Particulate Matter and Subclinical Atherosclerosis: Associations between Different Particle Sizes and Sources with Carotid Intima-Media Thickness in the SAPALDIA Study

Long-term exposure to particulate matter pollution and incidence of ischemic and hemorrhagic stroke: A prospective cohort study in Eastern China

Although epidemiological studies have demonstrated significant associations of long-term exposure to particulate matter (PM) air pollution with stroke, evidence on the long-term effects of PM exposure on cause-specific stroke incidence is scarce and inconsistent. We incorporated 33,282 and 33,868 individuals aged 35-75 years without a history of ischemic or hemorrhagic stroke at the baseline in 2014, who were followed up till 2021. Residential exposures to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and particulate matter with an aerodynamic diameter less than 10 μm (PM10) for each participant were predicted using a satellite-based model with a spatial resolution of 1 × 1 km. We employed time-varying Cox proportional hazards models to assess the long-term effect of PM pollution on incident stroke. We identified 926 cases of ischemic stroke and 211 of hemorrhagic stroke. Long-term PM exposure was significantly associated with increased incidence of both ischemic and hemorrhagic stroke, with almost 2 times higher risk on hemorrhagic stroke. Specifically, a 10 μg/m³ increase in 3-year average concentrations of PM2.5 was linked to a hazard ratio (HR) of 1.35 (95% confidence interval (CI): 1.18-1.54) for incident ischemic stroke and 1.79 (95% CI: 1.36-2.34) for incident hemorrhagic stroke. The HR related to PM10, though smaller, remained statistically significant, with a HR of 1.25 for ischemic stroke and a HR of 1.51 for hemorrhagic stroke. The excess risks are larger among rural residents and individuals with lower educational attainment. The present cohort study contributed to the mounting evidence on the increased risk of incident stroke associated with long-term PM exposures. Our results further provide valuable evidence on the heightened sensitivity of hemorrhagic stroke to air pollution exposures compared with ischemic stroke.

Harnessing AI to unmask Copenhagen's invisible air pollutants: A study on three ultrafine particle metrics

Ultrafine particles (UFPs) are airborne particles with a diameter of less than 100 nm. They are emitted from various sources, such as traffic, combustion, and industrial processes, and can have adverse effects on human health. Long-term mean ambient average particle size (APS) in the UFP range varies over space within cities, with locations near UFP sources having typically smaller APS. Spatial models for lung deposited surface area (LDSA) within urban areas are limited and currently there is no model for APS in any European city. We collected particle number concentration (PNC), LDSA, and APS data over one-year monitoring campaign from May 2021 to May 2022 across 27 locations and estimated annual mean in Copenhagen, Denmark, and obtained additionally annual mean PNC data from 6 state-owned continuous monitors. We developed 94 predictor variables, and machine learning models (random forest and bagged tree) were developed for PNC, LDSA, and APS. The annual mean PNC, LDSA, and APS were, respectively, 5523 pt/cm3, 12.0 μm2/cm3, and 46.1 nm. The final R2 values by random forest (RF) model were 0.93 for PNC, 0.88 for LDSA, and 0.85 for APS. The 10-fold, repeated 10-times cross-validation R2 values were 0.65, 0.67, and 0.60 for PNC, LDSA, and APS, respectively. The root mean square error for final RF models were 296 pt/cm3, 0.48 μm2/cm3, and 1.60 nm for PNC, LDSA, and APS, respectively. Traffic-related variables, such as length of major roads within buffers 100-150 m and distance to streets with various speed limits were amongst the highly-ranked predictors for our models. Overall, our ML models achieved high R2 values and low errors, providing insights into UFP exposure in a European city where average PNC is quite low. These hyperlocal predictions can be used to study health effects of UFPs in the Danish Capital.

Particle lung deposited surface area (LDSAal) size distributions in different urban environments and geographical regions: Towards understanding of the PM2.5 dose-response

Recent studies indicate that monitoring only fine particulate matter (PM2.5) may not be enough to understand and tackle the health risk caused by particulate pollution. Health effects per unit PM2.5 seem to increase in countries with low PM2.5, but also near local pollution sources (e.g., traffic) within cities. The aim of this study is to understand the differences in the characteristics of lung-depositing particles in different geographical regions and urban environments. Particle lung deposited surface area (LDSAal) concentrations and size distributions, along with PM2.5, were compared with ambient measurement data from Finland, Germany, Czechia, Chile, and India, covering traffic sites, residential areas, airports, shipping, and industrial sites. In Finland (low PM2.5), LDSAal size distributions depended significantly on the urban environment and were mainly attributable to ultrafine particles (<100 nm). In Central Europe (moderate PM2.5), LDSAal was also dependent on the urban environment, but furthermore heavily influenced by the regional aerosol. In Chile and India (high PM2.5), LDSAal was mostly contributed by the regional aerosol despite that the measurements were done at busy traffic sites. The results indicate that the characteristics of lung-depositing particles vary significantly both within cities and between geographical regions. In addition, ratio between LDSAal and PM2.5 depended notably on the environment and the country, suggesting that LDSAal exposure per unit PM2.5 may be multiple times higher in areas having low PM2.5 compared to areas with continuously high PM2.5. These findings may partly explain why PM2.5 seems more toxic near local pollution sources and in areas with low PM2.5. Furthermore, performance of a typical sensor based LDSAal measurement is discussed and a new LDSAal2.5 notation indicating deposition region and particle size range is introduced. Overall, the study emphasizes the need for country-specific emission mitigation strategies, and the potential of LDSAal concentration as a health-relevant pollution metric.

Long-term exposure to ambient fine particulate matter and carotid intima media thickness at bilateral, left and right in adults from Mexico City: Results from GEA study

BACKGROUND

PM2.5 exposure has been associated with intima-media thickness (cIMT) increase. However, very few studies distinguished between left and right cIMT in relation to PM2.5 exposure.

AIM

To evaluate associations between chronic exposure to PM2.5 and cIMT at bilateral, left, and right in adults from Mexico City.

METHODS

This study comprised 913 participants from the control group, participants without personal or family history of cardiovascular disease, of the Genetics of Atherosclerosis Disease Mexican study (GEA acronym in Spanish), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. To assess the associations between chronic exposure to PM2.5 (per 5 μg/m3 increase) at different lag years (1-4 years) and cIMT (bilateral, left, and right) we applied distributed lag non-linear models (DLNMs).

RESULTS

The median and interquartile range for cIMT at bilateral, left, and right, were 630 (555, 735), 640 (550, 750), and 620 (530, 720) μm, respectively. Annual average PM2.5 exposure was 26.64 μg/m3, with median and IQR, of 24.46 (23.5-25.46) μg/m3. Results from DLNMs adjusted for age, sex, body mass index, low-density lipoproteins, and glucose, showed that PM2.5 exposure for year 1 and 2, were positively and significantly associated with right-cIMT [6.99% (95% CI: 3.67; 10.42) and 2.98% (0.03; 6.01), respectively]. Negative associations were observed for PM2.5 at year 3 and 4 and right-cIMT; however only year 3 was statistically significant [-2.83% (95% CI: 5.12; -0.50)]. Left-cIMT was not associated with PM2.5 exposure at any lag year. The increase in bilateral cIMT followed a similar pattern as that observed for right-cIMT, but with lower estimates.

CONCLUSIONS

Our results suggest different susceptibility between left and right cIMT associated with PM2.5 exposure highlighting the need of measuring both, left and right cIMT, regarding ambient air pollution in epidemiological studies.

Spatiotemporal Heterogeneity of Lung-Deposited Surface Area in Zurich Switzerland: Lung-Deposited Surface Area as a New Routine Metric for Ambient Particle Monitoring

Objective: To assess the spatiotemporal heterogeneity of lung-deposited particle surface area concentration (LDSA), while testing the long-term performance of a prototype of low-cost-low-maintenance LDSA sensors. One factor hampering epidemiological studies on fine to ultrafine particles (F-to-UFP) exposure is exposure error due to their high spatiotemporal heterogeneity, not reflected in particle mass. Though LDSA shows consistent associations between F-to-UFP exposure and health effects, LDSA data are limited. Methods: We measured LDSA in a network of ten sensors, including urban, suburban, and rural environments in Zurich, Switzerland. With traffic counts, traffic co-pollutant concentrations, and meteorological parameters, we assessed the drivers of the LDSA observations. Results: LDSA reflected the high spatiotemporal heterogeneity of F-to-UFP. With micrometeorological influences, local sources like road traffic, restaurants, air traffic, and residential combustion drove LDSA. The temporal pattern of LDSA reflected that of the local sources. Conclusion: LDSA may be a viable metric for inexpensively characterizing F-to-UFP exposure. The tested devices generated sound data and may significantly contribute to filling the LDSA exposure data gap, providing grounds for more statistically significant epidemiological studies and regulation of F-to-UFP.

Associations of time-weighted individual exposure to ambient particulate matter with carotid atherosclerosis in Beijing, China

BACKGROUND

Time-location information (time spent on commuting, indoors and outdoors around residential and work places and physical activity) and infiltrated outdoor pollution was less considered estimating individual exposure to ambient air pollution. Studies investigating the association between individual exposure to particulate matter (PM) with aerodynamic diameter < 10 μm (PM₁₀) and < 2.5 μm (PM_2.5) and carotid atherosclerosis presented inconsistent results. Moreover, combined effect of pollutants on carotid atherosclerosis was not fully explored. We aimed to investigate the association between long-term individual time-weighted average exposure to PM_2.5 and PM₁₀ and the risk of carotid atherosclerosis, and further explore the overall effect of co-exposure to pollutants on carotid atherosclerosis.

