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Watkins WJ, Course CW, Cousins M, Hart K, Kotecha SJ, Kotecha S. Impact of ambient air pollution on lung function in preterm-born school-aged children. Thorax 2024; 79:553-563. [PMID: 38359924 PMCID: PMC11137460 DOI: 10.1136/thorax-2023-220233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
RATIONALE Increased outdoor air pollution worsens lung function in children. However, these associations are less well studied in preterm-born individuals. OBJECTIVES We assessed associations between ambient air pollutants and spirometry measures in preterm-born children. METHODS The Respiratory Health Outcomes in Neonates study recruited preterm-born children aged 7-12 years who were born at ≤34 week's gestation. We associated four ambient air pollutants (particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), PM10, nitrogen dioxide (NO2) and sulfur dioxide) at time of birth and spirometry assessment and averaged exposure between these two time points with spirometry measures, using linear regression analyses. Gestational age was banded into 23-28, 29-31 and 32-34 week's. Regression models estimated spirometry values against pollutant levels at birth and at the time of spirometry. MEASUREMENTS AND MAIN RESULTS From 565 preterm-born children, 542 (96%) had satisfactory data. After adjustments for early and current life factors, significant detrimental associations were noted between PM10 at birth and per cent predicted forced vital capacity (%FVC) for the 23-28 and 29-31 week's gestation groups and between current PM2.5 and NO2 exposure and %FVC for the 23-28 week's gestation group. No associations with spirometry were noted for the averaged pollution exposure between birth and spirometry. Predictive models showed 5.9% and 7.4% differences in %FVC between the highest and lowest current pollution exposures for PM2.5 and NO2, respectively, in the 23-28 week group. CONCLUSIONS Birth and current exposures to road-traffic-associated pollutants detrimentally affected %FVC in preterm-born school-aged children, who already have compromised lung function.
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Affiliation(s)
| | | | - Michael Cousins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
- Department of Paediatrics, Cardiff & Vale University Health Board, Cardiff, UK
| | - Kylie Hart
- Department of Paediatrics, Cardiff & Vale University Health Board, Cardiff, UK
| | - Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
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2
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Hazlehurst MF, Dearborn LC, Sherris AR, Loftus CT, Adgent MA, Szpiro AA, Ni Y, Day DB, Kaufman JD, Thakur N, Wright RJ, Sathyanarayana S, Carroll KN, Moore PE, Karr CJ. Long-term ozone exposure and lung function in middle childhood. ENVIRONMENTAL RESEARCH 2024; 241:117632. [PMID: 37967704 PMCID: PMC11067856 DOI: 10.1016/j.envres.2023.117632] [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: 09/08/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Ozone (O3) exposure interrupts normal lung development in animal models. Epidemiologic evidence further suggests impairment with higher long-term O3 exposure across early and middle childhood, although study findings to date are mixed and few have investigated vulnerable subgroups. METHODS Participants from the CANDLE study, a pregnancy cohort in Shelby County, TN, in the ECHO-PATHWAYS Consortium, were included if children were born at gestational age >32 weeks, completed a spirometry exam at age 8-9, and had a valid residential history from birth to age 8. We estimated lifetime average ambient O3 exposure based on each child's residential history from birth to age 8, using a validated fine-resolution spatiotemporal model. Spirometry was performed at the age 8-9 year study visit to assess Forced Expiratory Volume in the first second (FEV1) and Forced Vital Capacity (FVC) as primary outcomes; z-scores were calculated using sex-and-age-specific reference equations. Linear regression with robust variance estimators was used to examine associations between O3 exposure and continuous lung function z-scores, adjusted for child, sociodemographic, and home environmental factors. Potential susceptible subgroups were explored using a product term in the regression model to assess effect modification by child sex, history of bronchiolitis in infancy, and allergic sensitization. RESULTS In our sample (n = 648), O3 exposure averaged from birth to age 8 was modest (mean 26.6 [SD 1.1] ppb). No adverse associations between long-term postnatal O3 exposure were observed with either FEV1 (β = 0.12, 95% CI: -0.04, 0.29) or FVC (β = 0.03, 95% CI: -0.13, 0.19). No effect modification by child sex, history of bronchiolitis in infancy, or allergic sensitization was detected for associations with 8-year average O3. CONCLUSIONS In this sample with low O3 concentrations, we did not observe adverse associations between O3 exposures averaged from birth to age 8 and lung function in middle childhood.
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Affiliation(s)
- Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | - Drew B Day
- Center for Child Health, Behavior, and Development of Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Joel D Kaufman
- Departments of Epidemiology and of Environmental and Occupational Health Sciences, School of Public Health, and Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Neeta Thakur
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Rosalind J Wright
- Departments of Pediatrics and of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, School of Medicine and Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and Seattle Children's Research Institute, Seattle, WA, USA
| | - Kecia N Carroll
- Departments of Pediatrics and of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Catherine J Karr
- Department of Pediatrics, School of Medicine and Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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3
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Chen J, Zeng Y, Lau AK, Guo C, Wei X, Lin C, Huang B, Lao XQ. Chronic exposure to ambient PM 2.5/NO 2 and respiratory health in school children: A prospective cohort study in Hong Kong. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 252:114558. [PMID: 36696726 DOI: 10.1016/j.ecoenv.2023.114558] [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: 10/07/2022] [Revised: 01/08/2023] [Accepted: 01/15/2023] [Indexed: 06/17/2023]
Abstract
Despite increasing concerns about the detrimental effects of air pollution on respiratory health, limited evidence is available on these effects in the Hong Kong population, especially in children. In this prospective cohort study between 2012 and 2017, we aimed to investigate the associations between exposure to air pollution (concentrations of fine particulate matter [PM2.5] and nitrogen dioxide [NO2]) and respiratory health (lung function parameters and respiratory diseases and symptoms) in schoolchildren. We recruited 5612 schoolchildren aged 6-16 years in Hong Kong. We estimated the annual average concentrations of ambient PM2.5 and NO2 at each participant's address using spatiotemporal models. We conducted spirometry tests on all participants to measure their lung function parameters and used a self-administered questionnaire to collect information on their respiratory diseases and symptoms and a wide range of covariates. Linear mixed models were used to investigate the associations between exposure to air pollution and lung function. Mixed-effects logistic regression models with random effects were used to investigate the associations of exposure to air pollution with respiratory diseases and symptoms. In all of the participants, every 5-μg/m3 increase in the ambient PM2.5 concentration was associated with changes of - 13.90 ml (95 % confidence interval [CI]: -23.65 ml, -4.10 ml), - 4.20 ml (-15.60 ml, 7.15 ml), 27.20 ml/s (-3.95 ml/s, 58.35 ml/s), and - 19.80 ml/s (-38.35 ml/s, -1.25 ml/s) in forced expiratory volume in 1 s, forced vital capacity, peak expiratory flow, and maximal mid-expiratory flow, respectively. The corresponding lung function estimates for every 5-μg/m3 increase in the ambient NO2 concentration were - 2.70 ml (-6.05 ml, 0.60 ml), - 1.40 ml (-5.40 ml, 2.60 ml), - 6.60 ml/s (-19.75 ml/s, 6.55 ml/s), and - 3.05 ml/s (-11.10 ml/s, 5.00 ml/s), respectively. We did not observe significant associations between PM2.5/NO2 exposure and most respiratory diseases and symptoms. Stratified analyses by sex and age showed that the associations between exposure to air pollution and lung function parameters were stronger in male participants and older participants (11-14 year old group) than in female participants and younger participants (6-10 year old group), respectively. Our results suggest that chronic exposure to air pollution is detrimental to the respiratory health of schoolchildren, especially that of older boys. Our findings reinforce the importance of air pollution mitigation to protect schoolchildren's respiratory health.
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Affiliation(s)
- Jinjian Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Alexis Kh Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China; Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Department of Urban Planning and Design, Faculty of Architecture, the University of Hong Kong, Hong Kong SAR
| | - Xianglin Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Bo Huang
- Department of Geography and Resource Management, the Chinese University of Hong Kong, Hong Kong, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Department of Biomedical Sciences, the City University of Hong Kong, Hong Kong, China; School of Public Health, Zhengzhou University, Zhengzhou, China.
