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Xu R, Luo L, Yuan T, Chen W, Wei J, Shi C, Wang S, Liang S, Li Y, Zhong Z, Liu L, Zheng Y, Deng X, Liu T, Fan Z, Liu Y, Zhang J. Association of short-term exposure to ambient fine particulate matter and ozone with outpatient visits for anxiety disorders: A hospital-based case-crossover study in South China. J Affect Disord 2024; 361:277-284. [PMID: 38844166 DOI: 10.1016/j.jad.2024.06.007] [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: 03/06/2024] [Revised: 04/25/2024] [Accepted: 06/02/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND The short-term adverse effects of ambient fine particulate matter (PM2.5) and ozone (O3) on anxiety disorders (ADs) remained inconclusive. METHODS We applied an individual-level time-stratified case-crossover study, which including 126,112 outpatient visits for ADs during 2019-2021 in Guangdong province, China, to investigate the association of short-term exposure to PM2.5 and O3 with outpatient visits for ADs, and estimate excess outpatient visits in South China. Daily residential air pollutant exposure assessments were performed by extracting grid data (spatial resolution: 1 km × 1 km) from validated datasets. We employed the conditional logistic regression model to quantify the associations and excess outpatient visits. RESULTS The results of the single-pollutant models showed that each 10 μg/m3 increase of PM2.5 and O3 exposures was significantly associated with a 3.14 % (95 % confidence interval: 2.47 %, 3.81 %) and 0.88 % (0.49 %, 1.26 %) increase in odds of outpatient visits for ADs, respectively. These associations remained robust in 2-pollutant models. The proportion of outpatient visits attributable to PM2.5 and O3 exposures was up to 7.20 % and 8.93 %, respectively. Older adults appeared to be more susceptible to PM2.5 exposure, especially in cool season, and subjects with recurrent outpatient visits were more susceptible to O3 exposure. LIMITATION As our study subjects were from one single hospital in China, it should be cautious when generalizing our findings to other regions. CONCLUSION Short-term exposure to ambient PM2.5 and O3 was significantly associated with a higher odds of outpatient visits for ADs, which can contribute to considerable excess outpatient visits.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ting Yuan
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wangni Chen
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Sirong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Sihan Liang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zihua Zhong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xinyi Deng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingting Liu
- Health Department, The Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Zhaoyu Fan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Jie Zhang
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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Rowan C, R D'Souza R, Zheng X, Crooks J, Hohsfield K, Tong D, Chang HH, Ebelt S. Dust storms and cardiorespiratory emergency department visits in three Southwestern United States: application of a monitoring-based exposure metric. ENVIRONMENTAL RESEARCH, HEALTH : ERH 2024; 2:031003. [PMID: 39015250 PMCID: PMC11247357 DOI: 10.1088/2752-5309/ad5751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 07/18/2024]
Abstract
Climate change is projected to increase the risk of dust storms, particularly in subtropical dryland, including the southwestern US. Research on dust storm's health impacts in the US is limited and hindered by challenges in dust storm identification. This study assesses the potential link between dust storms and cardiorespiratory emergency department (ED) visits in the southwestern US. We acquired data for 2005-2016 from eight IMPROVE (Interagency Monitoring of PROtected Visual Environments) sites in Arizona, California, and Utah. We applied a validated algorithm to identify dust storm days at each site. We acquired patient-level ED visit data from state agencies and ascertained visits for respiratory, cardiovascular, and cause-specific subgroups among patients residing in ZIP codes within 50 km of an IMPROVE site. Using a case-crossover design, we estimated short-term associations of ED visits and dust storms, controlling for temporally varying covariates. During 2005-2016, 40 dust storm days occurred at the eight IMPROVE sites. Mean PM10 and PM2.5 levels were three to six times greater on dust storm days compared to non-dust storm days. Over the study period, there were 2 524 259 respiratory and 2 805 925 cardiovascular ED visits. At lags of 1, 2, and 3 days after a dust storm, we observed 3.7% (95% CI: 1.0%, 7.6%), 4.9% (95% CI: 1.1%, 8.9%), and 5.0% (95% CI: 1.3%, 8.9%) elevated odds of respiratory ED visits compared to non-dust storm days. Estimated associations of dust storm days and cardiovascular disease ED visits were largely consistent with the null. Using a monitoring-based exposure metric, we observed associations among dust storms and respiratory ED visits. The results add to growing evidence of the health threat posed by dust storms. The dust storm metric was limited by lack of daily data; future research should consider information from satellite and numerical models to enhance dust storm characterization.
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Affiliation(s)
- Claire Rowan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Rohan R D'Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Xiaping Zheng
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - James Crooks
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, United States of America
| | - Kirk Hohsfield
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, United States of America
| | - Daniel Tong
- Department of Atmospheric, Oceanic & Earth Sciences, George Mason University, Fairfax, VA, United States of America
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Stefanie Ebelt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
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Kono M, Su TY, Chang YY, Chou CCK, Lee CT, Chen PC, Wu WT. Assessing the impact of specific PM 2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan. ENVIRONMENTAL RESEARCH 2024; 255:119130. [PMID: 38735375 DOI: 10.1016/j.envres.2024.119130] [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: 03/11/2024] [Revised: 05/05/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES This study aims to assess the specific PM2.5-bound metallic elements that contribute to asthma emergency department visits by using a case-crossover study design. METHODS This study analyzed data from 11,410 asthma emergency department visits as case group and 22,820 non-asthma onset dates occurring one week and two weeks preceding the case day as controls from 2017 to 2020. PM2.5 monitoring data and 35 PM.2.5-bound metallic elements from six different regions in Taiwan were collected. Conditional logistic regression models were used to assess the relationship between asthma and PM2.5-bound metallic elements. RESULTS Our investigation revealed a statistically significant risk of asthma emergency department visits associated with PM2.5 exposure at lag 0, 1, 2, and 3 during autumn. Additionally, PM2.5-bound hafnium (Hf), thallium (Tl), rubidium (Rb), and aluminum (Al) exhibited a consistently significant positive correlation with asthma emergency department visits at lags 1, 2, and 3. In stratified analyses by area, age, and sex, PM2.5-bound Hf showed a significant and consistent correlation. CONCLUSIONS This study provides evidence of PM2.5-bound metallic elements effects in asthma exacerbations, particularly for Hf. It emphasizes the importance of understanding the origins of these metallic elements and pursuing emission reductions to mitigate regional health risks.
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Affiliation(s)
- Miku Kono
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ting-Yao Su
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; School of Public Health, National Defense Medical Center, Taipei City, Taiwan
| | - Yu-Yin Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | | | - Chung-Te Lee
- Graduate Institute of Environmental Engineering, National Central University, Taoyuan City, Taiwan
| | - Pau-Chung Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
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Ouyang Y, Yang J, Zhang J, Yan Y, Sun S, Wang J, Li X, Chen R, Zhang L. Airborne pollen exposure and risk of hospital admission for allergic rhinitis in Beijing: A time-stratified case-crossover study. Clin Transl Allergy 2024; 14:e12380. [PMID: 38956945 PMCID: PMC11220181 DOI: 10.1002/clt2.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/16/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Airborne pollen is a crucial risk factor in allergic rhinitis (AR). The severity of AR symptoms can vary based on pollen type and concentration. This study aimed to estimate the association between exposure to different pollen types and AR risk. METHODS We obtained data from patients admitted to the Beijing Tongren Hospital for AR, and data on pollen concentration, meteorological factors, and fine particulate matter (PM2.5) from 13 districts in Beijing from 2016 to 2019. We used a time-stratified case-crossover study design and calculated odds ratios (ORs) related to the risk of AR associated with a 10 grain/1000 mm2 increase in total pollen concentrations for specific pollen types. A stratified analysis was conducted to assess whether the associations were varied by age and sex. RESULTS The OR of AR associated with a 10 grain/1000 mm2 increase in the 7-day average pollen concentration was 1.014 (95% CI: 1.014, 1.015), 1.076 (95% CI: 1.070, 1.082), 1.024 (95% CI: 1.023, 1.025), 1.042 (95% CI: 1.039, 1.045), 1.142 (95% CI: 1.137, 1.147), 1.092 (95% CI: 1.088, 1.097), 1.046 (95% CI: 1.035, 1.058), and 1.026 (95% CI: 1.024, 1.028) for total pollen, Ulmus, Cupressaceae, Populus, Fraxinus, Pinus, Betula, and Artemisia, respectively. Both tree pollen (Ulmus, Cupressaceae, Populus, Fraxinus, Betula, and Pinus) and weed pollen (Artemisia, Chenopodium, and Humulus) were correlated with an increased risk of AR. These associations remained consistent across distinct subgroups defined by both age and sex. CONCLUSION Exposure to pollen from trees and weeds might be associated with an increased risk of AR. This research provides valuable scientific support for both clinical practitioners and patients with AR regarding the hazards of pollen exposure.
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Affiliation(s)
- Yuhui Ouyang
- Department of AllergyBeijing Tongren HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of Nasal DiseasesBeijing Institute of OtolaryngologyBeijingChina
- Research Unit of Diagnosis and Treatment of Chronic Nasal DiseasesChinese Academy of Medical SciencesBeijingChina
| | - Jun Yang
- Beijing Key Laboratory of Nasal DiseasesBeijing Institute of OtolaryngologyBeijingChina
| | - Jingxuan Zhang
- Department of AllergyBeijing Tongren HospitalCapital Medical UniversityBeijingChina
| | - Yun Yan
- Department of AllergyBeijing Tongren HospitalCapital Medical UniversityBeijingChina
| | - Shengzhi Sun
- School of Public HealthCapital Medical UniversityBeijingChina
| | - Jiajia Wang
- School of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaobo Li
- School of Public HealthCapital Medical UniversityBeijingChina
| | - Rui Chen
- School of Public HealthCapital Medical UniversityBeijingChina
- Beijing Laboratory of Allergic DiseasesCapital Medical UniversityBeijingChina
| | - Luo Zhang
- Department of AllergyBeijing Tongren HospitalCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of Nasal DiseasesBeijing Institute of OtolaryngologyBeijingChina
- Research Unit of Diagnosis and Treatment of Chronic Nasal DiseasesChinese Academy of Medical SciencesBeijingChina
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Ha S, Abatzoglou JT, Adebiyi A, Ghimire S, Martinez V, Wang M, Basu R. Impacts of heat and wildfire on preterm birth. ENVIRONMENTAL RESEARCH 2024; 252:119094. [PMID: 38723988 DOI: 10.1016/j.envres.2024.119094] [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: 01/30/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Climate change continues to increase the frequency, intensity, and duration of heat events and wildfires, both of which are associated with adverse pregnancy outcomes. Few studies simultaneously evaluated exposures to these increasingly common exposures. OBJECTIVES We investigated the relationship between exposure to heat and wildfire smoke and preterm birth (PTB). METHODS In this time-stratified case-crossover study, participants consisted of 85,806 California singleton PTBs (20-36 gestational weeks) from May through October of 2015-2019. Birthing parent ZIP codes were linked to high-resolution daily weather, PM2.5 from wildfire smoke, and ambient air pollution data. Heat day was defined as a day with apparent temperature >98th percentile within each ZIP code and heat wave was defined as ≥2 consecutive heat days. Wildfire-smoke day was defined as a day with any exposure to wildfire-smoke PM2.5. Conditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) comparing exposures during a hazard period (lags 0-6) compared to control periods. Analyses were adjusted for relative humidity, fine particles, and ozone. RESULTS Wildfire-smoke days were associated with 3.0% increased odds of PTB (ORlag0: 1.03, CI: 1.00-1.05). Compared with white participants, associations appeared stronger among Black, Hispanic, Asian, and American Indians/Alaskan Native participants. Heatwave days (ORlag2: 1.07, CI: 1.02-1.13) were positively associated with PTB, with stronger associations among those simultaneously exposed to wildfire smoke days (ORlag2: 1.19, CI: 1.11-1.27). Similar findings were observed for heat days and when other temperature metrics (e.g., maximum, minimum) were used. DISCUSSION Heat and wildfire increased PTB risk with evidence of synergism. As the occurrence and co-occurrence of these events increase, exposure reduction among pregnant people is critical, especially among racial/ethnic minorities.
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Affiliation(s)
- Sandie Ha
- Department of Public Health, School of Social Sciences, Humanities and Arts, Health Science Research Institute, University of California, 5200 N Lake Rd, 95343, Merced, CA, USA.
| | - John T Abatzoglou
- Department of Management of Complex Systems, School of Engineering, University of California, Merced, USA
| | - Adeyemi Adebiyi
- Department of Life and Environmental Sciences, School of Natural Sciences, University of California, Merced, USA
| | - Sneha Ghimire
- Department of Public Health, School of Social Sciences, Humanities and Arts, Health Science Research Institute, University of California, 5200 N Lake Rd, 95343, Merced, CA, USA
| | - Valerie Martinez
- Department of Public Health, School of Social Sciences, Humanities and Arts, Health Science Research Institute, University of California, 5200 N Lake Rd, 95343, Merced, CA, USA
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
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Xu Z, Yi W, Bach A, Tong S, Ebi KL, Su H, Cheng J, Rutherford S. Multimorbidity and emergency hospitalisations during hot weather. EBioMedicine 2024; 104:105148. [PMID: 38705102 PMCID: PMC11087953 DOI: 10.1016/j.ebiom.2024.105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND People with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases). METHODS From the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median. FINDINGS There were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure. INTERPRETATION While individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup. FUNDING Wellcome.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Weizhuo Yi
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; School of Public Health, Anhui Medical University, Hefei, China
| | - Aaron Bach
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, USA
| | - Hong Su
- School of Public Health, Anhui Medical University, Hefei, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
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Landguth EL, Knudson J, Graham J, Orr A, Coyle EA, Smith P, Semmens EO, Noonan C. Seasonal extreme temperatures and short-term fine particulate matter increases pediatric respiratory healthcare encounters in a sparsely populated region of the intermountain western United States. Environ Health 2024; 23:40. [PMID: 38622704 PMCID: PMC11017546 DOI: 10.1186/s12940-024-01082-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Evaluating while accounting for these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health is becoming more important. METHODS We explored short-term exposure to air pollution on children's respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated healthcare events. The main outcome measure included individual-based address located respiratory-related healthcare visits for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for ages 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis with distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 14 prior-days modified by temperature or season. RESULTS For asthma, increases of 1 µg/m3 in PM2.5 exposure 7-13 days prior a healthcare visit date was associated with increased odds that were magnified during median to colder temperatures and winter periods. For LRTIs, 1 µg/m3 increases during 12 days of cumulative PM2.5 with peak exposure periods between 6-12 days before healthcare visit date was associated with elevated LRTI events, also heightened in median to colder temperatures but no seasonal effect was observed. For URTIs, 1 unit increases during 13 days of cumulative PM2.5 with peak exposure periods between 4-10 days prior event date was associated with greater risk for URTIs visits that were intensified during median to hotter temperatures and spring to summer periods. CONCLUSIONS Delayed, short-term exposure increases of PM2.5 were associated with elevated odds of all three pediatric respiratory healthcare visit categories in a sparsely population area of the inter-Rocky Mountains, USA. PM2.5 in colder temperatures tended to increase instances of asthma and LRTIs, while PM2.5 during hotter periods increased URTIs.
