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Liu C, Wang J, Tan Y, Liu C, Qu X, Liu H, Tan M, Deng C, Qin X, Xiang Y. CTNNAL1 promotes the structural integrity of bronchial epithelial cells through the RhoA/ROCK1 pathway. Acta Biochim Biophys Sin (Shanghai) 2024; 56:753-762. [PMID: 38602002 PMCID: PMC11177105 DOI: 10.3724/abbs.2024026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024] Open
Abstract
Adhesion molecules play critical roles in maintaining the structural integrity of the airway epithelium in airways under stress. Previously, we reported that catenin alpha-like 1 (CTNNAL1) is downregulated in an asthma animal model and upregulated at the edge of human bronchial epithelial cells (HBECs) after ozone stress. In this work, we explore the potential role of CTNNAL1 in the structural adhesion of HBECs and its possible mechanism. We construct a CTNNAL1 ‒/‒ mouse model with CTNNAL1-RNAi recombinant adeno-associated virus (AAV) in the lung and a CTNNAL1-silencing cell line stably transfected with CTNNAL1-siRNA recombinant plasmids. Hematoxylin and eosin (HE) staining reveals that CTNNAL1 ‒/‒ mice have denuded epithelial cells and structural damage to the airway. Silencing of CTNNAL1 in HBECs inhibits cell proliferation and weakens extracellular matrix adhesion and intercellular adhesion, possibly through the action of the cytoskeleton. We also find that the expressions of the structural adhesion-related molecules E-cadherin, integrin β1, and integrin β4 are significantly decreased in ozone-treated cells than in vector control cells. In addition, our results show that the expression levels of RhoA/ROCK1 are decreased after CTNNAL1 silencing. Treatment with Y27632, a ROCK inhibitor, abolished the expressions of adhesion molecules induced by ozone in CTNNAL1-overexpressing HBECs. Overall, the findings of the present study suggest that CTNNAL1 plays a critical role in maintaining the structural integrity of the airway epithelium under ozone challenge, and is associated with epithelial cytoskeleton dynamics and the expressions of adhesion-related molecules via the RhoA/ROCK1 pathway.
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Affiliation(s)
- Caixia Liu
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral DiseasesHunan University of Chinese MedicineChangsha410208China
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Jinmei Wang
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Yurong Tan
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Chi Liu
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Xiangping Qu
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Huijun Liu
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Meiling Tan
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Changqing Deng
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral DiseasesHunan University of Chinese MedicineChangsha410208China
| | - Xiaoqun Qin
- School of Basic MedicineCentral South UniversityChangsha410078China
| | - Yang Xiang
- School of Basic MedicineCentral South UniversityChangsha410078China
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Mokarram M, Taripanah F, Pham TM. Using neural networks and remote sensing for spatio-temporal prediction of air pollution during the COVID-19 pandemic. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:122886-122905. [PMID: 37979107 DOI: 10.1007/s11356-023-30859-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
The study aims to monitor air pollution in Iranian metropolises using remote sensing, specifically focusing on pollutants such as O3, CH4, NO2, CO2, SO2, CO, and suspended particles (aerosols) in 2001 and 2019. Sentinel 5 satellite images are utilized to prepare maps of each pollutant. The relationship between these pollutants and land surface temperature (LST) is determined using linear regression analysis. Additionally, the study estimates air pollution levels in 2040 using Markov and Cellular Automata (CA)-Markov chains. Furthermore, three neural network models, namely multilayer perceptron (MLP), radial basis function (RBF), and long short-term memory (LSTM), are employed for predicting contamination levels. The results of the research indicate an increase in pollution levels from 2010 to 2019. It is observed that temperature has a strong correlation with contamination levels (R2 = 0.87). The neural network models, particularly RBF and LSTM, demonstrate higher accuracy in predicting pollution with an R2 value of 0.90. The findings highlight the significance of managing industrial towns to minimize pollution, as these areas exhibit both high pollution levels and temperatures. So, the study emphasizes the importance of monitoring air pollution and its correlation with temperature. Remote sensing techniques and advanced prediction models can provide valuable insights for effective pollution management and decision-making processes.