METHODS

The study population included 3069 participants derived from the Beijing Health Management Cohort (BHMC) study. Daily concentration of ambient air pollutants was estimated by land-use regression model at both residential and work addresses, and one- and two-year time-weighted average individual exposure was calculated by further considering personal activity pattern and infiltration of ambient air pollution indoors. We explored the association of PM_2.5 and PM₁₀ with carotid atherosclerosis and pooled the overall effect of co-exposure to ambient air pollutants by quantile g-computation.

RESULTS

A significant association between time-weighted average exposure to PM_2.5 and PM₁₀ and carotid atherosclerosis was observed. Per interquartile range increase in two-year exposure to PM_2.5 (Hazard ratio (HR): 1.322, 95% confidence interval (CI): 1.219-1.434) and PM₁₀ (HR:1.213, 95% CI: 1.116-1.319) showed the strongest association with carotid atherosclerosis, respectively. Individuals in higher quartiles of pollutants were at higher risk for carotid atherosclerosis compared with those in the lowest quartile group. Concentration response functions documented the nearly linear and nonlinear relationship and interpreted the upward trends of the risk for carotid atherosclerosis with increasing level of pollutant concentrations. Moreover, effect estimates for the mixture of pollutants and carotid atherosclerosis were larger than any of the individual pollutants (HR (95% CI) was 1.510 (1.338-1.704) and 1.613 (1.428-1.822) per quartile increase for one-year and two-year time-weighted average exposure, respectively).

CONCLUSIONS

Individual time-weighted average exposure to PM_2.5 and PM₁₀ was associated with carotid atherosclerosis. Co-exposure to ambient air pollution was also positively associated with carotid atherosclerosis.

Snapshots of wintertime urban aerosol characteristics: Local sources emphasized in ultrafine particle number and lung deposited surface area

Urban air fine particles are a major health-relating problem. However, it is not well understood how the health-relevant features of fine particles should be monitored. Limitations of PM_2.5 (mass concentration of sub 2.5 μm particles), which is commonly used in the health effect estimations, have been recognized and, e.g., World Health Organization (WHO) has released good practice statements for particle number (PN) and black carbon (BC) concentrations (2021). In this study, a characterization of urban wintertime aerosol was done in three environments: a detached housing area with residential wood combustion, traffic-influenced streets in a city centre and near an airport. The particle characteristics varied significantly between the locations, resulting different average particle sizes causing lung deposited surface area (LDSA). Near the airport, departing planes had a major contribution on PN, and most particles were smaller than 10 nm, similarly as in the city centre. The high hourly mean PN (>20 000 1/cm³) stated in the WHO's good practices was clearly exceeded near the airport and in the city centre, even though traffic rates were reduced due to a SARS-CoV-2-related partial lockdown. In the residential area, wood combustion increased both BC and PM_2.5, but also PN of sub 10 and 23 nm particles. The high concentrations of sub 10 nm particles in all the locations show the importance of the chosen lower size limit of PN measurement, e.g., WHO states that the lower limit should be 10 nm or smaller. Furthermore, due to ultrafine particle emissions, LDSA per unit PM_2.5 was 1.4 and 2.4 times higher near the airport than in the city centre and the residential area, respectively, indicating that health effects of PM_2.5 depend on urban environment as well as conditions, and emphasizing the importance of PN monitoring in terms of health effects related to local pollution sources.

Source-oriented risk and lung-deposited surface area (LDSA) of ultrafine particles in a Southeast Asia urban area

Submicron and ultrafine particle (UFP) exposure may be epidemiologically and toxicologically linked to pulmonary, neurodegenerative, and cardiovascular diseases. This study explores UFP and fine particle sources using a positive matrix factorization (PMF) model based on PM_2.5 chemical compositions and particle number size distributions (PNSDs). The particle chemical composition and size distribution contributions are simultaneously identified to evaluate lung deposition and excess cancer risks. High correlations between the PNSD and chemical composition apportionment results were observed. Fresh and aged traffic particles dominated the number concentrations, while heterogeneous, photochemical reactions and/or regional transport may have resulted in secondary aerosol formation. Fresh and aged road traffic particle sources mostly contributed to the lung deposition dosage in the pulmonary region (~53 %), followed by the tracheobronchial (~30.4 %) and head regions (~16.6 %). However, lung-deposited surface area (LDSA) concentrations were dominated by aged road traffic (~39.2 %) and secondary aerosol (~33.2 %) sources. The excess cancer risks caused by Cr⁶⁺, Ni, and As were also mainly contributed to by aged road traffic (~31.7 %) and secondary aerosols (~67 %). The source apportionments based on the physical and chemical properties of aerosol particles are complementary, offering a health impact benchmark of UFPs in a Southeast Asia urban city.

Association of long-term exposure to PM2.5 and survival following ischemic heart disease

BACKGROUND

Numerous studies have suggested that long-term exposure to particulate matter ≤2.5 μm (PM_2.5) may cause cardiovascular morbidity and mortality. However, susceptibility among those with a history of ischemic heart disease is less clearly understood. We aimed to evaluate whether long-term PM_2.5 exposure is related to mortality among patients with ischemic heart disease.

METHODS

We followed up 306,418 patients hospitalized with ischemic heart disease in seven major cities in South Korea between 2008 and 2016 using the National Health Insurance Database. We linked the modeled PM_2.5 data corresponding to each patient's administrative districts and estimated hazard ratios (HRs) of cause-specific mortality associated with the long-term exposure to PM_2.5 in time-varying Cox proportional hazard models after adjusting for individual- and area-level characteristics. We also estimated HRs by sex, age group (65-74 vs. ≥75 years), and household income.

RESULTS

Of the patients with ischemic heart disease, mean age at the discharge was 76.8 years, and 105,913 died during a mean follow-up duration of 21.4 months. The HR of all-cause mortality was 1.10 [95% confidence intervals (CI): 1.07, 1.14] per 10 μg/m³ increase in a 12-month moving average PM_2.5. The HRs of cardiovascular, stroke, and ischemic heart disease were 1.17 (95% CI: 1.11, 1.24), 1.17 (95% CI: 1.06, 1.30), and 1.25 (95% CI: 1.15, 1.35), respectively. The subgroup analyses showed that participants aged 65-74 years were more susceptible to adverse effects of PM_2.5 exposure. We did not observe any differences in the risk by sex and household income.

CONCLUSION

Mortality from all-cause and cardiovascular disease following hospitalization due to ischemic heart disease was higher among individuals with greater PM_2.5 exposure in seven major cities in South Korea. The result supports the association of long-term exposure to air pollution with poor prognosis among patients with ischemic heart disease.

Exposure to O3 and NO2 in physically active adults: an evaluation of physiological parameters and health risk assessment

The gaseous air pollutants ozone (O₃) and nitrogen dioxide (NO₂) have a large public health relevance and trigger environmental health risk. On the other hand, despite the health benefits, exercise practices might increase the susceptibility to air pollutants exposure. However, there are innumerous lifestyle factors besides physical activity habits that must be considered in the daily air pollution exposure and are still not fully comprehended. This study aimed to evaluate the effects of O₃ and NO₂ exposure on cardiorespiratory fitness, lipid accumulation product (LAP), and environmental health risk during the entire daily routine of physically active adults that exercise in outdoor and indoor environments. One hundred and twenty healthy young men were assigned to untrained (n = 52), indoor exercise (n = 36), and outdoor exercise (n = 32) groups, following their lifestyle exercise habits, and O₃ and NO₂ were assessed by personal monitoring. Exercised groups demonstrated higher healthy eating index (HEI) (p < 0.001), physical activity (PA) (p < 0.001), metabolic equivalent of task (MET) (p < 0.001), and peak oxygen uptake VO_2peak (p < 0.001), while outdoor group had lower LAP index (p < 0.001) and higher O₃ concentration (p = 0.0442). Environmental health risk demonstrated no difference (p > 0.05). The higher O₃ concentration was positively correlated with the risk quotient (p = 0.003) and MET (p = 0.020), and a negative correlation between LAP and VO_2peak was observed (p < 0.001). In conclusion, physically active individuals might have a lower risk of developing cardiovascular and metabolic diseases despite the higher O₃ concentration exposure, and the exposure during exercise did not represent an additional health risk.

Assessing and Validating the Ability of Machine Learning to Handle Unrefined Particle Air Pollution Mobile Monitoring Data Randomly, Spatially, and Spatiotemporally

Many epidemiological studies have evaluated the accuracy of machine learning models in predicting levels of particulate number (PN) and black carbon (BC) pollutant concentrations. However, few studies have investigated the ability of machine learning to predict the pollutant concentration with using unrefined mobile measurement data and explore the reliability of the prediction models. Additionally, researchers are moving away from using fixed-site data in favor of using mobile monitoring data in a variety of locations to develop hourly empirical models of particulate air pollution. This study compared the differences between long-term (daily average) and short-term (hourly average and 1 s unrefined data) model performance in three different classes of cross validation: randomly, spatially, and spatially temporally. This study used secondary data describing BC and PN pollutant levels in the rural location of Blacksburg (VA). Our results show that the model based on unrefined data was able to detect the pollutant hot spot areas with similar accuracy compared to the aggregated model. Moreover, the performance was found to improve when temporal data added to the model: the 10-fold MAE for the BC and PN were 0.44 μg/m³ and 3391 pt/cm³, respectively, for the unrefined data (one second data) model. The findings detailed here will add to the literature on the correlation between data (pre)processing and the efficacy of machine learning models in predicting pollution levels while also enhancing our understanding of more reliable validation strategies.

