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Wang Y, Peng M, Hu C, Zhan Y, Yao Y, Zeng Y, Zhang Y. Excess deaths and loss of life expectancy attributed to long-term NO 2 exposure in the Chinese elderly. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 281:116627. [PMID: 38925032 DOI: 10.1016/j.ecoenv.2024.116627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Evidence linking nitrogen dioxide (NO2) air pollution to life span of high-vulnerability older adults is extensively scarce in low- and middle-income countries. This study seeks to quantify mortality risk, excess deaths, and loss of life expectancy (LLE) associated with long-term exposure to NO2 among elderly individuals in China. METHODS A nationwide dynamic cohort of 20352 respondents ≥65 years old were enrolled from the China Longitudinal Health and Longevity Survey during 2005-2018. Residential exposures to NO2 and co-pollutants were assessed by well-validated spatiotemporal prediction models. A Cox regression model with time-dependent covariates was utilized to quantify the association of all-cause mortality with NO2 exposure, controlling for confounders such as demographics, lifestyle, health status, and ambient temperature. NO2-attributable deaths and LLE were evaluated for the years 2010 and 2020 based on the pooled NO2-mortality relation derived from multi-national cohort investigations. Decomposition analyses were conducted to dissociate net shift in NO2-related deaths between 2010 and 2020 into four primary contributing factors. RESULTS A total of 14313 deaths were recorded during follow-up of approximately 100 hundred person-years (median 3.6 years). We observed an approximately linear relationship (nonlinear P = 0.882) of NO2 exposure with all-cause death across a broad range from 6.6 to 95.7 μg/m3. Every 10-μg/m3 rise in yearly average NO2 concentration was linked to a hazard ratio (HR) of 1.045 (95% confidence interval [CI]: 1.031-1.059). In the updated meta-analysis of this study and 9 existing cohorts, we estimated a pooled HR of 1.043 (95% CI: 1.023-1.063) for each 10-μg/m3 growth in NO2. Reaching a 10-μg/m3 counterfactual target of NO2 concentration in China could avoid 0.33 (95% empirical CI: 0.19-0.49) million premature deaths and an LLE of 0.40 (95% empirical CI: 0.23-0.59) years in 2010, which greatly dropped to 0.24 (95% empirical CI: 0.14-0.36) million deaths and 0.21 (95% empirical CI: 0.12-0.31) years of LLE in 2020. The net fall in NO2-attributable deaths (-26.8%) between 2010 and 2020 was primarily driven by the declines in both NO2 concentration (-41.6%) and mortality rate (-27.1%) under population growth (+41.0%) and age structure transition (+0.9%). CONCLUSIONS Our findings provide national evidence for increased risk of premature death and loss of life expectancy attributed to later-life NO2 exposure among the elderly in China. In an accelerated aging society, strengthened clean air actions should be formulated to minimize the health burden and regional inequality in NO2-attributable mortality.
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Affiliation(s)
- Yaqi Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Minjin Peng
- Department of Outpatient, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Chengyang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing 100191, China; Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing 100871, China.
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing 100871, China.