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Affiliation(s)
- Marzieh Mokarram
- Department of Geography, Faculty of Economics, Management and Social Sciences, Shiraz University, Shiraz, Iran
| | - Farideh Taripanah
- Department of Desert Control and Management, University of Kashan, Kashan, Iran
| | - Tam Minh Pham
- Research Group On "Fuzzy Set Theory and Optimal Decision-Making Model in Economics and Management", Vietnam National University, Hanoi, 144 Xuan Thuy Str., Hanoi, 100000, Vietnam.
- VNU School of Interdisciplinary Studies, Vietnam National University, Hanoi, 144 Xuan Thuy Str., Hanoi, 100000, Vietnam.
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Wang D, Wang Y, Liu Q, Sun W, Wei L, Ye C, Zhu R. Association of Air Pollution with the Number of Common Respiratory Visits in Children in a Heavily Polluted Central City, China. TOXICS 2023; 11:815. [PMID: 37888666 PMCID: PMC10610878 DOI: 10.3390/toxics11100815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Children's respiratory health is vulnerable to air pollution. Based on data collected from June 2019 to June 2022 at a children's hospital in Zhengzhou, China, this study utilized Spearman correlation analysis and a generalized additive model (GAM) to examine the relationship between daily visits for common respiratory issues in children and air pollutant concentrations. Results show that the number of upper respiratory tract infection (URTI), pneumonia (PNMN), bronchitis (BCT), and bronchiolitis (BCLT) visits in children showed a positive correlation with PM2.5, PM10, NO2, SO2, and CO while exhibiting a negative correlation with temperature and relative humidity. The highest increases in PNMN visits in children were observed at lag 07 for NO2, SO2, and CO. A rise of 10 μg/m3 in NO2, 1 μg/m3 in SO2, and 0.1 mg/m3 in CO corresponded to an increase of 9.7%, 2.91%, and 5.16% in PNMN visits, respectively. The effects of air pollutants on the number of BCT and BCLT visits were more pronounced in boys compared to girls, whereas no significant differences were observed in the number of URTI and PNMN visits based on sex. Overall, air pollutants significantly affect the prevalence of respiratory diseases in children, and it is crucial to improve air quality to protect the children's respiratory health.
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Affiliation(s)
- Dan Wang
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Yanan Wang
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
| | - Qianqian Liu
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Wenxin Sun
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
| | - Liangkui Wei
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Chengxin Ye
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Rencheng Zhu
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
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Dąbrowiecki P, Chciałowski A, Dąbrowiecka A, Piórkowska A, Badyda A. Exposure to ambient air pollutants and short-term risk for exacerbations of allergic rhinitis: a time-stratified, case-crossover study in the three largest urban agglomerations in Poland. Respir Physiol Neurobiol 2023:104095. [PMID: 37355057 DOI: 10.1016/j.resp.2023.104095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
Allergic rhinitis (AR) affects 10% of the world population, with an increased prevalence in regions with substantial air pollution, but the association between exposure to air pollutants and the short-term risk of AR exacerbations is unclear. We used a time-series approach to analyze the risk of hospital admissions due to AR over 8 days from exposure to various air pollutants. Distributed lag nonlinear models were used to analyze data gathered between 2012 and 2018 in the three largest urban agglomerations in Poland. The analyses were carried out separately for the warm (April - September) and cold seasons (October - March). Overall, there were 1407 admissions due to AR. In the warm season, the rate ratio (95% confidence interval) for admission per 10µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 microns (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 microns (PM2.5); 0.946 (0.826, 1.085) for nitrogen dioxide (NO2); 0.837 (0.418, 1.677) for sulfur dioxide (SO2); and 1.112 (1.011, 1.224) for ozone (O3). In the cold season, the rate ratio for admission per 10µg/m3 was 1.035 (0.985, 1.088) for PM10; 1.041 (0.977, 1.108) for PM2.5; 1.252 (1.122, 1.398) for NO2; 0.921 (0.717, 1.181) for SO2; and 1.030 (1.011, 1.050) for O3. In conclusion, the risk of admission due to AR increased significantly after exposure to O3 in the warm and cold seasons. Exposure to PM10 was associated with a significantly increased risk of AR hospitalizations in the warm season only, whereas exposure to NO2 was associated with a significantly increased risk of AR admission in the cold season.