Individualized References of Carotid Stiffening Quantified With Ultrafast Ultrasound Imaging: Model Construction and Preliminary Validation

To establish and preliminarily validate an individualized reference of carotid stiffness quantified by ultrafast pulse wave velocity (ufPWV), our study included 225 healthy individuals in the modeling cohort and 628 individuals in the validation cohort. All participants underwent assessment of carotid intima-media thickness (cIMT), pulse wave velocity-beginning of systole and pulse wave velocity-end of systole (PWV-ES). A threshold equation of estimated PWV-ES was obtained by multiple linear regression analysis in the modeling cohort as follows: estimated PWV-ES (m/s) = 0.080 × age (y) + 0.767 × low-density lipoprotein (mmol/L) + 0.040 × systolic blood pressure (mm Hg) + 0.372 × sex (male = 1, female = 0) - 2.803. With this equation, the validation cohort was divided into the low PWV-ES (actual PWV-ES ≤ estimated PWV-ES) and high PWV-ES (actual PWV-ES > estimated PWV-ES) groups. A clear boundary was found to be present between the low PWV-ES and high PWV-ES groups in the validation cohort. Participants with increasing PWV-ES increased with age gradually. We further subdivided participants into cIMT subgroups using a cutoff thickness of 0.050 cm. Diagnostic performance analysis revealed that the sensitivity and specificity of the threshold equation were 78.9% and 73.9%, respectively. We established and validated a novel individualized reference equation for estimated PWV-ES, which can likely expand the application of prospective ufPWV assessment.

Alterations of IL-1beta and TNF-alpha expression in RAW264.7 cell damage induced by two samples of PM2.5 with different compositions

Fine particulate matter 2.5 (PM2.5) has been demonstrated by previous studies to be associated with cell damage. To explore the impact of the composition of PM2.5 on PM2.5-mediated inflammation, this study investigated the composition of PM2.5 collected during the wintertime indoor heating season and observed its inflammatory effect. Samples were collected during the heating season from December 5, 2017, to January 8, 2018, in Xi'an. Compositions of organic carbon (OC), elemental carbon (EC), and water-soluble ions were analysed. Two representative samples (sample 1 and 2) were selected with significant differences in compositions. They were configured into four concentrations (0.1 μg/mL, 1 μg/mL, 10 μg/mL, 20 μg/mL) and used as interventions on RAW264.7 cells for 4 h and 24 h separately. Cell viability was detected by CCK-8. Tumour necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) gene and protein expression levels were detected by real-time quantitative real-time polymerase chain reaction (RT-qPCR) and western blotting. The results showed that the cell viability of sample 1 intervened cells at 4 h and 24 h was lower than that of sample 2. IL-1β gene in most PM2.5 intervention groups was lower than in the control group. Protein expression was higher at 4 h than at 24 h. In conclusion, PM2.5 components influence cell viability and expression of IL-1β and TNF-α, while high concentrations of NO3-, Cl-, Na+, K+, Mg2+, Ca2+, and others in the PM2.5 composition have a significant harmful effect.

Adverse outcome pathway of fine particulate matter leading to increased cardiovascular morbidity and mortality: An integrated perspective from toxicology and epidemiology

Fine particulate matter (PM_2.5) exposure is a major threat to public health, and is listed as one of the leading factors associated with global premature mortality. Among the adverse health effects on multiple organs or tissues, the influence of PM_2.5 exposure on cardiovascular system has drawn more and more attention. Although numerous studies have investigated the mechanisms responsible for the cardiovascular toxicity of PM_2.5, the various mechanisms have not been integrated due to the variety of the study models, different levels of toxicity assessment endpoints, etc. Adverse Outcome Pathway (AOP) framework is a useful tool to achieve this goal so as to facilitate comprehensive understanding of toxicity assessment of PM_2.5 on cardiovascular system. This review aims to illustrate the causal mechanistic relationships of PM_2.5-triggered cardiovascular toxicity from different levels (from molecular/cellular/organ to individual/population) by using AOP framework. Based on the AOP Wiki and published literature, we propose an AOP framework focusing on the cardiovascular toxicity induced by PM_2.5 exposure. The molecular initiating event (MIE) is identified as reactive oxygen species generation, followed by the key events (KEs) of oxidative damage and mitochondria dysfunction, which induces vascular endothelial dysfunction via vascular endothelial cell autophagy dysfunction, vascular fibrosis via vascular smooth muscle cell activation, cardiac dysregulation via myocardial apoptosis, and cardiac fibrosis via fibroblast proliferation and myofibroblast differentiation, respectively; all of the above cardiovascular injuries ultimately elevate cardiovascular morbidity and mortality in the general population. As far as we know, this is the first work on PM_2.5-related cardiovascular AOP construction. In the future, more work needs to be done to explore new markers in the safety assessment of cardiovascular toxicity induced by PM_2.5.

Fine particulate matter air pollution and subclinical cardiovascular outcomes: A longitudinal study in 15 Chinese cities

AIMS

Although previous studies have linked short-term exposure to fine particulate matter (PM_2.5) air pollution with various molecular biomarkers of cardiovascular system, limited evidence is available for indicators at clinical or subclinical levels. We examined the associations between short-term PM_2.5 exposure and a range of clinical or subclinical indicators of cardiovascular health in general population.

METHODS AND RESULTS

A longitudinal repeated-measure study was conducted among 247,640 participants who repeatedly visited health examination centers in 15 typical cities across China from 2013 to 2020. A total of 19 well-established indicators of cardiovascular risk or injury were evaluated and air quality data at nearest fixed-site monitors were collected. Linear mixed-effects models with distributed lag models were used to analyze the potentially lagged effects of PM_2.5. The average daily PM_2.5 concentration was 48 μg/m³ during the study period. PM_2.5 exposure was associated with significant changes of 16 indicators with the effects generally peaked on lag 0 to 3 day. For an interquartile range (IQR) elevation (37 μg/m³) in PM_2.5 concentrations over lag 0-7 day, the cumulative percentage changes were 0.50% to 1.27% in heart rates and blood pressure, 0.10% to 5.04% in inflammatory markers, -0.29% to 1.39% in blood viscosity parameters, -0.67% to 3.45% in blood lipids, 0.89% in blood homocysteine, 0.13% to 0.78% in myocardial enzymes, and 3.03% in pulse wave velocity. These associations were not substantially changed after adjusting concomitant exposures to gaseous pollutants.

CONCLUSION

Short-term exposure to PM_2.5 may induce early cardiovascular effects in general population, including acute inflammation, myocardial injury, increased blood viscosity, vascular stiffness and hyperlipidemia.

Air pollution as a risk factor for Cognitive Impairment no Dementia (CIND) and its progression to dementia: A longitudinal study

BACKGROUND AND AIM

Accumulation of evidence has raised concern regarding the harmful effect of air pollution on cognitive function, but results are diverging. We aimed to investigate the longitudinal association of long-term exposure to air pollutants and cognitive impairment and its further progression to dementia in older adults residing in an urban area.

METHODS

Data were obtained from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Cognitive impairment, no dementia (CIND) was assessed by a comprehensive neuropsychological battery (scoring ≥1.5 standard deviations below age-specific means in ≥1 cognitive domain). We assessed long-term residential exposure to particulate matters (PM_2.5 and PM₁₀) and nitrogen oxides (NO_x) with dispersion modeling. The association with CIND was estimated using Cox proportional hazards models with 3-year moving average air pollution exposure. We further estimated the effect of long-term air pollution exposure on the progression of CIND to dementia using Cox proportional hazards models.

RESULTS

Among 1987 cognitively intact participants, 301 individuals developed CIND during the 12-year follow-up. A 1-μg/m³ increment in PM_2.5 exposure was associated with a 75% increased risk of incident CIND (HR = 1.75, 95 %CI: 1.54, 1.99). Weaker associations were found for PM₁₀ (HR for 1-μg/m³ = 1.08, 95 %CI: 1.03-1.14) and NO_x (HR for 10 μg/m³ = 1.18, 95 %CI: 1.04-1.33). Among those with CIND at baseline (n = 607), 118 participants developed dementia during follow-up. Results also show that exposure to air pollution was a risk factor for the conversion from CIND to dementia (PM_2.5: HR for 1-μg/m³ = 1.90, 95 %CI: 1.48-2.43; PM₁₀: HR for 1-μg/m³ = 1.14, 95 %CI: 1.03-1.26; and NO_x: HR for 10 μg/m³ = 1.34, 95 %CI: 1.07-1.69).

CONCLUSION

We found evidence of an association between long-term exposure to ambient air pollutants and incidence of CIND. Of special interest is that air pollution also was a risk factor for the progression from CIND to dementia.

Relationship between life-time exposure to ambient fine particulate matter and carotid artery intima-media thickness in Australian children aged 11-12 years

Long-term exposure to air pollutants, especially particulates, in adulthood is related to cardiovascular diseases and vascular markers of atherosclerosis. However, whether vascular changes in children is related to exposure to air pollutants remains unknown. This study examined whether childhood exposure to air pollutants was related to a marker of cardiovascular risk, carotid intima-media thickness (CIMT) in children aged 11-12 years old. Longitudinal Study of Australian Children (LSAC) recruited parents and their children born in 2003-4. Among the participants, CheckPoint examination was conducted when the children were 11-12 years old. Ultrasound of the right carotid artery was performed using standardized protocols. Average and maximum far-wall CIMT, carotid artery distensibility, and elasticity were quantified using semiautomated software. Annual and life-time exposure to air pollutants was estimated using satellite-based land-use regression by residential postcodes. A total of 1063 children (50.4% girls) with CIMT data, serum cholesterol, and modeled estimates of NO₂ and PM_2.5 exposure for the period 2003 to 2015 were included. The average and maximum CIMT, carotid distensibility, and elasticity were 497 μm (standard deviation, SD 58), 580 μm (SD 44), 17.4% (SD 3.2), and 0.48%/mmHg (SD 0.09), respectively. The life-time average concentrations of PM_2.5 and NO₂ were 6.4 μg/m³ (SD 1.4) and 6.4 ppb (SD 2.4), respectively. Both average and maximum CIMT were significantly associated with average ambient PM_2.5 concentration (average CIMT: +5.5 μm per μg/m³, 95% confidence interval, CI 2.4 to 8.5, and maximum CIMT: +4.9 μm per μg/m³, CI 2.3 to 7.6), estimated using linear regression, adjusting for potential confounders. CIMT was not significantly related to NO₂ exposure. Carotid artery diameter, distensibility, and elasticity were not significantly associated with air pollutants. We conclude that life-time exposure to low levels of PM_2.5 in children might have measurable adverse impacts on vascular structure by age 11-12 years.

