Y, Ni H, Bai L, Cheng Q, Zhang H, Wang S, Xie M, Zhao D, Su H. The short-term association between air pollution and childhood asthma hospital admissions in urban areas of Hefei City in China: A time-series study. ENVIRONMENTAL RESEARCH 2019; 169:510-516. [PMID: 30544078 DOI: 10.1016/j.envres.2018.11.043] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 10/29/2018] [Accepted: 11/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The impacts of air pollution on asthma attacks have become a hotspot. Previous studies mainly focused on the developed countries or cities. There have been very limited studies in less-developed region to quantify the effects of air pollutants on asthma admissions in children. This study aims to assess the short-term impact of air pollutants on asthma hospital admissions for children in Hefei, China. METHODS Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) were applied to investigate the effects of air pollutants on daily childhood hospital admissions of asthma from 2015 to 2016, controlling for meteorological factors. Subgroup analyses by sex and age were performed. RESULTS There were a total of 17,227 asthma admissions during 2015-2016. We found positive correlations between childhood asthma hospital visits and concentrations of NO2, O3, PM10 and PM2.5. Significantly, NO2 exhibited robust positive correlations with cumulative effects 1.551 (95% CI: 1.306-1.841, lag0-3 days) in single-pollutant model and 1.580 (95% CI: 1.315-1.899, lag0-3 days) in multiple-pollutant model. CONCLUSIONS Air pollutants had adverse effects on childhood asthma. NO2 presented the greatest effect, followed by PM2.5. Results will be important for health authority and guardians to realize the severity of air pollution on the increased risk of asthma, so as to develop relevant strategies and health interventions to meet the challenges of childhood asthma and reduce air pollution.
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Affiliation(s)
- Yanwu Zhang
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Hong Ni
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Province Children's Hospital, Hefei, Anhui 230051, China
| | - Lijun Bai
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Qiang Cheng
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Heng Zhang
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Shusi Wang
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Mingyu Xie
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Desheng Zhao
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
| | - Hong Su
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
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26
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Ai S, Qian ZM, Guo Y, Yang Y, Rolling CA, Liu E, Wu F, Lin H. Long-term exposure to ambient fine particles associated with asthma: A cross-sectional study among older adults in six low- and middle-income countries. ENVIRONMENTAL RESEARCH 2019; 168:141-145. [PMID: 30316099 DOI: 10.1016/j.envres.2018.09.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/30/2018] [Accepted: 09/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Ambient PM2.5 is considered harmful to the respiratory system. However, little has been shown about the long-term association between ambient PM2.5 and asthma. METHODS A survey from 2007 to 2010 was conducted among adults over 50 years of age in six low- and middle- income countries (including China, India, Ghana, Mexico, Russia, and South Africa), which belonged to one part of a prospective cohort study - the Study on global AGEing and adult health. The yearly mean PM2.5 concentrations of the residential communities of participants were estimated from remote sensing data. A mixed effects model was applied to investigate the association between ambient PM2.5 and asthma. RESULTS A total of 4553 asthma patients were identified among the 29,249 participants in this study, producing a prevalence of 15.57%. For each 10 μg/m3 increase in PM2.5, the adjusted prevalence ratio of asthma was 1.05 (95% Confidence Interval: 1.01, 1.08) after controlling for the effects of sex, age, BMI, education attainment, smoking status, alcohol consumption, and occupational exposure. Further analyses showed that males and smokers might be particularly vulnerable populations. Additionally, it was estimated that about 5.12% of the asthma cases in the study population (95% Confidence Interval: 1.44%, 9.23%) could be attributed to long-term PM2.5 exposure. CONCLUSION Long-term exposure to PM2.5 might be an important risk factor of asthma. Effective air pollution reduction measures should be taken to reduce PM2.5 concentrations in order to reduce the associated asthma cases and disease burden.
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Affiliation(s)
- Siqi Ai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Min Qian
- College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Yanfei Guo
- Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Yin Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Craig A Rolling
- College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Echu Liu
- College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Fan Wu
- Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China.
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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27
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Lovinsky-Desir S, Acosta LM, Rundle AG, Miller RL, Goldstein IF, Jacobson JS, Chillrud SN, Perzanowski MS. Air pollution, urgent asthma medical visits and the modifying effect of neighborhood asthma prevalence. Pediatr Res 2019; 85:36-42. [PMID: 30337671 PMCID: PMC6353679 DOI: 10.1038/s41390-018-0189-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/14/2018] [Accepted: 08/26/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Social and environmental stressors may modify associations between environmental pollutants and asthma symptoms. We examined if neighborhood asthma prevalence (higher: HAPN vs. lower: LAPN), a surrogate for underlying risk factors for asthma, modified the relationship between pollutants and urgent asthma visits. METHODS Through zip code, home addresses were linked to New York City Community Air Survey's land use regression model for street-level, annual average nitrogen dioxide (NO2), particulate matter (PM2.5), elemental carbon (EC), summer average ozone (O3), winter average sulfur dioxide (SO2) concentrations. Poisson regression models were fit to estimate the association (prevalence ratio, PR) between pollutant exposures and seeking urgent asthma care. RESULTS All pollutants, except O3 were higher in HAPN than LAPN (P < 0.01). Neighborhood asthma prevalence modified the relationship between pollutants and urgent asthma (P-interaction < 0.01, for NO2 and SO3). Associations between pollutants and urgent asthma were observed only in LAPN (NO2: PR = 1.38, P = 0.01; SO3: PR = 1.85, P = 0.04). No association was observed between pollutants and urgent asthma among children in HAPN (P > 0.05). CONCLUSIONS Relationships between modeled street-level pollutants and urgent asthma were stronger in LAPN compared to HAPN. Social stressors that may be more prevalent in HAPN than LAPN, could play a greater role in asthma exacerbations in HAPN vs. pollutant exposure alone.