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Affiliation(s)
- Erin L Landguth
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Jonathon Knudson
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Jon Graham
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Mathematical Sciences, University of Montana, Missoula, USA
| | - Ava Orr
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Emily A Coyle
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Paul Smith
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Pediatric Pulmonology, Community Medical Center, Missoula, MT, USA
| | - Erin O Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Curtis Noonan
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Sun D, Zhang F, Ruan L, Zhao D, Tang H, Zhu W. Is short-term exposure to primary gaseous air pollutants associated with AIDS-related deaths? Evidence from a time-stratified case-crossover study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02664-y. [PMID: 38570349 DOI: 10.1007/s00484-024-02664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/24/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
Primary gaseous air pollutants have been associated with death from multiple causes, however, it remains unknown if they play a role in premature mortality among individuals living with HIV/AIDS. Data on HIV/AIDS patients were collected from the Hubei Provincial Center for Disease Control and Prevention, with a total of 1,467 AIDS-related deaths (ARD) between 2013 and 2020. Daily mean sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were generated by artificial intelligence algorithms combined with big data. We employed a time-stratified case-crossover approach and conditional logistical regression models to investigate the acute effects of primary gaseous air pollutants on ARD. Per interquartile range increase in the concentrations of SO2 was significantly linked with ARD, with a corresponding odds ratio (OR) of 1.17 [95% confidence intervals (CIs): 1.01, 1.35] at lag 4 day. Furthermore, our findings indicated that males exhibited a heightened vulnerability to the adverse effects of SO2 and NO2, for example, the ORs were 1.24 (95% CIs: 1.05, 1.47) and 1.16 (95% CIs: 1.01, 1.34), respectively. Moreover, individuals aged over 65 years were more susceptible to SO2 and CO. Additionally, we identified the warm season as a sensitive period for mortality associated with SO2 and NO2. Our study furnished fresh evidence regarding the detrimental effects of primary gaseous air pollutants on ARD.
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Affiliation(s)
- Dan Sun
- Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, 430030, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Lianguo Ruan
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430023, China.
- Hubei Clinical Research Center for Infectious Diseases, Wuhan, 430023, China.
- Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, 430023, China.
- Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, China.
| | - Dingyuan Zhao
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Heng Tang
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
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Aron J, Baldomero AK, Rau A, Fiecas MB, Wendt CH, Berman JD. Individual Risk Factors of PM 2.5 Associated With Wintertime Mortality in Urban Patients With COPD. Chest 2024; 165:825-835. [PMID: 37858719 PMCID: PMC11026168 DOI: 10.1016/j.chest.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/19/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Air pollution contributes to premature mortality, but potential impacts differ in populations with existing disease, particularly for individuals with multiple risk factors. Although COPD increases vulnerability to air pollution, individuals with COPD and other individual risk factors are at the intersection of multiple risks and may be especially susceptible to the effect of acute outdoor air pollution. RESEARCH QUESTION What is the association between wintertime air pollution and mortality in patients with COPD and the modifying role of individual risk factors? STUDY DESIGN AND METHODS This study evaluated 19,243 deceased veterans with prior COPD diagnosis who had resided in 25 US metropolitan regions (2016-2019). Electronic health records included patient demographic characteristics; smoking status; and comorbidities such as asthma, coronary artery disease (CAD), obesity, and diabetes. Using geocoded addresses, individuals were assigned wintertime fine particulate matter (particulate matter smaller than 2.5 μg in diameter [PM2.5]) and nitrogen dioxide air pollution exposures. Associations between acute air pollution and mortality were estimated by using a time-stratified case-crossover design with a conditional logistic model, and individual risk differences were assessed according to stratified analysis. RESULTS A 1.05 (95% CI, 1.02-1.09) mortality risk was estimated for each 10 μg/m3 increase in daily wintertime PM2.5). Older patients and Black individuals displayed elevated risk. Obesity was a substantial air pollution-related mortality risk factor (OR, 1.11; 95% CI, 1.01-1.23), and the estimated risk for individuals with obesity plus CAD or obesity plus diabetes was 16% higher. INTERPRETATION Wintertime PM2.5 exposure was associated with elevated mortality risk in people with COPD, but individuals with multiple comorbidities, notably obesity, had high vulnerability. Our study suggests that obesity, CAD, and diabetes are understudied modifiers of air pollution-related risks for people with existing COPD.
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Affiliation(s)
- Jordan Aron
- Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Arianne K Baldomero
- Pulmonary, Allergy, Critical Care and Sleep Medicine, Medical School, University of Minnesota, Minneapolis, MN; Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, MN; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN
| | - Austin Rau
- Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Mark B Fiecas
- Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Christine H Wendt
- Pulmonary, Allergy, Critical Care and Sleep Medicine, Medical School, University of Minnesota, Minneapolis, MN; Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, MN
| | - Jesse D Berman
- Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
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10
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Zhang J, Xu Z, Han P, Fu Y, Wang Q, Wei X, Wang Q, Yang L. Exploring the Modifying Role of GDP and Greenness on the Short Effect of Air Pollutants on Respiratory Hospitalization in Beijing. GEOHEALTH 2024; 8:e2023GH000930. [PMID: 38505689 PMCID: PMC10949333 DOI: 10.1029/2023gh000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
It is unclear whether Gross Domestic Product (GDP) and greenness have additional modifying effects on the association between air pollution and respiratory system disease. Utilizing a time-stratified case-crossover design with a distributed lag linear model, we analyzed the association between six pollutants (PM2.5, PM10, NO2, SO2, O3, and CO) and 555,498 respiratory hospital admissions in Beijing from 1st January 2016 to 31st December 2019. We employed conditional logistic regression, adjusting for meteorological conditions, holidays and influenza, to calculate percent change of hospitalization risk. Subsequently, we performed subgroup analysis to investigate potential effect modifications using a two-sample z test. Every 10 μg/m3 increase in PM2.5, PM10, NO2, SO2, and O3 led to increases of 0.26% (95%CI: 0.17%, 0.35%), 0.15% (95%CI: 0.09%, 0.22%), 0.61% (95%CI: 0.44%, 0.77%), 1.72% (95%CI: 1.24%, 2.21%), and 0.32% (95%CI: 0.20%, 0.43%) in admissions, respectively. Also, a 1 mg/m3 increase in CO levels resulted in a 2.50% (95%CI: 1.96%, 3.04%) rise in admissions. The links with NO2 (p < 0.001), SO2 (p < 0.001), O3 (during the warm season, p < 0.001), and CO (p < 0.001) were significantly weaker among patients residing in areas with higher levels of greenness. No significant modifying role of GDP was observed. Greenness can help mitigate the effects of air pollutants, while the role of GDP needs further investigation.
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Affiliation(s)
- Jiawei Zhang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Zhihu Xu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthBeijingChina
| | - Peien Han
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Yaqun Fu
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Quan Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Brown SchoolWashington University in St. LouisSt. LouisMOUSA
| | - Xia Wei
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Department of Health Services Research and PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Qingbo Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Li Yang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
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11
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Zhang F, Zhu S, Zhao D, Tang H, Ruan L, Zhu W. Ambient temperature variations and AIDS-related mortality: A time-stratified case-crossover study in 103 counties, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169474. [PMID: 38135089 DOI: 10.1016/j.scitotenv.2023.169474] [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: 09/30/2023] [Revised: 12/16/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Climate change, characterized by the steady ascent of global temperatures and the escalating unpredictability of climate patterns, poses multifaceted challenges to public health worldwide. However, vulnerable groups, particularly the population affected by HIV/AIDS, have received little attention. OBJECTIVES We aimed to examine the impacts of temperature variations on AIDS-related mortality. METHODS Data on individuals with HIV/AIDS were collected from the HIV/AIDS Comprehensive Response Information Management System between 2013 and 2019. Temperature variation metrics were constructed by diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV0-t). Time-stratified case-crossover design with conditional logistic regression models was used to investigate the associations between ambient temperature variations and AIDS-related mortality. RESULTS Each 1 °C elevated in DTR was linked with a 5.28 % [95 % confidence intervals (CIs): 1.61, 9.08] increment in AIDS-related mortality at a lag of 0-6 days. Stronger associations between DTR and AIDS-related mortality were observed in the married than in single, with corresponding excess ORs (%) of 5.33 (95 % CIs: 0.29, 10.62) versus 4.79 (95 % CIs: -0.50, 10.36) for 1 °C increased in DTR at lag 0-6 days. Additionally, we noticed the impact of DTR was more pronounced in the warm season, leading to a 7.32 % (95 % CIs: 0.57, 14.51) elevation in the risks of AIDS-related mortality for 1 °C increase in DTR at lag 0-6 days, while the effect value decreased to 5.16 % (95 % CIs: 0.71, 9.81) in the cold season. CONCLUSIONS Our findings indicated that DTR might be a significant risk factor for AIDS-related deaths among ambient temperature variation indicators, and underscored the importance of considering temperature variability in public health interventions aimed at mitigating this risk of AIDS-related mortality.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Dingyuan Zhao
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Heng Tang
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Lianguo Ruan
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430023, China; Hubei Clinical Research Center for Infectious Diseases, Wuhan 430023, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan 430023, China; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan 430023, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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12
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Tobias A, Kim Y, Madaniyazi L. Time-stratified case-crossover studies for aggregated data in environmental epidemiology: a tutorial. Int J Epidemiol 2024; 53:dyae020. [PMID: 38380445 PMCID: PMC10879751 DOI: 10.1093/ije/dyae020] [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: 03/31/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
The case-crossover design is widely used in environmental epidemiology as an effective alternative to the conventional time-series regression design to estimate short-term associations of environmental exposures with a range of acute events. This tutorial illustrates the implementation of the time-stratified case-crossover design to study aggregated health outcomes and environmental exposures, such as particulate matter air pollution, focusing on adjusting covariates and investigating effect modification using conditional Poisson regression. Time-varying confounders can be adjusted directly in the conditional regression model accounting for the adequate lagged exposure-response function. Time-invariant covariates at the subpopulation level require reshaping the typical time-series data set into a long format and conditioning out the covariate in the expanded stratum set. When environmental exposure data are available at geographical units, the stratum set should combine time and spatial dimensions. Moreover, it is possible to examine effect modification using interaction models. The time-stratified case-crossover design offers a flexible framework to properly account for a wide range of covariates in environmental epidemiology studies.
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Affiliation(s)
- Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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13
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Liu T, Shi C, Wei J, Xu R, Li Y, Wang R, Lu W, Liu L, Zhong C, Zhong Z, Zheng Y, Wang T, Hou S, Lv Z, Huang S, Chen G, Zhou Y, Sun H, Liu Y. Extreme temperature events and dementia mortality in Chinese adults: a population-based, case-crossover study. Int J Epidemiol 2024; 53:dyad119. [PMID: 37690069 DOI: 10.1093/ije/dyad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND The effect of exposure to extreme temperature events (ETEs) on dementia mortality remains largely unknown. We aimed to quantify the association of ETE exposure with dementia mortality. METHODS We conducted a population-based, case-crossover study among 57 791 dementia deaths in Jiangsu province, China, during 2015-20. Daily mean temperatures were extracted from a validated grid dataset at each subject's residential address, and grid-specific exposures to heat wave and cold spell were assessed with a combination of their intensity and duration. We applied conditional logistic regression models to investigate cumulative and lag effects for ETE exposures. RESULTS Exposure to ETE with each of all 24 definitions was associated with an increased odds of dementia mortality, which was higher when exposed to heat wave. Exposure to heat wave (daily mean temperature ≥95th percentile, duration ≥3 days (d); P95_3d) and cold spell (≤5th percentile, duration ≥3 d; P5_3d) was associated with a 75% (95% CI: 61%, 90%) and 30% (19%, 43%) increase in odds of dementia mortality, respectively. Definitions with higher intensity were generally associated with a higher odds of dementia mortality. We estimated that 6.14% of dementia deaths were attributable to exposure to heat wave (P90_2d) and cold spell (P10_2d). No effect modifications were observed by sex or age, except that the association for heat wave was stronger among women. CONCLUSIONS Exposure to both heat wave and cold spell was associated with an increased odds of dementia mortality. Our findings highlight that reducing individual ETE exposures may be helpful in preventing deaths from dementia, especially among women in summer.
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Affiliation(s)
- Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui Wang
- Luohu District Chronic Disease Hospital, Shenzhen, Guangdong, China
| | - Wenfeng Lu
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chenghui Zhong
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zihua Zhong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingting Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Sihan Hou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ziquan Lv
- Central Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yun Zhou
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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14
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Zhu Y, Chen R, Liu C, Niu Y, Meng X, Shi S, Yu K, Huang G, Xie L, Lin S, Huang M, Huang M, Chen S, Kan H, Liu F, Chu C. Short-term exposure to ozone may trigger the onset of Kawasaki disease: An individual-level, case-crossover study in East China. CHEMOSPHERE 2024; 349:140828. [PMID: 38040257 DOI: 10.1016/j.chemosphere.2023.140828] [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: 06/06/2023] [Revised: 11/14/2023] [Accepted: 11/26/2023] [Indexed: 12/03/2023]
Abstract
Kawasaki disease (KD) is an acute, systemic vasculitis that primarily affects children aged under the age of 5. While environmental factors have been linked to the development of KD, the specific role of ozone (O3) pollution in triggering the disease onset remains uncertain. This study aimed to examine the associations between short-term O3 exposure and KD onset in children. Utilizing a satellite-based model with a spatial resolution of 1 × 1 km, we matched 1808 KD patients (out of a total of 6115 eligible individuals) to pre-onset ozone exposures based on their home addresses in East China between 2013 and 2020. Our findings revealed a significant association of O3 exposure with KD onset on the day of onset (lag 0 day). However, this association attenuated and became statistically insignificant on lag 1 and lag 2 days. Each interquartile range (52.32 μg/m3) increase in O3 concentration at lag 0 day was associated with a 16.2% (95% CI: 3.6%, 30.3%) increased risk of KD onset. The E-R curve for O3 exhibited a plateau at low concentrations and then increased rapidly at concentrations ≥75 μg/m3. Notably, these associations were stronger in male children, younger children (<2 years of age) and patients experiencing KD onset during the warm season. This study provides novel epidemiological evidence indicating that short-term O3 exposure is associated with an increased risk of childhood KD onset. These findings emphasized the importance of considering this environmental risk factor in KD prevention strategies.