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4
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Wu CC, Wang CC, Chung WY, Sheu CC, Yang YH, Cheng MY, Lai RS, Leung SY, Lin CC, Wei YF, Lin CH, Lin SH, Hsu JY, Huang WC, Tseng CC, Lai YF, Cheng MH, Chen HC, Yang CJ, Hsu SC, Su CH, Wang CJ, Liu HJ, Chen HL, Hsu YT, Hung CH, Lee CL, Huang MS, Huang SK. Environmental risks and sphingolipid signatures in adult asthma and its phenotypic clusters: a multicentre study. Thorax 2023; 78:225-232. [PMID: 35710744 DOI: 10.1136/thoraxjnl-2021-218396] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 05/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adult asthma is phenotypically heterogeneous with unclear aetiology. We aimed to evaluate the potential contribution of environmental exposure and its ensuing response to asthma and its heterogeneity. METHODS Environmental risk was evaluated by assessing the records of National Health Insurance Research Database (NHIRD) and residence-based air pollution (particulate matter with diameter less than 2.5 micrometers (PM2.5) and PM2.5-bound polycyclic aromatic hydrocarbons (PAHs)), integrating biomonitoring analysis of environmental pollutants, inflammatory markers and sphingolipid metabolites in case-control populations with mass spectrometry and ELISA. Phenotypic clustering was evaluated by t-distributed stochastic neighbor embedding (t-SNE) integrating 18 clinical and demographic variables. FINDINGS In the NHIRD dataset, modest increase in the relative risk with time-lag effect for emergency (N=209 837) and outpatient visits (N=638 538) was observed with increasing levels of PM2.5 and PAHs. Biomonitoring analysis revealed a panel of metals and organic pollutants, particularly metal Ni and PAH, posing a significant risk for current asthma (ORs=1.28-3.48) and its severity, correlating with the level of oxidative stress markers, notably Nε-(hexanoyl)-lysine (r=0.108-0.311, p<0.05), but not with the accumulated levels of PM2.5 exposure. Further, levels of circulating sphingosine-1-phosphate and ceramide-1-phosphate were found to discriminate asthma (p<0.001 and p<0.05, respectively), correlating with the levels of PAH (r=0.196, p<0.01) and metal exposure (r=0.202-0.323, p<0.05), respectively, and both correlating with circulating inflammatory markers (r=0.186-0.427, p<0.01). Analysis of six phenotypic clusters and those cases with comorbid type 2 diabetes mellitus (T2DM) revealed cluster-selective environmental risks and biosignatures. INTERPRETATION These results suggest the potential contribution of environmental factors from multiple sources, their ensuing oxidative stress and sphingolipid remodeling to adult asthma and its phenotypic heterogeneity.
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Affiliation(s)
- Chao-Chien Wu
- Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Yu Chung
- Department of Computer Science and Information Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan
| | - Chau-Chyun Sheu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Maioli, Taiwan
| | | | - Ruay-Sheng Lai
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Sum-Yee Leung
- Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - Chi-Cheng Lin
- Department of Internal Medicine, Antai Medical Care Corp Antai Tian Sheng Memorial Hospital, Pingtung, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Hsiung Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.,Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan
| | - Sheng-Hao Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.,Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan
| | - Jeng-Yuan Hsu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Chang Huang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Medical Technology, Jen-Teh Junior College of Medicine Nursing and Management, Miaoli, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chia-Cheng Tseng
- Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - Yung-Fa Lai
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Meng-Hsuan Cheng
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chih-Jen Yang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Chang Hsu
- Emergency Department, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan.,Department of Emergency, Taipei Medical University School of Medicine, Taipei, Taiwan
| | - Chian-Heng Su
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chien-Jen Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Maioli, Taiwan
| | - Huei-Ju Liu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Maioli, Taiwan
| | - Hua-Ling Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Maioli, Taiwan
| | - Yuan-Ting Hsu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Maioli, Taiwan
| | - Chih-Hsing Hung
- Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan .,Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chon-Lin Lee
- Department of Marine Environment and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ming-Shyan Huang
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan .,Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shau-Ku Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Maioli, Taiwan .,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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5
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Han CH, Pak H, Lee JM, Chung JH. : Short-term effects of exposure to particulate matter on hospital admissions for asthma and chronic obstructive pulmonary disease. Medicine (Baltimore) 2022; 101:e30165. [PMID: 36107568 PMCID: PMC9439629 DOI: 10.1097/md.0000000000030165] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We investigated the effects of particulate matter (PM) factors on hospitalization rates for asthma and chronic obstructive pulmonary disease (COPD). We obtained data on pollutants-PM10, PM2.5-in Seoul, South Korea. We also investigated data for asthma and COPD exacerbation that required hospitalization from 2006 to 2016. We used a time-stratified case-crossover design and generalized additive models with log transformation to assess adjusted risk, and conditional logistic regression was performed to analyze these data. Our study showed that PM10 and PM2.5, on different best lag days, were associated with increased risks of COPD or asthma hospitalization. The odds ratios (ORs) for each per-unit increase in PM10 and PM2.5 were higher in patients with male asthma (PM10: OR, 1.012; 95% confidence interval [CI], 1.008-1.016 and PM2.5: OR, 1.015; 95% CI, 1008-1.023), preschool asthma (PM10: OR, 1.015; 95% CI, 1.006-1.015 and PM2.5: OR, 1.015; 95% CI, 1.009-1.024), male COPD (PM10: OR, 1.012; 95% CI, 1.005-1.019 and PM2.5: OR, 1.013; 95% CI, 1.000-1.026), and senior COPD (PM10: OR, 1.016; 95% CI, 1.008-1.024 and PM2.5: OR, 1.022; 95% CI, 1.007-1.036). Increasing PM levels increased hospitalizations for asthma and COPD. Additionally, the consequences may be different according to age and sex, and PM2.5 may have a more significant effect on airway disease patients than PM10.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Haeyong Pak
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jung Mo Lee
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
- *Correspondence: Jae Ho Chung, Department of Internal Medicine, International St. Mary`s Hospital, 22711 Simgokro 100Gil 25 Seo-gu Incheon, Republic of Korea (e-mail: )
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6
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Carraro S, Ferraro VA, Zanconato S. Impact of air pollution exposure on lung function and exhaled breath biomarkers in children and adolescents. J Breath Res 2022; 16. [PMID: 35947967 DOI: 10.1088/1752-7163/ac8895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/10/2022] [Indexed: 11/12/2022]
Abstract
A growing number of scientific papers focus on the description and quantification of the detrimental effects of pollution exposure on human health. The respiratory system is one of the main targets of these effects and children are potentially a vulnerable population. Many studies analyzed the effects of short- and long-term exposure to air pollutants on children's respiratory function. Aim of the present narrative review is to summarize the results of the available cohort studies which investigated how children's lung function is affected by exposure to air pollution. In addition, an overview is provided on the association, in children, between pollution exposure and exhaled breath biomarkers, as possible indicators of the pathogenetic mechanisms involved in pollution-related lung damages. The identified cohort studies suggest that, beside the possible impact of recent exposure, early and lifetime exposure are the variables most consistently associated with a reduction in lung function parameters in both children and adolescents. As for the effect of air pollution exposure on exhaled breath biomarkers, the available studies show an association with increased exhaled nitric oxide, with increased concentrations of malondialdehyde and 8-isoprostane in exhaled breath condensate (EBC), and with EBC acidification. These studies, therefore, suggest lung inflammation and oxidative stress as possible pathogenetic mechanisms involved in pollution related lung damages. Taken together, the available data underscore the importance of the development and application of policies aimed at reducing air pollutant concentration, since the protection of children's lung function can have a beneficial impact on adults' respiratory health in the future.
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Affiliation(s)
- Silvia Carraro
- Women's and Children's Health Department, University of Padova, via Giustiniani 3, Padova, 35128, ITALY
| | - Valentina Agnese Ferraro
- Women's and Children's Health Department, University of Padova, via Giustiniani, 3, Padova, 35128, ITALY
| | - Stefania Zanconato
- Women's and Children's Health Department, University of Padova, via Giustiniani 3, Padova, 35128, ITALY
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Markozannes G, Pantavou K, Rizos EC, Sindosi OΑ, Tagkas C, Seyfried M, Saldanha IJ, Hatzianastassiou N, Nikolopoulos GK, Ntzani E. Outdoor air quality and human health: An overview of reviews of observational studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119309. [PMID: 35469927 DOI: 10.1016/j.envpol.2022.119309] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NOX, NO2, O3, PM10, PM2.5, and SO2 and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM2.5, PM10, NO2, and SO2 concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM2.5, PM10, O3, NO2, and SO2 concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Evangelos C Rizos
- Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece; School of Medicine, European University Cyprus, Nicosia, Cyprus; Hellenic Open University, Patra, Greece
| | - Ourania Α Sindosi
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | - Christos Tagkas
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maike Seyfried
- Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA
| | - Nikos Hatzianastassiou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | | | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA.
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8
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Stapleton A, Casas M, García J, García R, Sunyer J, Guerra S, Abellan A, Lavi I, Dobaño C, Vidal M, Gascon M. Associations between pre- and postnatal exposure to air pollution and lung health in children and assessment of CC16 as a potential mediator. ENVIRONMENTAL RESEARCH 2022; 204:111900. [PMID: 34419474 DOI: 10.1016/j.envres.2021.111900] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/27/2021] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Early life exposure to air pollution can affect lung health. Previous studies have not assessed the implications of both pre- and postnatal exposure to air pollutants on lung function at repeated ages during childhood. In addition, there is the need to identify potential mediators of such effect. OBJECTIVES To longitudinally assess the association between pre- and postnatal air pollution exposure and lung function during childhood. We also aimed to explore the role of Club cell secretory protein (CC16) as a potential mediator in this association. METHODOLOGY We included 487 mother-child pairs from the INMA (INfancia y Medio Ambiente) Sabadell birth cohort, recruited between 2004 and 2006. Air pollution exposure was estimated for pregnancy, pre-school age, and school-age using temporally adjusted land use regression (LUR) modelling. Lung function was measured at ages 4, 7, 9 and 11 by spirometry. At age 4, serum CC16 levels were determined in 287 children. Multivariable linear regression models and linear mixed modelling were applied, while considering potential confounders. RESULTS Prenatal exposure to Particulate Matter (PM)10 and PMcoarse had the most consistent associations with reduced lung function in cross-sectional models. Associations with postnatal exposure were less consistent. Increasing CC16 levels at 4 years were associated with an increase in FEF25-75 (β = 120.4 mL, 95% CI: 6.30, 234.5) from 4 to 11 years of age. No statistically significant associations were found between pre- or postnatal air pollution and CC16 at age 4. CONCLUSION Increasing levels of air pollution exposure, particularly prenatal PM10 and PMcoarse exposure, were associated with a reduction in lung function. We were not able to confirm our hypothesis on the mediation role of CC16 in this association, however our results encourage further exploration of this possibility in future studies.