Commuter types identified using clustering and their associations with source-specific PM2.5

Traffic-related fine particulate matter air pollution (tr-PM_2.5) has been associated with adverse health outcomes such as cardiopulmonary morbidity and mortality, with in-vehicle tr-PM_2.5 exposure contributing to total personal pollution exposure. Trip characteristics, including time of day, day of the week, and traffic congestion, are associated with in-vehicle PM_2.5 exposures. We hypothesized that some commuter characteristics, such as whether commuters travel primarily during rush hour, would also be associated with increased tr-PM_2.5 exposures. The commute data consisted of unscripted personal vehicle trips of 46 commuters in the Washington, D.C. metro area over 48-h, with a total of 320 trips. We identified commuter types using sparse K-means clustering, which identifies the hours throughout the day important for clustering commuters. Source-specific PM_2.5 over 48 h was estimated using Positive Matrix Factorization. Linear regression was used to estimate differences in source-specific PM_2.5 by commuter cluster. Two commuter clusters were identified using the clustering approach: rush hour commuters, who primarily travelled during rush hour, and sporadic commuters, who travelled throughout the day. The hours given the largest weights by sparse K-means were 7-8 a.m. and 6-7 p.m., corresponding to peak travel times. Integrated black carbon (BC) was higher for rush hour commuters (median = 3.1 μg/m³ (IQR = 1.5)) compared to sporadic commuters (2.0 μg/m³ (IQR = 1.9)). Mobile PM_2.5, consisting primarily of tailpipe emissions and brake/tire wear, was also higher for rush hour commuters (2.9 μg/m³ (IQR = 1.6)) compared to sporadic commuters (2.1 μg/m³ (IQR = 2.4)), though this difference was not statistically significant in regression models. Estimated differences between commuter types for secondary/mixed PM_2.5 and road salt PM_2.5 were smaller. Further research may elucidate whether commuter characteristics are an efficient way to identify individuals with highest tr-PM_2.5 exposures associated with commuting and to develop effective mitigation strategies.

A randomized crossover trial of HEPA air filtration to reduce cardiovascular risk for near highway residents: Methods and approach

BACKGROUND

Near highway residents are exposed to elevated levels of traffic-related air pollution (TRAP), including ultrafine particles, which are associated with adverse health effects. The efficacy of using in-home air filtration units that reduce exposure and potentially yield health benefits has not been tested in a randomized controlled trial.

METHODS

We will conduct a randomized double-blind crossover trial of portable air filtration units for 200 adults 30 years and older who live in near-highway homes in Somerville, MA, USA. We will recruit participants from 172 households. The intervention periods will be one month of true or sham filtration, followed by a one-month wash out period and then a month of the alternate intervention. The primary health outcome will be systolic blood pressure (BP); secondary outcome measures will include diastolic and central BP, C-Reactive Protein (CRP) and D-dimer. Reasons for success or failure of the intervention will be evaluated in a subset of homes using indoor/outdoor monitoring for particulate pollution, personal monitoring, size and composition of particulate pollution, tracking of time spent in the room with the filter, and interviews for qualitative feedback.

RESULTS

This trial has begun recruitment and is expected to take 2-3 years to be completed. Recruitment has been particularly challenging because of additional precautions required by the COVID-19 pandemic.

DISCUSSION

This study has the potential to shed light on the value of using portable air filtration in homes close to highways to reduce exposure to TRAP and whether doing so has benefits for cardiovascular health.

Effect of Reducing Ambient Traffic-Related Air Pollution on Blood Pressure: A Randomized Crossover Trial

Supplemental Digital Content is available in the text.

Exposure to traffic-related air pollution (TRAP) may contribute to increased prevalence of hypertension and elevated blood pressure (BP) for residents of near-highway neighborhoods. Relatively few studies have investigated the effects of reducing TRAP exposure on short-term changes in BP. We assessed whether reducing indoor TRAP concentrations by using stand-alone high-efficiency particulate arrestance (HEPA) filters and limiting infiltration through doors and windows effectively prevented acute (ie, over a span of hours) increases in BP. Using a 3-period crossover design, 77 participants were randomized to attend three 2-hour-long exposure sessions separated by 1-week washout periods. Each participant was exposed to high, medium, and low TRAP concentrations in a room near an interstate highway. Particle number concentrations, black carbon concentrations, and temperature were monitored continuously. Systolic BP (SBP), diastolic BP, and heart rate were measured every 10 minutes. Outcomes were analyzed with a linear mixed model. The primary outcome was the change in SBP from 20 minutes from the start of exposure. SBP increased with exposure duration, and the amount of increase was related to the magnitude of exposure. The mean change in SBP was 0.6 mm Hg for low exposure (mean particle number and black carbon concentrations, 2500 particles/cm³ and 149 ng/m³), 1.3 mm Hg for medium exposure (mean particle number and black carbon concentrations, 11 000 particles/cm³ and 409 ng/m³), and 2.8 mm Hg for high exposure (mean particle number and black carbon concentrations, 30 000 particles/cm³ and 826 ng/m³; linear trend P=0.019). There were no statistically significant differences in the secondary outcomes, diastolic BP, or heart rate. In conclusion, reducing indoor concentrations of TRAP was effective in preventing acute increases in SBP.

Association of air pollution and greenness with carotid plaque: A prospective cohort study in China

Previous studies indicated that exposure to air pollution was associated with the progress of atherosclerosis, but evidence is very limited in China and even in the world. This study aims to assess the associations of long-term exposures to air pollution and greenness with the occurrence of carotid plaque. Participants of this cohort study were urban residents and office workers who visited Hebei General Hospital for routine physical examination annually from September 2016 through to December 2018. Eligible participants were people diagnosed the absence of carotid plaque clinically at their first hospital visit and were followed up at their second or third hospital visit. Exposure to particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5), nitrogen dioxide (NO2) and ozone (O3) were estimated using an inverse distance weighted (IDW) method. The level of greenness was assessed using the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The associations were evaluated using Cox proportional hazards regression models. Among 4,137 participants, 575 showed the occurrence of carotid plaque during the follow-up period. After controlling for potential confounders, the hazard ratios (HRs) and 95% confidence intervals (95%CIs) of carotid plaque associated with per interquartile range (IQR) increase in PM2.5, NO2, and O3 were 1.78 (1.55, 2.03), 1.32 (1.14, 1.53) and 1.99 (1.71, 2.31), respectively. Increased EVI and NDVI were significantly associated with lower risk of carotid plaque [HR (and 95%CI): 0.84 (0.77, 0.93) and 0.87 (0.80, 0.94)]. PM2.5 significantly mediated 80.47% or 93.00% of the estimated association between EVI or NDVI and carotid plaque. In light of the significant associations between air pollution, greenness and carotid plaque in this study, continued efforts are needed to curb air pollution and plan more green space considering their effects on vascular disease.

The critical role of endothelial function in fine particulate matter-induced atherosclerosis

Ambient and indoor air pollution contributes annually to approximately seven million premature deaths. Air pollution is a complex mixture of gaseous and particulate materials. In particular, fine particulate matter (PM2.5) plays a major mortality risk factor particularly on cardiovascular diseases through mechanisms of atherosclerosis, thrombosis and inflammation. A review on the PM2.5-induced atherosclerosis is needed to better understand the involved mechanisms. In this review, we summarized epidemiology and animal studies of PM2.5-induced atherosclerosis. Vascular endothelial injury is a critical early predictor of atherosclerosis. The evidence of mechanisms of PM2.5-induced atherosclerosis supports effects on vascular function. Thus, we summarized the main mechanisms of PM2.5-triggered vascular endothelial injury, which mainly involved three aspects, including vascular endothelial permeability, vasomotor function and vascular reparative capacity. Then we reviewed the relationship between PM2.5-induced endothelial injury and atherosclerosis. PM2.5-induced endothelial injury associated with inflammation, pro-coagulation and lipid deposition. Although the evidence of PM2.5-induced atherosclerosis is undergoing continual refinement, the mechanisms of PM2.5-triggered atherosclerosis are still limited, especially indoor PM2.5. Subsequent efforts of researchers are needed to improve the understanding of PM2.5 and atherosclerosis. Preventing or avoiding PM2.5-induced endothelial damage may greatly reduce the occurrence and development of atherosclerosis.

Short-term effects of outdoor air pollution on acute ischaemic stroke occurrence: a case-crossover study in Tianjin, China

OBJECTIVE

Ambient air pollution is associated with ischaemic stroke incidence. However, most of the previous studies used stroke-related hospital admission rather than stroke onset itself. This study aimed to evaluate the relationship between ambient air pollutant exposures and acute ischaemic stroke based on the timing of symptom onset.

METHODS

A time-stratified, case-crossover analysis was performed among 520 patients who had ischaemic stroke admitted to the Second Hospital of Tianjin Medical University (Tianjin, China) between 1 April 2018 and 31 March 2019 (365 days). Daily air pollutant concentrations of particulate matter with aerodynamic diameter 2.5 µm, particulate matter with aerodynamic diameter 10 µm (PM10), sulfur dioxide, nitrogen dioxide, carbon monoxide and ozone were obtained from fixed-site monitoring stations. We used conditional logistic regression to estimate OR and 95% CI corresponding to an increase in IQR of each air pollutant after adjusting for the effects of temperature and relative humidity.