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Affiliation(s)
- Stephanie Lovinsky-Desir
- Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - Luis M Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rachel L Miller
- Division of Pulmonary, Allergy and Critical Care of Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Inge F Goldstein
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Judith S Jacobson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, New York, NY, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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28
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Liu S, Chiang YT, Tseng CC, Ng E, Yeh GL, Fang WT. The Theory of Planned Behavior to Predict Protective Behavioral Intentions against PM2.5 in Parents of Young Children from Urban and Rural Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102215. [PMID: 30309043 PMCID: PMC6210761 DOI: 10.3390/ijerph15102215] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 12/19/2022]
Abstract
Smog and air pollution have fast become significant environmental problems and are attributed to rapid global industrialization and urbanization. Emissions of fine particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) increase smog and air pollution, with strong impacts on human health. Children are particularly vulnerable. While increasing studies are being conducted on the behaviors leading to PM2.5 toxicity from the perspective of environmental toxicants, there is a lack of research on factors influencing anti-PM2.5 behavioral intentions. Thus, this study aims to narrow this gap by adapting the theory of planned behavior framework to investigate the effects of attitude, subjective norms, and perceived behavioral control on protective behavioral intentions against PM2.5. In total, 1277 online questionnaires were collected from parents of young children living in urban and rural areas of Beijing, and the data was analyzed using correlation, regression, and path analyses. Results revealed that there were significant differences between parents from urban and rural areas in terms of attitude (t = 4.727 > 1.96, p < 0.001), subjective norms (t = 5.529 > 1.96, p < 0.001), perceived behavioral control (t = 6.155 > 1.96, p < 0.001), and anti-PM2.5 behavioral intentions (t = 6.838 > 1.96, p < 0.001). Path analysis revealed that parents from urban and rural areas had different behavioral intention paths. For urban parents, the findings indicated that subjective norms (β = 0.73, t = 21.84 > 3.29) and perceived behavioral control (γ = 0.22, t = 6.12 > 3.29) had direct impacts on anti-PM2.5 behavioral intentions. In contrast, the attitudes (γ = 0.39, t = 3.74 > 3.29) and subjective norms (β = 0.60, t = 8.55 > 3.29) of rural parents were found to directly influence anti-PM2.5 behavioral intentions.
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Affiliation(s)
- Shumei Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 106, Taiwan.
| | - Yi-Te Chiang
- Graduate Institute of Environmental Education, National Taiwan Normal University, Taipei 116, Taiwan.
| | - Chie-Chien Tseng
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 106, Taiwan.
| | - Eric Ng
- School of Management and Enterprise, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
| | - Gwo-Liang Yeh
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 106, Taiwan.
| | - Wei-Ta Fang
- Graduate Institute of Environmental Education, National Taiwan Normal University, Taipei 116, Taiwan.
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29
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Shrestha SK, Katelaris C, Dharmage SC, Burton P, Vicendese D, Tham R, Abramson MJ, Erbas B. High ambient levels of grass, weed and other pollen are associated with asthma admissions in children and adolescents: A large 5-year case-crossover study. Clin Exp Allergy 2018; 48:1421-1428. [PMID: 29975808 DOI: 10.1111/cea.13225] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/30/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pollen is an important aeroallergen that triggers asthma exacerbations in children, but we know little about the impact of different pollen types in cities with varying climatic conditions and pollen seasons. OBJECTIVES We aimed to assess the role of ambient level of different types of pollen on a large time series of child and adolescent asthma hospitalizations in Sydney, Australia. METHODS Childhood asthma hospitalization and the daily ambient pollen concentrations of different species were collected in South-West Sydney. With a bidirectional case-crossover design, we fitted conditional logistic regression models to measure the associations between instantaneous and up to 3 days lagged effects of pollen concentrations on asthma hospitalizations after controlling for potential confounders and testing for interactions. RESULTS A total of 2098 children, more boys (59.7%) and 2-5 years old (62.6%), were hospitalized due to asthma. The geometric mean concentration of Cupressus, 7.88 [5.02] grains/m3 , was the highest during the study period. The increase from 75th to 90th percentile of grass (OR = 1.037, 95% CI 1.005-1.070), weed other than Plantago species (OR = 1.053, 95% CI 1.009-1.098) and unclassified pollen (OR = 1.034, 95% CI 1.010-1.058) were significantly associated with the odds of asthma hospitalizations. Boys were at greater risk of asthma exacerbations associated with grass (OR = 1.046, 95% CI 1.003-1.090) and unclassified pollen (OR = 1.041, 95% CI 1.010-1.073). There was evidence of effect modification by age groups for Cupressus, conifer, total tree and total pollen. CONCLUSIONS Although boys are more vulnerable to grass pollen, weed, and other pollen are also important triggers of asthma exacerbations in all children and adolescents. These findings are important for urban green space planning and the development of pollen monitoring systems for families with children at risk of asthma exacerbations during peak pollen seasons.
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Affiliation(s)
- Som K Shrestha
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | | | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Pamela Burton
- Department of Medicine, Campbelltown Hospital, Sydney, NSW, Australia
| | - Don Vicendese
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Rachel Tham
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
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Yu Y, Yu Z, Sun P, Lin B, Li L, Wang Z, Ma R, Xiang M, Li H, Guo S. Effects of ambient air pollution from municipal solid waste landfill on children's non-specific immunity and respiratory health. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 236:382-390. [PMID: 29414361 DOI: 10.1016/j.envpol.2017.12.094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/04/2017] [Accepted: 12/24/2017] [Indexed: 06/08/2023]
Abstract
This cross-sectional study investigated the association between air pollutant (AP) and respiratory health of 951 children residing near a municipal solid waste (MSW) landfill in Northern China. Results showed that students in non-exposure areas had significantly higher levels of lysozyme, secretory immunoglobulin A (SIgA), and better lung capacity than students in exposure areas (p < .05). Multiple regression model analysis indicated that lysozyme levels exhibited a consistent negative association with methane (CH4: β = -76.3, 95% CI -105 to -47.7) and sulfuretted hydrogen (H2S: β = -11.7, 95% CI -20.2 to -3.19). In addition, SIgA levels were negatively associated with H2S (β = -68.9, 95% CI -97.9 to -39.9) and ammonia (NH3: β = -30.3, 95% CI -51.7 to -8.96). Among all AP, H2S and sulfur dioxide (SO2) were the most robustly related with reduced lung function. H2S exposure was negatively associated with six lung function indices, 1-s forced expiratory volume (FEV1%), mean forced expiratory flow between 25% and 75% (MMF), maximum voluntary ventilation (MVV), and forced expiratory flow at 25%, 50%, and 75% of the pulmonary volume (FEF25, FEF50, FEF75); and SO2 was negatively associated with FEV1%, MVV, FEF25, FEF50 and FEF75. Our results suggested that AP exposure was negatively associated with more lung function parameters in boys than in girls. In conclusion, our findings suggested that children living adjacent to landfill sites were more likely to have deficient non-specific immunity and impaired lung function.