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Affiliation(s)
- Anna Stapleton
- Maastricht University, Faculty of Health, Medicine and Life Sciences, the Netherlands
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Judith García
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Raquel García
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Stefano Guerra
- ISGlobal, Barcelona, Spain; Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Spanish Consortium for research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mireia Gascon
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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9
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Han CH, Pak H, Chung JH. Short-term effects of exposure to particulate matter and air pollution on hospital admissions for asthma and chronic obstructive pulmonary disease in Gyeonggi-do, South Korea, 2007-2018. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1535-1541. [PMID: 34900286 PMCID: PMC8617096 DOI: 10.1007/s40201-021-00709-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/10/2021] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Research is lacking on the impacts of exposure to particulate matter (PM) and air pollution on patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, we investigate the effects of various air pollution factors on hospitalization for asthma and COPD. METHODS We obtained data on pollutants-PM10, PM2.5, carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2)-in Gyeonggi-do, South Korea. We also extracted data from Korean National Health Insurance records and investigated asthma and COPD attacks that required hospitalization from January 2007 through February 2018. We used generalized additive models with Poisson distribution and log transformation to calculate adjusted risk. A time-stratified case-crossover design was used, and conditional logistic regression was performed to analyze these data. RESULTS Per-unit increases in concentrations of PM10, PM2.5, SO2, NO2, CO, and O3 on different best lag days were associated with increased risks for hospital admission for COPD and asthma. SO2 had the strongest effect on hospital admission for asthma (odds ratio [OR], 1.535; 95 % confidence interval [CI], 1.450-1.619). SO2 also had the strongest effect on hospital admission for COPD (OR, 1.659; 95 % CI, 1.541-1.786). Subgroup analyses showed that these relationships were stronger in seniors (≥ 65 years old) and women with asthma than in men and nonseniors with COPD. CONCLUSIONS Short-term exposure to PM10, PM2.5, CO, O3, NO2, and SO2 may result in hospitalization for asthma and COPD. Of these pollutants, SO2 has the strongest effects. Therefore, patients with COPD and asthma should be cautioned against performing outdoor activities when SO2 levels are high.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Haeyong Pak
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Simgokro 100Gil 25 Seo-gu, 22711 Incheon, Republic of Korea
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10
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Ayaz KM, Rajkumar R, Basma AG, Emad AJ, Abdullah AH, Hajar H, Mohammad OM, Al-Jahdali H. The effects of the COVID-19 lockdown on severe asthma in patients taking biologic therapy and air pollution in Riyadh. Ann Thorac Med 2021; 16:354-360. [PMID: 34820023 PMCID: PMC8588946 DOI: 10.4103/atm.atm_559_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 04/08/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND: The curfews and lockdowns imposed during the COVID-19 pandemic may decreased the volume of traffic and reduced air pollution. In addition, social distancing measures may contribute to reducing infection and asthma exacerbation. OBJECTIVE: The objective of this study was to assess asthma control and asthma medication use among severe asthmatics on biologics before and after the COVID-19 pandemic. METHODS: This is a cross-sectional survey study of patients with severe asthma receiving biologic therapy at King Abdulaziz Medical City-Riyadh, Saudi Arabia. We looked at the effects of the COVID-19 lockdown on this cohort of severe asthmatics on biologic therapy from March till June 2020 over a period of 12 weeks. We investigated changes in patients’ symptoms and asthma control using the asthma control test (ACT) score and other parameters including emergency department visits, hospitalizations, use of oral prednisolone, changes in inhaler therapy, frequency of bronchodilator use, and patient perception of their symptoms before and after the lockdown period. RESULTS: A total of 56, Female 39 (69%), mean age ± SD 47.4 ± 13.8 years. The duration of bronchial asthma since diagnosis ranged from 4 to 30 years. Most patients had been treated with omalizumab (47, 84%); the rest received mepolizumab (7, 12.5%) and dupilumab (2, 3.6%). All these patients had been on biologic therapy for 5 months, ranging from 5 to 120 months. Most of the patients (45, 80.4%) agreed that their symptoms of asthma had improved with biologic therapy. Most of the patients felt that overall asthma symptoms are better after curfew and lockdown 28 (50%). Less use of bronchodilators postcurfew was reported in 38% of the patients. Asthma control (≥20) using ACT score was significantly higher among patients in postcurfew and lockdown period compared to precurfew period 34 (61.7%) and 23 (41%) (P = 0.001), respectively. CONCLUSIONS: Asthma control was better postcurfew and lockdown. A decrease in air pollution and social distances may be a contributing factor.
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Affiliation(s)
- Khan Mohammad Ayaz
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Rajendram Rajkumar
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Al-Ghamdi Basma
- Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Al-Jahdaly Emad
- Department of Occupational and Environmental Medicine, College of Medicine, Umm AlQura University, Makkah, Saudi Arabia
| | - Al-Harbi Abdullah
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hayyan Hajar
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Obaidi Mostafa Mohammad
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hamdan Al-Jahdali
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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11
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Wang D, Tayarani M, Yueshuai He B, Gao J, Chow JYJ, Oliver Gao H, Ozbay K. Mobility in post-pandemic economic reopening under social distancing guidelines: Congestion, emissions, and contact exposure in public transit. TRANSPORTATION RESEARCH. PART A, POLICY AND PRACTICE 2021; 153:151-170. [PMID: 34566278 PMCID: PMC8450489 DOI: 10.1016/j.tra.2021.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/04/2021] [Accepted: 09/06/2021] [Indexed: 05/25/2023]
Abstract
COVID-19 has raised new challenges for transportation in the post-pandemic era. The social distancing requirement, with the aim of reducing contact risk in public transit, could exacerbate traffic congestion and emissions. We propose a simulation tool to evaluate the trade-offs between traffic congestion, emissions, and policies impacting travel behavior to mitigate the spread of COVID-19 including social distancing and working from home. Open-source agent-based simulation models are used to evaluate the transportation system usage for the case study of New York City. A Post Processing Software for Air Quality (PPS-AQ) estimation is used to evaluate the air quality impacts. Finally, system-wide contact exposure on the subway is estimated from the traffic simulation output. The social distancing requirement in public transit is found to be effective in reducing contact exposure, but it has negative congestion and emission impacts on Manhattan and neighborhoods at transit and commercial hubs. While telework can reduce congestion and emissions citywide, in Manhattan the negative impacts are higher due to behavioral inertia and social distancing. The findings suggest that contact exposure to COVID-19 on subways is relatively low, especially if social distancing practices are followed. The proposed integrated traffic simulation models and air quality estimation model can help policymakers evaluate the impact of policies on traffic congestion and emissions as well as identifying hot spots, both temporally and spatially.
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Affiliation(s)
- Ding Wang
- C2SMART University Transportation Center, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Mohammad Tayarani
- School of Civil and Environmental Engineering, Cornell University, Ithaca, NY, USA
- Center for Transportation, Environment, and Community Health, Cornell University, Ithaca, NY, USA
| | - Brian Yueshuai He
- C2SMART University Transportation Center, New York University Tandon School of Engineering, Brooklyn, NY, USA
- Department of Civil and Environmental Engineering, UCLA, Los Angeles, CA, USA
| | - Jingqin Gao
- C2SMART University Transportation Center, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Joseph Y J Chow
- C2SMART University Transportation Center, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - H Oliver Gao
- School of Civil and Environmental Engineering, Cornell University, Ithaca, NY, USA
- Center for Transportation, Environment, and Community Health, Cornell University, Ithaca, NY, USA
| | - Kaan Ozbay
- C2SMART University Transportation Center, New York University Tandon School of Engineering, Brooklyn, NY, USA
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12
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Turcu C, Crane M, Hutchinson E, Lloyd S, Belesova K, Wilkinson P, Davies M. A multi-scalar perspective on health and urban housing: an umbrella review. BUILDINGS & CITIES 2021; 2:734-758. [PMID: 34738085 PMCID: PMC7611930 DOI: 10.5334/bc.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With more than half the world's population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth's natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.