RESULTS

Overall, a higher risk of ischaemic stroke was found between April and September. During this period PM10 was associated with an increased risk of ischaemic stroke (1-day lag: OR=1.49, 95% CI 1.09 to 2.02; 3-day mean: OR=1.58, 95% CI 1.09 to 2.29) among patients between 34 and 70 years old. Positive associations were also observed between PM10 (1-day lag: OR=1.51, 95% CI 1.10 to 2.07; 3-day mean: OR=1.57, 95% CI 1.08 to 2.29), ozone (1-day lag: OR=1.83, 95% CI 1.16 to 2.87; 3-day mean: OR=1.90, 95% CI 1.06 to 3.42) and ischaemic stroke occurrence among those with hyperlipidaemia.

CONCLUSION

Our results suggest that air pollution is associated with a higher risk of ischaemic stroke in younger people or people with hyperlipidemia. These findings still need to be further investigated.

The aryl hydrocarbon receptor as a target of environmental stressors - Implications for pollution mediated stress and inflammatory responses

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor regulating the expression of genes, for instance encoding the monooxygenases cytochrome P450 (CYP) 1A1 and CYP1A2, which are important enzymes in metabolism of xenobiotics. The AHR is activated upon binding of polycyclic aromatic hydrocarbons (PAHs), persistent organic pollutants (POPs), and related ubiquitous environmental chemicals, to mediate their biological and toxic effects. In addition, several endogenous and natural compounds can bind to AHR, thereby modulating a variety of physiological processes. In recent years, ambient particulate matter (PM) associated with traffic related air pollution (TRAP) has been found to contain significant amounts of PAHs. PM containing PAHs are of increasing concern as a class of agonists, which can activate the AHR. Several reports show that PM and AHR-mediated induction of CYP1A1 results in excessive generation of reactive oxygen species (ROS), causing oxidative stress. Furthermore, exposure to PM and PAHs induce inflammatory responses and may lead to chronic inflammatory diseases, including asthma, cardiovascular diseases, and increased cancer risk. In this review, we summarize findings showing the critical role that the AHR plays in mediating effects of environmental pollutants and stressors, which pose a risk of impacting the environment and human health.

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PAHs present on ambient air pollution particles are ligands of the cellular AHR.

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AHR-dependent induction of CYP1, AKR, NOX and COX-2 genes can be a source of ROS generation.

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AHR signaling and NRF2 signaling interact to regulate the expression of antioxidant genes.

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Air pollution and ROS can affect inflammation, which is partially triggered by AHR and associated immune responses.

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Skin, lung, and the cardiovascular system are major target sites for air pollution-induced inflammation.

Ambient PM2.5 and Annual Lung Cancer Incidence: A Nationwide Study in 295 Chinese Counties

Most studies have examined PM2.5 effects on lung cancer mortalities, while few nationwide studies have been conducted in developing countries to estimate the effects of PM2.5 on lung cancer incidences. To fill this gap, this work aims to examine the effects of PM2.5 exposure on annual incidence rates of lung cancer for males and females in China. We performed a nationwide analysis in 295 counties (districts) from 2006 to 2014. Two regression models were employed to analyse data controlling for time, location and socioeconomic characteristics. We also examined whether the estimates of PM2.5 effects are sensitive to the adjustment of health and behaviour covariates, and the issue of the changing cancer registries each year. We further investigated the modification effects of region, temperature and precipitation. Generally, we found significantly positive associations between PM2.5 and incidence rates of lung cancer for males and females. If concurrent PM2.5 changes by 10 g/m³, then the incidence rate relative to its baseline significantly changes by 4.20% (95% CI: 2.73%, 5.88%) and 2.48% (95% CI: 1.24%, 4.14%) for males and females, respectively. The effects of exposure to PM2.5 were still significant when further controlling for health and behaviour factors or using 5 year consecutive data from 91 counties. We found the evidence of long-term lag effects of PM2.5. We also found that temperature appeared to positively modify the effects of PM2.5 on the incidence rates of lung cancer for males. In conclusion, there were significantly adverse effects of PM2.5 on the incidence rates of lung cancer for both males and females in China. The estimated effect sizes might be considerably lower than those reported in developed countries. There were long-term lag effects of PM2.5 on lung cancer incidence in China.

Ultrafine Particle Number Concentration Model for Estimating Retrospective and Prospective Long-Term Ambient Exposures in Urban Neighborhoods

Short-term exposure to ultrafine particles (UFP; <100 nm in diameter), which are present at high concentrations near busy roadways, is associated with markers of cardiovascular and respiratory disease risk. To date, few long-term studies (months to years) have been conducted due to the challenges of long-term exposure assignment. To address this, we modified hybrid land-use regression models of particle number concentrations (PNCs; a proxy for UFP) for two study areas in Boston (MA) by replacing the measured PNC term with an hourly model and adjusting for overprediction. The hourly PNC models used covariates for meteorology, traffic, and sulfur dioxide concentrations (a marker of secondary particle formation). We compared model performance against long-term PNC data collected continuously from 9 years before and up to 3 years after the model-development period. Model predictions captured the major temporal variations in the data and model performance remained relatively stable retrospectively and prospectively. The Pearson correlation of modeled versus measured hourly log-transformed PNC at a long-term monitoring site for 9 years prior was 0.74. Our results demonstrate that highly resolved spatial-temporal PNC models are capable of estimating ambient concentrations retrospectively and prospectively with generally good accuracy, giving us confidence in using these models in epidemiological studies.

Association between ambient and household air pollution with carotid intima-media thickness in peri-urban South India: CHAI-Project

BACKGROUND

Evidence linking ambient air pollution with atherosclerosis is lacking from low- and middle-income countries. Additionally, evidence regarding the association between household air pollution and atherosclerosis is limited. We evaluated the association between ambient fine particulate matter [particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5)] and biomass fuel use on carotid intima-media thickness (CIMT), a surrogate of atherosclerosis, in India.

METHODS

We analysed the third follow-up of the Andhra Pradesh Children and Parent Study cohort (2010-2012), which recruited participants from 28 peri-urban villages. Our primary outcome was mean CIMT, measured using a standardized protocol. We estimated annual average PM2.5 outdoors at residence using land-use regression. Biomass cooking fuel was self-reported. We fitted a within-between linear-mixed model adjusting for potential confounders.

RESULTS

Among 3278 participants (48% women, mean age 38 years), mean PM2.5 was 32.7 [range 24.4-38.2] µg/m3, and 60% used biomass. After confounder adjustment, we observed positive associations between within-village variation in PM2.5 and CIMT in all participants [1.79%, 95% confidence interval (CI), -0.31 to 3.90 per 1  µg/m3 of PM2.5] and in men (2.98%, 95% CI, 0.23-5.72, per 1  µg/m3 of PM2.5). Use of biomass cooking fuel was associated with CIMT in all participants (1.60%, 95% CI, -0.46 to 3.65), especially in women with an unvented stove (6.14%, 95% CI, 1.40-10.89). The point-estimate for the PM2.5 association was larger in sub-groups with higher cardiometabolic risk profile.

CONCLUSIONS

Ambient and household air pollution were positively associated with CIMT in a peri-urban population of India, although with limited precision for some estimates. We observed differences in the association between ambient and household air pollution and CIMT by gender.

Complex contaminant mixtures and their associations with intima-media thickness

Background

The burden of cardiovascular disease (CVD) morbidity and mortality is higher among Indigenous persons, who also experience greater health disparities when compared to non-Indigenous Canadians, particularly in remote regions of Canada. Assessment of carotid intima-media thickness (cIMT), a noninvasive screening tool and can be used as biomarker to assess increased CVD risk. Few studies have examined environmental contaminant body burden and its association with cIMT.

Methods

Data from the Environment-and-Health Study in the Eeyou Istchee territory of northern Québec, Canada was used to assess complex body burden mixtures of POPs, metals and metalloids among (n = 535) Indigenous people between 15 and 87 years of age with cIMT. First, Principal Component Analysis (PCA) was used to reduce the complexity of the contaminant data. Second, based on the underlying PCA profiles from the biological data, we examined each of the prominent principal component (PC) axes on cIMT using multivariable linear regression models. Lastly, based on these PC axes, cIMT was also regressed on summed (Σ) organic compound concentrations, polychlorinated biphenyl, perfluorinated compounds, respectively, ∑10 OCs, ∑13 PCBs, ∑3PFCs, and nickel.

Results

Most organochlorines and PFCs loaded primarily on PC-1 (53% variation). Nickel, selenium, and cadmium were found to load on PC-5. Carotid-IMT was significantly associated with PC-1 β = 0.004 (95 % CI 0.001, 0.007), and PC-5 β = 0.013 (95 % CI 0.002, 0.023). However, the association appears to be greater for PC-5, accounting for 3% of the variation, and mostly represented by nickel. Results show that that both nickel, and ∑3PFCs were similarly associated with cIMT β = 0.001 (95 % CI 0.0003, 0.003), and β = 0.001 (95 % CI 0.0004, 0.002), respectively. But ∑10OCs was significantly associated with a slightly greater β = 0.004 (95 % CI 0.001, 0.007) cIMT change, though with less precision. Lastly, ∑13PCBs also increased β = 0.002 (95 % CI 0.0004, 0.003) cIMT after fully adjusting for covariates.

Conclusion

Our results suggest that environmental contaminants are associated with cIMT. This is important for the Cree from the Eeyou Istchee territory who may experience higher body burdens of contaminants than non-Indigenous Canadians.