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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2
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Jia X, Zhang B, Yu Y, Xia W, Lu Z, Guo X, Xue F. Greenness mitigate cause-specific mortality associated with air pollutants in ischemic and hemorrhagic stroke patients: An ecological health cohort study. ENVIRONMENTAL RESEARCH 2024; 251:118512. [PMID: 38458591 DOI: 10.1016/j.envres.2024.118512] [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: 10/17/2023] [Revised: 01/24/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Air pollution is one of the most serious environmental risks to mortality of stroke. However, there exists a noteworthy knowledge gap concerning the different stroke subtypes, causes of death, the susceptibility of stroke patient, and the role of greenness in this context. METHODS We analyzed data from an ecological health cohort, which included 334,261 patients aged ≥40 years with stroke (comprising 288,490 ischemic stroke and 45,771 hemorrhagic stroke) during the period 2013-2019. We used Cox proportional hazards models with time-varying exposure to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the associations of annual average fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with both all-cause and cause-specific mortality. Additionally, we conducted analyses to examine the effect modification by greenness and identify potential susceptibility factors through subgroup analyses. RESULT In multivariable-adjusted models, long-term exposure to PM2.5 and NO2 was associated with increased risk of all-cause mortality (HR: 1.038, 95% CI: 1.029-1.047 for PM2.5; HR: 1.055, 95% CI: 1.026-1.085 for NO2, per 10 μg/m3, for ischemic stroke patients; similar for hemorrhagic stroke patients). Gradually increasing effect sizes were shown for CVD mortality and stroke mortality. The HRs of mortality were slightly weaker with high versus low vegetation exposure. Cumulative exposures increased the HRs of pollutant-related mortality, and greater greenness decreased this risk. Two subtypes of stroke patients exhibited diverse patterns of benefit. CONCLUSION Increasing residential greenness attenuates the increased risk of mortality with different patterns due to chronic air pollutants for ischemic and hemorrhagic stroke, offering valuable insights for precise tertiary stroke prevention strategies.
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Affiliation(s)
- Xianjie Jia
- Department of Biostatistics, School of Public Health, Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Ying Yu
- Department of Physiology, Bengbu Medical College, Bengbu, China
| | - Wanning Xia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Zilong Lu
- Department of Physiology, Bengbu Medical College, Bengbu, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
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3
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Camilleri SF, Kerr GH, Anenberg SC, Horton DE. All-Cause NO 2-Attributable Mortality Burden and Associated Racial and Ethnic Disparities in the United States. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2023; 10:1159-1164. [PMID: 38106529 PMCID: PMC10720462 DOI: 10.1021/acs.estlett.3c00500] [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: 07/14/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/19/2023]
Abstract
Nitrogen dioxide (NO2) is a regulated pollutant that is associated with numerous health impacts. Recent advances in epidemiology indicate high confidence linking NO2 exposure with increased mortality, an association that recent studies suggest persists even at concentrations below regulatory thresholds. While large disparities in NO2 exposure among population subgroups have been reported, U.S. NO2-attributable mortality rates and their disparities remain unquantified. Here we provide the first estimate of NO2-attributable all-cause mortality across the contiguous U.S. (CONUS) at the census tract-level. We leverage fine-scale, satellite-informed, land use regression model NO2 concentrations and census tract-level baseline mortality data to characterize the associated disparities among different racial/ethnic subgroups. Across CONUS, we estimate that the NO2-attributable all-cause mortality is ∼170,850 (95% confidence interval: 43,970, 251,330) premature deaths yr-1 with large variability across census tracts and within individual cities. Additionally, we find that higher NO2 concentrations and underlying susceptibilities for predominately Black communities lead to NO2-attributable mortality rates that are ∼47% higher compared to CONUS-wide average rates. Our results highlight the substantial U.S. NO2 mortality burden, particularly in marginalized communities, and motivate adoption of more stringent standards to protect public health.