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Affiliation(s)
- Catalina Turcu
- The Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Melanie Crane
- The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Hutchinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
| | - Simon Lloyd
- Climate and Health Programme (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Kristine Belesova
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, Faculty of the Built Environment, University College London, London, UK
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13
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Holm SM, Balmes JR. Systematic Review of Ozone Effects on Human Lung Function, 2013 through 2020. Chest 2021; 161:190-201. [PMID: 34389296 PMCID: PMC8783034 DOI: 10.1016/j.chest.2021.07.2170] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 01/09/2023] Open
Abstract
Background Ozone effects on lung function are particularly important to understand in the context of the air pollution-health outcomes epidemiologic literature, given the complex relationships between ozone and other air pollutants with known lung function effects. Research Question What has been learned about the association between ozone exposures and lung function from epidemiology studies published from 2013 through 2020? Study Design and Methods On March 18, 2018, and September 8, 2020, PubMed was searched using the terms health AND ozone, filtering to articles in English and about humans, from 2013 or later. An additional focused review searching for ozone AND (lung function OR FEV1OR FVC) was performed June 26, 2021. Articles were selected for this review if they reported a specific relationship between a lung function outcome and ozone exposure. Results Of 3,271 articles screened, 53 ultimately met criteria for inclusion. A systematic review with assessment of potential for bias was conducted, but a meta-analysis was not carried out because of differences in exposure duration and outcome quantification. Consistent evidence exists of small decreases in children’s lung function, even associated with very low levels of short-term ozone exposure. The effects on adult lung function from exposure to low-level, short-term ozone are less clear, although ozone-associated decrements may occur in the elderly. Finally, long-term ozone exposure decreases both lung function and lung function growth in children, although few new studies have examined long-term ozone and lung function in adults. Interpretation Much of this literature involves concentrations below the current US Environmental Protection Agency’s National Ambient Air Quality Standard of 70 parts per billion over an 8-h averaging time, suggesting that this current standard may not protect children adequately from ozone-related decrements in lung function.
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Affiliation(s)
- Stephanie M Holm
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA; Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA; Division of Occupational and Environmental Medicine, University of California, San Francisco, San Francisco, CA.
| | - John R Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA; Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA; Division of Occupational and Environmental Medicine, University of California, San Francisco, San Francisco, CA
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14
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Nejjari C, Marfak A, Rguig A, Maaroufi A, El Marouani I, El Haloui A, El Johra B, Ouahabi R, Moulki R, Azami AI, El Achhab Y. Ambient air pollution and emergency department visits among children and adults in Casablanca, Morocco. AIMS Public Health 2021; 8:285-302. [PMID: 34017892 PMCID: PMC8116191 DOI: 10.3934/publichealth.2021022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022] Open
Abstract
This study presents the relationships between ambient air pollutants and morbidity and emergency department visits among children and adults performed in Great Casablanca, the most populated and economic region in Morocco. This research was analyzed using conditional Poisson model for the period 2011-2013. In the period of study, the daily average concentrations of SO2, NO2, O3 and PM10 in Casablanca were 209.4 µg/m3, 61 µg/m3, 113.2 µg/m3 and 75.1 µg/m3, respectively. In children less than 5 years old, risk of asthma could be increased until 12% per 10 µg/m3 increase in NO2, PM10, SO2 and O3. In children over 5 years and adults, an increase of 10 µg/m3 air pollutant can cause an increase until 3% and 4% in respiratory consultations and acute respiratory infection, respectively. Similarly, impact on emergency department visits due to respiratory and cardiac illness was established. Our results suggest a not negligible impact on morbidity of outdoor air pollution by NO2, SO2, O3, and PM10.
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Affiliation(s)
- Chakib Nejjari
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Morocco
- Mohammed VI University for Health Sciences, Casablanca, Morocco
| | - Abdelghafour Marfak
- National School of Public Health, Rabat, Morocco
- Laboratory of Health Sciences and Technology, Higher Institute of Health Sciences, Hassan 1 University of Settat, Morocco
| | | | | | | | | | - Bouchra El Johra
- General Directorate of Meteorology of Morocco in Casablanca, Morocco
| | | | - Rachid Moulki
- Regional Health Directorate of Casablanca-Settat, Casablanca, Morocco
| | | | - Youness El Achhab
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, Morocco
- Regional Center for Careers Education and Training, Fez-Meknes, Morocco
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15
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Liu L, Liu C, Chen R, Zhou Y, Meng X, Hong J, Cao L, Lu Y, Dong X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Zhang X. Associations of short-term exposure to air pollution and emergency department visits for pediatric asthma in Shanghai, China. CHEMOSPHERE 2021; 263:127856. [PMID: 32822929 DOI: 10.1016/j.chemosphere.2020.127856] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 05/08/2023]
Abstract
There is limited evidence regarding the relationship between air pollution and pediatric asthma in developing countries. This study aimed to investigate the association between short-term exposure to ambient air pollutants and pediatric asthma emergency department (ED) visits in Shanghai, China. We collected data on six criteria air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and daily ED visits for pediatric asthma patients from 66 hospitals in Shanghai from 2016 to 2018. The generalized additive model combined with polynomial distributed lag model was applied to explore the associations. We fitted two-pollutant models and stratified the analyses by sex, age, and season. In total, we identified 108,817 emergency department visits for pediatric asthma. A 10 μg/m3 increase in the concentrations of PM2.5, NO2, SO2, and O3 was significantly associated with increased risks of pediatric asthma ED visits, with relative risk of pediatric asthma of 1.011 [95% confidence interval (CI): 1.002, 1.021], 1.030 (95%CI: 1.017, 1.043), 1.106 (95%CI: 1.041, 1.174), and 1.009 (95%CI: 1.001, 1.017), respectively. The associations of NO2 remained robust in the two-pollutant models. There were stronger associations for older children (6-18 years) and in warm seasons. The concentration-response curves for pediatric asthma and PM2.5, NO2, SO2, and O3 were steeper at lower and moderate concentrations but became flatter at higher concentrations. This analysis provided evidence that short-term exposure to air pollutants (PM2.5, NO2, SO2, and O3) could increase the risk of asthma exacerbations among children, and health benefits would be gained from improved air quality.
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Affiliation(s)
- Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China.
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16
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Lee JT. Review of epidemiological studies on air pollution and health effects in children. Clin Exp Pediatr 2021; 64:3-11. [PMID: 32517422 PMCID: PMC7806407 DOI: 10.3345/cep.2019.00843] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/21/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022] Open
Abstract
There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children's health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.
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Affiliation(s)
- Jong-Tae Lee
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
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17
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Cai Y, Hansell AL, Granell R, Blangiardo M, Zottoli M, Fecht D, Gulliver J, Henderson AJ, Elliott P. Prenatal, Early-Life, and Childhood Exposure to Air Pollution and Lung Function: The ALSPAC Cohort. Am J Respir Crit Care Med 2020; 202:112-123. [PMID: 32142356 DOI: 10.1164/rccm.201902-0286oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rationale: Exposure to air pollution during intrauterine development and through childhood may have lasting effects on respiratory health.Objectives: To investigate lung function at ages 8 and 15 years in relation to air pollution exposures during pregnancy, infancy, and childhood in a UK population-based birth cohort.Methods: Individual exposures to source-specific particulate matter ≤10 μm in aerodynamic diameter (PM10) during each trimester, 0-6 months, 7-12 months (1990-1993), and up to age 15 years (1991-2008) were examined in relation to FEV1% predicted and FVC% predicted at ages 8 (n = 5,276) and 15 (n = 3,446) years using linear regression models adjusted for potential confounders. A profile regression model was used to identify sensitive time periods.Measurements and Main Results: We did not find clear evidence of a sensitive exposure period for PM10 from road traffic. At age 8 years, 1 μg/m3 higher exposure during the first trimester was associated with lower FEV1% predicted (-0.826; 95% confidence interval [CI], -1.357 to -0.296) and FVC% predicted (-0.817; 95% CI, -1.357 to -0.276), but similar associations were seen for exposures for other trimesters, 0-6 months, 7-12 months, and 0-7 years. Associations were stronger among boys, as well as children whose mother had a lower education level or smoked during pregnancy. For PM10 from all sources, the third trimester was associated with lower FVC% predicted (-1.312; 95% CI, -2.100 to -0.525). At age 15 years, no adverse associations with lung function were seen.Conclusions: Exposure to road-traffic PM10 during pregnancy may result in small but significant reductions in lung function at age 8 years.
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Affiliation(s)
- Yutong Cai
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and.,MRC Centre for Environment and Health, Department of Analytical, Environmental and Forensic Sciences, School of Population Health and Environmental Science, King's College London, London, United Kingdom.,The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Anna L Hansell
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and.,Centre for Environmental Health and Sustainability, University of Leicester, Leicester, United Kingdom
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Marta Blangiardo
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and
| | - Mariagrazia Zottoli
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Daniela Fecht
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and
| | - John Gulliver
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and.,Centre for Environmental Health and Sustainability, University of Leicester, Leicester, United Kingdom
| | - A John Henderson
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Paul Elliott
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, and.,UK Dementia Research Institute, Imperial College London, London, United Kingdom.,Imperial Biomedical Research Centre, Imperial College London and Imperial College NHS Healthcare Trust, London, United Kingdom.,National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards, London, United Kingdom; and.,Health Data Research UK - London, London, United Kingdom
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18
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Tiotiu AI, Novakova P, Nedeva D, Chong-Neto HJ, Novakova S, Steiropoulos P, Kowal K. Impact of Air Pollution on Asthma Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176212. [PMID: 32867076 PMCID: PMC7503605 DOI: 10.3390/ijerph17176212] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022]
Abstract
Asthma is a chronic respiratory disease characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Evidence suggests that air pollution has a negative impact on asthma outcomes in both adult and pediatric populations. The aim of this review is to summarize the current knowledge on the effect of various outdoor and indoor pollutants on asthma outcomes, their burden on its management, as well as to highlight the measures that could result in improved asthma outcomes. Traffic-related air pollution, nitrogen dioxide and second-hand smoking (SHS) exposures represent significant risk factors for asthma development in children. Nevertheless, a causal relation between air pollution and development of adult asthma is not clearly established. Exposure to outdoor pollutants can induce asthma symptoms, exacerbations and decreases in lung function. Active tobacco smoking is associated with poorer asthma control, while exposure to SHS increases the risk of asthma exacerbations, respiratory symptoms and healthcare utilization. Other indoor pollutants such as heating sources and molds can also negatively impact the course of asthma. Global measures, that aim to reduce exposure to air pollutants, are highly needed in order to improve the outcomes and management of adult and pediatric asthma in addition to the existing guidelines.