THE EXPOSOME IN HUMAN EVOLUTION: FROM DUST TO DIESEL

Global exposures to air pollution and cigarette smoke are novel in human evolutionary history and are associated with about 16 million premature deaths per year. We investigate the history of the human exposome for relationships between novel environmental toxins and genetic changes during human evolution in six phases. Phase I: With increased walking on savannas, early human ancestors inhaled crustal dust, fecal aerosols, and spores; carrion scavenging introduced new infectious pathogens. Phase II: Domestic fire exposed early Homo to novel toxins from smoke and cooking. Phases III and IV: Neolithic to preindustrial Homo sapiens incurred infectious pathogens from domestic animals and dense communities with limited sanitation. Phase V: Industrialization introduced novel toxins from fossil fuels, industrial chemicals, and tobacco at the same time infectious pathogens were diminishing. Thereby, pathogen-driven causes of mortality were replaced by chronic diseases driven by sterile inflammogens, exogenous and endogenous. Phase VI: Considers future health during global warming with increased air pollution and infections. We hypothesize that adaptation to some ancient toxins persists in genetic variations associated with inflammation and longevity.

Characteristics of cohort studies of long-term exposure to PM2.5: a systematic review

This study systematically reviewed all the cohort studies investigating the relationship between long-term exposure to PM_2.5 and any health outcome until February 2018. We searched ISI Web of Knowledge, Pubmed, and Scopus databases for peer-reviewed journal research articles published in English. We only extracted the results of the single-pollutant main analysis of each study, excluding the effect modifications and sensitivity analyses. Out of the initial 9523 articles, 203 articles were ultimately included for analysis. Based on the different characteristics of studies such as study design, outcome, exposure assessment method, and statistical model, we calculated the number and relative frequency of analyses with statistically significant and insignificant results. Most of the studies were prospective (84.8%), assessed both genders (66.5%), and focused on a specific age range (86.8%). Most of the articles (78.1%) had used modeling techniques for exposure assessment of cohorts' participants. Among the total of 317 health outcomes, the most investigated outcomes include mortality due to cardiovascular disease (6.19%), all causes (5.48%), lung cancer (4.00%), ischemic heart disease (3.50%), and non-accidental causes (3.50%). The percentage of analyses with statistically significant results were higher among studies that used prospective design, mortality as the outcome, fixed stations as exposure assessment method, hazard ratio as risk measure, and no covariate adjustment. We can somehow conclude that the choice of right characteristics for cohort studies can make a difference in their results.

Associations of ambient PM2.5 and O3 with cardiovascular mortality: a time-series study in Hefei, China

China is among the countries with the worst air quality throughout the world. As PM_2.5 was not included in the national air quality monitoring network before January 2013 in China, no study has investigated the associations of ambient PM_2.5 and O₃ with cardiovascular mortality in Hefei, China. In this time-series analysis, Poisson regression in generalized additive model was adopted to assess the associations between the air pollutants and cardiovascular mortality during the 2013-2015 in Hefei, China. The findings showed that the daily average level of PM_2.5 and O₃ was 77.8 μg/m³ and 60.1 μg/m³ in the study period, respectively. PM_2.5 and O₃ exposure tended to increase cardiovascular mortality, but the associations were statistically insignificant. Further stratified analyses by seasons showed that with every 10 μg/m³ increase of PM_2.5 in the cold season (October-March), the risk of cardiovascular death increased by 0.22% (95% CI 0.05%, 0.39%); while every 10 μg/m³ increase of O₃ in the warm season (April-September), the risk of cardiovascular death increased by 1.29% (95% CI 0.26%, 2.33%) on Lag0. Interestingly, stratified analysis by gender showed that the associations of PM_2.5, but not O₃ exposure, could significantly increase cardiovascular mortality in females, but not males. The findings of this study especially underscored the adverse associations of PM_2.5 and O₃ exposure with females in specific seasons. More studies are needed to verify our findings and further investigate the underlying mechanisms. Graphical Abstract.

Using Mobile Monitoring to Develop Hourly Empirical Models of Particulate Air Pollution in a Rural Appalachian Community

Most empirical air quality models (e.g., land use regression) focus on urban areas. Mobile monitoring for model development offers the opportunity to explore smaller, rural communities - an understudied population. We use mobile monitoring to systematically sample all daylight hours (7 am to 7 pm) to develop empirical models capable of estimating hourly concentrations in Blacksburg, VA, a small town in rural Appalachia (population: 182 635). We collected ∼120 h of mobile monitoring data for particle number (PN) and black carbon (BC). We developed (1) daytime (12-h average) models that approximate long-term concentrations and (2) spatiotemporal models for estimating hourly concentrations. Model performance for the daytime models is consistent with previous fixed-site and short-term sampling studies; adjusted R² (10-fold CV R²) was 0.80 (0.69) for the PN model and 0.67 (0.58) for the BC model. The spatiotemporal models had comparable performance (10-fold CV R² for the PN [BC] models: 0.42 [0.25]) to previous mobile monitoring studies that isolate specific time periods. Temporal and spatial model coefficients had similar magnitudes in the spatiotemporal models suggesting both factors are important for exposure. We observed similar spatial patterns in Blacksburg (e.g., roadway gradients) as in other studies in urban areas suggesting similar exposure disparities exist in small, rural communities.

Inflammatory marker and aryl hydrocarbon receptor-dependent responses in human macrophages exposed to emissions from biodiesel fuels

Biodiesel or renewable diesel fuels are alternative fuels produced from vegetable oil and animal tallow that are being considered to help reduce the use of petroleum-based fuels and emissions of air pollutants including greenhouse gases. Here, we analyzed the gene expression of inflammatory marker responses and the cytochrome P450 1A1 (CYP1A1) enzyme after exposure to diesel and biodiesel emission samples generated from an in-use heavy-duty diesel vehicle. Particulate emission samples from petroleum-based California Air Resource Board (CARB)-certified ultralow sulfur diesel (CARB ULSD), biodiesel, and renewable hydro-treated diesel all induced inflammatory markers such as cyclooxygenase-2 (COX)-2 and interleukin (IL)-8 in human U937-derived macrophages and the expression of the xenobiotic metabolizing enzyme CYP1A1. Furthermore, the results indicate that the particle emissions from CARB ULSD and the alternative diesel fuel blends activate the aryl hydrocarbon receptor (AhR) and induce CYP1A1 in a dose- and AhR-dependent manner which was supported by the AhR luciferase reporter assay and gel shift analysis. Based on a per mile emissions with the model year 2000 heavy duty vehicle tested, the effects of the alternative diesel fuel blends emissions on the expression on inflammatory markers like IL-8 and COX-2 tend to be lower than emission samples derived from CARB ULSD fuel. The results will help to assess the potential benefits and toxicity from biofuel use as alternative fuels in modern technology diesel engines.

Long-Term Exposure to Ultrafine Particles and Incidence of Cardiovascular and Cerebrovascular Disease in a Prospective Study of a Dutch Cohort

BACKGROUND

There is growing evidence that exposure to ultrafine particles (UFP; particles smaller than [Formula: see text]) may play an underexplored role in the etiology of several illnesses, including cardiovascular disease (CVD).

OBJECTIVES

We aimed o investigate the relationship between long-term exposure to ambient UFP and incident cardiovascular and cerebrovascular disease (CVA). As a secondary objective, we sought to compare effect estimates for UFP with those derived for other air pollutants, including estimates from two-pollutant models.

METHODS

Using a prospective cohort of 33,831 Dutch residents, we studied the association between long-term exposure to UFP (predicted via land use regression) and incident disease using Cox proportional hazard models. Hazard ratios (HR) for UFP were compared to HRs for more routinely monitored air pollutants, including particulate matter with aerodynamic diameter [Formula: see text] ([Formula: see text]), PM with aerodynamic diameter [Formula: see text] ([Formula: see text]), and [Formula: see text].

RESULTS

Long-term UFP exposure was associated with an increased risk for all incident CVD [[Formula: see text] per [Formula: see text]; 95% confidence interval (CI): 1.03, 1.34], myocardial infarction (MI) ([Formula: see text]; 95% CI: 1.00, 1.79), and heart failure ([Formula: see text]; 95% CI: 1.17, 2.66). Positive associations were also estimated for [Formula: see text] ([Formula: see text]; 95% CI: 1.01, 1.48 per [Formula: see text]) and coarse PM ([Formula: see text]; HR for all [Formula: see text]; 95% CI: 1.01, 1.45 per [Formula: see text]). CVD was not positively associated with [Formula: see text] (HR for all [Formula: see text]; 95% CI: 0.75, 1.28 per [Formula: see text]). HRs for UFP and CVAs were positive, but not significant. In two-pollutant models ([Formula: see text] and [Formula: see text]), positive associations tended to remain for UFP, while HRs for [Formula: see text] and [Formula: see text] generally attenuated towards the null.

CONCLUSIONS

These findings strengthen the evidence that UFP exposure plays an important role in cardiovascular health and that risks of ambient air pollution may have been underestimated based on conventional air pollution metrics. https://doi.org/10.1289/EHP3047.

Ambient air pollution and daily hospital admissions: A nationwide study in 218 Chinese cities

There have been few large multicity studies to evaluate the acute health effects of ambient air pollution on morbidity risk in developing counties. In this study, we examined the short-term associations of air pollution with daily hospital admissions in China. We conducted a nationwide time-series study in 218 Chinese cities between 2014 and 2016. Data on daily hospital admissions counts were obtained from the National Health Insurance Database for Urban Employees covering 0.28 billion enrollees. We used generalized additive model with Poisson regression to estimate the associations in each city, and we performed random-effects meta-analysis to pool the city-specific estimates. More than 60 million hospital admissions were analyzed in this study. At the national-average level, each 10 μg/m³ increase in PM₁₀, SO₂, and NO₂, and 1 mg/m³ increase in CO at lag 0 day was associated with a 0.29% (95% CI, 0.23%-0.36%), 1.16% (95% CI, 0.92%-1.40%), 1.68% (95% CI, 1.40%-1.95%), and 2.59% (95% CI, 1.69%-3.50%) higher daily hospital admissions, respectively. The associations of air pollution with hospital admissions remained statistically significant at levels below the current Chinese Ambient Air Quality Standards. The effect estimates were larger in cities with lower air pollutants levels or higher air temperatures and relative humidity, as well as in the elderly. In conclusion, our findings provide robust evidence of increased hospital admissions in association with short-term exposure to ambient air pollution in China.