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Affiliation(s)
- Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Kexin Yu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Guoying Huang
- Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Liping Xie
- Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Siyuan Lin
- Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Min Huang
- Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Meirong Huang
- Pediatric Heart Center, Shanghai Children's Medical Center, Shanghai, China
| | - Sun Chen
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China
| | - Fang Liu
- Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China.
| | - Chen Chu
- Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Shanghai, 201102, China.
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15
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Sørensen M, Pershagen G, Thacher JD, Lanki T, Wicki B, Röösli M, Vienneau D, Cantuaria ML, Schmidt JH, Aasvang GM, Al-Kindi S, Osborne MT, Wenzel P, Sastre J, Fleming I, Schulz R, Hahad O, Kuntic M, Zielonka J, Sies H, Grune T, Frenis K, Münzel T, Daiber A. Health position paper and redox perspectives - Disease burden by transportation noise. Redox Biol 2024; 69:102995. [PMID: 38142584 PMCID: PMC10788624 DOI: 10.1016/j.redox.2023.102995] [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: 11/09/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/26/2023] Open
Abstract
Transportation noise is a ubiquitous urban exposure. In 2018, the World Health Organization concluded that chronic exposure to road traffic noise is a risk factor for ischemic heart disease. In contrast, they concluded that the quality of evidence for a link to other diseases was very low to moderate. Since then, several studies on the impact of noise on various diseases have been published. Also, studies investigating the mechanistic pathways underlying noise-induced health effects are emerging. We review the current evidence regarding effects of noise on health and the related disease-mechanisms. Several high-quality cohort studies consistently found road traffic noise to be associated with a higher risk of ischemic heart disease, heart failure, diabetes, and all-cause mortality. Furthermore, recent studies have indicated that road traffic and railway noise may increase the risk of diseases not commonly investigated in an environmental noise context, including breast cancer, dementia, and tinnitus. The harmful effects of noise are related to activation of a physiological stress response and nighttime sleep disturbance. Oxidative stress and inflammation downstream of stress hormone signaling and dysregulated circadian rhythms are identified as major disease-relevant pathomechanistic drivers. We discuss the role of reactive oxygen species and present results from antioxidant interventions. Lastly, we provide an overview of oxidative stress markers and adverse redox processes reported for noise-exposed animals and humans. This position paper summarizes all available epidemiological, clinical, and preclinical evidence of transportation noise as an important environmental risk factor for public health and discusses its implications on the population level.
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Affiliation(s)
- Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Denmark.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jesse Daniel Thacher
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Timo Lanki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland; School of Medicine, University of Eastern Finland, Kuopio, Finland; Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Benedikt Wicki
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Manuella Lech Cantuaria
- Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark; Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Jesper Hvass Schmidt
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Gunn Marit Aasvang
- Department of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Sadeer Al-Kindi
- Department of Medicine, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Michael T Osborne
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, MA, USA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Philip Wenzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Juan Sastre
- Department of Physiology, Faculty of Pharmacy, University of Valencia, Spain
| | - Ingrid Fleming
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt Am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner Site RheinMain, Frankfurt, Germany
| | - Rainer Schulz
- Institute of Physiology, Faculty of Medicine, Justus-Liebig University, Gießen, 35392, Gießen, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Marin Kuntic
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Jacek Zielonka
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Helmut Sies
- Institute for Biochemistry and Molecular Biology I, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Katie Frenis
- Hematology/Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Stem Cell Program, Boston Children's Hospital, Boston, MA, USA
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.
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16
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Wu C, He G, Wu W, Meng R, Zhou C, Bai G, Yu M, Gong W, Huang B, Xiao Y, Hu J, Xiao J, Zeng F, Yang P, Liu D, Zhu Q, Chen Z, Yu S, Huang C, Du Y, Liang X, Liu T, Ma W. Ambient PM 2.5 and cardiopulmonary mortality in the oldest-old people in China: A national time-stratified case-crossover study. MED 2024; 5:62-72.e3. [PMID: 38218176 DOI: 10.1016/j.medj.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/03/2023] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Evidence on the associations of fine particulate matter (PM2.5) with cardiopulmonary mortality in the oldest-old (aged 80+ years) people remains limited. METHODS We conducted a time-stratified case-crossover study of 1,475,459 deaths from cardiopulmonary diseases in China to estimate the associations between short-term exposure to ambient PM2.5 and cardiopulmonary mortality among the oldest-old people. FINDINGS Each 10 μg/m3 increase in PM2.5 concentration (6-day moving average [lag05]) was associated with higher mortality from cardiopulmonary diseases (excess risks [ERs] = 1.69%, 95% confidence interval [CI]: 1.54%, 1.84%), cardiovascular diseases (ER = 1.72%, 95% CI: 1.54%, 1.90%), and respiratory diseases (ER = 1.62%, 95% CI: 1.33%, 1.91%). Compared to the other groups, females (ER = 1.94%, 95% CI: 1.73%, 2.15%) (p for difference test = 0.043) and those aged 95-99 years (ER = 2.31%, 95% CI: 1.61%, 3.02%) (aged 80-85 years old was the reference, p for difference test = 0.770) presented greater mortality risks. We found 14 specific cardiopulmonary causes associated with PM2.5, out of which emphysema (ER = 3.20%, 95% CI: 1.57%, 4.86%) had the largest association. Out of the total deaths, 6.27% (attributable fraction [AF], 95% CI: 5.72%, 6.82%) were ascribed to short-term PM2.5 exposure. CONCLUSIONS This study provides evidence of PM2.5-induced cardiopulmonary mortality and calls for targeted prevention actions for the oldest-old people. FUNDING This work was supported by the National Key Research and Development Program of China, the National Natural Science Foundation of China, the Foreign Expert Program of the Ministry of Science and Technology, the Natural Science Foundation of Guangdong, China, and the Science and Technology Program of Guangzhou.
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Affiliation(s)
- Cuiling Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Wei Wu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Chunliang Zhou
- Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha 450001, China
| | - Guoxia Bai
- Institute of Non-communicable Diseases Prevention and Control, Tibet Center for Disease Control and Prevention, Lhasa 850000, China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Biao Huang
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Pan Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Dan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou 510080, China
| | - Xiaofeng Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China.
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou 510632, China
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Xu R, Sun H, Zhong Z, Zheng Y, Liu T, Li Y, Liu L, Luo L, Wang S, Lv Z, Huang S, Shi C, Chen W, Wei J, Xia W, Liu Y. Ozone, Heat Wave, and Cardiovascular Disease Mortality: A Population-Based Case-Crossover Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:171-181. [PMID: 38100468 DOI: 10.1021/acs.est.3c06889] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
A case-crossover study among 511,767 cardiovascular disease (CVD) deaths in Jiangsu province, China, during 2015-2021 was conducted to assess the association of exposure to ambient ozone (O3) and heat wave with CVD mortality and explore their possible interactions. Heat wave was defined as extreme high temperature for at least two consecutive days. Grid-level heat waves were defined by multiple combinations of apparent temperature thresholds and durations. Residential O3 and heat wave exposures were assessed using grid data sets (spatial resolution: 1 km × 1 km for O3; 0.0625° × 0.0625° for heat wave). Conditional logistic regression models were applied for exposure-response analyses and evaluation of additive interactions. Under different heat wave definitions, the odds ratios (ORs) of CVD mortality associated with medium-level and high-level O3 exposures ranged from 1.029 to 1.107 compared with low-level O3, while the ORs for heat wave exposure ranged from 1.14 to 1.65. Significant synergistic effects on CVD mortality were observed for the O3 and heat wave exposures, which were generally greater with higher levels of the O3 exposure, higher temperature thresholds, and longer durations of heat wave exposure. Up to 5.8% of the CVD deaths were attributable to O3 and heat wave. Women and older adults were more vulnerable to the exposure to O3 and heat wave exposure. Exposure to both O3 and heat wave was significantly associated with an increased odds of CVD mortality, and O3 and heat wave can interact synergistically to trigger CVD deaths.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Hong Sun
- Institute of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Zihua Zhong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Lu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Sirong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ziquan Lv
- Central Laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong 518055, China
| | - Suli Huang
- School of Public Health, Shenzhen University Medical School, Shenzhen University, Shenzhen, Guangdong 518055, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing 100081, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20740, United States
| | - Wenhao Xia
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Department of Cardiology, Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University, Nanning, Guangxi 530022, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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18
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Olsen Y, Arildskov E, Hansen SN, Pedersen M, Dharmage SC, Kloster M, Sigsgaard T. Outdoor Alternaria and Cladosporium spores and acute asthma. Clin Exp Allergy 2023; 53:1256-1267. [PMID: 37748858 DOI: 10.1111/cea.14397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Outdoor Alternaria and Cladosporium spores are ubiquitous. Few studies have assessed their impact on asthma hospitalizations providing conflicting results, mainly focused on vulnerable paediatric populations. We aimed to study the impact of outdoor Alternaria and Cladosporium concentrations on acute hospitalizations in the Capital Region of Denmark. METHODS This is a bi-directional case-crossover study with 26 years of national registry data at individual level on acute asthma hospitalizations and daily average data on Alternaria and Cladosporium, pollen (Artemisia, Poaceae), maximal temperature, and air pollution. Conditional logistic regression models were applied to assess the associations. Concentration quartiles at lag 0 were used for categorizing the exposure. RESULTS For lags 0-2, the odds of hospitalization were significantly higher for both Alternaria and Cladosporium at concentration quartile 2-4 compared with quartile 1. When stratified for age and sex, odds of hospitalization at Alternaria quartiles 2-4 were significantly higher in males below 40 years at lag 0-2, and at lag 0 in females (18-30 years), while quartiles 2-4 of Cladosporium concentrations were associated with significantly higher odds in boys (0-17 years) at lag 1-3, males (18-39 years) at lag 0-1, females (18-39 years) at lag 1-2, males (40-64 years) at lag 0-2, females (40-64 years) at lag 0 and 2, in seniors (65+ years) male at lag 1-2 and female at lag 0-1. The effect of Alternaria varied significantly depending on the level of Cladosporium (p < .0001). CONCLUSION Ambient Alternaria and Cladosporium spores can induce asthma hospitalizations. Males are more susceptible to both genera. Males and females under age 40 years are more susceptible to Alternaria.
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Affiliation(s)
- Yulia Olsen
- Institute of Public Health & Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
| | - Elias Arildskov
- Department of Public Health - Section of Biostatistics, Aarhus University, Aarhus, Denmark
| | - Stefan Nygaard Hansen
- Department of Public Health - Section of Biostatistics, Aarhus University, Aarhus, Denmark
| | - Marianne Pedersen
- Department of Public Health - Section of Environment, Occupation & Health, Aarhus University, Aarhus, Denmark
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | | | - Torben Sigsgaard
- Institute of Public Health & Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
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19
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Martinson E, Chang HH, D’Souza RR, Ebelt S, Scovronick N. Association between outdoor temperature and fatal police shootings in the United States, 2015-2021. Environ Epidemiol 2023; 7:e267. [PMID: 38912390 PMCID: PMC11189680 DOI: 10.1097/ee9.0000000000000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/02/2023] [Indexed: 06/25/2024] Open
Abstract
Background Here, we investigate the association between outdoor temperature and fatal police shootings in the United States between 2015 and 2021. Methods We conducted a time-stratified case-crossover study. Data on fatal police shootings were from the Washington Post's Fatal Force database and temperature data were from Daymet. Results A 5°C increase in maximum same-day temperature was associated with a 1.033 (95% CI = 1.002, 1.065) increased odds of a fatal police shooting. In stratified analyses, the strongest associations were observed in victims who were armed (OR, 1.052 [95% CI = 1.017, 1.088), White (OR, 1.052 [95% CI = 1.006, 1.100), or aged 45+ (OR, 1.110 [95% CI = 1.044, 1.181]). In additional subgroup analyses, relative risks were also generally higher among those who were armed. Conclusions There is evidence of an association between outdoor temperature and fatal police shootings in the United States, particularly when the victims were reported as armed. This study cannot determine if the associations are a result of any specific causes (e.g., increased police aggression or other factors).
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Affiliation(s)
- Ellen Martinson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Howard H. Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rohan R. D’Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
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20
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Lv X, Shi W, Yuan K, Zhang Y, Cao W, Li C, Xu L, Wu L, Sun S, Hong F. Hourly Air Pollution Exposure and Emergency Hospital Admissions for Stroke: A Multicenter Case-Crossover Study. Stroke 2023; 54:3038-3045. [PMID: 37901948 DOI: 10.1161/strokeaha.123.044191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Daily exposure to ambient air pollution is associated with stroke morbidity and mortality; however, the association between hourly exposure to air pollutants and risk of emergency hospital admissions for stroke and its subtypes remains relatively unexplored. METHODS We obtained hourly concentrations of fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) from the China National Environmental Monitoring Center. We conducted a time-stratified case-crossover study among 86 635 emergency hospital admissions for stroke across 10 hospitals in 3 cities (Jinhua, Hangzhou, and Zhoushan) in Zhejiang province, China, between January 1, 2016 and December 31, 2021. Using a conditional logistic regression combined with a distributed lag linear model, we estimated the association between hourly exposure to multiple air pollutants and risk of emergency hospital admissions for total stroke, ischemic stroke, hemorrhagic stroke, and undetermined type. RESULTS Hourly exposure to PM2.5, PM10, NO2, and SO2 was associated with an increased risk of hospital admissions for total stroke and ischemic stroke. The associations were most pronounced during the concurrent hour of exposure and lasted for ≈2 hours. We found that the risk was more pronounced among male patients or those aged <65 years old. CONCLUSIONS Our findings suggest that exposure to PM2.5, PM10, NO2, and SO2, but not CO and O3, is associated with emergency hospital admissions for total stroke or ischemic stroke shortly after exposure. Implementing targeted pollution emission reduction measures may have significant public health implications in controlling and reducing the burden of stroke.