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Affiliation(s)
- Sara F Camilleri
- Department
of Earth and Planetary Sciences, Northwestern
University, Evanston, Illinois 60208, United States
| | - Gaige Hunter Kerr
- Department
of Environmental and Occupational Health, The George Washington University, Washington, DC 20052, United States
| | - Susan C Anenberg
- Department
of Environmental and Occupational Health, The George Washington University, Washington, DC 20052, United States
| | - Daniel E Horton
- Department
of Earth and Planetary Sciences, Northwestern
University, Evanston, Illinois 60208, United States
- Trienens
Institute for Sustainability and Energy, Northwestern University, Evanston, Illinois 60208, United States
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4
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Mananga ES, Lopez E, Diop A, Dongomale PJT, Diane F. The impact of the air pollution on health in New York City. J Public Health Res 2023; 12:22799036231205870. [PMID: 38034845 PMCID: PMC10687960 DOI: 10.1177/22799036231205870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/07/2023] [Indexed: 12/02/2023] Open
Abstract
New York City is attempting to find a solution to an issue that many states and cities face: how to minimize air pollution so that it has fewer negative impacts on human health. Despite having the highest population in the United States (US), New York City typically has reasonably clean air. As the City and State of New York have worked to reduce emissions from local and regional sources, the air quality in New York City has improved during the past few decades. Despite these advancements, air pollution still poses a severe hazard to the health of everyone living in New York's environment. Various diseases including respiratory, circulatory, neurological, gastrointestinal, and urinary illnesses, which can be fatal, are intimately associated with air pollution. This review article will concentrate on how air pollution affects respiratory diseases such as asthma in children. In addition to analyzing the severe effects of air pollution on the vulnerable population, this review article will highlight the health repercussions of air pollution on New York City and its residents. furthermore, we argue for potential ideas and discoveries while also putting up a policy option to lower air pollution.
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Affiliation(s)
- Eugene S Mananga
- The Graduate Center, The City University of New York, New York, NY, USA
- Department of Engineering, Physics, and Technology, Bronx Community College, The City University of New York, Bronx, NY, USA
- Extension School, Harvard University, Cambridge, MA, USA
| | - Erika Lopez
- Department of Engineering, Physics, and Technology, Bronx Community College, The City University of New York, Bronx, NY, USA
| | - Aissata Diop
- Department of Engineering, Physics, and Technology, Bronx Community College, The City University of New York, Bronx, NY, USA
| | - Paulin JT Dongomale
- Department of Geosciences and Geological and Petroleum Engineering, Missouri University of Science and Technology, Rolla, MO, USA
| | - Fambougouri Diane
- Department of Engineering, Physics, and Technology, Bronx Community College, The City University of New York, Bronx, NY, USA
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5
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Iyanna N, Yolton K, LeMasters G, Lanphear BP, Cecil KM, Schwartz J, Brokamp C, Rasnick E, Xu Y, MacDougall MC, Ryan PH. Air pollution exposure and social responsiveness in childhood: The cincinnati combined childhood cohorts. Int J Hyg Environ Health 2023; 251:114172. [PMID: 37116232 PMCID: PMC10682723 DOI: 10.1016/j.ijheh.2023.114172] [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: 01/18/2023] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
Autism Spectrum Disorder (ASD) affects about 1 in 44 children and environmental exposures may contribute to disease onset. Air pollution has been associated with adverse neurobehavioral outcomes, yet little research has examined its association with autistic-like behaviors. Therefore, our objective was to examine the association between exposure to air pollution, including NO2 and PM2.5, during pregnancy and the first year of life to ASD-like behaviors during childhood. Participants (n = 435) enrolled in the Cincinnati Childhood Allergy and Air Pollution Study and the Health Outcomes and Measures of the Environment Study were included in the analysis. Daily exposures to NO2 and PM2.5 at the residential addresses of participants were estimated using validated spatiotemporal models and averaged to obtain prenatal and first year exposure estimates. ASD-like behaviors were assessed via the Social Responsiveness Scale (SRS) questionnaire at age 12. Linear regression models adjusting for confounders were applied to estimate the association between pollutants and SRS scores. After adjusting for covariates, the association between NO2 and PM2.5 and SRS scores remained positive but were no longer statistically significant. Prenatal and first year exposure to NO2 were associated with total SRS T-scores with an estimated 0.4 point increase (95% CI: -0.7, 1.6) per 5.2 ppb increase in NO2 exposure and 0.7 point (95% CI: -0.3, 1.6) per 4.2 ppb increase in NO2 exposure, respectively. For PM2.5, a 2.6 μg/m3 increase in prenatal exposure was associated with a 0.1 point increase (95% CI: -1.1, 1.4) in SRS Total T-scores and a 1.3 μg/m3 increase first year of life was associated with a 1 point increase (95% CI: -0.2, 2.3). In summary, exposure to NO2 and PM2.5 during pregnancy and the first year of life were not significantly associated with higher autistic-like behaviors measured with SRS scores after adjustment of covariates. Additional research is warranted given prior studies suggesting air pollution contributes to ASD.