Aerobic training reduces oxidative stress in skeletal muscle of rats exposed to air pollution and supplemented with chromium picolinate

Objective: The purpose of this study was to investigate the effects of chromium picolinate (CrPic) supplementation associated with aerobic exercise using measures of oxidative stress in rats exposed to air pollution.

Methods: Sixty-one male Wistar rats were divided into eight groups: residual oil fly ash (ROFA) exposure and sedentary (ROFA-SED); ROFA exposure, sedentary and supplemented (ROFA-SED-CrPic); ROFA exposure and trained (ROFA-AT); ROFA exposure, supplemented and trained (ROFA-AT-CrPic); sedentary (Sal-SED); sedentary and supplemented (Sal-SED-CrPic); trained (Sal-AT); and supplemented and trained (Sal-AT-CrPic). Rats exposed to ROFA (air pollution) received 50 µg of ROFA daily via intranasal instillation. Supplemented rats received CrPic (1 mg/kg/day) daily by oral gavage. Exercise training was performed on a rat treadmill (5×/week). Oxidative parameters were evaluated at the end of protocols.

Results: Trained groups demonstrated lower gain of body mass (P < .001) and increased exercise tolerance (P < .0001). In the gastrocnemius, trained groups demonstrated increased SOD activity (P < .0001) and decrease levels of TBARS (P = .0014), although CAT activity did not differ among groups (P = .4487).

Conclusion: Air pollution exposure did not lead to alterations in oxidative markers in lungs and heart, and exercise training was responsible for decreasing oxidative stress of the gastrocnemius.

Perturbation of metabolic pathways mediates the association of air pollutants with asthma and cardiovascular diseases

BACKGROUND

Epidemiologic evidence indicates common risk factors, including air pollution exposure, for respiratory and cardiovascular diseases, suggesting the involvement of common altered molecular pathways.

OBJECTIVES

The goal was to find intermediate metabolites or metabolic pathways that could be associated with both air pollutants and health outcomes ("meeting-in-the-middle"), thus shedding light on mechanisms and reinforcing causality.

METHODS

We applied a statistical approach named 'meet-in-the-middle' to untargeted metabolomics in two independent case-control studies nested in cohorts on adult-onset asthma (AOA) and cardio-cerebrovascular diseases (CCVD). We compared the results to identify both common and disease-specific altered metabolic pathways.

RESULTS

A novel finding was a strong association of AOA with ultrafine particles (UFP; odds ratio 1.80 [1.26, 2.55] per increase by 5000 particles/cm3). Further, we have identified several metabolic pathways that potentially mediate the effect of air pollution on health outcomes. Among those, perturbation of Linoleate metabolism pathway was associated with air pollution exposure, AOA and CCVD.

CONCLUSIONS

Our results suggest common pathway perturbations may occur as a consequence of chronic exposure to air pollution leading to increased risk for both AOA and CCVD.

Relationship of Time-Activity-Adjusted Particle Number Concentration with Blood Pressure

Emerging evidence suggests long-term exposure to ultrafine particulate matter (UFP, aerodynamic diameter < 0.1 µm) is associated with adverse cardiovascular outcomes. We investigated whether annual average UFP exposure was associated with measured systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and hypertension prevalence among 409 adults participating in the cross-sectional Community Assessment of Freeway Exposure and Health (CAFEH) study. We used measurements of particle number concentration (PNC, a proxy for UFP) obtained from mobile monitoring campaigns in three near-highway and three urban background areas in and near Boston, Massachusetts to develop PNC regression models (20-m spatial and hourly temporal resolution). Individual modeled estimates were adjusted for time spent in different micro-environments (time-activity-adjusted PNC, TAA-PNC). Mean TAA-PNC was 22,000 particles/cm³ (sd = 6500). In linear models (logistic for hypertension) adjusted for the minimally sufficient set of covariates indicated by a directed acyclic graph (DAG), we found positive, non-significant associations between natural log-transformed TAA-PNC and SBP (β = 5.23, 95%CI: −0.68, 11.14 mmHg), PP (β = 4.27, 95%CI: −0.79, 9.32 mmHg), and hypertension (OR = 1.81, 95%CI: 0.94, 3.48), but not DBP (β = 0.96, 95%CI: −2.08, 4.00 mmHg). Associations were stronger among non-Hispanic white participants and among diabetics in analyses stratified by race/ethnicity and, separately, by health status.

Mitochondrial dysfunction, perturbations of mitochondrial dynamics and biogenesis involved in endothelial injury induced by silica nanoparticles

As silica nanoparticles (SiNPs) pervade the global economy, however, the followed emissions during the manufacturing, use, and disposal stages inevitably bring an environmental release, potentially result in harmful impacts. Endothelial dysfunction precedes cardiovascular disease, and is often accompanied by mitochondrial impairment and dysfunction. We had reported endothelial dysfunction induced by SiNPs, however, the related mechanisms by which SiNPs interact with mitochondria are not well understood. In the present study, we examined SiNPs-induced mitochondrial dysfunction, and further demonstrated their adverse effects on mitochondrial dynamics and biogenesis in endothelial cells (HUVECs). Consequently, SiNPs entered mitochondria, caused mitochondrial swelling, cristae disruption and even disappearance. Further analyses revealed SiNPs increased the intracellular level of mitochondrial reactive oxygen species, eventually resulting in the collapse of mitochondrial membrane potential, impairments in ATP synthesis, cellular respiration and the activities of three ATP-dependent enzymes (including Na⁺/K⁺-ATPase, Ca²⁺-ATPase and Ca²⁺/Mg²⁺-ATPase), as well as an elevated intracellular calcium level. Furthermore, mitochondria in SiNPs-treated HUVECs displayed a fission phenotype. Accordingly, dysregulation of the key gene expressions (FIS1, DRP1, OPA1, Mfn1 and Mfn2) involved in fission/fusion event further certified the SiNPs-induced perturbation of mitochondrial dynamics. Meanwhile, SiNPs-treated HUVECs displayed declined levels of mitochondrial DNA copy number, PGC-1α, NRF1 and also TFAM, indicating an inhibition of mitochondrial biogenesis triggered by SiNPs via PGC-1α-NRF1-TFAM signaling. Overall, SiNPs triggered endothelial toxicity through mitochondria as target, including the induction of mitochondrial dysfunction, as well as the perturbations of their dynamics and biogenesis.

Long-Term Effects of Ambient Particulate Matter (With an Aerodynamic Diameter ≤2.5 μm) on Hypertension and Blood Pressure and Attributable Risk Among Reproductive-Age Adults in China

Background

Epidemiological evidence on the association between long‐term exposure to ambient fine particulate matter (with an aerodynamic diameter ≤2.5 μm; PM_2.5) and hypertension is mixed. We investigated the long‐term association between ambient fine particles and hypertension in reproductive‐age adults.

Methods and Results

This analysis included 39 348 119 reproductive‐age (20–49 years) participants from the National Free Preconception Health Examination Project from April 22, 2010 to December 31, 2015 across China. The estimation of annual average ambient PM_2.5 concentrations for each community was realized through using satellite‐based spatial statistical models. Linear mixed models and 2‐level logistic regressions adjusted for potential confounders with natural cubic splines were used to investigate the shape of PM_2.5–blood pressure and PM_2.5‐hypertension, respectively. The effect modification by sex, obesity, smoking status, age, diabetes mellitus, urbanity, race, and region was also taken into account. The concentration‐response relationship between PM_2.5 and hypertension was nonlinear, with a threshold concentration of 47.9 μg/m³. The odds ratio of hypertension related to a 10‐μg/m³ increase in PM_2.5 above threshold was 1.010 (95% confidence interval, 1.007–1.012). A 10‐μg/m³ increase in PM_2.5 above threshold corresponded to a 0.569 (95% confidence interval, 0.564–0.573) mm Hg elevation in systolic blood pressure and a 0.384 (95% confidence interval, 0.381–0.388) mm Hg elevation in diastolic blood pressure. There were 2.3% (95% confidence interval, 2.2%–2.4%) of the hypertension cases that could be attributed to PM_2.5 exposures in reproductive‐age adult populations.

Conclusions

Long‐term exposures to PM_2.5 above certain levels might increase population risk for hypertension and might be responsible for China's avoidable hypertension burden in reproductive‐age adults.

Longitudinal associations of long-term exposure to ultrafine particles with blood pressure and systemic inflammation in Puerto Rican adults

BACKGROUND

Few longitudinal studies have examined the association between ultrafine particulate matter (UFP, particles < 0.1 μm aerodynamic diameter) exposure and cardiovascular disease (CVD) risk factors. We used data from 791 adults participating in the longitudinal Boston Puerto Rican Health Study (Massachusetts, USA) between 2004 and 2015 to assess whether UFP exposure was associated with blood pressure and high sensitivity C-reactive protein (hsCRP, a biomarker of systemic inflammation).

METHODS

Residential annual average UFP exposure (measured as particle number concentration, PNC) was assigned using a model accounting for spatial and temporal trends. We also adjusted PNC values for participants' inhalation rate to obtain the particle inhalation rate (PIR) as a secondary exposure measure. Multilevel linear models with a random intercept for each participant were used to examine the association of UFP with blood pressure and hsCRP.