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Affiliation(s)
- Xin Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Wanying Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Kun Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Yangchang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China (W.C.)
| | - Chunrong Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China (C.L.)
| | - Lufei Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Human Resources, Peking University Cancer Hospital and Institute, China (L.X.)
| | - Lizhi Wu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China (L.W.)
| | - Shengzhi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China (X.L., W.S., K.Y., Y.Z., S.S.)
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China (S.S., F.H.)
| | - Feng Hong
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China (S.S., F.H.)
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21
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Shirinde J, Wichmann J. Temperature modifies the association between air pollution and respiratory disease mortality in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1122-1131. [PMID: 35581190 DOI: 10.1080/09603123.2022.2076813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM10, NO2, SO2 air pollution and daily respiratory disease mortality in Cape Town. A time-stratified case-crossover epidemiological design was applied. Susceptibility by sex and age groups (15-64 years and ≥65 years) was also investigated. On days with medium Tapp levels, NO2 displayed a stronger association with respiratory mortality than PM10 or SO2. Females appeared to be more susceptible to NO2 at medium Tapp levels to males. The 15-64-year-old age group seemed to be more vulnerable to NO2 and PM10 at medium Tapp levels compared to the elderly (≥65 years). At high Tapp levels, females were more susceptible to PM10. The 15-64-year-old group were more vulnerable to NO2 and SO2. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased air pollution and temperature.
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Affiliation(s)
- Joyce Shirinde
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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22
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Shelke A, Shelke S, Acharya S, Shukla S. Synergistic Epidemic or Syndemic: An Emerging Pattern of Human Diseases. Cureus 2023; 15:e48286. [PMID: 38058320 PMCID: PMC10696284 DOI: 10.7759/cureus.48286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
Synergistic epidemics refer to the phenomenon where the occurrence and interaction of multiple diseases or health conditions exacerbate their individual impact, leading to complex health challenges and increased vulnerability in populations. Syndemics are a complex, multilevel phenomenon. In a population with biological interactions, a syndemic is the accumulation of two or more concurrent or sequential epidemics, which significantly worsens the situation. Disease concentration, disease interaction, and their underlying social forces, such as poverty and social inequality, are the fundamental concepts. Extensive political, economic, and cultural factors have contributed to cluster epidemics of several infectious diseases, particularly HIV and tuberculosis. Concerning the SAVA (substance abuse, violence, AIDS) syndemic, this narrative review article explores the complex interactions between substance abuse, violence, and HIV/AIDS. Further, it describes in-depth interactions between the COVID-19 syndemic's health conditions, societal factors, biological factors, and global dynamics. The review also emphasizes how infectious and non-communicable diseases interact, emphasizing how having one condition can make the severity and outcomes of another worse. It investigates the causes of synergistic epidemics and the impact of environmental factors. Syndemics acknowledge that the presence of one condition can worsen the severity and progression of others and take into account the intricate relationships between diseases. We can create more efficient plans to enhance health outcomes, lessen disparities, and promote healthier communities by understanding the connections between disorders and the underlying social determinants. This narrative review provides insights into the emerging patterns of human diseases within synergistic epidemics.
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Affiliation(s)
- Aditi Shelke
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Saurabh Shelke
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Samarth Shukla
- Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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23
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Duncan S, Reed C, Spurlock T, Sugg MM, Runkle JD. Acute Health Effects of Wildfire Smoke Exposure During a Compound Event: A Case-Crossover Study of the 2016 Great Smoky Mountain Wildfires. GEOHEALTH 2023; 7:e2023GH000860. [PMID: 37869265 PMCID: PMC10588979 DOI: 10.1029/2023gh000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023]
Abstract
In 2016, unprecedented intense wildfires burned over 150,000 acres in the southern Appalachian Mountains in the United States. Smoke from these fires greatly impacted the region and exposure to this smoke was significant. A bidirectional case-crossover design was applied to assess the relationship between PM2.5 (a surrogate for wildfire smoke) exposure and respiratory- and cardiovascular-related emergency department (ED) visits in Western North Carolina during these events. For 0-, 3-, and 7-day lags, findings indicated a significant increase in the odds of being admitted to the ED for a respiratory (ORs: 1.055, 95% CI: 1.048-1.063; 1.083, 1.074-1.092; 1.066, 1.058-1.074; respectively) or cardiovascular event (ORs: 1.052, 95% CI: 1.045-1.060; 1.074, 1.066-1.081; 1.067, 1.060-1.075; respectively) for every 5 μg/m3 increase in PM2.5 over a chosen cutpoint of 20.4 μg/m3. For all endpoints assessed except for emphysema, there were statistically significant increases in odds from 5.1% to 8.3%. In general, this increase was most pronounced 3 days after exposure. Additionally, individuals aged 55+ generally experience higher odds of heart disease at the 3- and 7-day lag points, and Black/African Americans generally experience higher odds of asthma at the 3-day lag point. In general, larger fires and increased numbers of fires within counties resulted in higher health burden at same day exposure. In a secondary analysis, the odds of an ED visit increased by over 40% in several cases among people exposed to days above the Environmental Protection Agency 24-hr PM2.5 standard of 35 μg/m3. Our findings provide new understanding on the health impacts of wildfires on rural populations in the southeastern US.
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Affiliation(s)
- Sara Duncan
- School of Health SciencesWestern Carolina UniversityNCCullowheeUSA
| | - Charlie Reed
- North Carolina Institute for Climate StudiesNorth Carolina State UniversityNCAshevilleUSA
| | - Taylin Spurlock
- Department of Geography and PlanningAppalachian State UniversityBooneNCUSA
| | - Margaret M. Sugg
- Department of Geography and PlanningAppalachian State UniversityBooneNCUSA
| | - Jennifer D. Runkle
- North Carolina Institute for Climate StudiesNorth Carolina State UniversityNCAshevilleUSA
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Xu Z, Watzek JT, Phung D, Oberai M, Rutherford S, Bach AJE. Heat, heatwaves, and ambulance service use: a systematic review and meta-analysis of epidemiological evidence. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1523-1542. [PMID: 37495745 PMCID: PMC10457246 DOI: 10.1007/s00484-023-02525-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
Ambulance data has been reported to be a sensitive indicator of health service use during hot days, but there is no comprehensive summary of the quantitative association between heat and ambulance dispatches. We conducted a systematic review and meta-analysis to retrieve and synthesise evidence published up to 31 August 2022 about the association between heat, prolonged heat (i.e. heatwaves), and the risk of ambulance dispatches. We initially identified 3628 peer-reviewed papers and included 48 papers which satisfied the inclusion criteria. The meta-analyses showed that, for each 5 °C increase in mean temperature, the risk of ambulance dispatches for all causes and for cardiovascular diseases increased by 7% (95% confidence interval (CI): 5%, 10%) and 2% (95% CI: 1%, 3%), respectively, but not for respiratory diseases. The risk of ambulance dispatches increased by 6% (95% CI: 4%, 7%), 7% (95% CI: 5%, 9%), and 18% (95% CI: 12%, 23%) under low-intensity, severe, and extreme heatwaves, respectively. We observed two potential sources of bias in the existing literature: (1) bias in temperature exposure measurement; and (2) bias in the ascertainment of ambulance dispatch causes. This review suggests that heat exposure is associated with an increased risk of ambulance dispatches, and there is a dose-response relationship between heatwave intensity and the risk of ambulance dispatches. For future studies assessing the heat-ambulance association, we recommend that (1) using data on spatially refined gridded temperature that is either very well interpolated or derived from satellite imaging may be an alternative to reduce exposure measurement bias; and (2) linking ambulance data with hospital admission data can be useful to improve health outcome classification.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Jessica T Watzek
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Mehak Oberai
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia
- Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Aaron J E Bach
- School of Medicine and Dentistry, Griffith University, Parklands Drive, Southport, Gold Coast, QLD, 4222, Australia.
- Cities Research Institute, Griffith University, Gold Coast, Australia.
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Sharma R, Humphrey JL, Frueh L, Kinnee EJ, Sheffield PE, Clougherty JE. Neighborhood violence and socioeconomic deprivation influence associations between acute air pollution and temperature on childhood asthma in New York city. ENVIRONMENTAL RESEARCH 2023; 231:116235. [PMID: 37244495 PMCID: PMC10364588 DOI: 10.1016/j.envres.2023.116235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
Ambient air pollution, temperature, and social stressor exposures are linked with asthma risk, with potential synergistic effects. We examined associations for acute pollution and temperature exposures, with modification by neighborhood violent crime and socioeconomic deprivation, on asthma morbidity among children aged 5-17 years year-round in New York City. Using conditional logistic regression in a time-stratified, case-crossover design, we quantified percent excess risk of asthma event per 10-unit increase in daily, residence-specific exposures to PM2.5, NO2, SO2, O3, and minimum daily temperature (Tmin). Data on 145,834 asthma cases presenting to NYC emergency departments from 2005 to 2011 were obtained from the New York Statewide Planning and Research Cooperative System (SPARCS). Residence- and day-specific spatiotemporal exposures were assigned using the NYC Community Air Survey (NYCCAS) spatial data and daily EPA pollution and NOAA weather data. Point-level NYPD violent crime data for 2009 (study midpoint) was aggregated, and Socioeconomic Deprivation Index (SDI) scores assigned, by census tract. Separate models were fit for each pollutant or temperature exposure for lag days 0-6, controlling for co-exposures and humidity, and mutually-adjusted interactions (modification) by quintile of violent crime and SDI were assessed. We observed stronger main effects for PM2.5 and SO2 in the cold season on lag day 1 [4.90% (95% CI: 3.77-6.04) and 8.57% (5.99-11.21), respectively]; Tmin in the cold season on lag day 0 [2.26% (1.25-3.28)]; and NO2 and O3 in the warm season on lag days 1 [7.86% (6.66-9.07)] and 2 [4.75% (3.53-5.97)], respectively. Violence and SDI modified the main effects in a non-linear manner; contrary to hypotheses, we found stronger associations in lower-violence and -deprivation quintiles. At very high stressor exposures, although asthma exacerbations were highly prevalent, pollution effects were less apparent-suggesting potential saturation effects in socio-environmental synergism.
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Affiliation(s)
- Rachit Sharma
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Jamie L Humphrey
- Center for Health Analytics, Media & Policy, RTI International, Research Triangle Park, NC, USA
| | - Lisa Frueh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Ellen J Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, USA
| | - Perry E Sheffield
- Department of Environmental Medicine and Public Health, and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Xu R, Huang S, Shi C, Wang R, Liu T, Li Y, Zheng Y, Lv Z, Wei J, Sun H, Liu Y. Extreme Temperature Events, Fine Particulate Matter, and Myocardial Infarction Mortality. Circulation 2023; 148:312-323. [PMID: 37486993 DOI: 10.1161/circulationaha.122.063504] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/08/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Extreme temperature events (ETEs), including heat wave and cold spell, have been linked to myocardial infarction (MI) morbidity; however, their effects on MI mortality are less clear. Although ambient fine particulate matter (PM2.5) is suggested to act synergistically with extreme temperatures on cardiovascular mortality, it remains unknown if and how ETEs and PM2.5 interact to trigger MI deaths. METHODS A time-stratified case-crossover study of 202 678 MI deaths in Jiangsu province, China, from 2015 to 2020, was conducted to investigate the association of exposure to ETEs and PM2.5 with MI mortality and evaluate their interactive effects. On the basis of ambient apparent temperature, multiple temperature thresholds and durations were used to build 12 ETE definitions. Daily ETEs and PM2.5 exposures were assessed by extracting values from validated grid datasets at each subject's geocoded residential address. Conditional logistic regression models were applied to perform exposure-response analyses and estimate relative excess odds due to interaction, proportion attributable to interaction, and synergy index. RESULTS Under different ETE definitions, the odds ratio of MI mortality associated with heat wave and cold spell ranged from 1.18 (95% CI, 1.14-1.21) to 1.74 (1.66-1.83), and 1.04 (1.02-1.06) to 1.12 (1.07-1.18), respectively. Lag 01-day exposure to PM2.5 was significantly associated with an increased odds of MI mortality, which attenuated at higher exposures. We observed a significant synergistic interaction of heat wave and PM2.5 on MI mortality (relative excess odds due to interaction >0, proportion attributable to interaction >0, and synergy index >1), which was higher, in general, for heat wave with greater intensities and longer durations. We estimated that up to 2.8% of the MI deaths were attributable to exposure to ETEs and PM2.5 at levels exceeding the interim target 3 value (37.5 μg/m3) of World Health Organization air quality guidelines. Women and older adults were more vulnerable to ETEs and PM2.5. The interactive effects of ETEs or PM2.5 on MI mortality did not vary across sex, age, or socioeconomic status. CONCLUSIONS This study provides consistent evidence that exposure to both ETEs and PM2.5 is significantly associated with an increased odds of MI mortality, especially for women and older adults, and that heat wave interacts synergistically with PM2.5 to trigger MI deaths but cold spell does not. Our findings suggest that mitigating both ETE and PM2.5 exposures may bring health cobenefits in preventing premature deaths from MI.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (S.H.)
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China (C.S.)
| | - Rui Wang
- Luohu District Chronic Disease Hospital, Shenzhen, Guangdong, China (R.W.)
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
| | - Ziquan Lv
- Central Laboratory of Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China (Z.L.)
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park (J.W.)
| | - Hong Sun
- Institute of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China (H.S.)