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Affiliation(s)
- 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
| | - Ziling 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
| | - Peng Sun
- China Institute of Atomic Energy, Beijing, 102413, China
| | - Bigui Lin
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China
| | - Liangzhong Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China
| | - Zhengdong Wang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China
| | - Ruixue Ma
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China
| | - Mingdeng Xiang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China
| | - Hui Li
- State Environmental Protection Key Laboratory of Environmental Risk Assessment and Control on Chemical Process, East China University of Science and Technology, Shanghai, 200237, China.
| | - Shu Guo
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, China.
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Szyszkowicz M, Kousha T, Castner J, Dales R. Air pollution and emergency department visits for respiratory diseases: A multi-city case crossover study. ENVIRONMENTAL RESEARCH 2018; 163:263-269. [PMID: 29459308 DOI: 10.1016/j.envres.2018.01.043] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/27/2018] [Accepted: 01/28/2018] [Indexed: 05/23/2023]
Abstract
Increasing evidence suggests that ambient air pollution is a major risk factor for both acute and chronic respiratory disease exacerbations and emergencies. The objective of this study was to determine the association between ambient air pollutants and emergency department (ED) visits for respiratory conditions in nine districts across the province of Ontario in Canada. Health, air pollutant (PM2.5, NO2, O3, and SO2), and meteorological data were retrieved from April 2004 to December 2011. Respiratory diseases were categorized as: chronic obstructive pulmonary disease (COPD, including bronchiectasis) and acute upper respiratory diseases. A case-crossover design was used to test the associations between ED visits and ambient air pollutants, stratified by sex and season. For COPD among males, positive results were observed for NO2 with lags of 3-6 days, for PM2.5 with lags 1-8, and for SO2 with lags of 4-8 days. For COPD among females, positive results were observed for O3 with lags 2-4 days, and for SO2 among lags of 3-6 days. For upper respiratory disease emergencies among males, positive results were observed for NO2 (lags 5-8 days), for O3, (lags 0-6 days), PM2.5 (all lags), and SO2 (lag 8), and among females, positive results were observed for NO2 for lag 8 days, for O3, PM2.5 among all lags. Our study provides evidence of the associations between short-term exposure to air pollution and increased risk of ED visits for upper and lower respiratory diseases in an environment where air pollutant concentrations are relatively low.
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Affiliation(s)
| | - Termeh Kousha
- Population Studies Division, Health Canada, Ottawa, Canada; Department of Mathematics and Statistics, University of Ottawa, Ottawa, Canada.
| | | | - Robert Dales
- Population Studies Division, Health Canada, Ottawa, Canada; University of Ottawa and The Ottawa Hospital Research Institute, Canada.
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Veremchuk LV, Tsarouhas K, Vitkina TI, Mineeva EE, Gvozdenko TA, Antonyuk MV, Rakitskii VN, Sidletskaya KA, Tsatsakis AM, Golokhvast KS. Impact evaluation of environmental factors on respiratory function of asthma patients living in urban territory. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 235:489-496. [PMID: 29324378 DOI: 10.1016/j.envpol.2017.12.122] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/30/2017] [Accepted: 12/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Environmental pollution, local climatic conditions and their association with the prevalence and exacerbation of asthma are topics of intense current medical investigation. MATERIALS AND METHODS Air pollution in the area of Vladivostock was estimated both by the index of emission volumes of "air gaseous components" (nitrogen oxide and nitrogen dioxide, formaldehyde, hydrogen sulfide, carbon monoxide) in urban atmosphere and by mass spectrometric analysis of precipitates in snow samples. A total of 172 local asthma patients (101 controlled-asthma patients-CAP and 71 non-controlled asthma patients - nCAP) were evaluated with the use of spirometry and body plethysmography. Airway obstruction reversibility was evaluated with the use of an inhaled bronchodilator. Using discriminant analysis the association of environmental parameters with clinical indices of asthma patients is explored and thresholds of impact are established. RESULTS CAP presented high sensitivity to large-size suspended air particles and to several of the studied climatic parameters. Discriminant analysis showed high values of Wilks' lambda index (α = 0.69-0.81), which implies limited influence of environmental factors on the respiratory parameters of CAP. nCAP were more sensitive and susceptible to the majority of the environmental factors studied, including air suspended toxic metals particles (Cr, Zn and Ni). Air suspended particles showed higher tendency for pathogenicity in nCAP population than in the CAP, with a wider range of particle sizes being involved. Dust fractions ranging from 0 to 1 μm and from 50 to 100 μm were additionally implicated compared to CAP group. Considerably lowest thresholds levels of impact are calculated for nCAP.
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Affiliation(s)
- Lyudmila V Veremchuk
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Konstantinos Tsarouhas
- Department of Cardiology, University Hospital of Larissa, 41110, Terma Mezourlo, Larissa, Greece.
| | - Tatyana I Vitkina
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Elena E Mineeva
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Tatyana A Gvozdenko
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Marina V Antonyuk
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Valeri N Rakitskii
- Federal Scientific Center of Hygiene, F.F. Erisman, 2, Semashko Street, Mytishchi, Moscow Region 141014, Russia.
| | - Karolina A Sidletskaya
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia.
| | - Aristidis M Tsatsakis
- Far Eastern Federal University, SEC Nanotechnology, Ajax Settlement, Russkiy Island, Vladivostok, 690922, Russia; Laboratory of Toxicology, Medical School, University of Crete, GR-71003, Voutes, Heraklion, Crete, Greece.
| | - Kirill S Golokhvast
- Research Institute of Medical Climatology and Rehabilitation Treatment (Vladivostok Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration), 73g Russkaya Street, Vladivostok, 690105, Russia; Far Eastern Federal University, SEC Nanotechnology, Ajax Settlement, Russkiy Island, Vladivostok, 690922, Russia; Pacific Geographical Institute, Far Eastern Branch, Russian Academy of Sciences, 7 Radio Street, Vladivostok, 690041, Russia.