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Affiliation(s)
- Piotr Dąbrowiecki
- Military Institute of Medicine, Department of Allergology and Infectious Diseases, 128 Szaserów St., 04-141 Warsaw, Poland; Polish Federation of Asthma Allergy and COPD Patients Associations, 5/162 Promyka St., 01-604 Warsaw, Poland
| | - Andrzej Chciałowski
- Military Institute of Medicine, Department of Allergology and Infectious Diseases, 128 Szaserów St., 04-141 Warsaw, Poland
| | - Agata Dąbrowiecka
- Medical University of Maria Sklodowska-Curie in Warsaw, 12 Solidarności Ave., 03-412, Warsaw, Poland
| | - Anna Piórkowska
- Warsaw University of Technology, Faculty of Building Services Hydro- and Environmental Engineering, 20 Nowowiejska St., 00-653 Warsaw, Poland
| | - Artur Badyda
- Polish Federation of Asthma Allergy and COPD Patients Associations, 5/162 Promyka St., 01-604 Warsaw, Poland; Warsaw University of Technology, Faculty of Building Services Hydro- and Environmental Engineering, 20 Nowowiejska St., 00-653 Warsaw, Poland.
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Seposo X, Ueda K, Fook Sheng Ng C, Madaniyazi L, Sugata S, Yoshino A, Takami A. Role of oxides of nitrogen in the ozone-cardiorespiratory visit association. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120802. [PMID: 36473642 DOI: 10.1016/j.envpol.2022.120802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Ozone (O3)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O3 exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O3 concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O3-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed to the risks observed at the low ozone concentration range. In this study, we examined the short-term effects of photochemical oxidant (Ox, parts per billiion) on outpatient cardiorespiratory visits in 21 Japanese cities after adjusting for other air pollutant-specific C-R functions. Daily cardiorespiratory visits from January 1, 2014 to December 31, 2016 were obtained from the Japanese Medical Data Center Co. Ltd. Similar period of meteorological and air pollution variables were obtained from relevant data sources. We utilized a time-stratified case crossover design coupled with the generalized additive mixed model (TSCC-GAMM) to estimate the association between Ox and cardiorespiratory outpatient visits, after adjusting for several covariates. A total of 2,588,930 visits were recorded across the study period, with a mean of 111.87 and a standard deviation of 138.75. The results revealed that crude Ox-cardiorespiratory visits exhibited a U-shaped pattern. However, adjustment of the oxides of nitrogen, particularly nitrogen monoxide (NO), attenuated the lower risk curve and subsequently altered the shape of the C-R function, with a substantial reduction observed during winter. NO- and nitrogen dioxide (NO2)-adjusted Ox-cardiorespiratory associations increased nearly linearly, without an apparent threshold. Current evidence suggests the importance of adjusting the oxides of nitrogen in estimating the Ox C-R risk functions.
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Affiliation(s)
- Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan; Ateneo Center for Research and Innovation, Ateneo School of Medicine and Public Health, Atene de Manila University, Philippines.