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China (R.X., T.L., Y. Li, Y.Z., Y. Liu)
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Zhu X, Chen R, Zhang Y, Hu J, Jiang Y, Huang K, Wang J, Li W, Shi B, Chen Y, Li L, Li B, Cheng X, Yu B, Wang Y, Kan H. Low ambient temperature increases the risk and burden of atrial fibrillation episodes: A nationwide case-crossover study in 322 Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163351. [PMID: 37030388 DOI: 10.1016/j.scitotenv.2023.163351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Non-optimum ambient temperature has recently been acknowledged as an independent risk factor for disease burden, but its impact on atrial fibrillation (AF) episodes was rarely evaluated. OBJECTIVES To examine the associations between ambient non-optimum temperature and symptom onset of AF episodes and calculate the corresponding disease burden. METHODS We conducted an individual-level, time-stratified, case-crossover analysis based on a nationwide registry, which comprises of 94,711 eligible AF patients from 1993 hospitals in 322 Chinese cities from January 2015 to December 2021. Multiple moving 24 h average temperatures prior to the symptom onset of AF episodes were calculated as lag days. The associations were analyzed using conditional logistic regression combined with distributed lag non-linear models with a duration of lag 0-7 days, after controlling for criteria air pollutants. Stratification analyses were performed to explore possible effect modifiers. RESULTS There was a monotonically increasing relationship of AF onset risk with decreasing temperature. The excess AF risk occurred at lag 1 d and lasted for 5 days. Nationally, the cumulative relative risk of AF episode onset associated with extremely low temperature (-9.3 °C) over lag 0-7 d was 1.25 (95 % confidence interval: 1.08, 1.45), compared with the reference temperature (31.5 °C). The exposure-response curve was steeper in the south than in the north where there was levelling-off at lower temperature. Nationally, 7.59 % of acute AF episodes could be attributable to non-optimum temperatures. The attributable fraction was larger for southern residents, males and patients <65 years. CONCLUSION This nationwide study provides novel and robust evidence that declining ambient temperature could increase the risk of AF episode onset. We also provide the first-hand evidence that a considerable proportion of acute AF episodes could be attributable to non-optimum temperatures.
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Affiliation(s)
- Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yong Zhang
- Department of Emergency, Wuhan Asia General Hospital, Wuhan, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Kai Huang
- Department of Cardiology, Institute of Cardiovascular Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianan Wang
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Li
- Department of Cardiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yundai Chen
- Senior Department of Cardiology, the Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Lang Li
- Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bao Li
- Department of Cardiology, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaoshu Cheng
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Bo Yu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai, China.
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28
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Pan C, Xu C, Zheng J, Song R, Lv C, Zhang G, Tan H, Ma Y, Zhu Y, Han X, Li C, Yan S, Zheng W, Wang C, Zhang J, Bian Y, Ma J, Cheng K, Liu R, Hou Y, Chen Q, Zhao X, McNally B, Chen R, Kan H, Meng X, Chen Y, Xu F. Fine and coarse particulate air pollution and out-of-hospital cardiac arrest onset: a nationwide case-crossover study in China. JOURNAL OF HAZARDOUS MATERIALS 2023; 457:131829. [PMID: 37320898 DOI: 10.1016/j.jhazmat.2023.131829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) is a global public health concern. Nationwide studies on the effects of short-term exposure to particulate matter (PM) on OHCA risk are rare in regions with high PM levels, and evidence for coarse PM (PM2.5-10) is limited and inconsistent. To evaluate the associations between fine PM (PM2.5) and PM2.5-10 and OHCA onset, a time-stratified case-crossover study was conducted on 77,261 patients with cardiac OHCA in 26 cities across China in 2020. Daily PM2.5 and PM2.5-10 concentrations were assessed with high-resolution and full-coverage PM estimations. Conditional logistic regression models were applied in analyses. Each interquartile range of PM increase in 3-day moving average was associated with an increased risk of cardiac OHCA onset of 2.37% (95% CI, 1.20-3.56%) for PM2.5 and 2.12% (95% CI, 0.70-3.56%) for PM2.5-10. Stratified analyses showed higher susceptibility in patients over 75 years for PM2.5 exposure and with diabetes for PM2.5-10. This first nationwide study in region with high PM levels and great PM variability found not only PM2.5 but also PM2.5-10 were associated with a higher risk of OHCA onset, which could add powerful epidemiological evidence to this field and provide new evidence for the formulation of air quality guidelines.
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Affiliation(s)
- Chang Pan
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Jiaqi Zheng
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Ruixue Song
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Guoqiang Zhang
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Huiqiong Tan
- Emergency and Intensive Care Center, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Ma
- Department of Intensive Care Unit, Chongqing University Central Hospital, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical Center, Chongqing, China
| | - Yimin Zhu
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
| | - Chaoqian Li
- Department of Emergency, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shengtao Yan
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Wen Zheng
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chunyi Wang
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jianbo Zhang
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yuan Bian
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jingjing Ma
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Kai Cheng
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Rugang Liu
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yaping Hou
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Qiran Chen
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xiangkai Zhao
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Bryan McNally
- Emory University School of Medicine, Atlanta, GA, USA
| | - Renjie Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Fudan University, Shanghai, China.
| | - Yuguo Chen
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
| | - Feng Xu
- Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
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29
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Lei J, Chen R, Liu C, Zhu Y, Xue X, Jiang Y, Shi S, Gao Y, Kan H, Xuan J. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. Int J Epidemiol 2023; 52:715-726. [PMID: 37159523 DOI: 10.1093/ije/dyad056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. METHODS We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. RESULTS A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. CONCLUSIONS This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
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Affiliation(s)
- Jian Lei
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xiaowei Xue
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou, China
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Zhou Q, Shi H, Wu R, Zhu H, Qin C, Liang Z, Sun S, Zhao J, Wang Y, Huang J, Jin Y, Zheng Z, Li J, Zhang Z. Associations between hourly ambient particulate matter air pollution and ambulance emergency calls among 3,022,164 patients: time stratified case-crossover study. JMIR Public Health Surveill 2023. [PMID: 37243735 DOI: 10.2196/47022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Associations between short-term exposure to ambient particulate matter (PM) air pollutants and mortality or hospital admissions have been well documented in previous studies. Less is known about the associations of hourly exposure to PM air pollutants with ambulance emergency calls (AECs) for all causes and specific causes by conducting a case-crossover study. In addition, different patterns of AECs may be attributed to different seasons and daytime/nighttime periods. OBJECTIVE In this study, we quantified the risk of all-cause and cause-specific AECs associated with hourly PM air pollutants between 1 January 2013 and 31 December 2019 in Shenzhen, China. We also examined whether the observed associations of particulate matter air pollutants with AECs for all causes differed across strata defined by sex, age, season, and time of day. METHODS We used ambulance emergency dispatch data and environmental data between 1 January 2013 and 31 December 2019 from the Shenzhen Ambulance Emergency Centre and the National Environmental Monitor Station to conduct a time-stratified case-crossover study design to estimate the associations of air pollutants (i.e., PM2.5, PM10) with all-cause AECs and cause-specific AECs. We generated a well-established distributed lag nonlinear model for nonlinear concentration response and nonlinear lag response functions. We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for public holidays, season, time of day, day of the week, hourly temperature, and hourly humidity to examine the association of all-cause and cause-specific AECs with hourly air pollutant concentrations. RESULTS A total of 3,022,164 patients were identified during the study period in Shenzhen. Each IQR increase in PM2.5 (24.0 µg/m3) and PM10 (34.0 µg/m3) concentrations in 24 hours was associated with an increased risk of AECs (PM2.5: all-cause, 1.8%, 95% CI, 0.8%-2.4%; PM10: all-cause, 2.0%, 95% CI, 1.1%-2.9%). We observed a stronger association of all-cause AECs with PM2.5 and PM10 in the daytime than in the nighttime and in the elderly group than in the younger group (PM2.5 daytime, 1.7%, 95% CI, 0.5%-3.0%; nighttime, 1.4%, 95% CI, 0.3%-2.6%; PM10 daytime, 2.1%, 95% CI, 0.9%-3.4%; nighttime, 1.7%, 95% CI, 0.6%-2.8%; PM2.5 18-64 years, 1.4%, 95% CI, 0.6%-2.1%; ≥65 years, 1.6%, 95% CI, 0.6%-2.6%; PM10 18-64 years, 1.8%, 95% CI, 0.9%-2.6%; ≥65 years, 2.0%, 95% CI, 1.1%-3.0%). CONCLUSIONS The risk of all-cause AECs increased consistently with increasing concentrations of PM air pollutants, showing a nearly linear relationship with no apparent thresholds. Particulate matter air pollution increase was associated with a higher risk of AECs for all causes, cardiovascular, respiratory, and reproductive AECs. The results of this study may be valuable to air pollution attributable to the distribution of emergency resources, and consistent air pollution control. CLINICALTRIAL
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Affiliation(s)
- Qiang Zhou
- Shenzhen Center for Prehospital Care, Shenzhen, CN
| | - Hanxu Shi
- Peking University, Xueyuan Road, Beijing, CN
| | - Rengyu Wu
- Shenzhen Center for Prehospital Care, Shenzhen, CN
| | - Hong Zhu
- Shenzhen Center for Prehospital Care, Shenzhen, CN
| | - Congzhen Qin
- Shenzhen Center for Prehospital Care, Shenzhen, CN
| | | | | | | | - Yasha Wang
- Peking University, Xueyuan Road, Beijing, CN
| | - Jie Huang
- Southern University of Science and Technology, Shenzhen, CN
| | - Yinzi Jin
- Peking University, Xueyuan Road, Beijing, CN
| | | | - Jingyan Li
- China National Environmental Monitoring Centre, Beijing, CN
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Liu T, Gong W, Zhou C, Bai G, Meng R, Huang B, Zhang H, Xu Y, Hu R, Hou Z, Xiao Y, Li J, Xu X, Jin D, Qin M, Zhao Q, Xu Y, Hu J, Xiao J, He G, Rong Z, Zeng F, Yang P, Liu D, Yuan L, Cao G, Chen Z, Yu S, Yang S, Huang C, Du Y, Yu M, Lin L, Liang X, Ma W. Mortality burden based on the associations of ambient PM 2.5 with cause-specific mortality in China: Evidence from a death-spectrum wide association study (DWAS). ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115045. [PMID: 37235896 DOI: 10.1016/j.ecoenv.2023.115045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Although studies have estimated the associations of PM2.5 with total mortality or cardiopulmonary mortality, few have comprehensively examined cause-specific mortality risk and burden caused by ambient PM2.5. Thus, this study investigated the association of short-term exposure to PM2.5 with cause-specific mortality using a death-spectrum wide association study (DWAS). Individual information of 5,450,764 deaths during 2013-2018 were collected from six provinces in China. Daily PM2.5 concentration in the case and control days were estimated by a random forest model. A time-stratified case-crossover study design was applied to estimate the associations (access risk, ER) of PM2.5 with cause-specific mortality, which was then used to calculate the population-attributable fraction (PAF) of mortality and the corresponding mortality burden caused by PM2.5. Each 10 μg/m3 increase in PM2.5 concentration (lag03) was associated with a 0.80 % [95 % confidence interval (CI): 0.73 %, 0.86 %] rise in total mortality. We found greater mortality effect at PM2.5 concentrations < 50 μg/m3. Stratified analyses showed greater ERs in females (1.01 %, 95 %CI: 0.91 %, 1.11 %), children ≤ 5 years (2.17 %, 95 %CI: 0.85 %, 3.51 %), and old people ≥ 70 years. We identified 33 specific causes (level 2) of death which had significant associations with PM2.5, including 16 circulatory diseases, 9 respiratory diseases, and 8 other causes. The PAF estimated based on the overall association between PM2.5 and total mortality was 3.16 % (95 %CI: 2.89 %, 3.40 %). However, the PAF was reduced to 2.88 % (95 %CI: 1.88 %, 3.81 %) using the associations of PM2.5 with 33 level 2 causes of death, based on which 250.15 (95 %CI: 163.29, 330.93) thousand deaths were attributable to short-term PM2.5 exposure across China in 2019. Overall, this study provided a comprehensive picture on the death-spectrum wide association between PM2.5 and morality in China. We observed robust positive cause-specific associations of PM2.5 with mortality risk, which may provide more precise basis in assessing the mortality burden of air pollution.
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Affiliation(s)
- Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Chunliang Zhou
- Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha 450001, China
| | - Guoxia Bai
- Institute of Non-communicable Diseases Prevention and Control,Tibet Center for Disease Control and Prevention, Lhasa 850000, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Biao Huang
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Haoming Zhang
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Zhulin Hou
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - Junhua Li
- Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha 450001, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Donghui Jin
- Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha 450001, China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - Qinglong Zhao
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Yiqing Xu
- Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha 450001, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanghao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Pan Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Dan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Lixia Yuan
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Ganxiang Cao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Shangfeng Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou 510080, China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xiaofeng Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health,School of Medicine, Jinan University, Guangzhou 510632, China.
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Henderson SB, McLean KE, Ding Y, Yao J, Turna NS, McVea D, Kosatsky T. Hot weather and death related to acute cocaine, opioid and amphetamine toxicity in British Columbia, Canada: a time-stratified case-crossover study. CMAJ Open 2023; 11:E569-E578. [PMID: 37369523 DOI: 10.9778/cmajo.20210291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Previous research has shown that cocaine-associated deaths occur more frequently in hot weather, which has not been described for other illicit drugs or combinations of drugs. The study objective was to evaluate the relation between temperature and risk of death related to cocaine, opioids and amphetamines in British Columbia, Canada. METHODS We extracted data on all deaths with cocaine, opioid or amphetamine toxicity recorded as an underlying or contributing cause from BC vital statistics for 1998-2017. We used a time-stratified case-crossover design to estimate the effect of temperature on the risk of death associated with acute drug toxicity during the warmer months (May through September). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each 10°C increase in the 2-day average maximum temperature at the residential location. RESULTS We included 4913 deaths in the analyses. A 10°C increase in the 2-day average maximum temperature was associated with an OR of 1.43 (95% CI 1.11-1.86) for deaths with only cocaine toxicity recorded (n = 561), an OR of 1.15 (95% CI 0.99-1.33) for deaths with opioids only (n = 1682) and an OR of 1.11 (95% CI 0.60-2.04) for deaths with amphetamines only (n = 133). There were also elevated effects when toxicity from multiple drugs was recorded. Sensitivity analyses showed differences in the ORs by sex, by climatic region, and when the location of death was used instead of the location of residence. INTERPRETATION Increasing temperatures were associated with higher odds of death due to drug toxicity, especially for cocaine alone and combined with other drugs. Targeted interventions are necessary to prevent death associated with toxic drug use during hot weather.