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Affiliation(s)
- Nidhi Iyanna
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Grace LeMasters
- Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's and Women's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Kim M Cecil
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, USA
| | - Cole Brokamp
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Erika Rasnick
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melinda C MacDougall
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patrick H Ryan
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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6
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Vigna L, Tirelli AS, Grossi E, Turolo S, Tomaino L. Metal Body Burden as Cardiovascular Risk Factor in Adults with Metabolic Syndrome and Overweight-Obesity Analysed with an Artificial Neural Network: The Role of Hair Mineralograms. Metabolites 2023; 13:679. [PMID: 37367837 DOI: 10.3390/metabo13060679] [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: 03/12/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
In determining the so-called "body burden", hair has been widely accepted for assessing toxic element exposure. However, its role in assessing essential elements is controversial. This study investigates the possible relationship between hair minerals, metabolic syndrome (MetS) and cardiovascular (CV) risk in non-occupationally exposed subjects with overweight-obesity. Ninety-five voluntary participants (aged 51 ± 12) were recruited in Northern Italy. Hair samples were collected and analysed via inductively coupled plasma mass spectrometry; the total toxicity index (TI) was calculated as well. To evaluate cardiovascular risk factors in the presence or absence of MetS, the following factors were considered via the innovative artificial neural network (ANN) method Auto-CM: hair mineralograms (31 elements) and 25 variables including blood pressure, anthropometric parameters, insulin resistance and biochemical serum markers assessing inflammation. The Framingham risk score, fatty liver index (FLI), visceral adiposity index and CV risk scores were also taken into consideration. As shown by the semantic map, which was subsequently confirmed by an activation and competition system (ACS), obesity parameters are strictly associated with CV risk factors, TI and inflammation; meanwhile, the single mineral elements seem to be unimportant. Data obtained via ANN demonstrate that MetS may be at least partly mediated by altered mineral levels also in the presence of obesity and that waist circumference is a crucial point to be monitored rather than BMI alone. Furthermore, the mineral body burden is one of the important factors for CV risk.
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Affiliation(s)
- Luisella Vigna
- Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Amedea Silvia Tirelli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Enzo Grossi
- Villa Santa Maria Foundation, 22038 Tavernerio, Italy
| | - Stefano Turolo
- Pediatric Nephrology and Dialysis, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Laura Tomaino
- Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
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7
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Kephart JL, Gouveia N, Rodriguez DA, Indvik K, Alfaro T, Texcalac JL, Miranda JJ, Bilal U, Roux AVD. Ambient nitrogen dioxide in 47,187 neighborhoods across 326 cities in eight Latin American countries: population exposures and associations with urban features. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.02.23289390. [PMID: 37205591 PMCID: PMC10187449 DOI: 10.1101/2023.05.02.23289390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Health research on ambient nitrogen dioxide (NO2) is sparse in Latin America, despite the high prevalence of NO2-associated respiratory diseases in the region. This study describes within-city distributions of ambient NO2 concentrations at high spatial resolution and urban characteristics associated with neighborhood ambient NO2 in 326 Latin American cities. Methods We aggregated estimates of annual surface NO2 at 1 km2 spatial resolution for 2019, population counts, and urban characteristics compiled by the SALURBAL project to the neighborhood level (i.e., census tracts). We described the percent of the urban population living with ambient NO2 levels exceeding WHO Air Quality Guidelines. We used multilevel models to describe associations of neighborhood ambient NO2 concentrations with population and urban characteristics at the neighborhood and city levels. Findings We examined 47,187 neighborhoods in 326 cities from eight Latin American countries. Of the ≈236 million urban residents observed, 85% lived in neighborhoods with ambient annual NO2 above WHO guidelines. In adjusted models, higher neighborhood-level educational attainment, closer proximity to the city center, and lower neighborhood-level greenness were associated with higher ambient NO2. At the city level, higher vehicle congestion, population size, and population density were associated with higher ambient NO2. Interpretation Almost nine out of every 10 residents of Latin American cities live with ambient NO2 concentrations above WHO guidelines. Increasing neighborhood greenness and reducing reliance on fossil fuel-powered vehicles warrant further attention as potential actionable urban environmental interventions to reduce population exposure to ambient NO2. Funding Wellcome Trust, National Institutes of Health, Cotswold Foundation.