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Affiliation(s)
- Angelica I. Tiotiu
- Department of Pulmonology, University Hospital of Nancy, 54395 Nancy, France
- Development of Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54395 Nancy, France
- Correspondence: ; Tel.: +33-383-154-299
| | - Plamena Novakova
- Clinic of Clinical Allergy, Medical University, 1000 Sofia, Bulgaria;
| | | | - Herberto Jose Chong-Neto
- Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba 80000-000, Brazil;
| | - Silviya Novakova
- Allergy Unit, Internal Consulting Department, University Hospital “St. George”, 4000 Plovdiv, Bulgaria;
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece;
| | - Krzysztof Kowal
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-037 Bialystok, Poland;
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19
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Residential Links to Air Pollution and School Children with Asthma in Vilnius (Population Study). ACTA ACUST UNITED AC 2020; 56:medicina56070346. [PMID: 32668717 PMCID: PMC7404686 DOI: 10.3390/medicina56070346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
Background and objectives: Many studies have been carried out on the negative health effects of exposure to PM10, PM 2.5, NO2, CO, SO2 and B[a]P for small populations. The main purpose of this study was to explore the association of air pollution to diagnosis of asthma for the whole huge population of school children between 7–17 years in Vilnius (Lithuania) using geographical information system analysis tools. Material and Methods: In the research, a child population of 51,235 individuals was involved. From this large database, we identified children who had asthma diagnosis J45 (ICD-10 AM). Residential pollution concentrations and proximity to roads and green spaces were obtained using the ArcGIS spatial analysis tool from simulated air pollution maps. Multiple stepwise logistic regression was used to explore the relation between air pollution concentration and proximity between the roads and green spaces where children with asthma were living. Further, we explored the interaction between variables. Results: From 51,235 school children aged 7–17 years, 3065 children had asthma in 2017. We investigated significant associations, such as the likelihood of getting sick with age (odds ratio (OR) = 0.949, p < 0.001), gender (OR = 1.357, p = 0.003), NO2 (OR = 1.013, p = 0.019), distance from the green spaces (OR = 1.327, p = 0.013) and interactions of age × gender (OR = 1.024, p = 0.051). The influence of gender on disease is partly explained by different age dependency slopes for boys and girls. Conclusions: According to our results, younger children are more likely to get sick, more cases appended on the lowest age group from 7 to 10 years (almost half cases (49.2%)) and asthma was respectively nearly twice more common in boys (64.1%) than in girls (35.9%). The risk of asthma is related to a higher concentration of NO2 and residence proximity to green spaces.
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20
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Tayarani M, Rowangould G. Estimating exposure to fine particulate matter emissions from vehicle traffic: Exposure misclassification and daily activity patterns in a large, sprawling region. ENVIRONMENTAL RESEARCH 2020; 182:108999. [PMID: 31855700 DOI: 10.1016/j.envres.2019.108999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
Vehicle traffic is responsible for a significant portion of toxic air pollution in urban areas that has been linked to a wide range of adverse health outcomes. Most vehicle air quality analyses used for transportation planning and health effect studies estimate exposure from the measured or modeled concentration of an air pollutant at a person's home. This study evaluates exposure to fine particulate matter from vehicle traffic and the magnitude and cause of exposure misclassification that result from not accounting for population mobility during the day in a large, sprawling region. We develop a dynamic exposure model by integrating activity-based travel demand, vehicle emission, and air dispersion models to evaluate the magnitude, components and spatial patterns of vehicle exposure misclassification in the Atlanta, Georgia metropolitan area. Overall, we find that population exposure estimates increase by 51% when population mobility is accounted for. Errors are much larger in suburban and rural areas where exposure is underestimated while exposure may be overestimated near high volume roadways and in the urban core. Exposure while at work and traveling account for much of the error. We find much larger errors than prior studies, all of which have focused on more compact urban regions. Since many people spend a large part of their day away from their homes and vehicle emissions are known to create "hotspots" along roadways, home-based exposure is unlikely to be a robust estimator of a person's actual exposure. Accounting for population mobility in vehicle emission exposure studies may reveal more effective mitigation strategies, important differences in exposure between population groups with different travel patterns, and reduce exposure misclassification in health studies.
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Affiliation(s)
- Mohammad Tayarani
- School of Civil & Environmental Engineering, Cornell University, Ithaca, NY, USA
| | - Gregory Rowangould
- University of Vermont, Department of Civil and Environmental Engineering, Votey Hall, 33 Colchester Ave., Burlington, VT, 05405, USA.
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21
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Xing X, Hu L, Guo Y, Bloom MS, Li S, Chen G, Yim SHL, Gurram N, Yang M, Xiao X, Xu S, Wei Q, Yu H, Yang B, Zeng X, Chen W, Hu Q, Dong G. Interactions between ambient air pollution and obesity on lung function in children: The Seven Northeastern Chinese Cities (SNEC) Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 699:134397. [PMID: 31677469 DOI: 10.1016/j.scitotenv.2019.134397] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/23/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Children are vulnerable to air pollution-induced lung function deficits, and the prevalence of obesity has been increasing in children. To evaluate the joint effects of long-term PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 μm) exposure and obesity on children's lung function, a cross-sectional sample of 6740 children (aged 7-14 years) was enrolled across seven northeastern Chinese cities from 2012 to 2013. Weight and lung function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF), were measured according to standardized protocols. Average PM1, PM2.5, PM10 and nitrogen dioxide (NO2) exposure levels were estimated using a spatiotemporal model, and sulphur dioxide (SO2) and ozone (O3) exposure were estimated using data from municipal air monitoring stations. Two-level logistic regression and general linear models were used to analyze the joint effects of body mass index (BMI) and air pollutants. The results showed that long-term air pollution exposure was associated with lung function impairment and there were significant interactions with BMI. Associations were stronger among obese and overweight than normal weight participants (the adjusted odds ratios (95% confidence intervals) for PM1 and lung function impairments in three increasing BMI categories were 1.50 (1.07-2.11) to 2.55 (1.59-4.07) for FVC < 85% predicted, 1.44 (1.03-2.01) to 2.51 (1.53-4.11) for FEV1 < 85% predicted, 1.34 (0.97-1.84) to 2.04 (1.24-3.35) for PEF < 75% predicted, and 1.34 (1.01-1.78) to 1.93 (1.26-2.95) for MMEF < 75% predicted). Consistent results were detected in linear regression models for PM1, PM2.5 and SO2 on FVC and FEV1 impairments (PInteraction < 0.05). These modification effects were stronger among females and older participants. These results can provide policy makers with more comprehensive information for to develop strategies for preventing air pollution induced children's lung function deficits among children.
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Affiliation(s)
- Xiumei Xing
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Liwen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael S Bloom
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Steve Hung Lam Yim
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Namratha Gurram
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Mo Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiang Xiao
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shuli Xu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qi Wei
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hongyao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Boyi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaowen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wen Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qiang Hu
- Department of Pediatric Surgery, Weifang People's Hospital, Weifang 261041, China.
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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22
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Zhang L, Morisaki H, Wei Y, Li Z, Yang L, Zhou Q, Zhang X, Xing W, Hu M, Shima M, Toriba A, Hayakawa K, Tang N. Characteristics of air pollutants inside and outside a primary school classroom in Beijing and respiratory health impact on children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113147. [PMID: 31522002 DOI: 10.1016/j.envpol.2019.113147] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/28/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
This study investigated the spatial and temporal distributions of particulate and gaseous air pollutants in a primary school in Beijing and assessed their health impact on the children. The results show that air quality inside the classroom was greatly affected by the input of outdoor pollutants; high levels of pollution were observed during both the heating and nonheating periods and indicate that indoor and outdoor air pollution posed a threat to the children's health. Traffic sources near the primary school were the main contributors to indoor and outdoor pollutants during both periods. Moreover, air quality in this primary school was affected by coal combustion and atmospheric reactions during the heating and nonheating periods, respectively. Based on the estimation by exposure-response functions and the weighting of indoor and outdoor pollutants during different periods, the levels of PM2.5, PM 10 and O3 at school had adverse respiratory health effects on children. Longer exposures during the nonheating period contributed to higher health risks. These results emphasized that emission sources nearby had a direct impact on air quality in school and children's respiratory health. Therefore, measures should be taken for double control on air pollution inside and outside the classroom to protect children from it.