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Affiliation(s)
- Sarah B Henderson
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Kathleen E McLean
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Yue Ding
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Jiayun Yao
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Nikita Saha Turna
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - David McVea
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
| | - Tom Kosatsky
- Environmental Health Services (Henderson, McLean, Yao, Saha Turna, McVea, Kosatsky), BC Centre for Disease Control; School of Population and Public Health (Henderson, Ding, McVea, Kosatsky), University of British Columbia, Vancouver, BC
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Stowell JD, Sun Y, Spangler KR, Milando CW, Bernstein A, Weinberger KR, Sun S, Wellenius GA. Warm-season temperatures and emergency department visits among children with health insurance. ENVIRONMENTAL RESEARCH, HEALTH : ERH 2023; 1:015002. [PMID: 36337257 PMCID: PMC9623446 DOI: 10.1088/2752-5309/ac78fa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 01/25/2023]
Abstract
High ambient temperatures have become more likely due to climate change and are linked to higher rates of heat-related illness, respiratory and cardiovascular diseases, mental health disorders, and other diseases. To date, far fewer studies have examined the effects of high temperatures on children versus adults, and studies including children have seldom been conducted on a national scale. Compared to adults, children have behavioral and physiological differences that may give them differential heat vulnerability. We acquired medical claims data from a large database of commercially insured US children aged 0-17 from May to September (warm-season) 2016-2019. Daily maximum ambient temperature and daily mean relative humidity estimates were aggregated to the county level using the Parameter-elevation Relationships on Independent Slopes dataset, and extreme heat was defined as the 95th percentile of the county-specific daily maximum temperature distribution. Using a case-crossover design and temperature lags 0-5 days, we estimated the associations between extreme heat and cause-specific emergency department visits (ED) in children aged <18 years, using the median county-specific daily maximum temperature distribution as the reference. Approximately 1.2 million ED visits in children from 2489 US counties were available during the study period. The 95th percentile of warm-season temperatures ranged from 71 °F to 112 °F (21.7 °C to 44.4 °C). Comparing 95th to the 50th percentile, extreme heat was associated with higher rates of ED visits for heat-related illness; endocrine, nutritional and metabolic diseases; and otitis media and externa, but not for all-cause admissions. Subgroup analyses suggested differences by age, with extreme heat positively associated with heat-related illness for both the 6-12 year (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.16, 1.56) and 13-17 year age groups (OR: 1.55, 95% CI: 1.37, 1.76). Among children with health insurance across the US, days of extreme heat were associated with higher rates of healthcare utilization. These results highlight the importance of individual and population-level actions to protect children and adolescents from extreme heat, particularly in the context of continued climate change.
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Affiliation(s)
- Jennifer D Stowell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Keith R Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Chad W Milando
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
| | - Aaron Bernstein
- Boston Children’s Hospital, Boston, MA, United States of America
| | - Kate R Weinberger
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
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Cai M, Wei J, Zhang S, Liu W, Wang L, Qian Z, Lin H, Liu E, McMillin SE, Cao Y, Yin P. Short-term air pollution exposure associated with death from kidney diseases: a nationwide time-stratified case-crossover study in China from 2015 to 2019. BMC Med 2023; 21:32. [PMID: 36694165 PMCID: PMC9875429 DOI: 10.1186/s12916-023-02734-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Long-term exposure to air pollution has been associated with the onset and progression of kidney diseases, but the association between short-term exposure to air pollution and mortality of kidney diseases has not yet been reported. METHODS A nationally representative sample of 101,919 deaths from kidney diseases was collected from the Chinese Center for Disease Control and Prevention from 2015 to 2019. A time-stratified case-crossover study was applied to determine the associations. Satellite-based estimates of air pollution were assigned to each case and control day using a bilinear interpolation approach and geo-coded residential addresses. Conditional logistic regression models were constructed to estimate the associations adjusting for nonlinear splines of temperature and relative humidity. RESULTS Each 10 µg/m3 increment in lag 0-1 mean concentrations of air pollutants was associated with a percent increase in death from kidney disease: 1.33% (95% confidence interval [CI]: 0.57% to 2.1%) for PM1, 0.49% (95% CI: 0.10% to 0.88%) for PM2.5, 0.32% (95% CI: 0.08% to 0.57%) for PM10, 1.26% (95% CI: 0.29% to 2.24%) for NO2, and 2.9% (95% CI: 1.68% to 4.15%) for SO2. CONCLUSIONS: Our study suggests that short-term exposure to ambient PM1, PM2.5, PM10, NO2, and SO2 might be important environmental risk factors for death due to kidney diseases in China.
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Affiliation(s)
- Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, 20740, USA
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Wei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, 63103, USA
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Echu Liu
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Yu Cao
- Information Center, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
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Seposo X, Ueda K, Fook Sheng Ng C, Madaniyazi L, Sugata S, Yoshino A, Takami A. Role of oxides of nitrogen in the ozone-cardiorespiratory visit association. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120802. [PMID: 36473642 DOI: 10.1016/j.envpol.2022.120802] [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: 11/24/2021] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Ozone (O3)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O3 exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O3 concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O3-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed to the risks observed at the low ozone concentration range. In this study, we examined the short-term effects of photochemical oxidant (Ox, parts per billiion) on outpatient cardiorespiratory visits in 21 Japanese cities after adjusting for other air pollutant-specific C-R functions. Daily cardiorespiratory visits from January 1, 2014 to December 31, 2016 were obtained from the Japanese Medical Data Center Co. Ltd. Similar period of meteorological and air pollution variables were obtained from relevant data sources. We utilized a time-stratified case crossover design coupled with the generalized additive mixed model (TSCC-GAMM) to estimate the association between Ox and cardiorespiratory outpatient visits, after adjusting for several covariates. A total of 2,588,930 visits were recorded across the study period, with a mean of 111.87 and a standard deviation of 138.75. The results revealed that crude Ox-cardiorespiratory visits exhibited a U-shaped pattern. However, adjustment of the oxides of nitrogen, particularly nitrogen monoxide (NO), attenuated the lower risk curve and subsequently altered the shape of the C-R function, with a substantial reduction observed during winter. NO- and nitrogen dioxide (NO2)-adjusted Ox-cardiorespiratory associations increased nearly linearly, without an apparent threshold. Current evidence suggests the importance of adjusting the oxides of nitrogen in estimating the Ox C-R risk functions.
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Affiliation(s)
- Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan; Ateneo Center for Research and Innovation, Ateneo School of Medicine and Public Health, Atene de Manila University, Philippines.
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Japan; Environmental Health Sciences, Department of Global Ecology, Graduate School of Global Environmental Sciences, Kyoto University, Japan; Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; School of International Health, Graduate School of Medicine, The University of Tokyo, Japan
| | - Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; Institute of Tropical Medicine, Nagasaki University, Japan
| | - Seiji Sugata
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
| | - Ayako Yoshino
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
| | - Akinori Takami
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
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Chen Z, Fu Q, Wu L, Xu P, Xu D, Pan X, Lou X, Wang X, Yao K, Mo Z. Quantifying the associations of the air pollutant SO 2 on outpatient visits for conjunctivitis in Hangzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:13246-13255. [PMID: 36125687 DOI: 10.1007/s11356-022-23073-x] [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: 06/07/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study is to further investigate the single and cumulative associations of SO2 on outpatient visits for conjunctivitis. Data from outpatient visits, air pollutants, and meteorology was collected by the Eye Center of the Second Affiliated Hospital of the Zhejiang University School of Medicine, the Environmental Protection Department of Zhejiang Province, and the Meteorological Administration of Zhejiang Province from July 1, 2014, to November 30, 2019. A Poisson generalized linear regression model (PGLM), combined with a distributed lag nonlinear model (DLNM), was employed to analyze the association between SO2 and outpatient visits for conjunctivitis using PM2.5 and NO2 as covariates. Of the 539,649 outpatients for conjunctivitis recruited for analysis, 58.1% were female. Obvious single associations of SO2 were observed in outpatient visits for conjunctivitis, which is consistent with our previous results using a time-stratified case crossover design. A delay in the associations of SO2 on outpatient visits for conjunctivitis was further confirmed, with the longest lag being 12 days. The strongest lag effect was found at lag 0-11 with RR95th vs 25th = 1.30 (1.24, 1.37), and RR90h vs 25th = 1.23 (1.18, 1.28). Furthermore, the results showed that old people may be more sensitive to the associations of SO2 than adults and the younger ones. Our study provides the first evidence that outpatient visits for conjunctivitis are positively associated with both single and cumulative air pollutant SO2 exposure, suggesting that people especially elders had better to decrease outdoor activities when the SO2 concentration is above safe level.
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Affiliation(s)
- Zhijian Chen
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Qiuli Fu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Lab of Ophthalmology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lizhi Wu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Peiwei Xu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Dandan Xu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xuejiao Pan
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xiaoming Lou
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xiaofeng Wang
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Lab of Ophthalmology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Zhe Mo
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China.
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Yang H, Liao J, Wang J, Yang C, Jiao K, Wang X, Huang Z, Ma X, Liu X, Liao J, Ma L. PM 2.5-Associated Hospitalization Risk of Cardiovascular Diseases in Wuhan: Cases Alleviated by Residential Greenness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:746. [PMID: 36613068 PMCID: PMC9819994 DOI: 10.3390/ijerph20010746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
PM2.5, a type of particulate matter with an aerodynamic diameter of less than 2.5 μm, is associated with the occurrence of cardiovascular diseases (CVDs), while greenness seems to be associated with better cardiovascular health. We identified 499,336 CVD cases in Wuhan's 74 municipal hospitals between 2017 and 2019. A high-resolution PM2.5 model and a normalized difference vegetation index (NDVI) map were established to estimate individual exposures. The time-stratified case-crossover design and conditional logistic regression models were applied to explore the associations between PM2.5 and CVDs under different levels of environmental factors. Greenness could alleviate PM2.5-induced hospitalization risks of cardiovascular diseases. Compared with patients in the low-greenness group (ER = 0.99%; 95% CI: 0.71%, 1.28%), patients in the high-greenness group (ER = 0.45%; 95% CI: 0.13%, 0.77%) showed a lower increase in total CVD hospitalizations. After dividing the greenness into quartiles and adding long-term PM2.5 exposure as a control factor, no significant PM2.5-associated hospitalization risks of CVD were identified in the greenest areas (quartile 4), whether the long-term PM2.5 exposure level was high or low. Intriguingly, in the least green areas (quartile 1), the PM2.5-induced excess risk of CVD hospitalization was 0.58% (95% CI: 0.04%, 1.11%) in the long-term high-level PM2.5 exposure group, and increased to 1.61% (95% CI: 0.95%, 2.27%) in the long-term low-level PM2.5 exposure group. In the subgroup analysis, males and participants aged 55-64 years showed more significant increases in the PM2.5-induced risk of contracting CVDs with a reduction in greenness and fine particle exposure conditions. High residential greenness can greatly alleviate the PM2.5-induced risk of cardiovascular admission. Living in the areas with long-term low-level PM2.5 may make people more sensitive to short-term increases in PM2.5, leading to CVD hospitalization.
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Affiliation(s)
- Haomin Yang
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jianpeng Liao
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jing Wang
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Can Yang
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Kuizhuang Jiao
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaodie Wang
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Zenghui Huang
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xuxi Ma
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xingyuan Liu
- Wuhan Information Center of Health and Family Planning, Wuhan 430021, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430081, China
| | - Lu Ma
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
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Lou X, Zhang P, Shi N, Ding Z, Xu Z, Liu B, Hu W, Yan T, Wang J, Liu L, Zha Y, Wang J, Chen W, Xu C, Xu J, Jiang H, Ma H, Yuan W, Wang C, Liao Y, Wang D, Yao L, Chen M, Li G, Li Y, Wang P, Li X, Lu C, Tang W, Wan J, Li R, Xiao X, Zhang C, Jiao J, Zhang W, Yuan J, Lan L, Li J, Zhang P, Zheng W, Chen J. Associations between short-term exposure of ambient particulate matter and hemodialysis patients death: A nationwide, longitudinal case-control study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 852:158215. [PMID: 36028020 DOI: 10.1016/j.scitotenv.2022.158215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Long-term exposure to particulate air pollutants can lead to an increase in mortality of hemodialysis patients, but evidence of mortality risk with short-term exposure to ambient particulate matter is lacking. This study aimed to estimate the association of short-term exposure to ambient particulate matter across a wide range of concentrations with hemodialysis patients mortality. METHODS We performed a time-stratified case-crossover study to estimate the association between short-term exposures to PM2.5 and PM10 and mortality of hemodialysis patients. The study included 18,114 hemodialysis death case from 279 hospitals in 41 cities since 2013. Daily particulate matter exposures were calculated by the inverse distance-weighted model based on each case's dialysis center address. Conditional logistic regression were implemented to quantify exposure-response associations. The sensitivity analysis mainly explored the lag effect of particulate matter. RESULTS During the study period, there were 18,114 case days and 61,726 control days. Of all case and control days, average PM2.5 and PM10 levels were 43.98 μg/m3 and 70.86 μg/m3, respectively. Each short-term increase of 10 μg/m3 in PM2.5 and PM10 were statistically significantly associated with a relative increase of 1.07 % (95 % confidence interval [CI]: 0.99 % - 1.15 %) and 0.89 % (95 % CI: 0.84 % - 0.94 %) in daily mortality rate of hemodialysis patients, respectively. There was no evidence of a threshold in the exposure-response relationship. The mean of daily exposure on the same day of death and one-day prior (Lag 01 Day) was the most plausible exposure time window. CONCLUSIONS This study confirms that short-term exposure to particulate matter leads to increased mortality in hemodialysis patients. Policy makers and public health practices have a clear and urgent opportunity to pass air quality control policies that care for hemodialysis populations and incorporate air quality into the daily medical management of hemodialysis patients.