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Affiliation(s)
- Josiah L. Kephart
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Nelson Gouveia
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Daniel A. Rodriguez
- Department of City and Regional Planning and Institute for Transportation Studies, University of California, Berkeley, California, USA
| | - Katy Indvik
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Tania Alfaro
- Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, Chile
| | - José Luis Texcalac
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Usama Bilal
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
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8
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Wang Y, Liu P, Schwartz J, Castro E, Wang W, Chang H, Scovronick N, Shi L. Disparities in ambient nitrogen dioxide pollution in the United States. Proc Natl Acad Sci U S A 2023; 120:e2208450120. [PMID: 37036985 PMCID: PMC10120073 DOI: 10.1073/pnas.2208450120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 03/08/2023] [Indexed: 04/12/2023] Open
Abstract
Average ambient concentrations of nitrogen dioxide (NO2), an important air pollutant, have declined in the United States since the enactment of the Clean Air Act. Despite evidence that NO2 disproportionately affects racial/ethnic minority groups, it remains unclear what drives the exposure disparities and how they have changed over time. Here, we provide evidence by integrating high-resolution (1 km × 1 km) ground-level NO2 estimates, sociodemographic information, and source-specific emission intensity and location for 217,740 block groups across the contiguous United States from 2000 to 2016. We show that racial/ethnic minorities are disproportionately exposed to higher levels of NO2 pollution compared with Whites across the United States and within major metropolitan areas. These inequities persisted over time and have worsened in many cases, despite a significant decrease in the national average NO2 concentration over the 17-y study period. Overall, traffic contributes the largest fraction of NO2 disparity. Contributions of other emission sources to exposure disparities vary by location. Our analyses offer insights into policies aimed at reducing air pollution exposure disparities among races/ethnicities and locations.
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Affiliation(s)
- Yifan Wang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA30322
| | - Pengfei Liu
- School of Earth and Atmospheric Sciences, Georgia Institute of Technology, Atlanta, GA30322
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Wenhao Wang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA30322
| | - Howard Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA30322
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA30322
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA30322
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9
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Song J, Wang Y, Zhang Q, Qin W, Pan R, Yi W, Xu Z, Cheng J, Su H. Premature mortality attributable to NO 2 exposure in cities and the role of built environment: A global analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 866:161395. [PMID: 36621501 DOI: 10.1016/j.scitotenv.2023.161395] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/19/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental risks accumulate in cities, including polluted air and health disparities, but these risks can be reduced through scientific city planning. The purpose of this study was to investigate the global burden of premature mortality attributable to NO2 exposure in urban areas and the role of the built environment in this regard. METHODS An approach based on health impact assessment was used to estimate the premature mortality burdens associated with NO2 exposure in 13,169 urban areas around the world using globally gridded NO2 and population estimates, baseline mortality, and epidemiologically derived exposure-response functions. We used the most recent WHO recommended value (i.e.,10 μg/m3) as a counterfactual concentration. Finally, the relationship between the characteristics of the built environment at the city level and the burden of NO2-related mortality was evaluated. RESULTS Worldwide, 549,715(95%CI: 276204-815,023) cases of death attributable to NO2 exposure in urban areas could be prevented if compliance with the latest WHO guideline, accounting for 2.7 % (95%CI:1.4 %-4.0 %) of total