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Affiliation(s)
- Lulu Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Hiroshi Morisaki
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China.
| | - Zhigang Li
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Lu Yang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Quanyu Zhou
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Xuan Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Wanli Xing
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Min Hu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Science and Engineering, Peking University, Beijing, 100871, China
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akira Toriba
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Kazuichi Hayakawa
- Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Ning Tang
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan; Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan.
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23
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Mentz G, Robins TG, Batterman S, Naidoo RN. Effect modifiers of lung function and daily air pollutant variability in a panel of schoolchildren. Thorax 2019; 74:1055-1062. [PMID: 31534032 DOI: 10.1136/thoraxjnl-2017-211458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Acute pollutant-related lung function changes among children varies across pollutants and lag periods. We examined whether short-term air pollutant fluctuations were related to daily lung function among a panel of children and whether these effects are modified by airway hyperresponsiveness, location and asthma severity. METHODS Students from randomly selected grade 4 classrooms at seven primary schools in Durban, participated, together with asthmatic children from grades 3-6 (n=423). The schools were from high pollutant exposed communities (south) and compared with schools from communities with lower levels of pollution (north), with similar socioeconomic profiles. Interviews, spirometry and methacholine challenge testing were conducted. Bihourly lung function measurements were performed over a 3-week period in four phases. During all schooldays, students blew into their personal digital monitors every 1.5-2 hours. Nitrogen dioxide (NO2), nitrogen oxide (NO), sulphur dioxide and particulate matter (<10 μm diameter) (PM10) were measured at each school. Generalised estimating equations assessed lag effects, using single-pollutant (single or distributed lags) models. RESULTS FEV1 declines ranged from 13 to 18 mL per unit increase in IQR for NO and 14-23 mL for NO2. Among the 5-day average models, a 20 mL and 30 mL greater drop in FEV1 per IQR for NO2 and NO, respectively, among those with airway hyperresponsiveness compared with those without. Effects were seen among those with normal airways. CONCLUSIONS This first panel study in sub-Saharan Africa, showed significant declines in lung function, in response to NO and NO2 with effects modified by airway hyperresponsiveness or persistent asthma.
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Affiliation(s)
| | | | | | - Rajen N Naidoo
- Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
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24
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Shin SW, Bae DJ, Park CS, Lee JU, Kim RH, Kim SR, Chang HS, Park JS. Effects of air pollution on moderate and severe asthma exacerbations. J Asthma 2019; 57:875-885. [PMID: 31122089 DOI: 10.1080/02770903.2019.1611844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Few studies have evaluated the impact of air pollution levels on the severity of exacerbations. Thus, we compared the relative risks posed by air pollutant levels on moderate and severe exacerbations.Methods: Exacerbation episodes of 618 from 143 adult asthmatics were retrospectively collected between 2005 and 2015 in a tertiary hospital of Korea. Air pollution GPS data for the location closest to each patient's home were obtained from the national ambient monitoring station. The relative impacts of air pollutants on asthma exacerbations were evaluated via a time-trend controlled symmetrical, bidirectional, case-crossover design using conditional logistic regression models on the day of the exacerbation (T-0) and up to 3 days before the exacerbation (T-1-T-3).Results: Overall asthma exacerbation were associated with O3 levels in summer and winter (OR: 1.012[1.003-1.02] and 1.009[1.003-1.016]), SO2 levels in spring and summer (OR: 1.009[1-1.018] and 1.02[1.006-1.035]) and NO2 levels in winter (OR: 1.007[1.003-1.011]). Analyses of the temporal relationship between O3 concentrations and exacerbations demonstrated that 63.2% of episodes in the summer occurred when the O3 concentrations on T-1 were significantly higher than those on control days, while 51% of exacerbation episodes in the winter occurred. Severe and moderate exacerbations were similarly associated with O3 levels in winter (OR: 1.012 [1.003-1.02] vs. 1.01 [0.999-1.021], p > 0.05) and in summer (OR: 1.006 [1.002-1.009] vs. 1.009 [1.003-1.016], p > 0.05).Conclusions: Asthma exacerbations may be associated with the seasonal elevation of O3, SO2 and NO2 levels in summer and winter with the similar relative risk between moderate and severe exacerbations.
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Affiliation(s)
- Seung-Woo Shin
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Da-Jeong Bae
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Jong-Uk Lee
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Ryun-Hee Kim
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Sung Roul Kim
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea
| | - Hun-Soo Chang
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Jong Sook Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
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25
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Lewis TC, Metitiri EE, Mentz GB, Ren X, Carpenter AR, Goldsmith AM, Wicklund KE, Eder BN, Comstock AT, Ricci JM, Brennan SR, Washington GL, Owens KB, Mukherjee B, Robins TG, Batterman SA, Hershenson MB. Influence of viral infection on the relationships between airway cytokines and lung function in asthmatic children. Respir Res 2018; 19:228. [PMID: 30463560 PMCID: PMC6249926 DOI: 10.1186/s12931-018-0922-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Few longitudinal studies examine inflammation and lung function in asthma. We sought to determine the cytokines that reduce airflow, and the influence of respiratory viral infections on these relationships. METHODS Children underwent home collections of nasal lavage during scheduled surveillance periods and self-reported respiratory illnesses. We studied 53 children for one year, analyzing 392 surveillance samples and 203 samples from 85 respiratory illnesses. Generalized estimated equations were used to evaluate associations between nasal lavage biomarkers (7 mRNAs, 10 proteins), lung function and viral infection. RESULTS As anticipated, viral infection was associated with increased cytokines and reduced FVC and FEV1. However, we found frequent and strong interactions between biomarkers and virus on lung function. For example, in the absence of viral infection, CXCL10 mRNA, MDA5 mRNA, CXCL10, IL-4, IL-13, CCL4, CCL5, CCL20 and CCL24 were negatively associated with FVC. In contrast, during infection, the opposite relationship was frequently found, with IL-4, IL-13, CCL5, CCL20 and CCL24 levels associated with less severe reductions in both FVC and FEV1. CONCLUSIONS In asthmatic children, airflow obstruction is driven by specific pro-inflammatory cytokines. In the absence of viral infection, higher cytokine levels are associated with decreasing lung function. However, with infection, there is a reversal in this relationship, with cytokine abundance associated with reduced lung function decline. While nasal samples may not reflect lower airway responses, these data suggest that some aspects of the inflammatory response may be protective against viral infection. This study may have ramifications for the treatment of viral-induced asthma exacerbations.
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Affiliation(s)
- Toby C. Lewis
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
- Environmental Health Sciences, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
- Health Behavior/Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Ediri E. Metitiri
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Graciela B. Mentz
- Health Behavior/Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Xiaodan Ren
- Environmental Health Sciences, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Ashley R. Carpenter
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Adam M. Goldsmith
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Kyra E. Wicklund
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
- Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Breanna N. Eder
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Adam T. Comstock
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Jeannette M. Ricci
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Sean R. Brennan
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Ginger L. Washington
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Kendall B. Owens
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
| | - Bhramar Mukherjee
- Departments of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Thomas G. Robins
- Environmental Health Sciences, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Stuart A. Batterman
- Environmental Health Sciences, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Marc B. Hershenson
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
- Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, USA
| | - the Community Action Against Asthma Steering Committee
- Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, 1150 W. Medical Center Dr., Building MSRB2, Room 3570B, Ann Arbor, MI 48109-5688 USA
- Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, USA
- Departments of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
- Environmental Health Sciences, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
- Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
- Health Behavior/Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
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Brugha R, Edmondson C, Davies JC. Outdoor air pollution and cystic fibrosis. Paediatr Respir Rev 2018; 28:80-86. [PMID: 29793860 DOI: 10.1016/j.prrv.2018.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 02/01/2023]
Abstract
Outdoor air pollution is increasingly identified as a contributor to respiratory and cardiovascular disease. Pro-inflammatory particles and gases are inhaled deep into the lungs, and are associated with impaired lung growth and exacerbations of chronic respiratory diseases. The magnitude of these effects are of interest to patients and families, and have been assessed in studies specific to CF. Using systematic review methodology, we sought to collate these studies in order to summarise the known effects of air pollution in cystic fibrosis, and to present information on decreasing personal air pollution exposures.
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Affiliation(s)
- Rossa Brugha
- Gene Therapy, National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, United Kingdom.
| | - Claire Edmondson
- Gene Therapy, National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, United Kingdom.
| | - Jane C Davies
- Gene Therapy, National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, United Kingdom.