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Mentz G, Robins TG, Batterman S, Naidoo RN. Acute respiratory symptoms associated with short term fluctuations in ambient pollutants among schoolchildren in Durban, South Africa. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 233:529-539. [PMID: 29102883 PMCID: PMC5764788 DOI: 10.1016/j.envpol.2017.10.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 05/10/2023]
Abstract
Ambient air pollution has been associated with adverse respiratory outcomes, especially among children with asthma. This study reports on associations between daily ambient air pollutant concentrations and the respiratory symptoms of schoolchildren living in Durban, South Africa. This city is Africa's busiest port and a key hub for imported crude oil and exported refined petroleum and petrochemical products, and it experiences a mixture of air pollutants that reflects emissions from industry, traffic and biomass burning. Children in four communities in the highly industrialized southern portion of the city were compared to children of similar socio-economic profiles living in the north of the city. One school was selected in each community. A total of 423 children were recruited. Symptom logs were completed every 1.5-2 h over 3-week period in each of four seasons. Ambient concentrations of NO2, NO, SO2, CO, O3, PM2.5 and PM10 were measured throughout the study. Generalized estimating equation (GEE) models were used to estimate odds ratios (ORs) and assess lag effects (1-5 days) using single pollutant (single lags or distributed lags) models. Concentrations of SO2 and NOx were markedly higher in the south, while PM10 did not vary. Significant increase in the odds ratios of cough were identified for the various lags analyzed. The OR of symptoms was further increased among those living in the south compared to the north. In conclusion, in this analysis of over 70,000 observations, we provide further evidence that exposure to PM10, SO2, NO2 and NO is associated with significantly increased occurrence of respiratory symptoms among children. This was evident for cough, shortness of breath, and chest tightness, across the four pollutants and for different lags of exposure. This is the first study describing these changes in sub-Saharan Africa.
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Affiliation(s)
- Graciela Mentz
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Thomas G Robins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Room 321, George Campbell Building, Durban, 4041, South Africa.
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The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020178. [PMID: 29360738 PMCID: PMC5858253 DOI: 10.3390/ijerph15020178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022]
Abstract
Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits.
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Rodriguez-Villamizar LA, Rosychuk RJ, Osornio-Vargas A, Villeneuve PJ, Rowe BH. Proximity to two main sources of industrial outdoor air pollution and emergency department visits for childhood asthma in Edmonton, Canada. Canadian Journal of Public Health 2018; 108:e523-e529. [PMID: 29356659 DOI: 10.17269/cjph.108.6136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 11/15/2017] [Accepted: 10/02/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Children are recognized to be more susceptible than healthy adults to the effects of air pollution; however, relatively few Canadian studies of children have focused on industrial emissions. We conducted a spatial cross-sectional study to explore associations between emergency department (ED) visits for childhood asthma and residential proximity to two industrial sources of air pollution (coal-fired power plant and petrochemical industry) in Edmonton, Canada. METHODS Using administrative health care data for Alberta between 2004 and 2010, we conducted a spatial analysis of disease clusters of count data around these two industrial sources. The distance from children's place of residence to these industrial sources was determined by using the six-character postal code from the children's ED visit. Clusters of cases were identified at the census dissemination area. Negative binomial multivariable spatial regression was used to estimate the risks of clusters in relation to the distance to these industrial sources. RESULTS The relative risk of ED visits for asthma, calculated using a spatial scan test for events, was 10.4 (p value <0.01) within the power plant area when compared with the outside area. In addition, there was an inverse association of the distance to the power plant (coefficient = -0.01 per km) with asthma visits when multivariable models were used. No asthma clusters were identified around the petrochemical industrial area. CONCLUSION Our analyses revealed that there was a cluster of ED visits for asthma among children who lived near the coal-fired power plant just outside Edmonton.
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Affiliation(s)
- Laura A Rodriguez-Villamizar
- School of Public Health, University of Alberta, Edmonton, AB; Department of Public Health, Universidad Industrial de Santander, Bucaramanga, Colombia.
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Liu Y, Xie S, Yu Q, Huo X, Ming X, Wang J, Zhou Y, Peng Z, Zhang H, Cui X, Xiang H, Huang X, Zhou T, Chen W, Shi T. Short-term effects of ambient air pollution on pediatric outpatient visits for respiratory diseases in Yichang city, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 227:116-124. [PMID: 28458242 DOI: 10.1016/j.envpol.2017.04.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 06/07/2023]
Abstract
Previous studies have suggested that short-term exposure to ambient air pollution was associated with pediatric hospital admissions and emergency room visits for certain respiratory diseases; however, there is limited evidence on the association between short-term air pollution exposure and pediatric outpatient visits. Our aim was to quantitatively assess the short-term effects of ambient air pollution on pediatric outpatient visits for respiratory diseases. We conducted a time-series study in Yichang city, China between Jan 1, 2014 and Dec 31, 2015. Daily counts of pediatric respiratory outpatient visits were collected from 3 large hospitals, and then linked with air pollution data from 5 air quality monitoring stations by date. We used generalized additive Poisson models to conduct linear and nonlinear exposure-response analyses between air pollutant exposures and pediatric respiratory outpatient visits, adjusting for seasonality, day of week, public holiday, temperature, and relative humidity. Each interquartile range (IQR) increase in PM2.5 (lag 0), PM10 (lag 0), NO2 (lag 0), CO (lag 0), and O3 (lag 4) concentrations was significantly associated with a 1.91% (95% CI: 0.60%, 3.23%), 2.46% (1.09%, 3.85%), 1.88% (0.49%, 3.29%), 2.00% (0.43%, 3.59%), and 1.91% (0.45%, 3.39%) increase of pediatric respiratory outpatient visits, respectively. Similarly, the nonlinear exposure-response analyses showed monotonic increases of pediatric respiratory outpatient visits by increasing air pollutant exposures, though the associations for NO2 and CO attenuated at higher concentrations. These associations were unlikely modified by season. We did not observe significant association for SO2 exposure. Our results suggest that short-term exposures to PM2.5, PM10, NO2, CO, and O3 may account for increased risk of pediatric outpatient visits for respiratory diseases, and emphasize the needs for reduction of air pollutant exposures for children.
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Affiliation(s)
- Yuewei Liu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Shuguang Xie
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Qing Yu
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Xixiang Huo
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Xiaoyan Ming
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Jing Wang
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Yun Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhe Peng
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Hai Zhang
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Xiuqing Cui
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Hua Xiang
- Wuhan Regional Climate Center, Wuhan, Hubei, China
| | - Xiji Huang
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Ting Zhou
- School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingming Shi
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China.