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Japan; Environmental Health Sciences, Department of Global Ecology, Graduate School of Global Environmental Sciences, Kyoto University, Japan; Department of Hygiene, Graduate School of Medicine, Hokkaido University, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; School of International Health, Graduate School of Medicine, The University of Tokyo, Japan
| | - Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Japan; Institute of Tropical Medicine, Nagasaki University, Japan
| | - Seiji Sugata
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
| | - Ayako Yoshino
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
| | - Akinori Takami
- Regional Environment Conservation Division, National Institute for Environmental Studies, Japan
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Le DN, Nguyen HAP, Ngoc DT, Do THT, Ton NT, Van Le T, Ho TH, Van Dang C, Thai PK, Phung D. Air pollution and risk of respiratory and cardiovascular hospitalizations in a large city of the Mekong Delta Region. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:91165-91175. [PMID: 35881281 DOI: 10.1007/s11356-022-22022-y] [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: 04/07/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
It is important to explore air pollution and health effects in developing cities for early prevention rather than waiting for conditions to deteriorate as in the current megacities. This study aims to investigate the short-term health effects of air pollution in a large city in the Mekong Delta Region (MDR) of Vietnam. Air pollution data from January 2015 to December 2018 were collected from the Environmental Monitoring Centre of Can Tho City. The data of respiratory and cardiovascular disease (CVD) admissions in 18 hospitals and medical centers were collected. A time-series regression analysis was conducted using distributed lag models to examine the relationship between the air pollutants and hospitalizations including the delayed effect up to 7 days. The research findings reveal that a 10 μg increase in PM10 was associated with an increase of 2.5% in the risk of respiratory admission for all people and 2.2% in the risk of CVD admission for the elderly on the same day. The analysis stratified by age and sex indicates that PM10 resulted in a higher risk of respiratory admission among children (0-5 years old) and males compared with other groups. PM10 and NO2 were significantly associated with CVD admission among the elderly at lag 4 and 6 days. The effects of other air pollutants (SO2, O3) were not observed in this study. As development continues in this region, there is an urgent need for intervention measures to minimize the health impacts associated with the expected increases in air pollution in the MDR.
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Affiliation(s)
- Diep Ngoc Le
- Institute of Public Health in Ho Chi Minh City, 159 Hung Phu Street, Ho Chi Minh City, Vietnam
| | - Ha Ai Phan Nguyen
- Institute of Public Health in Ho Chi Minh City, 159 Hung Phu Street, Ho Chi Minh City, Vietnam
| | - Dang Tran Ngoc
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ho Chi Minh City, Vietnam
| | - Thuong Hoai Thi Do
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ho Chi Minh City, Vietnam
| | - Nghia Tuan Ton
- Office of WHO Representative in Vietnam, 304 Kim Ma Street, Hanoi, Vietnam
| | - Tuan Van Le
- Office of WHO Representative in Vietnam, 304 Kim Ma Street, Hanoi, Vietnam
| | - Tinh Huu Ho
- Institute of Public Health in Ho Chi Minh City, 159 Hung Phu Street, Ho Chi Minh City, Vietnam
| | - Chinh Van Dang
- Institute of Public Health in Ho Chi Minh City, 159 Hung Phu Street, Ho Chi Minh City, Vietnam
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Level 4/20 Cornwall Street, Woollongabba, QLD, 4102, Australia
| | - Dung Phung
- School of Public Health, Faculty of Medicine, University of Queensland, Room 427, Level 4, School of Public Health Building, 266 Herston Road, Herston, QLD, 4006, Australia.