mortalities in 2019. Across cities around the world, the age-standardized mortality rate (per 100,000 people) attributable to NO2 exposure ranged from 51.3 (95%CI:25.8-76.0) in Central Asia to 3.4(95%CI: 1.7-5.1) in Oceania. Although there was a significant decrease in premature mortality attributable to NO2 exposure globally, considerable regional heterogeneity exists, with cities in Central Asia and Andean Latin America in particular exhibiting an upward trend. Further, we discovered a positive association between population density and street connectivity with mortality attributable to NO2. While the increase in green and blue space were significantly associated with a lower NO2-associated mortality. CONCLUSION The findings of this study provided a comprehensive understanding of the premature mortality burden due to NO2 in cities throughout the world and the role that urban planning policies can play in reducing the health burden associated with air pollution.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuling Wang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Qin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Wei Qin
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, 288 Herston Road, Herston, QLD 4006 Brisbane, Australia
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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10
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Gu X, Jing D, Xiao Y, Zhou G, Yang S, Liu H, Chen X, Shen M. Association of air pollution and genetic risks with incidence of elderly-onset atopic dermatitis: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 253:114683. [PMID: 36857917 DOI: 10.1016/j.ecoenv.2023.114683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Elderly-onset atopic dermatitis (AD) is a remarkable subtype and has been put on the agenda owing to its difficulty to control. Understanding the influence of genetic and environmental exposures is crucial to preventing elderly-onset AD. OBJECTIVES To explore the association between genes and air pollution on incident elderly-onset AD. MATERIAL AND METHODS This study was based on UK Biobank that recruited over 500,000 participants. The genetic risks were categorized into low, intermediate, and high groups according to tertiles of polygenic risk scores. Mixed exposure to various air pollutants was assessed using the weighted quantile sum (WQS) and also categorized based on tertiles. Within each genetic risk group, whether air pollutant mixture was associated with incident elderly-onset AD was estimated. RESULTS 337,910 participants were included in the final analysis, and the mean age was 57.1. The median years for follow-up were 12.0, and the incident cases of AD were 2545. The medium and high air pollution mixture was significantly associated with incident AD compared with the low pollution group, with HRs of 1.182 (P = 0.003) and 1.359 (P < 0.001), respectively. In contrast, HR for medium and high genetic susceptibility was only 1.065 (P = 0.249) and 1.153 (P = 0.008). The population-attributable fraction of air pollution and genetic risk was 15.5 % (P < 0.001) and 6.4 % (P = 0.004). Additionally, compared with low genetic risk and low air pollution, high genetic risk and high air pollution was significantly associated with the incidence of elderly-onset AD with a HR of up to 1.523 (P < 0.001). There were no interactive effects between each group of genetic risks and air pollution. When grouped by sex, females could observe a stronger effect by genetic and air pollutant mixture exposure. CONCLUSION Air pollution and genetics both independently enhance the risk of newly developed AD, and the effect of air pollutants is stronger than the investigated genes.
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Affiliation(s)
- Xiaoyu Gu
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China
| | - Danrong Jing
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China
| | - Yi Xiao
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China
| | - Guowei Zhou
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China
| | - Songchun Yang
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China.
| | - Hong Liu
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China.
| | - Xiang Chen
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China.
| | - Minxue Shen
- Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha 410008, China; Furong Laboratory, Changsha, Hunan 410008, China; Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410013, China.