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Goodman JE, Zu K, Loftus CT, Tao G, Liu X, Lange S. Ambient ozone and asthma hospital admissions in Texas: a time-series analysis. Asthma Res Pract 2017; 3:6. [PMID: 28794889 PMCID: PMC5540296 DOI: 10.1186/s40733-017-0034-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 07/19/2017] [Indexed: 12/23/2022] Open
Abstract
Background Many studies have evaluated associations between asthma emergency department (ED) visits, hospital admissions (HAs), and ambient ozone (O3) across the US, but not in Texas. We investigated the relationship between O3 and asthma HAs, and the potential impacts of outdoor pollen, respiratory infection HAs, and the start of the school year in Texas. Methods We obtained daily time-series data on asthma HAs and ambient O3 concentrations for Dallas, Houston, and Austin, Texas for the years 2003–2011. Relative risks (RRs) and 95% confidence intervals (CIs) of asthma HAs per 10-ppb increase in 8-h maximum O3 concentrations were estimated from Poisson generalized additive models and adjusted for temporal trends, meteorological factors, pollen, respiratory infection HAs, day of the week, and public holidays. We conducted a number of sensitivity analyses to assess model specification. Results We observed weak associations between total asthma HAs and O3 at lags of 1 day (RR10 ppb = 1.012, 95% CI: 1.004–1.021), 2 days (RR10 ppb = 1.011, 95% CI: 1.002–1.019), and 0–3 days (RR10 ppb = 1.017, 95% CI: 1.005–1.030). The associations were primarily observed in children aged 5–14 years (e.g., for O3 at lag 0–3 days, RR10 ppb = 1.037, 95% CI: 1.011–1.064), and null in individuals 15 years or older. The effect estimates did not change significantly with adjustment for pollen and respiratory infections, but they attenuated considerably and lost statistical significance when August and September data were excluded. A significant interaction between time around the start of the school year and O3 at lag 2 day was observed, with the associations with pediatric asthma HAs stronger in August and September (RR10 ppb = 1.040, 95% CI: 1.012–1.069) than in the rest of the year (October–July) (RR10 ppb = 1.006, 95% CI: 0.986–1.026). Conclusions We observed small but statistically significant positive associations between total and pediatric asthma HAs and short-term O3 exposure in Texas, especially in August and September. Further research is needed to determine how the start of school could modify the observed association between O3 and pediatric asthma HAs. Electronic supplementary material The online version of this article (doi:10.1186/s40733-017-0034-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Ke Zu
- Gradient, 20 University Road, Cambridge, MA 02138 UK
| | | | - Ge Tao
- Gradient, 20 University Road, Cambridge, MA 02138 UK
| | - Xiaobin Liu
- Gradient, 20 University Road, Cambridge, MA 02138 UK
| | - Sabine Lange
- Texas Commission on Environmental Quality, 12100 Park 35 Circle, Austin, TX USA
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Impact of respiratory infections, outdoor pollen, and socioeconomic status on associations between air pollutants and pediatric asthma hospital admissions. PLoS One 2017; 12:e0180522. [PMID: 28719626 PMCID: PMC5515410 DOI: 10.1371/journal.pone.0180522] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/17/2017] [Indexed: 01/21/2023] Open
Abstract
Background Epidemiology studies have shown that ambient concentrations of ozone and fine particulate matter (PM2.5) are associated with increased emergency department (ED) visits and hospital admissions (HAs) for asthma. Objective Evaluate the impact of outdoor pollen, respiratory infections, and socioeconomic status (SES) on the associations between ambient ozone and PM2.5 and asthma HAs in New York City. Methods Daily ozone, PM2.5, meteorological factors, pollen, and hospitalization records during 1999 to 2009 were obtained for New York City residents. Daily counts of HAs for asthma and respiratory infections were calculated for all-age and specific age groups, and for high- and low-SES communities. Generalized additive models were used to examine ambient concentrations of ozone and PM2.5 and asthma HAs, potential confounding effects of outdoor pollen and HAs for respiratory infections, and potential effect modification by neighborhood SES. Results Both ozone and PM2.5 were statistically significantly associated with increased asthma HAs in children aged 6–18 years (per 10 ppb increase in ozone: RR = 1.0203, 95% CI: 1.0028–1.0382; per 10 μg/m3 increase in PM2.5: RR = 1.0218, 95% CI: 1.0007–1.0434), but not with total asthma HAs, or asthma HAs in other age groups. These associations were stronger for children living in the high-SES areas. Adjustment for respiratory infection HAs at various lags did not result in changes greater than 10% in the risk estimates for either ozone or PM2.5. In contrast, adjustment for outdoor pollen generally attenuated the estimated RRs for both ozone and PM2.5. Conclusions Ambient ozone and PM2.5 are associated with asthma HAs in school-age children, and these associations are not modified by SES. HAs for respiratory infections do not appear to be a confounder for observed ozone- and PM2.5-asthma HAs associations, but pollen may be a weak confounder.
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Requia WJ, Adams MD, Koutrakis P. Association of PM 2.5 with diabetes, asthma, and high blood pressure incidence in Canada: A spatiotemporal analysis of the impacts of the energy generation and fuel sales. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 584-585:1077-1083. [PMID: 28169030 DOI: 10.1016/j.scitotenv.2017.01.166] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 05/12/2023]
Abstract
Numerous studies have reported an association between fine particulate matter (PM2.5) and human health. Often these relationships are influenced by environmental factor that varies spatially and/or temporally. To our knowledge, there are no studies in Canada that have considered energy generation and fuel sales as PM2.5 effects modifiers. Determining exposure and disease-specific risk factors over space and time is crucial for disease prevention and control. In this study, we evaluated the association of PM2.5 with diabetes, asthma, and High Blood Pressure (HBP) incidence in Canada. Then we explored the impact of the energy generation and fuel sales on association changes. We fit an age-period-cohort as the study design, and we applied an over-dispersed Poisson regression model to estimate the risk. We conducted a sensitivity analysis to explore the impact of variation in clean energy rates and fuel sales on outcomes changes. The study included 117 health regions in Canada between 2007 and 2014. Our findings showed strong association of PM2.5 with diabetes, asthma, and HBP incidence. A two-year increase of 10μg/m3 in PM2.5 was associated with an increased risk of 5.34% (95% CI: 2.28%; 12.53%) in diabetes incidence, 2.24% (95% CI: 0.93%; 5.38%) in asthma incidence, and 8.29% (95% CI: 3.44%; 19.98%) in HBP incidence. Our sensitivity analysis findings suggest higher risks of diabetes, asthma and HBP incidence when there is low clean energy generation. On the other hand, we found lower risk when we considered high rate of clean energy generation. For example, considering only diabetes incidence, we found that the risk in health regions with low rates of clean electricity is approximately 700% higher than the risk in health regions with high rates of clean electricity. Furthermore, our analysis suggested that the risk in regions with low fuel sales is 66% lower than the risk is health regions with low rates of clean electricity. Our study provides support for the creation of effective environmental health public policies that take into account the risk factors present in Canadians health regions.