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Talaminos Barroso A, Márquez Martín E, Roa Romero LM, Ortega Ruiz F. Factors Affecting Lung Function: A Review of the Literature. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.arbr.2018.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kravitz-Wirtz N, Teixeira S, Hajat A, Woo B, Crowder K, Takeuchi D. Early-Life Air Pollution Exposure, Neighborhood Poverty, and Childhood Asthma in the United States, 1990⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1114. [PMID: 29848979 PMCID: PMC6025399 DOI: 10.3390/ijerph15061114] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/14/2018] [Accepted: 05/23/2018] [Indexed: 12/17/2022]
Abstract
Ambient air pollution is a well-known risk factor of various asthma-related outcomes, however, past research has often focused on acute exacerbations rather than asthma development. This study draws on a population-based, multigenerational panel dataset from the United States to assess the association of childhood asthma risk with census block-level, annual-average air pollution exposure measured during the prenatal and early postnatal periods, as well as effect modification by neighborhood poverty. Findings suggest that early-life exposures to nitrogen dioxide (NO₂), a marker of traffic-related pollution, and fine particulate matter (PM2.5), a mixture of industrial and other pollutants, are positively associated with subsequent childhood asthma diagnosis (OR = 1.25, 95% CI = 1.10⁻1.41 and OR = 1.25, 95% CI = 1.06⁻1.46, respectively, per interquartile range (IQR) increase in each pollutant (NO₂ IQR = 8.51 ppb and PM2.5 IQR = 4.43 µ/m³)). These effects are modified by early-life neighborhood poverty exposure, with no or weaker effects in moderate- and low- (versus high-) poverty areas. This work underscores the importance of a holistic, developmental approach to elucidating the interplay of social and environmental contexts that may create conditions for racial-ethnic and socioeconomic disparities in childhood asthma risk.
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Affiliation(s)
- Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA 95817, USA.
| | - Samantha Teixeira
- School of Social Work, Boston College, Chestnut Hill, MA 02467, USA.
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Bongki Woo
- School of Social Work, Boston College, Chestnut Hill, MA 02467, USA.
| | - Kyle Crowder
- Department of Sociology, University of Washington, Seattle, WA 98195, USA.
| | - David Takeuchi
- School of Social Work, Boston College, Chestnut Hill, MA 02467, USA.
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29
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Tsui HC, Chen CH, Wu YH, Chiang HC, Chen BY, Guo YL. Lifetime exposure to particulate air pollutants is negatively associated with lung function in non-asthmatic children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 236:953-961. [PMID: 29153727 DOI: 10.1016/j.envpol.2017.10.092] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Pulmonary function is known to be affected by acute and subacute exposure to ambient air pollution. However, the impacts of lifetime exposure to air pollution on the pulmonary function of children have been inconsistent. The present study investigated the impact of lifetime residential exposure to intermediate levels of air pollution on the pulmonary function of schoolchildren. METHODS In 2011, a survey of children aged 6-15 years was conducted in 44 schools in Taiwan. Atopic history, residential history, and environmental factors were recorded. Spirograms were obtained from a random sample of children without asthma. A total of 535 girls and 481 boys without a history of asthma were enrolled. Lifetime residential exposure to air pollutants, including particulate matter with an aerodynamic diameter less than 10 μm (PM10), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO), was estimated using the kriging method, based on monitored data from the Taiwan Environmental Protection Administration. Multiple linear regression was used to analyze the association between lifetime air pollution exposure and pulmonary function, after adjustment for potential confounders and recent exposure. RESULTS After adjustment for 7-day average air pollutant levels, a 10 μg/m3 increase in PM10 was related to reductions in the forced expiratory volume in 1 s (-2.00%; 95% confidence interval [CI] -3.09% to -0.90%), forced vital capacity (-1.86%; CI: -2.96% to -0.75%), and maximal midexpiratory flow (-2.28%; CI: -4.04% to -0.51%). These associations were independent of the other pollutants. CONCLUSION Lifetime exposure to 25-85 μg/m3 of PM10 has negative impacts on the pulmonary function of children.
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Affiliation(s)
- Hung-Chang Tsui
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Chi-Hsien Chen
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Ying-Hsuan Wu
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Hung-Che Chiang
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Bing-Yu Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
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Talaminos Barroso A, Márquez Martín E, Roa Romero LM, Ortega Ruiz F. Factors Affecting Lung Function: A Review of the Literature. Arch Bronconeumol 2018; 54:327-332. [PMID: 29496283 DOI: 10.1016/j.arbres.2018.01.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 11/30/2022]
Abstract
Lung function reference values are traditionally based on anthropometric factors, such as weight, height, sex, and age. FVC and FEV1 decline with age, while volumes and capacities, such as RV and FRC, increase. TLC, VC, RV, FVC and FEV1 are affected by height, since they are proportional to body size. This means that a tall individual will experience greater decrease in lung volumes as they get older. Some variables, such as FRC and ERV, decline exponentially with an increase in weight, to the extent that tidal volume in morbidly obese patients can be close to that of RV. Men have longer airways than women, causing greater specific resistance in the respiratory tract. The increased work of breathing to increase ventilation among women means that their consumption of oxygen is higher than men under similar conditions of physical intensity. Lung volumes are higher when the subject is standing than in other positions. DLCO is significantly higher in supine positions than in sitting or standing positions, but the difference between sitting and standing positions is not significant. Anthropometric characteristics are insufficient to explain differences in lung function between different ethnic groups, underlining the importance of considering other factors in addition to the conventional anthropometric measurements.
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Affiliation(s)
| | - Eduardo Márquez Martín
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Laura María Roa Romero
- Departamento de Ingeniería Biomédica, Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, España
| | - Francisco Ortega Ruiz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias CIBERES, España.
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31
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de F C Lichtenfels AJ, van der Plaat DA, de Jong K, van Diemen CC, Postma DS, Nedeljkovic I, van Duijn CM, Amin N, la Bastide-van Gemert S, de Vries M, Ward-Caviness CK, Wolf K, Waldenberger M, Peters A, Stolk RP, Brunekreef B, Boezen HM, Vonk JM. Long-term Air Pollution Exposure, Genome-wide DNA Methylation and Lung Function in the LifeLines Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:027004. [PMID: 29410382 PMCID: PMC6047358 DOI: 10.1289/ehp2045] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND Long-term air pollution exposure is negatively associated with lung function, yet the mechanisms underlying this association are not fully clear. Differential DNA methylation may explain this association. OBJECTIVES Our main aim was to study the association between long-term air pollution exposure and DNA methylation. METHODS We performed a genome-wide methylation study using robust linear regression models in 1,017 subjects from the LifeLines cohort study to analyze the association between exposure to nitrogen dioxide (NO2) and particulate matter (PM2.5, fine particulate matter with aerodynamic diameter ≤2.5 μm; PM10, particulate matter with aerodynamic diameter ≤10 μm) and PM2.5absorbance, indicator of elemental carbon content (estimated with land-use-regression models) with DNA methylation in whole blood (Illumina® HumanMethylation450K BeadChip). Replication of the top hits was attempted in two independent samples from the population-based Cooperative Health Research in the Region of Augsburg studies (KORA). RESULTS Depending on the p-value threshold used, we found significant associations between NO2 exposure and DNA methylation for seven CpG sites (Bonferroni corrected threshold p<1.19×10-7) or for 4,980 CpG sites (False Discovery Rate<0.05). The top associated CpG site was annotated to the PSMB9 gene (i.e., cg04908668). None of the seven Bonferroni significant CpG-sites were significantly replicated in the two KORA-cohorts. No associations were found for PM exposure. CONCLUSIONS Long-term NO2 exposure was genome-wide significantly associated with DNA methylation in the identification cohort but not in the replication cohort. Future studies are needed to further elucidate the potential mechanisms underlying NO2-exposure-related respiratory disease. https://doi.org/10.1289/EHP2045.
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Affiliation(s)
- Ana Julia de F C Lichtenfels
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
| | - Diana A van der Plaat
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
| | - Kim de Jong
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
| | - Cleo C van Diemen
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Dirkje S Postma
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen , Netherlands
| | - Ivana Nedeljkovic
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Sacha la Bastide-van Gemert
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Maaike de Vries
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
| | - Cavin K Ward-Caviness
- Institute of Epidemiology II, Helmholtz Zentrum München , Neuherberg, Germany
- Environmental Public Health Division, U.S. Environmental Protection Agency , Chapel Hill, North Carolina, USA
| | - Kathrin Wolf
- Institute of Epidemiology II, Helmholtz Zentrum München , Neuherberg, Germany
| | | | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München , Neuherberg, Germany
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences , Utrecht University, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, Netherlands
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Collaco JM, Appel LJ, McGready J, Cutting GR. The relationship of lung function with ambient temperature. PLoS One 2018; 13:e0191409. [PMID: 29346418 PMCID: PMC5773195 DOI: 10.1371/journal.pone.0191409] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/04/2018] [Indexed: 11/25/2022] Open
Abstract
Background Lung function is complex trait with both genetic and environmental factors contributing to variation. It is unknown how geographic factors such as climate affect population respiratory health. Objective To determine whether ambient air temperature is associated with lung function (FEV1) in the general population. Design/Setting Associations between spirometry data from two National Health and Nutrition Examination Survey (NHANES) periods representative of the U.S. non-institutionalized population and mean annual ambient temperature were assessed using survey-weighted multivariate regression. Participants/Measurements The NHANES III (1988–94) cohort included 14,088 individuals (55.6% female) and the NHANES 2007–12 cohort included 14,036 individuals (52.3% female), with mean ages of 37.4±23.4 and 34.4±21.8 years old and FEV1 percent predicted values of 99.8±15.8% and 99.2±14.5%, respectively. Results After adjustment for confounders, warmer ambient temperatures were associated with lower lung function in both cohorts (NHANES III p = 0.020; NHANES 2007–2012 p = 0.014). The effect was similar in both cohorts with a 0.71% and 0.59% predicted FEV1 decrease for every 10°F increase in mean temperature in the NHANES III and NHANES 2007–2012 cohorts, respectively. This corresponds to ~2 percent predicted difference in FEV1 between the warmest and coldest regions in the continental United States. Conclusions In the general U.S. population, residing in regions with warmer ambient air temperatures was associated with lower lung function with an effect size similar to that of traffic pollution. Rising temperatures associated with climate change could have effects on pulmonary function in the general population.