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Nhung NTT, Duc VT, Ngoc VD, Dien TM, Hoang LT, Ha TTT, Khue PM, Truong NX, Thanh NTN, Jegasothy E, Marks GB, Morgan G. Mortality benefits of reduction fine particulate matter in Vietnam, 2019. Front Public Health 2022; 10:1056370. [PMID: 36466445 PMCID: PMC9718030 DOI: 10.3389/fpubh.2022.1056370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction and objectives Studies assessing the health benefits of air pollution reduction in Vietnam are scarce. This study quantified the annual mortality burden due to PM2.5 pollution in Vietnam above the World Health Organization recommendation for community health (AQG: 5 μg/m3) and the proposed National Technical Regulation on Ambient Air Quality (proposed QCVN: 15 μg/m3). Methodology This study applied a health impact assessment methodology with the hazard risk function for non-communicable diseases (NCDs) and lower respiratory infections (LRIs) in the Global Exposure Mortality Model (GEMM) to calculate attributable deaths, Years of Life lost, and Loss of Life expectancy at birth due to air pollution in the Vietnamese population above 25 years of age in 11 provinces. We obtained annual average PM2.5 concentrations for Vietnam in 2019 at a 3x3 km grid modeled using Mixed Linear regression and multi-data sources. Population and baseline mortality data were obtained from administrative data system in Vietnam. We reported the findings at both the provincial and smaller district levels. Results Annual PM2.5 concentrations in all studied provinces exceeded both the AQG and the proposed QCVN. The maximum annual number of attributable deaths in the studied provinces if they had complied with WHO air quality guidelines was in Ha Noi City, with 5,090 (95%CI: 4,253-5,888) attributable deaths. At the district level, the highest annual rate of attributable deaths if the WHO recommendation for community health had been met was 104.6 (95%CI: 87.0-121.5) attributable deaths per 100,000 population in Ly Nhan (Ha Nam province). Conclusion A much larger number of premature deaths in Vietnam could potentially be avoided by lowering the recommended air quality standard. These results highlight the need for effective clean air action plans by local authorities to reduce air pollution and improve community health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam,Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam,*Correspondence: Nguyen Thi Trang Nhung ;
| | - Vu Tri Duc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vo Duc Ngoc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Le Tu Hoang
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Thi Thuy Ha
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Pham Minh Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Ngo Xuan Truong
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Nguyen Thi Nhat Thanh
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Edward Jegasothy
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
| | - Guy B. Marks
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia,Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia,Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
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Álvaro-Meca A, Sepúlveda-Crespo D, Resino R, Ryan P, Martínez I, Resino S. Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study. Environ Health 2022; 21:107. [PMID: 36348411 PMCID: PMC9640778 DOI: 10.1186/s12940-022-00928-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults. METHODS We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values). RESULTS Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O3 and higher values of relative humidity and NO2. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO2 [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O3 [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM10 at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI. CONCLUSION Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO2, O3, PM10, and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rosa Resino
- Departamento de Geografía, Facultad de Geografía e Historia, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo Ryan
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigaciones Sanitarias Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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9
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Ma Y, Shen J, Zhang Y, Wang H, Li H, Cheng Y, Guo Y. Short-term effect of ambient ozone pollution on respiratory diseases in western China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:4129-4140. [PMID: 35001229 DOI: 10.1007/s10653-021-01174-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
Ambient air pollution has been regarded as an important cause of the morbidity and mortality of respiratory diseases. In the current work, a total of 469,490 respiratory emergency room (ER) visits in Lanzhou, China from Jan 1, 2013 to Dec 31, 2016 were collected. A generalized additive model (GAM) was used to investigate the association between O3 and respiratory ER visits for the different gender and age subgroups. The results showed that: (a) with per inter-quartile range (IQR) (31 µg/m3) increase in O3, the greatest relative risk (RR) of respiratory ER visits for the total was 1.014 (95% CI 1.008-1.020) at lag 4 days. Females and 16-to-45-year-olds were relatively more sensitive to O3; (b) the significant lag effects were found in single-day lag models, with the highest RR values for different groups were observed at lag 3-lag 5 days. The multi-day cumulative lag effects were stronger for the total; (c) in the multiple-pollutant models, the effects of O3 were generally increased when introducing other pollutants (PM10, PM2.5, SO2 and NO2) for adjustment. This study demonstrated that short-term exposure to O3 increased the RR of respiratory ER visits in Lanzhou, China.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Heping Li