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Affiliation(s)
- Weeberb J Requia
- School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Matthew D Adams
- Department of Geography and Environmental Studies, Ryerson University, Canada.
| | - Petros Koutrakis
- Harvard T.H. Chan School of Public Health, Harvard University, United States.
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Lim H, Kwon HJ, Lim JA, Choi JH, Ha M, Hwang SS, Choi WJ. Short-term Effect of Fine Particulate Matter on Children's Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis. J Prev Med Public Health 2017; 49:205-19. [PMID: 27499163 PMCID: PMC4977771 DOI: 10.3961/jpmph.16.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/14/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies. METHODS Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger's test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3. RESULTS We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM2.5 on children's hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children's hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m3 increase in PM2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I2=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe. CONCLUSIONS We strengthened the evidence on the short-term effect of PM2.5 on children's hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.
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Affiliation(s)
- Hyungryul Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ji-Ae Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jong Hyuk Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Seung-Sik Hwang
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Won-Jun Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
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O’ Lenick CR, Chang HH, Kramer MR, Winquist A, Mulholland JA, Friberg MD, Sarnat SE. Ozone and childhood respiratory disease in three US cities: evaluation of effect measure modification by neighborhood socioeconomic status using a Bayesian hierarchical approach. Environ Health 2017; 16:36. [PMID: 28381221 PMCID: PMC5382444 DOI: 10.1186/s12940-017-0244-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 03/24/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Ground-level ozone is a potent airway irritant and a determinant of respiratory morbidity. Susceptibility to the health effects of ambient ozone may be influenced by both intrinsic and extrinsic factors, such as neighborhood socioeconomic status (SES). Questions remain regarding the manner and extent that factors such as SES influence ozone-related health effects, particularly across different study areas. METHODS Using a 2-stage modeling approach we evaluated neighborhood SES as a modifier of ozone-related pediatric respiratory morbidity in Atlanta, Dallas, & St. Louis. We acquired multi-year data on emergency department (ED) visits among 5-18 year olds with a primary diagnosis of respiratory disease in each city. Daily concentrations of 8-h maximum ambient ozone were estimated for all ZIP Code Tabulation Areas (ZCTA) in each city by fusing observed concentration data from available network monitors with simulations from an emissions-based chemical transport model. In the first stage, we used conditional logistic regression to estimate ZCTA-specific odds ratios (OR) between ozone and respiratory ED visits, controlling for temporal trends and meteorology. In the second stage, we combined ZCTA-level estimates in a Bayesian hierarchical model to assess overall associations and effect modification by neighborhood SES considering categorical and continuous SES indicators (e.g., ZCTA-specific levels of poverty). We estimated ORs and 95% posterior intervals (PI) for a 25 ppb increase in ozone. RESULTS The hierarchical model combined effect estimates from 179 ZCTAs in Atlanta, 205 ZCTAs in Dallas, and 151 ZCTAs in St. Louis. The strongest overall association of ozone and pediatric respiratory disease was in Atlanta (OR = 1.08, 95% PI: 1.06, 1.11), followed by Dallas (OR = 1.04, 95% PI: 1.01, 1.07) and St. Louis (OR = 1.03, 95% PI: 0.99, 1.07). Patterns of association across levels of neighborhood SES in each city suggested stronger ORs in low compared to high SES areas, with some evidence of non-linear effect modification. CONCLUSIONS Results suggest that ozone is associated with pediatric respiratory morbidity in multiple US cities; neighborhood SES may modify this association in a non-linear manner. In each city, children living in low SES environments appear to be especially vulnerable given positive ORs and high underlying rates of respiratory morbidity.
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Affiliation(s)
- Cassandra R. O’ Lenick
- Department of Environmental Health, Rollins School of Public Health, Emory University, Second Floor, Claudia Nance Rollins Building, Rm. 2030 B, 1518 Clifton Road NE, Atlanta, GA 30322 USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, Second Floor, Claudia Nance Rollins Building, Rm. 2030 B, 1518 Clifton Road NE, Atlanta, GA 30322 USA
| | - James A. Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA USA
| | - Mariel D. Friberg
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Second Floor, Claudia Nance Rollins Building, Rm. 2030 B, 1518 Clifton Road NE, Atlanta, GA 30322 USA
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Orellano P, Quaranta N, Reynoso J, Balbi B, Vasquez J. Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis. PLoS One 2017; 12:e0174050. [PMID: 28319180 PMCID: PMC5358780 DOI: 10.1371/journal.pone.0174050] [Citation(s) in RCA: 269] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 03/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. Material and methods We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). Results Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. Conclusion This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags.
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Affiliation(s)
- Pablo Orellano
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina
| | - Nancy Quaranta
- Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina.,Comisión de Investigaciones Científicas (CIC), La Plata, Argentina
| | - Julieta Reynoso
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
| | - Brenda Balbi
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
| | - Julia Vasquez
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
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Outdoor Environment and Pediatric Asthma: An Update on the Evidence from North America. Can Respir J 2017; 2017:8921917. [PMID: 28239256 PMCID: PMC5292365 DOI: 10.1155/2017/8921917] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/09/2016] [Accepted: 12/20/2016] [Indexed: 01/19/2023] Open
Abstract
Introduction. The evidence about the association between asthma and outdoor environmental factors has been inadequate for certain allergens. Even less is known about how these associations vary across seasons and climate regions. We reviewed recent literature from North America for research related to outdoor environmental factors and pediatric asthma, with attention to spatial-temporal variations of these associations. Method. We included indexed literature between years 2010 and 2015 on outdoor environmental factors and pediatric asthma, by searching PubMed. Results. Our search resulted in 33 manuscripts. Studies about the link between pediatric asthma and traffic-related air pollutants (TRAP) consistently confirmed the correlation between TRAP and asthma. For general air pollution, the roles of PM2.5 and CO were consistent across studies. The link between asthma and O3 varied across seasons. Regional variation exists in the role of SO2. The impact of pollen was consistent across seasons, whereas the role of polycyclic aromatic hydrocarbon was less consistent. Discussion. Recent studies strengthened the evidence about the roles of PM2.5, TRAP, CO, and pollen in asthma, while the evidence for roles of PM10-2.5, PM10, O3, NO2, SO2, and polycyclic aromatic hydrocarbon in asthma was less consistent. Spatial-temporal details of the environment are needed in future studies of asthma and environment.