RESULTS

Overall, in adjusted models, an inter-quartile range increase in PNC was associated with increased hsCRP (β = 6.8; 95% CI = - 0.3, 14.0%) but not with increased systolic blood pressure (β = 0.96; 95% CI = - 0.33, 2.25 mmHg), pulse pressure (β = 0.70; 95% CI = - 0.27, 1.67 mmHg), or diastolic blood pressure (β = 0.55; 95% CI = - 0.20, 1.30 mmHg). There were generally stronger positive associations among women and never smokers. Among men, there were inverse associations of PNC with systolic blood pressure and pulse pressure. In contrast to the primary findings, an inter-quartile range increase in the PIR was positively associated with systolic blood pressure (β = 1.03; 95% CI = 0.00, 2.06 mmHg) and diastolic blood pressure (β = 1.01; 95% CI = 0.36, 1.66 mmHg), but not with pulse pressure or hsCRP.

CONCLUSIONS

We observed that exposure to PNC was associated with increases in measures of CVD risk markers, especially among certain sub-populations. The exploratory PIR exposure metric should be further developed.

Development and Comparison of Air Pollution Exposure Surfaces Derived from On-Road Mobile Monitoring and Short-Term Stationary Sidewalk Measurements

Land-use regression (LUR) models of air pollutants are frequently developed on the basis of short-term stationary or mobile monitoring approaches, which raises the question of whether these two data collection protocols lead to similar exposure surfaces. In this study, we measured ultrafine particles (UFP) and black carbon (BC) concentrations in Toronto during summer 2016, using two short-term data collection approaches: mobile, involving 3023 road segments sampled on bicycles, and stationary, involving 92 sidewalk locations. We developed four LUR models and exposure surfaces, for the two pollutants and measurement protocols. Coefficients of determination ( R²) varied from 0.434 to 0.525. Various small-scale traffic variables were included in the mobile LUR. Pearson correlation coefficients between the mobile and stationary surfaces were 0.23 for UFP and 0.49 for BC. We also compared the two surfaces using personal exposures from a panel study in Toronto conducted during the same period. The personal exposures differed from the outdoor exposures derived from the combination of GPS information and exposure surfaces. For UFP, the median for personal outdoor exposure was 26 344 part/cm³, while the cycling and stationary surfaces predicted medians of 31 201 and 19 057 part/cm³. Similar trends were observed for BC, with median exposures of 1764 (personal), 1799 (cycling), and 1469 ng/m³ (stationary).

A critical review of assays for hazardous components of air pollution

Increased mortality and diverse morbidities are globally associated with exposure to ambient air pollution (AAP), cigarette smoke (CS), and household air pollution (HAP). The AAP-CS-HAP aerosols present heterogeneous particulate matter (PM) of diverse chemical and physical characteristics. Some epidemiological models have assumed the same health hazards by PM weight for AAP, CS, and HAP regardless of the composition. While others have recognized that biological activities and toxicity will vary with components, we focus particularly on oxidation because of its major role in assay outcomes. Our review of PM assays considers misinterpretations of some chemical measures used for oxidative activity. Overall, there is low consistency across chemical and cell-based assays for oxidative and inflammatory activity. We also note gaps in understanding how much airborne PM of various sizes enter cells and organs. For CS, the body burden per cigarette may be much below current assumptions. Synergies shown for health hazards of AAP and CS suggest crosstalk in detoxification pathways mediated by AHR, NF-κB, and Nrf2. These complex genomic and biochemical interactions frustrate resolution of the toxicity of specific AAP components. We propose further strategies based on targeted gene expression based on cell-type differences.

Modelling daily PM2.5 concentrations at high spatio-temporal resolution across Switzerland

Spatiotemporal resolved models were developed predicting daily fine particulate matter (PM_2.5) concentrations across Switzerland from 2003 to 2013. Relatively sparse PM_2.5 monitoring data was supplemented by imputing PM_2.5 concentrations at PM₁₀ sites, using PM_2.5/PM₁₀ ratios at co-located sites. Daily PM_2.5 concentrations were first estimated at a 1 × 1km resolution across Switzerland, using Multiangle Implementation of Atmospheric Correction (MAIAC) spectral aerosol optical depth (AOD) data in combination with spatiotemporal predictor data in a four stage approach. Mixed effect models (1) were used to predict PM_2.5 in cells with AOD but without PM_2.5 measurements (2). A generalized additive mixed model with spatial smoothing was applied to generate grid cell predictions for those grid cells where AOD was missing (3). Finally, local PM_2.5 predictions were estimated at each monitoring site by regressing the residuals from the 1 × 1km estimate against local spatial and temporal variables using machine learning techniques (4) and adding them to the stage 3 global estimates. The global (1 km) and local (100 m) models explained on average 73% of the total,71% of the spatial and 75% of the temporal variation (all cross validated) globally and on average 89% (total) 95% (spatial) and 88% (temporal) of the variation locally in measured PM_2.5 concentrations.

Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations

BACKGROUND

Exposure to airborne ultrafine particle (UFP; <100 nm in aerodynamic diameter) is an emerging public health problem. Nevertheless, the benefit of using high efficiency particulate arrestance (HEPA) filtration to reduce UFP concentrations in homes is not yet clear.

METHODS

We conducted a randomized crossover study of HEPA filtration without a washout period in 23 homes of low-income Puerto Ricans in Boston and Chelsea, MA (USA). Most participants were female, older adults who were overweight or obese. Particle number concentrations (PNC, a proxy for UFP) were measured indoors and outdoors at each home continuously for six weeks. Homes received both HEPA filtration and sham filtration for three weeks each in random order.

RESULTS

Median PNC under HEPA filtration was 50-85% lower compared to sham filtration in most homes, but we found no benefit in terms of reduced inflammation; associations between hsCRP, IL-6, or TNFRII in blood samples and indoor PNC were inverse and not statistically significant.

CONCLUSIONS

Limitations to our study design likely contributed to our findings. Limitations included carry-over effects, a population that may have been relatively unresponsive to UFP, reduction in PNC even during sham filtration that limited differences between HEPA and sham filtration, window opening by participants, and lack of fine-grained (room-specific) participant time-activity information. Our approach was similar to other recent HEPA intervention studies of particulate matter exposure and cardiovascular risk, suggesting that there is a need for better study designs.

Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations

BACKGROUND

Exposure to airborne ultrafine particle (UFP; <100 nm in aerodynamic diameter) is an emerging public health problem. Nevertheless, the benefit of using high efficiency particulate arrestance (HEPA) filtration to reduce UFP concentrations in homes is not yet clear.

METHODS

We conducted a randomized crossover study of HEPA filtration without a washout period in 23 homes of low-income Puerto Ricans in Boston and Chelsea, MA (USA). Most participants were female, older adults who were overweight or obese. Particle number concentrations (PNC, a proxy for UFP) were measured indoors and outdoors at each home continuously for six weeks. Homes received both HEPA filtration and sham filtration for three weeks each in random order.

RESULTS

Median PNC under HEPA filtration was 50-85% lower compared to sham filtration in most homes, but we found no benefit in terms of reduced inflammation; associations between hsCRP, IL-6, or TNFRII in blood samples and indoor PNC were inverse and not statistically significant.

CONCLUSIONS

Limitations to our study design likely contributed to our findings. Limitations included carry-over effects, a population that may have been relatively unresponsive to UFP, reduction in PNC even during sham filtration that limited differences between HEPA and sham filtration, window opening by participants, and lack of fine-grained (room-specific) participant time-activity information. Our approach was similar to other recent HEPA intervention studies of particulate matter exposure and cardiovascular risk, suggesting that there is a need for better study designs.

Comparisons of Traffic-Related Ultrafine Particle Number Concentrations Measured in Two Urban Areas by Central, Residential, and Mobile Monitoring

Traffic-related ultrafine particles (UFP; <100 nanometers diameter) are ubiquitous in urban air. While studies have shown that UFP are toxic, epidemiological evidence of health effects, which is needed to inform risk assessment at the population scale, is limited due to challenges of accurately estimating UFP exposures. Epidemiologic studies often use empirical models to estimate UFP exposures; however, the monitoring strategies upon which the models are based have varied between studies. Our study compares particle number concentrations (PNC; a proxy for UFP) measured by three different monitoring approaches (central-site, short-term residential-site, and mobile on-road monitoring) in two study areas in metropolitan Boston (MA, USA). Our objectives were to quantify ambient PNC differences between the three monitoring platforms, compare the temporal patterns and the spatial heterogeneity of PNC between the monitoring platforms, and identify factors that affect correlations across the platforms. We collected >12,000 hours of measurements at the central sites, 1,000 hours of measurements at each of 20 residential sites in the two study areas, and >120 hours of mobile measurements over the course of ~1 year in each study area. Our results show differences between the monitoring strategies: mean one-minute PNC on-roads were higher (64,000 and 32,000 particles/cm3 in Boston and Chelsea, respectively) compared to central-site measurements (23,000 and 19,000 particles/cm3) and both were higher than at residences (14,000 and 15,000 particles/cm3). Temporal correlations and spatial heterogeneity also differed between the platforms. Temporal correlations were generally highest between central and residential sites, and lowest between central-site and on-road measurements. We observed the greatest spatial heterogeneity across monitoring platforms during the morning rush hours (06:00-09:00) and the lowest during the overnight hours (18:00-06:00). Longer averaging times (days and hours vs. minutes) increased temporal correlations (Pearson correlations were 0.69 and 0.60 vs. 0.39 in Boston; 0.71 and 0.61 vs. 0.45 in Chelsea) and reduced spatial heterogeneity (coefficients of divergence were 0.24 and 0.29 vs. 0.33 in Boston; 0.20 and 0.27 vs. 0.31 in Chelsea). Our results suggest that combining stationary and mobile monitoring may lead to improved characterization of UFP in urban areas and thereby lead to improved exposure assignment for epidemiology studies.