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Affiliation(s)
- Xiaowei Lou
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China; College of Medicine, Zhejiang University, Hangzhou, PR China
| | - Ping Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China; Zhejiang Dialysis Quality Control Center, PR China
| | - Nan Shi
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China
| | - Zhe Ding
- College of Medicine, Zhejiang University, Hangzhou, PR China
| | - Zhonggao Xu
- First Hospital of Jilin University, PR China
| | - Bicheng Liu
- Affiliated Zhongda Hospital of Southeast University, PR China
| | - Wenbo Hu
- Qinghai Provincial Peoples Hospital, PR China
| | - Tiekun Yan
- Tianjin Medical University General Hospital, PR China
| | - Jinwen Wang
- Yan'an Hospital of Kunming Medical University, PR China
| | - Ling Liu
- Second Affiliated Hospital of Chongqing Medical University, PR China
| | - Yan Zha
- Guizhou Provincial People's Hospital, PR China
| | - Jianqin Wang
- Second Affiliated Hospital of Lanzhou University, PR China
| | - Wei Chen
- First Affiliated Hospital of Sun yat-sen University, PR China
| | - Chenyun Xu
- Second Affiliated Hospital of Nanchang University, PR China
| | - Jinsheng Xu
- Fourth Hospital of Hebei Medical University, PR China
| | - Hongli Jiang
- First Affiliated Hospital of Xian Jiaotong University, PR China
| | - Huichao Ma
- Second Hospital of Tibet Autonomous Region, PR China
| | | | - Caili Wang
- First Affiliated Hospital of Baotou Medical College, PR China
| | - Yunhua Liao
- First Affiliated Hospital of Guangxi Medical University, PR China
| | - Deguang Wang
- Second Affiliated Hospital of Anhui Medical University, PR China
| | - Li Yao
- First Affiliated Hospital of China Medical University, PR China
| | - Menghua Chen
- General Hospital of Ningxia Medical University, PR China
| | - Guisen Li
- Sichuan Provincial Peoples Hospital, PR China
| | - Yun Li
- Jiangxi Provincial Peoples Hospital, PR China
| | - Pei Wang
- First Affiliated Hospital of Zhengzhou University, PR China
| | - Xuemei Li
- Peking Union Medical College Hospital, PR China
| | - Chen Lu
- Peoples Hospital of Xinjiang Uygur Autonomous Region, PR China
| | | | - Jianxin Wan
- First Affiliated Hospital of Fujian Medical University, PR China
| | - Rongshan Li
- Shanxi Provincial People's Hospital, PR China
| | | | - Chun Zhang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, PR China
| | - Jundong Jiao
- Second Affiliated Hospital of Harbin Medical University, PR China
| | - Wei Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China
| | - Jing Yuan
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China
| | - Lan Lan
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China
| | - Jingsong Li
- Research Center for Healthcare Data Science, Zhejiang Lab, PR China
| | - Peng Zhang
- School of Mathematical Sciences, Zhejiang University, PR China.
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, PR China.
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; National Key Clinical Department of Kidney Diseases, PR China; Institute of Nephropathy, Zhejiang University, Hangzhou, PR China; Zhejiang Dialysis Quality Control Center, PR China.
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Zhou P, Hu J, Yu C, Bao J, Luo S, Shi Z, Yuan Y, Mo S, Yin Z, Zhang Y. Short-term exposure to fine particulate matter constituents and mortality: case-crossover evidence from 32 counties in China. SCIENCE CHINA. LIFE SCIENCES 2022; 65:2527-2538. [PMID: 35713841 DOI: 10.1007/s11427-021-2098-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/23/2022] [Indexed: 06/15/2023]
Abstract
A growing number of studies associated increased mortality with exposures to specific fine particulate (PM2.5) constituents, while great heterogeneity exists between locations. In China, evidence linking PM2.5 constituents and mortality was extensively sparse. This study primarily aimed to quantify short-term associations between PM2.5 constituents and non-accidental mortality among the Chinese population. We collected daily mortality records from 32 counties in China between January 1, 2011, and December 31, 2013. Daily concentrations of main PM2.5 constituents (organic carbon (OC), elemental carbon (EC), nitrate (NO3-), sulfate (SO42-), and ammonium (NH4+)) were estimated using the modified Community Multiscale Air Quality model. Time-stratified case-crossover design with conditional logistic regression models was adopted to estimate mortality risks associated with short-term exposures to PM2.5 mass and its constituents. Stratification analyses were done by sex, age, and season. A total of 116,959 non-accidental deaths were investigated. PM2.5 concentrations on the day of death were averaged at 75.7 µg m-3 (control day: 75.6 µg m-3), with an interquartile range (IQR) of 65.2 µg m-3. Per IQR rise in PM2.5, EC, OC, NO3-, SO42-, and NH4+ at lag-04 day was associated with an increase in non-accidental mortality of 2.4% (95% confidence interval, (1.0-3.7), 1.7% (0.8-2.7), 2.9% (1.6-4.3), 2.1% (0.4-3.9), 1.0% (0.2-1.9), and 1.6% (0.3-2.9), respectively. Both PM2.5 mass and its constituents were strongly associated with elevated cardiovascular mortality risks, but only PM2.5, EC, and OC were positively associated with respiratory mortality at lag-3 day. PM2.5 mass and its constituents associated effects on mortality varied among sex- and age-specific subpopulations. Differences in the seasonal pattern of associations exist among PM2.5 constituents, with stronger effects related to EC and NO3- in warm months but SO42- and NH4+ in cold months. Short-term exposures to PM2.5 compositions were positively associated with increased risks of mortality, particularly those constituents from combustion-related sources.
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Affiliation(s)
- Peixuan Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jianlin Hu
- Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Junzhe Bao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhihao Shi
- Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Yang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Shaocai Mo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhouxin Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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Liu T, Zhou Y, Wei J, Chen Q, Xu R, Pan J, Lu W, Wang Y, Fan Z, Li Y, Xu L, Cui X, Shi C, Zhang L, Chen X, Bao W, Sun H, Liu Y. Association between short-term exposure to ambient air pollution and dementia mortality in Chinese adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 849:157860. [PMID: 35934025 DOI: 10.1016/j.scitotenv.2022.157860] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Short-term exposure to ambient air pollution has been linked to an increased risk of mortality from a variety of causes, but its effects on mortality from dementia remain largely unknown. OBJECTIVES To investigate the association between short-term exposure to ambient air pollution and dementia mortality, and quantitatively assess the excess mortality. METHODS In this time-stratified case-crossover study, 47,108 dementia deaths were identified in Jiangsu province, China during 2015-2019. Exposure to particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), PM10, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) was assessed by extracting daily concentrations from a validated grid dataset based on each subject's residential address. Conditional logistic regression models were applied for exposure-response analyses. RESULTS There were 47,108 case days and 159,852 control days during the study period. Each 10 μg/m3 increase of lag 04-day exposure to PM2.5, PM10, and NO2 was significantly associated with a 1.43 % (95 % CI: 0.77, 2.09 %), 1.06 % (0.59, 1.54 %), and 2.80 % (1.51, 4.10 %) increase in odds of dementia mortality, corresponding to an excess mortality of 4.87 %, 5.50 %, and 6.43 %, respectively. We estimated that reducing ambient air pollutant exposures to the WHO air quality guidelines would avoid up to 4.17 % of the dementia deaths, while the ambient air quality standards in China would only help avoid up to 0.39 %. CONCLUSIONS This study provides consistent evidence that short-term exposure to PM2.5, PM10, and NO2 is associated with increased odds of dementia mortality, which can be translated to a considerable excess mortality. Our findings highlight a potential approach to prevent deaths from dementia by reducing individual exposures to ambient air pollution, especially in areas with high levels of ambient air pollution.
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Affiliation(s)
- Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong 511436, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA
| | - Qi Chen
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jingju Pan
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Wenfeng Lu
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong 511436, China
| | - Yaqi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Zhaoyu Fan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Luxi Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Xiuqing Cui
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing 100081, China
| | - Lan Zhang
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Xi Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Wei Bao
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China.
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
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Álvaro-Meca A, Sepúlveda-Crespo D, Resino R, Ryan P, Martínez I, Resino S. Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study. Environ Health 2022; 21:107. [PMID: 36348411 PMCID: PMC9640778 DOI: 10.1186/s12940-022-00928-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults. METHODS We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values). RESULTS Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O3 and higher values of relative humidity and NO2. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO2 [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O3 [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM10 at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI. CONCLUSION Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO2, O3, PM10, and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rosa Resino
- Departamento de Geografía, Facultad de Geografía e Historia, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo Ryan
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigaciones Sanitarias Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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Zhou Y, Pan J, Xu R, Lu W, Wang Y, Liu T, Fan Z, Li Y, Shi C, Zhang L, Liu Y, Sun H. Asthma mortality attributable to ambient temperatures: A case-crossover study in China. ENVIRONMENTAL RESEARCH 2022; 214:114116. [PMID: 35988831 DOI: 10.1016/j.envres.2022.114116] [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: 04/21/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Whether ambient temperature exposure contributes to death from asthma remains unknown to date. We therefore conducted a case-crossover study in China to quantitatively evaluate the association and burden of ambient temperature exposure on asthma mortality. METHODS Using data from the National Mortality Surveillance System in China, we conducted a time-stratified case-crossover study of 15 888 individuals who lived in Hubei and Jiangsu province, China and died from asthma as the underlying cause in 2015-2019. Individual-level exposures to air temperature and apparent temperature on the date of death and 21 days prior were assessed based on each subject's residential address. Distributed lag nonlinear models based on conditional logistic regression were used to quantify exposure-response associations and calculate fraction and number of deaths attributable to non-optimum ambient temperatures. RESULTS We observed a reverse J-shaped association between air temperature and risk of asthma mortality, with a minimum mortality temperature of 21.3 °C. Non-optimum ambient temperature is responsible for substantial excess mortality from asthma. In total, 26.3% of asthma mortality were attributable to non-optimum temperatures, with moderate cold, moderate hot, extreme cold and extreme hot responsible for 21.7%, 2.4%, 2.1% and 0.9% of asthma mortality, respectively. The total attributable fraction and number was significantly higher among adults aged less than 80 years in hot temperature. CONCLUSIONS Exposure to non-optimum ambient temperature, especially moderate cold temperature, was responsible for substantial excess mortality from asthma. These findings have important implications for planning of public-health interventions to minimize the adverse respiratory damage from non-optimum ambient temperature.
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Affiliation(s)
- Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Jingju Pan
- Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenfeng Lu
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yaqi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaoyu Fan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunxiang Shi
- National Meteorological Information Center, Beijing, China
| | - Lan Zhang
- Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
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Using the Generalized Synthetic Control Method to Estimate the Impact of Extreme Weather Events on Population Health. Epidemiology 2022; 33:788-796. [PMID: 36166207 DOI: 10.1097/ede.0000000000001539] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Traditional epidemiologic approaches such as time-series or case-crossover designs are often used to estimate the effects of extreme weather events but can be limited by unmeasured confounding. Quasi-experimental methods are a family of methods that leverage natural experiments to adjust for unmeasured confounding indirectly. The recently developed generalized synthetic control method that exploits the timing of an exposure is well suited to estimate the impact of acute environmental events on health outcomes. To demonstrate how this method can be used to study extreme weather events, we examined the impact of the 20-26 October 2007 Southern California wildfire storm on respiratory hospitalizations. METHODS We used generalized synthetic control to compare the average number of ZIP code-level respiratory hospitalizations during the wildfire storm between ZIP codes that were classified as exposed versus unexposed to wildfire smoke. We considered wildfire exposure eligibility for each ZIP code using fire perimeters and satellite-based smoke plume data. We retrieved respiratory hospitalization discharge data from the Office of Statewide Health Planning and Development. R code to implement the generalized synthetic control method is included for reproducibility. RESULTS The analysis included 172 exposed and 578 unexposed ZIP codes. We estimated that the average effect of the wildfire storm among the exposed ZIP codes was an 18% (95% confidence interval: 10% to 29%) increase in respiratory hospitalizations. CONCLUSIONS We illustrate the use of generalized synthetic control to leverage natural experiments to quantify the health impacts of extreme weather events when traditional approaches are unavailable or limited by assumptions.
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Rahman MM, McConnell R, Schlaerth H, Ko J, Silva S, Lurmann FW, Palinkas L, Johnston J, Hurlburt M, Yin H, Ban-Weiss G, Garcia E. The Effects of Coexposure to Extremes of Heat and Particulate Air Pollution on Mortality in California: Implications for Climate Change. Am J Respir Crit Care Med 2022; 206:1117-1127. [PMID: 35727303 PMCID: PMC9704834 DOI: 10.1164/rccm.202204-0657oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Extremes of heat and particulate air pollution threaten human health and are becoming more frequent because of climate change. Understanding the health impacts of coexposure to extreme heat and air pollution is urgent. Objectives: To estimate the association of acute coexposure to extreme heat and ambient fine particulate matter (PM2.5) with all-cause, cardiovascular, and respiratory mortality in California from 2014 to 2019. Methods: We used a case-crossover study design with time-stratified matching using conditional logistic regression to estimate mortality associations with acute coexposures to extreme heat and PM2.5. For each case day (date of death) and its control days, daily average PM2.5 and maximum and minimum temperatures were assigned (0- to 3-day lag) on the basis of the decedent's residence census tract. Measurements and Main Results: All-cause mortality risk increased 6.1% (95% confidence interval [CI], 4.1-8.1) on extreme maximum temperature-only days and 5.0% (95% CI, 3.0-8.0) on extreme PM2.5-only days, compared with nonextreme days. Risk increased by 21.0% (95% CI, 6.6-37.3) on days with exposure to both extreme maximum temperature and PM2.5. Increased risk of cardiovascular and respiratory mortality on extreme coexposure days was 29.9% (95% CI, 3.3-63.3) and 38.0% (95% CI, -12.5 to 117.7), respectively, and were more than the sum of individual effects of extreme temperature and PM2.5 only. A similar pattern was observed for coexposure to extreme PM2.5 and minimum temperature. Effect estimates were larger over age 75 years. Conclusions: Short-term exposure to extreme heat and air pollution alone were individually associated with increased risk of mortality, but their coexposure had larger effects beyond the sum of their individual effects.