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11
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Wang Y, Luo S, Wei J, Yang Z, Hu K, Yao Y, Zhang Y. Ambient NO 2 exposure hinders long-term survival of Chinese middle-aged and older adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158784. [PMID: 36116662 DOI: 10.1016/j.scitotenv.2022.158784] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/25/2022] [Accepted: 09/11/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Serval longitudinal investigations have reported relationships between long-term nitrogen dioxide (NO2) exposure and mortality. In developing countries such as China, however, the cohort evidence was extremely rare. In this study, we aimed to establish the concentration-response relationship between long-term exposure to NO2 and mortality in Chinese adults. METHODS We conducted a prospective cohort study followed up from 2011 to 2018, by enrolling 15,440 participants aged ≥45 years from 28 provincial regions of China. NO2 concentration estimates were derived from high-quality spatiotemporal datasets developed by machine learning methods and were assigned for each participant according to their residential cities. We applied Cox proportional hazard models with time-varying exposures to assess the association of all-cause death with long-term NO2 exposure. Subgroup analyses were performed to identify effect modifications. RESULTS A total of 1646 death events occurred during 105,478.5 person-years' follow-up (median 7.1 years). No evident violation for linear NO2-mortality relationship (P nonlinear = 0.332) was observed at a range of 7.4-45.0 μg/m3. Per 10-μg/m3 rise in NO2 was associated with an hazard ratio of 1.220 (95% confidence interval: 1.103-1.350) for all-cause mortality. The association between NO2 and mortality was generally robust after adjusting for co-pollutants including fine particulate matter or/and ozone. Only participants aged 65 and over (1.351 [1.193-1.531]) suffered from increased risks of death associated with NO2 exposure, and an evident effect modification by age (P = 0.008) was identified. The elevated risk of death induced by NO2 was also observed in participants living in rural areas and those with elementary school education or below, though effect modifications were non-significant in these subgroups. CONCLUSIONS This study provided novel evidence that long-term NO2 exposure could be an independent risk for mortality among Chinese middle-aged and older adults. Our findings highlighted the importance of controlling air pollution induced by vehicle emissions.
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Affiliation(s)
- Yaqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park 20742, USA
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing 100191, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China.
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12
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Qiu X, Wei Y, Weisskopf M, Spiro A, Shi L, Castro E, Coull B, Koutrakis P, Schwartz J. Air pollution, climate conditions and risk of hospital admissions for psychotic disorders in U.S. residents. ENVIRONMENTAL RESEARCH 2023; 216:114636. [PMID: 36283440 PMCID: PMC9712244 DOI: 10.1016/j.envres.2022.114636] [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: 07/01/2022] [Revised: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The physical environmental risk factors for psychotic disorders are poorly understood. This study aimed to examine the associations between exposure to ambient air pollution, climate measures and risk of hospitalization for psychotic disorders and uncover potential disparities by demographic, community factors. METHODS Using Health Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs), we applied zero-inflated negative binomial regression to obtain relative risks of hospitalization due to psychotic disorders associated with increases in residential exposure to ambient air pollution (fine particulate matter, PM2.5; nitrogen dioxide, NO2), temperature and cumulative precipitation. The analysis covered all-age residents in eight U.S. states over the period of 2002-2016. We additionally investigated modification by age, sex and area-level poverty, percent of blacks and Hispanics. RESULTS Over the study period and among the covered areas, we identified 1,211,100 admissions due to psychotic disorders. For each interquartile (IQR) increase in exposure to PM2.5 and NO2, we observed a relative risk (RR) of 1.11 (95% confidence interval (CI) = 1.09, 1.13) and 1.27 (95% CI = 1.24, 1.31), respectively. For each 1 °C increase of temperature, the RR was 1.03 (95% CI = 1.03, 1.04). Males were more affected by NO2. Older age residents (≥30 yrs) were more sensitive to PM2.5 and temperature. Population living in economically disadvantaged areas were more affected by air pollution. CONCLUSIONS The study suggests that living in areas with higher levels of air pollutants and ambient temperature could contribute to additional risk of inpatient care for individuals with psychotic disorders.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Avron Spiro