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Affiliation(s)
- Joseph M. Collaco
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| | - Lawrence J. Appel
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - John McGready
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Garry R. Cutting
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Effects of Long-Term Exposure to Traffic-Related Air Pollution on Lung Function in Children. Curr Allergy Asthma Rep 2017; 17:41. [PMID: 28551888 PMCID: PMC5446841 DOI: 10.1007/s11882-017-0709-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lung function in early life has been shown to be an important predictor for peak lung function in adults and later decline. Reduced lung function per se is associated with increased morbidity and mortality. With this review, we aim to summarize the current epidemiological evidence on the effect of traffic-related air pollution on lung function in children and adolescents. We focus in particular on time windows of exposure, small airway involvement, and vulnerable sub-groups in the population. Findings from studies published to date support the notion that exposure over the entire childhood age range seems to be of importance for lung function development. We could not find any conclusive data to support evidence of sup-group effects considering gender, sensitization status, and asthma status, although a possibly stronger effect may be present for children with asthma. The long-term effects into adulthood of exposure to air pollution during childhood remains unknown, but current studies suggest that these deficits may be propagated into later life. In addition, further research on the effect of exposure on small airway function is warranted.
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Olaniyan T, Jeebhay M, Röösli M, Naidoo R, Baatjies R, Künzil N, Tsai M, Davey M, de Hoogh K, Berman D, Parker B, Leaner J, Dalvie MA. A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol. BMC Public Health 2017; 17:712. [PMID: 28915873 PMCID: PMC5602849 DOI: 10.1186/s12889-017-4726-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/08/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements. METHODS/DESIGN A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop). DISCUSSION This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature.
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Affiliation(s)
- Toyib Olaniyan
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
| | - Mohamed Jeebhay
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Rajen Naidoo
- University of Kwazulu-Natal, Durban, South Africa
| | - Roslynn Baatjies
- Cape Peninsula University of Technology, Cape Town, South Africa
| | - Nino Künzil
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Ming Tsai
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
- University of Washington, Seattle, WA 98195 USA
| | - Mark Davey
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Dilys Berman
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bhawoodien Parker
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa
| | - Joy Leaner
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Salvi V, Grua I, Cerveri G, Mencacci C, Barone-Adesi F. The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis. PLoS One 2017; 12:e0182088. [PMID: 28759599 PMCID: PMC5536271 DOI: 10.1371/journal.pone.0182088] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
Background Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes. Methods and findings A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19–1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association. Conclusions This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.
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Affiliation(s)
- Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
- * E-mail:
| | - Ilaria Grua
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, Novara, Italy
| | - Giancarlo Cerveri
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
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Orellano P, Quaranta N, Reynoso J, Balbi B, Vasquez J. Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis. PLoS One 2017; 12:e0174050. [PMID: 28319180 PMCID: PMC5358780 DOI: 10.1371/journal.pone.0174050] [Citation(s) in RCA: 267] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 03/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. Material and methods We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). Results Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. Conclusion This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags.
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Affiliation(s)
- Pablo Orellano
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina
| | - Nancy Quaranta
- Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina.,Comisión de Investigaciones Científicas (CIC), La Plata, Argentina
| | - Julieta Reynoso
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
| | - Brenda Balbi
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
| | - Julia Vasquez
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
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Ji H, Biagini Myers JM, Brandt EB, Brokamp C, Ryan PH, Khurana Hershey GK. Air pollution, epigenetics, and asthma. Allergy Asthma Clin Immunol 2016; 12:51. [PMID: 27777592 PMCID: PMC5069789 DOI: 10.1186/s13223-016-0159-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 10/04/2016] [Indexed: 12/13/2022] Open
Abstract
Exposure to traffic-related air pollution (TRAP) has been implicated in asthma development, persistence, and exacerbation. This exposure is highly significant as large segments of the global population resides in zones that are most impacted by TRAP and schools are often located in high TRAP exposure areas. Recent findings shed new light on the epigenetic mechanisms by which exposure to traffic pollution may contribute to the development and persistence of asthma. In order to delineate TRAP induced effects on the epigenome, utilization of newly available innovative methods to assess and quantify traffic pollution will be needed to accurately quantify exposure. This review will summarize the most recent findings in each of these areas. Although there is considerable evidence that TRAP plays a role in asthma, heterogeneity in both the definitions of TRAP exposure and asthma outcomes has led to confusion in the field. Novel information regarding molecular characterization of asthma phenotypes, TRAP exposure assessment methods, and epigenetics are revolutionizing the field. Application of these new findings will accelerate the field and the development of new strategies for interventions to combat TRAP-induced asthma.
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Affiliation(s)
- Hong Ji
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 7037, Cincinnati, OH 45229 USA ; Pyrosequencing lab for Genomic and Epigenomic research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229 USA
| | - Jocelyn M Biagini Myers
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 7037, Cincinnati, OH 45229 USA
| | - Eric B Brandt
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 7037, Cincinnati, OH 45229 USA
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229 USA
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229 USA
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 7037, Cincinnati, OH 45229 USA
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Stocks J, Lum S. Back to school: challenges and rewards of engaging young children in scientific research. Arch Dis Child 2016; 101:785-7. [PMID: 27117837 PMCID: PMC5013085 DOI: 10.1136/archdischild-2015-310347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/06/2016] [Indexed: 11/23/2022]
Affiliation(s)
- Janet Stocks
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, UK
| | - Sooky Lum
- Respiratory, Critical Care and Anaesthesia section (Portex Unit), UCL Institute of Child Health, London, UK
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Lum S, Bountziouka V, Quanjer P, Sonnappa S, Wade A, Beardsmore C, Chhabra SK, Chudasama RK, Cook DG, Harding S, Kuehni CE, Prasad KVV, Whincup PH, Lee S, Stocks J. Challenges in Collating Spirometry Reference Data for South-Asian Children: An Observational Study. PLoS One 2016; 11:e0154336. [PMID: 27119342 PMCID: PMC4847904 DOI: 10.1371/journal.pone.0154336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/11/2016] [Indexed: 01/28/2023] Open
Abstract
Availability of sophisticated statistical modelling for developing robust reference equations has improved interpretation of lung function results. In 2012, the Global Lung function Initiative(GLI) published the first global all-age, multi-ethnic reference equations for spirometry but these lacked equations for those originating from the Indian subcontinent (South-Asians). The aims of this study were to assess the extent to which existing GLI-ethnic adjustments might fit South-Asian paediatric spirometry data, assess any similarities and discrepancies between South-Asian datasets and explore the feasibility of deriving a suitable South-Asian GLI-adjustment.
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Affiliation(s)
- Sooky Lum
- Respiratory, Critical Care & Anaesthesia section (Portex Unit), UCL, Institute of Child Health, London, United Kingdom
- * E-mail:
| | - Vassiliki Bountziouka
- Respiratory, Critical Care & Anaesthesia section (Portex Unit), UCL, Institute of Child Health, London, United Kingdom
| | - Philip Quanjer
- Department of Pulmonary Diseases and Department of Paediatrics-Pulmonary Diseases, Erasmus Medical Centre, Erasmus University, Rotterdam, Netherlands
| | - Samatha Sonnappa
- Respiratory, Critical Care & Anaesthesia section (Portex Unit), UCL, Institute of Child Health, London, United Kingdom
- Department of Paediatric Pulmonology, Rainbow Children’s Hospital, Bangalore, India
| | - Angela Wade
- Clinical Epidemiology, Nutrition and Biostatistics section, UCL, Institute of Child Health, London, United Kingdom
| | - Caroline Beardsmore
- Institute for Lung Health, NIHR Leicester Respiratory Biomedical Research Unit, and Department of Infection, Immunity & Inflammation, University of Leicester, Leicester, United Kingdom
| | - Sunil K. Chhabra
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | | | - Derek G. Cook
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Seeromanie Harding
- Diabetes & Nutritional Sciences Division, Kings College London, London, United Kingdom
| | - Claudia E. Kuehni
- Institute of Social and Preventative Medicine, University of Bern, Switzerland
| | - K. V. V. Prasad
- Department of Physiology, Vemana Yoga Research Institute, Hyderabad, India
| | - Peter H. Whincup
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Simon Lee
- Respiratory, Critical Care & Anaesthesia section (Portex Unit), UCL, Institute of Child Health, London, United Kingdom
| | - Janet Stocks
- Respiratory, Critical Care & Anaesthesia section (Portex Unit), UCL, Institute of Child Health, London, United Kingdom
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