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Affiliation(s)
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine
| | - Hannah Schlaerth
- Department of Civil and Environmental Engineering, Viterbi School of Engineering
| | - Joseph Ko
- Department of Civil and Environmental Engineering, Viterbi School of Engineering
| | | | | | - Lawrence Palinkas
- Department of Population and Public Health Sciences, Keck School of Medicine
- Suzanne Dworak Peck School of Social Work, and
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine
| | - Michael Hurlburt
- Department of Population and Public Health Sciences, Keck School of Medicine
- Suzanne Dworak Peck School of Social Work, and
| | - Hao Yin
- Department of Economics, University of Southern California, Los Angeles, California
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - George Ban-Weiss
- Department of Civil and Environmental Engineering, Viterbi School of Engineering
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine
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Xu R, Wei J, Liu T, Li Y, Yang C, Shi C, Chen G, Zhou Y, Sun H, Liu Y. Association of short-term exposure to ambient PM 1 with total and cause-specific cardiovascular disease mortality. ENVIRONMENT INTERNATIONAL 2022; 169:107519. [PMID: 36152364 DOI: 10.1016/j.envint.2022.107519] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/31/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The acute effects of exposure to ambient particulate matter with an aerodynamic diameter ≤1 μm (PM1) on cardiovascular disease (CVD) mortality remain unclear. OBJECTIVES To investigate whether short-term exposure to ambient PM1 was associated with mortality from total and/or cause-specific CVDs, and estimate the excess mortality. METHODS A time-stratified case-crossover study was conducted among 1,081,507 CVD deaths in Jiangsu province, China from 2015 to 2020. We assessed daily residential ambient PM1 exposures using a validated grid dataset for each subject. Conditional logistic regression models and distributed lag linear or nonlinear models were employed to quantify the association of PM1 exposure with mortality during the same day of CVD death and 1 day prior. RESULTS Each 10 μg/m3 increase of PM1 exposure was significantly associated with a 1.46 % (95 % confidence interval: 1.28 %, 1.65 %), 1.95 % (1.28 %, 2.63 %), 1.16 % (0.86 %, 1.47 %), 1.41 % (1.13 %, 1.69 %), and 1.83 % (1.37 %, 2.30 %) increased odds of mortality from total CVDs, hypertensive diseases (HDs), ischemic heart diseases (IHDs), stroke, and sequelae of stroke, respectively (all p <0.05). No significant association was identified with mortality from pulmonary heart disease or chronic rheumatic heart diseases. The excess fraction of total CVD mortality attributable to PM1 exposure was 5.71 %, while the cause-specific excess fractions ranged from 4.98 % for IHDs to 7.46 % for HDs. Significantly higher excess fractions were observed for total and certain cause-specific CVD mortality in adults 80 years or older. CONCLUSIONS We found that short-term exposure to ambient PM1 was significantly associated with an increased odds of mortality from total and specific CVDs and may lead to considerable excess mortality especially among older adults. Our findings highlight a potential approach to prevent premature CVD deaths by reducing PM1 exposures and provide essential quantitative data for the development of future air quality standards for ambient PM1.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunyu Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Wang R, Xu R, Wei J, Liu T, Ye Y, Li Y, Lin Q, Zhou Y, Huang S, Lv Z, Tian Q, Liu Y. Short-Term Exposure to Ambient Air Pollution and Hospital Admissions for Sequelae of Stroke in Chinese Older Adults. GEOHEALTH 2022; 6:e2022GH000700. [PMID: 36447746 PMCID: PMC9696746 DOI: 10.1029/2022gh000700] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Extensive evidence suggests that ambient air pollution contributes to a higher risk of hospital admissions for cerebrovascular diseases; however, its association with admissions for sequelae of stroke remains unclear. A time-stratified case-crossover study was conducted among 31,810 older adults who were admitted to hospital for sequelae of stroke in Guangzhou, China during 2016-2019. For each subject, daily residential exposure to fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) was extracted from a validated grid data set. Conditional logistic regression models were used for exposure-response analyses. In single-pollutant models, each interquartile range (IQR) increase of lag 04-day exposure to CO (IQR: 0.25 mg/m3) and lag 3-day exposure to O3 (69.6 μg/m3) was significantly associated with a 4.53% (95% confidence interval: 1.67%, 7.47%) and 5.63% (1.92%, 9.48%) increase in odds of hospital admissions for sequelae of stroke, respectively. These associations did not significantly vary across age or sex. With further adjustment for each of the other pollutants in 2-pollutant models, the association for CO did not change significantly, while the association for O3 disappeared. We estimated that 7.72% of the hospital admissions were attributable to CO exposures. No significant or consistent association was observed for exposure to PM2.5, PM10, SO2, or NO2. In conclusion, short-term exposure to ambient CO, even at levels below the WHO air quality guideline, was significantly associated with an increased odds of hospital admissions for sequelae of stroke, which may lead to considerable excess hospital admissions.
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Affiliation(s)
- Rui Wang
- Luohu District Chronic Disease HospitalShenzhenChina
| | - Ruijun Xu
- Department of EpidemiologySchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Jing Wei
- Department of Atmospheric and Oceanic ScienceEarth System Science Interdisciplinary CenterUniversity of MarylandCollege ParkMDUSA
| | - Tingting Liu
- Department of EpidemiologySchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yunshao Ye
- Guangzhou Health Technology Identification & Human Resources Assessment CenterGuangzhouChina
| | - Yingxin Li
- Department of EpidemiologySchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Qiaoxuan Lin
- Guangzhou Health Technology Identification & Human Resources Assessment CenterGuangzhouChina
| | - Yun Zhou
- Department of Preventive MedicineSchool of Public HealthGuangzhou Medical UniversityGuangzhouChina
| | - Suli Huang
- Department of Environment and HealthShenzhen Center for Disease Control and PreventionShenzhenChina
| | - Ziquan Lv
- Department of Molecular EpidemiologyShenzhen Center for Disease Control and PreventionShenzhenChina
| | - Qi Tian
- Guangzhou Health Technology Identification & Human Resources Assessment CenterGuangzhouChina
| | - Yuewei Liu
- Department of EpidemiologySchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
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Zhang T, Wu Y, Guo Y, Yan B, Wei J, Zhang H, Meng X, Zhang C, Sun H, Huang L. Risk of illness-related school absenteeism for elementary students with exposure to PM 2.5 and O 3. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 842:156824. [PMID: 35738367 DOI: 10.1016/j.scitotenv.2022.156824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
Air pollution addresses short-term health effects on morbidity, especially for children. Assessing the impacts of air pollution on elementary students is critical for developing preparedness response strategies for this sensitive group. In the 2016-17 academic year, up to 687,748 groups of illness-related absence records and the information on whether the absentee had gone to a hospital or not were collected from 2564 elementary schools across Jiangsu Province China. We explored the associations between air pollution and illness-related records using a time-stratified case-crossover analysis with distributed lag non-linear design. An increase of 10 μg/m3 in the current-day concentration of PM2.5 and O3 was positively associated with illness-related absenteeism overall. The excess risk of absenteeism was 4.52 % (95%CI 4.37-4.67 %) for PM2.5 and 0.25 % (95%CI 0.01-0.36 %) for O3. The risk associated with O3 was boosted for the frequent absentees who tended to have basic diseases or were more vulnerable to infectious diseases. Students in 43.1 % illness-related absenteeism, mainly due to highly infectious diseases, only received home nursing without going to a hospital. The increase in the number of illness cases associated with PM2.5 and O3 estimated based on the illness-related absence data was 41.5 % and 18.6 % higher than that evaluated based on hospital visit records. Such underestimations persisted in sensitivity analyses and persisted in subgroups classified by gender or grade. Together, the performance of illness-related absence records far outweighed that of hospital visit data regarding the thorough evaluation of air pollution-related illness cases for elementary students. Improvement in air quality and home health care education are warranted as well for the health benefits of children.
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Affiliation(s)
- Ting Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Yangyang Wu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Beizhan Yan
- Lamont-Doherty Earth Observatory of Columbia University, 61 Rt. 9W., Palisades, NY 10964, United States
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, 20740, USA
| | - Hongliang Zhang
- Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China
| | - Xia Meng
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Can Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, Nanjing 210009, China.
| | - Lei Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
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Xu R, Tian Q, Wei J, Ye Y, Li Y, Lin Q, Wang Y, Liu L, Shi C, Xia W, Liu Y. Short-term exposure to ambient air pollution and readmissions for heart failure among 3660 post-discharge patients with hypertension in older Chinese adults. J Epidemiol Community Health 2022; 76:984-990. [PMID: 36198486 DOI: 10.1136/jech-2022-219676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/21/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite ambient air pollution being associated with various adverse cardiovascular outcomes, the acute effects of ambient air pollution on hospital readmissions for heart failure (HF) among post-discharge patients with hypertension remain less understood. METHODS We conducted a time-stratified case-crossover study among 3660 subjects 60 years or older who were admitted to hospital for HF after discharge for hypertension in Guangzhou, China during 2016-2019. For each subject, individualised residential exposures to ambient particulate matter with an aerodynamic diameter ≤1 µm (PM1), ≤2.5 µm (PM2.5), ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone were extracted from our validated grid dataset. RESULTS An IQR increase of lag 04-day exposure to PM1 (IQR: 11.6 μg/m3), PM2.5 (IQR 21.9 μg/m3), PM10 (IQR 35.0 μg/m3), SO2 (IQR 4.4 μg/m3), NO2 (IQR 23.3 μg/m3) and CO (IQR 0.25 mg/m3) was significantly associated with a 9.77% (95% CI 2.21% to 17.89%), 8.74% (95% CI 1.05% to 17.00%), 13.93% (95% CI 5.36% to 23.20%), 10.81% (95% CI 1.82% to 20.60%), 14.97% (95% CI 8.05% to 22.34%) and 7.37% (95% CI 0.98% to 14.16%) increase in odds of HF readmissions, respectively. With adjustment for other pollutants, the association for NO2 exposure remained stable, while the associations for PM1, PM2.5, PM10, SO2 and CO exposures became insignificant. Overall, an estimated 19.86% of HF readmissions were attributable to NO2 exposure, while reducing NO2 exposure to the WHO and China air quality standards would avoid 12.87% and 0.54% of readmissions, respectively. No susceptible populations were observed by sex, age or season. CONCLUSION Short-term exposure to ambient NO2 was significantly associated with an increased odds of HF readmissions among post-discharge patients with hypertension in older Chinese adults.
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Affiliation(s)
- Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qi Tian
- Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland at College Park, College Park, Maryland, USA
| | - Yunshao Ye
- Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China
| | - Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiaoxuan Lin
- Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China
| | - Yaqi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Wenhao Xia
- Department of Hypertension and Vascular Disease, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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Chen Q, Chen Q, Wang Q, Xu R, Liu T, Liu Y, Ding Z, Sun H. Particulate matter and ozone might trigger deaths from chronic ischemic heart disease. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113931. [PMID: 35914398 DOI: 10.1016/j.ecoenv.2022.113931] [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: 05/31/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
AIMS To study the association between short-term exposure to air pollutants and mortality of Chronic Ischemic Heart Disease (CIHD). METHODS Using a case-crossover design, we investigated 148,443 CIHD deaths from 2015 to 2020 in Jiangsu Province, China. Exposure to six ambient pollutants, including PM10, PM2.5, NO2, CO, SO2, and O3, was assessed by extracting daily concentrations from validated 10 km × 10 km pollutant grids at each subject's residential address. A conditional logistic regression approach was used to explore the exposure-response relationship with adjustment for temperature and relative humidity. We calculated the Population Attributable Fractions (PAFs) and the attributable deaths number of CIHD. RESULTS An increase of 10 μg/m3 in PM10 and PM2.5 exposure was associated with a 1.16% (95% CI: 0.85-1.48%) and 1.80% (1.36-2.24%) increase in CIHD mortality, respectively. A threshold value of 123 µg/m3 was identified for the association between O3 exposure and CIHD mortality. Controlling for PM2.5, each increase of 10 µg/m3 in O3 (>threshold) was statistically significantly associated with a 0.94% (0.19-1.71%) increase in CIHD mortality, however there was no association between NO2, SO2, CO exposure and CIHD mortality. Reducing PM2.5, PM10 and O3 to the WHO air quality guidelines would prevent 6.16% (95% CI: 4.70-7.58%), 4.30% (3.18-5.43%) and 1.29% (0.48-4.20%) of CIHD deaths, respectively. During the warm season, mortality and PAFs of CIHD associated with PM2.5, PM10, and O3 were significantly higher. CONCLUSIONS Short-term exposure to ambient PM2.5, PM10, and O3 might trigger deaths from CIHD. These findings indicate that the premature deaths of CIHD patients can be alleviated by reducing exposure to polluted air.
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Affiliation(s)
- Qing Chen
- Department of Planning and Finance, First People's Hospital of Lianyungang City 6, Zhenhua East Road, Lianyungang, Jiangsu, 222000, China
| | - Qi Chen
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Qingqing Wang
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 74 Zhongshan Second Road, Guangzhou, Guangdong 510080, China
| | - Zhen Ding
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China
| | - Hong Sun
- Department of Environment and Health, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China.
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Álvaro-Meca A, Goez MDC, Resino R, Matías V, Sepúlveda-Crespo D, Martínez I, Resino S. Environmental factors linked to hospital admissions in young children due to acute viral lower respiratory infections: A bidirectional case-crossover study. ENVIRONMENTAL RESEARCH 2022; 212:113319. [PMID: 35447151 DOI: 10.1016/j.envres.2022.113319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/14/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the association of the short-term exposure to environmental factors (relative humidity, temperature, NO2, SO2, O3, PM10, and CO) with hospital admissions due to acute viral lower respiratory infections (ALRI) in children under two years before the COVID-19 era. METHODS We performed a bidirectional case-crossover study in 30,445 children with ALRI under two years of age in the Spanish Minimum Basic Data Set (MBDS) from 2013 to 2015. Environmental data were obtained from Spain's State Meteorological Agency (AEMET). The association was assessed by conditional logistic regression. RESULTS Lower temperature one week before the day of the event (hospital admission) (q-value = 0.012) and higher relative humidity one week (q-value = 0.003) and two weeks (q-value<0.001) before the day of the event were related to a higher odds of hospital admissions. Higher NO2 levels two weeks before the event were associated with hospital admissions (q-value<0.001). Moreover, higher concentrations on the day of the event for SO2 (compared to lag time of 1-week (q-value = 0.026) and 2-weeks (q-value<0.001)), O3 (compared to lag time of 3-days (q-value<0.001), 1-week (q-value<0.001), and 2-weeks (q-value<0.001)), and PM10 (compared to lag time of 2-weeks (q-value<0.001)) were related to an increased odds of hospital admissions for viral ALRI. CONCLUSION Short-term exposure to environmental factors (climatic conditions and ambient air contaminants) was linked to a higher likelihood of hospital admissions due to ALRI. Our findings emphasize the importance of monitoring environmental factors to assess the odds of ALRI hospital admissions and plan public health resources.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rosa Resino
- Departamento de Geografía Humana, Facultad de Geografía e Historia, Universidad Complutense de Madrid. Madrid, Spain
| | - Vanesa Matías
- Servicio de Pedíatría, Hospital Clínico Universitario, Valladolid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain.
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