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Cordioli M, Pironi C, De Munari E, Marmiroli N, Lauriola P, Ranzi A. Combining land use regression models and fixed site monitoring to reconstruct spatiotemporal variability of NO 2 concentrations over a wide geographical area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 574:1075-1084. [PMID: 27672737 DOI: 10.1016/j.scitotenv.2016.09.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/18/2016] [Accepted: 09/11/2016] [Indexed: 06/06/2023]
Abstract
The epidemiological research benefits from an accurate characterization of both spatial and temporal variability of exposure to air pollution. This work aims at proposing a method to combine the high spatial resolution of Land Use Regression (LUR) models with the high temporal resolution of fixed site monitoring data, to model spatiotemporal variability of NO2 over a wide geographical area in Northern Italy. We developed seasonal LUR models to reconstruct the spatial distribution of a scaling factor that relates local concentrations to those measured at two reference central sites, one for the northern flat area and one for the southern mountain area. We calculated the daily average concentrations at 19 locations spread over the study areas as the product of the local scaling factor and the reference central site concentrations. We evaluated model performance comparing modeled and measured NO2 data. LUR model's R2 ranges from 0.76 to 0.92. The main predictors refers substantially to traffic, industrial land use, buildings volume and altitude a.s.l. The model's performance in reproducing measured concentrations was satisfactory. The temporal variability of concentrations was well captured: Spearman correlation between model and measures was >0.7 for almost all sites. Model's average absolute errors were in the order of 10μgm-3. The model for the southern area tends to overestimate measured concentrations. Our modeling framework was able to reproduce spatiotemporal differences in NO2 concentrations. This kind of model is less data-intensive than usual regional atmospheric models and it may be very helpful to assess population exposure within studies in which individual relevant exposure occurs along periods of days or months.
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Affiliation(s)
- M Cordioli
- National Interuniversity Consortium for Environmental Sciences (CINSA), Dorsoduro 2137, 30123, Venice, Italy; Environmental Health Reference Centre, Regional Agency for Environmental Protection and Energy of the Emilia-Romagna Region, Via Begarelli 13, Modena, Italy.
| | - C Pironi
- Regional Agency for Environmental Protection and Energy of the Emilia-Romagna Region, Local district of Parma, Viale Bottego, 9, 43121 Parma, Italy
| | - E De Munari
- Regional Agency for Environmental Protection and Energy of the Emilia-Romagna Region, Local district of Parma, Viale Bottego, 9, 43121 Parma, Italy
| | - N Marmiroli
- National Interuniversity Consortium for Environmental Sciences (CINSA), Dorsoduro 2137, 30123, Venice, Italy
| | - P Lauriola
- Environmental Health Reference Centre, Regional Agency for Environmental Protection and Energy of the Emilia-Romagna Region, Via Begarelli 13, Modena, Italy
| | - A Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Protection and Energy of the Emilia-Romagna Region, Via Begarelli 13, Modena, Italy
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Chen K, Glonek G, Hansen A, Williams S, Tuke J, Salter A, Bi P. The effects of air pollution on asthma hospital admissions in Adelaide, South Australia, 2003-2013: time-series and case-crossover analyses. Clin Exp Allergy 2016; 46:1416-1430. [PMID: 27513706 DOI: 10.1111/cea.12795] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 07/15/2016] [Accepted: 07/17/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND Air pollution can have adverse health effects on asthma sufferers, but the effects vary with geographic, environmental and population characteristics. There has been no long time-series study in Australia to quantify the effects of environmental factors including pollen on asthma hospitalizations. OBJECTIVES This study aimed to assess the seasonal impact of air pollutants and aeroallergens on the risk of asthma hospital admissions for adults and children in Adelaide, South Australia. METHODS Data on hospital admissions, meteorological conditions, air quality and pollen counts for the period 2003-2013 were sourced. Time-series analysis and case-crossover analysis were used to assess the short-term effects of air pollution on asthma hospitalizations. For the time-series analysis, generalized log-linear quasi-Poisson and negative binomial regressions were used to assess the relationships, controlling for seasonality and long-term trends using flexible spline functions. For the case-crossover analysis, conditional logistic regression was used to compute the effect estimates with time-stratified referent selection strategies. RESULTS A total of 36,024 asthma admissions were considered. Findings indicated that the largest effects on asthma admissions related to PM2.5 , NO2 , PM10 and pollen were found in the cool season for children (0-17 years), with the 5-day cumulative effects of 30.2% (95% CI: 13.4-49.6%), 12.5% (95% CI: 6.6-18.7%), 8.3% (95% CI: 2.5-14.4%) and 4.2% (95% CI: 2.2-6.1%) increases in risk of asthma hospital admissions per 10 unit increments, respectively. The largest effect for ozone was found in the warm season for children with the 5-day cumulative effect of an 11.7% (95% CI: 5.8-17.9%) increase in risk of asthma hospital admissions per 10 ppb increment in ozone level. CONCLUSION Findings suggest that children are more vulnerable and the associations between exposure to air pollutants and asthma hospitalizations tended to be stronger in the cool season compared to the warm season, with the exception of ozone. This study has important public health implications and provides valuable evidence for the development of policies for asthma management.
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Affiliation(s)
- K Chen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - G Glonek
- School of Mathematical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - A Hansen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - S Williams
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - J Tuke
- School of Mathematical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - A Salter
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - P Bi
- School of Public Health, University of Adelaide, Adelaide, SA, Australia.
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Gleason JA, Kratz NR, Greeley RD, Fagliano JA. Under the Weather: Legionellosis and Meteorological Factors. ECOHEALTH 2016; 13:293-302. [PMID: 26993637 DOI: 10.1007/s10393-016-1115-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/30/2015] [Accepted: 02/24/2016] [Indexed: 06/05/2023]
Abstract
The incidence of legionellosis, caused by the bacteria Legionella which are commonly found in the environment, has been increasing in New Jersey (NJ) over the last decade. The majority of cases are sporadic with no known source of exposure. Meteorological factors may be associated with increases in legionellosis. Time series and case-crossover study designs were used to evaluate associations of legionellosis and meteorological factors (temperature (daily minimum, maximum, and mean), precipitation, dew point, relative humidity, sea level pressure, wind speed (daily maximum and mean), gust, and visibility). Time series analyses of multi-factor models indicated increases in monthly relative humidity and precipitation were positively associated with monthly legionellosis rate, while maximum temperature and visibility were inversely associated. Case-crossover analyses of multi-factor models indicated increases in relative humidity occurring likely before incubation period was positively associated, while sea level pressure and visibility, also likely preceding incubation period, were inversely associated. It is possible that meteorological factors, such as wet, humid weather with low barometric pressure, allow proliferation of Legionella in natural environments, increasing the rate of legionellosis.