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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13
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Shukla K, Seppanen C, Naess B, Chang C, Cooley D, Maier A, Divita F, Pitiranggon M, Johnson S, Ito K, Arunachalam S. ZIP Code-Level Estimation of Air Quality and Health Risk Due to Particulate Matter Pollution in New York City. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7119-7130. [PMID: 35475336 PMCID: PMC9178920 DOI: 10.1021/acs.est.1c07325] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 05/19/2023]
Abstract
Exposure to PM2.5 is associated with hundreds of premature mortalities every year in New York City (NYC). Current air quality and health impact assessment tools provide county-wide estimates but are inadequate for assessing health benefits at neighborhood scales, especially for evaluating policy options related to energy efficiency or climate goals. We developed a new ZIP Code-Level Air Pollution Policy Assessment (ZAPPA) tool for NYC by integrating two reduced form models─Community Air Quality Tools (C-TOOLS) and the Co-Benefits Risk Assessment Health Impacts Screening and Mapping Tool (COBRA)─that propagate emissions changes to estimate air pollution exposures and health benefits. ZAPPA leverages custom higher resolution inputs for emissions, health incidences, and population. It, then, enables rapid policy evaluation with localized ZIP code tabulation area (ZCTA)-level analysis of potential health and monetary benefits stemming from air quality management decisions. We evaluated the modeled 2016 PM2.5 values against observed values at EPA and NYCCAS monitors, finding good model performance (FAC2, 1; NMSE, 0.05). We, then, applied ZAPPA to assess PM2.5 reduction-related health benefits from five illustrative policy scenarios in NYC focused on (1) commercial cooking, (2) residential and commercial building fuel regulations, (3) fleet electrification, (4) congestion pricing in Manhattan, and (5) these four combined as a "citywide sustainable policy implementation" scenario. The citywide scenario estimates an average reduction in PM2.5 of 0.9 μg/m3. This change translates to avoiding 210-475 deaths, 340 asthma emergency department visits, and monetized health benefits worth $2B to $5B annually, with significant variation across NYC's 192 ZCTAs. ZCTA-level assessments can help prioritize interventions in neighborhoods that would see the most health benefits from air pollution reduction. ZAPPA can provide quantitative insights on health and monetary benefits for future sustainability policy development in NYC.
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Affiliation(s)
- Komal Shukla
- Institute
for the Environment, The University of North
Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
| | - Catherine Seppanen
- Institute
for the Environment, The University of North
Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
| | - Brian Naess
- Institute
for the Environment, The University of North
Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
| | - Charles Chang
- Institute
for the Environment, The University of North
Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
| | - David Cooley
- Abt
Associates, Durham, North Carolina 27703, United States
| | - Andreas Maier
- Abt
Associates, Durham, North Carolina 27703, United States
| | - Frank Divita
- Abt
Associates, Durham, North Carolina 27703, United States
| | - Masha Pitiranggon
- New
York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, New York 10013, United States
| | - Sarah Johnson
- New
York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, New York 10013, United States
| | - Kazuhiko Ito
- New
York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, New York 10013, United States
| | - Saravanan Arunachalam
- Institute
for the Environment, The University of North
Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
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14
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Crosignani P. Comment on "Invited Perspective: The NO2 and Mortality Dilemma Solved? Almost There!". ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:38001. [PMID: 35294264 PMCID: PMC8926161 DOI: 10.1289/ehp11049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Paolo Crosignani
- International Society of Doctors for the Environment, Milan, Italy
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15
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Forastiere F, Peters A. Invited Perspective: The NO2 and Mortality Dilemma Solved? Almost There! ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:121304. [PMID: 34962423 PMCID: PMC8713649 DOI: 10.1289/ehp10286] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 05/30/2023]
Affiliation(s)
- Francesco Forastiere
- Istituto per la Ricerca e l’Innovazione Biomedica Consiglio Nazionale delle Ricerche, Palermo, Italy
- Environmental Research Group, Imperial College, London, UK
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center for Environmental Health, Neuherberg, Germany
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