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Affiliation(s)
- Jessie A Gleason
- Environmental and Occupational Health Surveillance Program, New Jersey Department of Health, 135 East State Street, P.O. Box 369, Trenton, NJ, 08625, USA.
| | - Natalie R Kratz
- Communicable Disease Service, New Jersey Department of Health, Trenton, NJ, USA
| | - Rebecca D Greeley
- Communicable Disease Service, New Jersey Department of Health, Trenton, NJ, USA
| | - Jerald A Fagliano
- Environmental and Occupational Health Surveillance Program, New Jersey Department of Health, 135 East State Street, P.O. Box 369, Trenton, NJ, 08625, USA
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[Seasonality in asthma: Impact and treatments]. Presse Med 2016; 45:1005-1018. [PMID: 27039335 DOI: 10.1016/j.lpm.2016.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/18/2016] [Accepted: 01/25/2016] [Indexed: 12/12/2022] Open
Abstract
The role of seasons should be taken into account in the management of asthma. The environment varies between seasons and it is well documented that asthma is modulated by environment. Viruses cause asthma exacerbations peak, in winter, in adults while the peak is present in September in children. Allergens are probably a less powerful source of asthma exacerbation than viruses but pollen involvement in spring and summer and dust mites in autumn are indisputable. Air pollutants, present in summer during the hottest periods, are also highly involved in asthma exacerbations. Indoor air pollution, in winter, is also implicated in asthma disease. All these environmental factors are synergistic and increase the risk of asthma exacerbation. Therapies should be adapted to each season depending on environmental factors potentially involved in the asthma disease.
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Alhanti BA, Chang HH, Winquist A, Mulholland JA, Darrow LA, Sarnat SE. Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:180-8. [PMID: 26350981 DOI: 10.1038/jes.2015.57] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/16/2015] [Indexed: 05/22/2023]
Abstract
Previous studies have found strong associations between asthma morbidity and major ambient air pollutants. Relatively little research has been conducted to assess whether age is a factor conferring susceptibility to air pollution-related asthma morbidity. We investigated the short-term relationships between asthma emergency department (ED) visits and ambient ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and fine particulate matter (PM2.5) in Atlanta (1993-2009), Dallas (2006-2009), and St. Louis (2001-2007). City-specific daily time-series analyses were conducted to estimate associations by age group (0-4, 5-18, 19-39, 40-64, and 65+ years). Sub-analyses were performed stratified by race and sex. City-specific rate ratios (RRs) were combined by inverse-variance weighting to provide an overall association for each strata. The overall RRs differed across age groups, with associations for all pollutants consistently strongest for children aged 5-18 years. The patterns of association across age groups remained generally consistent when models were stratified by sex and race, although the strong observed associations among 5-18 year olds appeared to be partially driven by non-white and male patients. Our findings suggest that age is a susceptibility factor for asthma exacerbations in response to air pollution, with school-age children having the highest susceptibility.
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Affiliation(s)
- Brooke A Alhanti
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Lyndsey A Darrow
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Szyszkowicz M, Kousha T, Kingsbury M, Colman I. Air Pollution and Emergency Department Visits for Depression: A Multicity Case-Crossover Study. ENVIRONMENTAL HEALTH INSIGHTS 2016; 10:155-61. [PMID: 27597809 PMCID: PMC5006648 DOI: 10.4137/ehi.s40493] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/07/2016] [Accepted: 08/09/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND The aim of this study was to investigate the associations between ambient air pollution and emergency department (ED) visits for depression. METHODS Health data were retrieved from the National Ambulatory Care Reporting System. ED visits for depression were retrieved from the National Ambulatory Care Reporting System using the International Classification of Diseases (ICD-10), Tenth revision codes; ICD-10: F32 (mild depressive episode) and ICD-10: F33 (recurrent depressive disorder). A case-crossover design was employed for this study. Conditional logistic regression models were used to estimate odds ratios. RESULTS For females, exposure to ozone was associated with increased risk of an ED visit for depression between 1 and 7 days after exposure, for males, between 1 and 5, and 8 days after exposure, with odds ratios ranging between 1.02 and 1.03. CONCLUSIONS These findings suggest that, as hypothesized, there is a positive association between exposure to air pollution and ED visits for depression.
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Affiliation(s)
| | - Termeh Kousha
- Department of Mathematics and Statistics, University of Ottawa, Ottawa, ON, Canada
| | - Mila Kingsbury
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ian Colman
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada
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Upper gastrointestinal bleeding due to peptic ulcer disease is not associated with air pollution: a case-crossover study. BMC Gastroenterol 2015; 15:131. [PMID: 26467538 PMCID: PMC4604641 DOI: 10.1186/s12876-015-0363-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/01/2015] [Indexed: 12/30/2022] Open
Abstract
Background Recent studies have demonstrated an association between short-term elevations in air pollution and an increased risk of exacerbating gastrointestinal disease. The objective of the study was to evaluate if day-to-day increases in air pollution concentrations were positively associated with upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD). Methods A time-stratified case-crossover study design was used. Adults presenting to hospitals with their first UGIB secondary to PUD from 2004–2010 were identified using administrative databases from Calgary (n = 1374; discovery cohort) and Edmonton (n = 1159; replication cohort). Daily concentrations of ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, and particulate matter (PM10 and PM2.5) were estimated in these two cities. Conditional logistic regression models were employed, adjusting for temperature and humidity. Odds ratios (OR) with 95 % confidence intervals (CI) were expressed relative to an interquartile range increase in the concentration of each pollutant. Results No statistically significant associations were observed for any of the individual pollutants based on same-day, or 1-day lag effects within the Calgary discovery cohort. When the air pollution exposures were assessed as 3-, 5-, and 7-day averages, some pollutants were inversely associated with UGIB in the discovery cohort; for example, 5-day averages of nitrogen dioxide (OR = 0.68; 95 % CI: 0.53–0.88), and particulate matter <2.5 μm (OR = 0.75; 95 % CI: 0.61–0.90). However, these findings could not be reproduced in the replication cohort. Conclusion Our findings suggest that short-term elevations in the level of ambient air pollutants does not increase the incidence of UGIB secondary to PUD. Electronic supplementary material The online version of this article (doi:10.1186/s12876-015-0363-6) contains supplementary material, which is available to authorized users.
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