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yongtao Guo
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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10
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Álvaro-Meca A, Goez MDC, Resino R, Matías V, Sepúlveda-Crespo D, Martínez I, Resino S. Environmental factors linked to hospital admissions in young children due to acute viral lower respiratory infections: A bidirectional case-crossover study. ENVIRONMENTAL RESEARCH 2022; 212:113319. [PMID: 35447151 DOI: 10.1016/j.envres.2022.113319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/14/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the association of the short-term exposure to environmental factors (relative humidity, temperature, NO2, SO2, O3, PM10, and CO) with hospital admissions due to acute viral lower respiratory infections (ALRI) in children under two years before the COVID-19 era. METHODS We performed a bidirectional case-crossover study in 30,445 children with ALRI under two years of age in the Spanish Minimum Basic Data Set (MBDS) from 2013 to 2015. Environmental data were obtained from Spain's State Meteorological Agency (AEMET). The association was assessed by conditional logistic regression. RESULTS Lower temperature one week before the day of the event (hospital admission) (q-value = 0.012) and higher relative humidity one week (q-value = 0.003) and two weeks (q-value<0.001) before the day of the event were related to a higher odds of hospital admissions. Higher NO2 levels two weeks before the event were associated with hospital admissions (q-value<0.001). Moreover, higher concentrations on the day of the event for SO2 (compared to lag time of 1-week (q-value = 0.026) and 2-weeks (q-value<0.001)), O3 (compared to lag time of 3-days (q-value<0.001), 1-week (q-value<0.001), and 2-weeks (q-value<0.001)), and PM10 (compared to lag time of 2-weeks (q-value<0.001)) were related to an increased odds of hospital admissions for viral ALRI. CONCLUSION Short-term exposure to environmental factors (climatic conditions and ambient air contaminants) was linked to a higher likelihood of hospital admissions due to ALRI. Our findings emphasize the importance of monitoring environmental factors to assess the odds of ALRI hospital admissions and plan public health resources.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rosa Resino
- Departamento de Geografía Humana, Facultad de Geografía e Historia, Universidad Complutense de Madrid. Madrid, Spain
| | - Vanesa Matías
- Servicio de Pedíatría, Hospital Clínico Universitario, Valladolid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain.
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11
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Tran QA, Le VTH, Ngo VT, Le TH, Phung DT, Berman JD, Nguyen HLT. The Association Between Ambient Temperatures and Hospital Admissions Due to Respiratory Diseases in the Capital City of Vietnam. Front Public Health 2022; 10:903623. [PMID: 35937271 PMCID: PMC9350518 DOI: 10.3389/fpubh.2022.903623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the short-term effects of ambient temperature on hospital admissions due to respiratory diseases among Hanoi residents. We collected 34,653 hospital admissions for 365 days (November 1, 2017, to November 31, 2018) from two hospitals in Hanoi. A quasi-Poisson regression model with time series analysis was used to explore the temperature-health outcome relationship's overall pattern. The non-linear curve indicated the temperatures with the lowest risk range from 22 degrees (Celcius) to 25 degrees (Celcius). On average, cold temperatures showed a higher risk than hot temperatures across all genders and age groups. Hospital admissions risk was highest at 13 degrees (Celcius) (RR = 1.39; 95% CI = 1.26–1.54) for cold effects and at 33 degrees (Celcius) (RR = 1.21, 95% CI = 1.04–1.39) for the hot effects. Temporal pattern analysis showed that the most effect on respiratory diseases occurred at a lag of 0 days for hot effect and at a lag of 1 day for cold effect. The risk of changing temperature among women and people over 5 years old was higher than other groups. Our results suggest that the risk of respiratory admissions was greatest when the temperature was low. Public health prevention programs should be enhanced to improve public awareness about the health risks of temperature changes, especially respiratory diseases risked by low temperatures.
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Affiliation(s)
- Quynh Anh Tran
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
| | - Vu Thuy Huong Le
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, United States
- *Correspondence: Vu Thuy Huong Le
| | - Van Toan Ngo
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Thi Hoan Le
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
| | - Dung T. Phung
- Centre for Environment and Population Health, Griffith University, Southport, QLD, Australia
| | - Jesse D. Berman
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, United States
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Short-Term Effects of Low-Level Ambient Air NO 2 on the Risk of Incident Stroke in Enshi City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116683. [PMID: 35682266 PMCID: PMC9180296 DOI: 10.3390/ijerph19116683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022]
Abstract
Previous studies found that exposure to ambient nitrogen dioxide (NO2) was associated with an increased risk of incident stroke, but few studies have been conducted for relatively low NO2 pollution areas. In this study, the short-term effects of NO2 on the risk of incident stroke in a relatively low-pollution area, Enshi city of Hubei Province, China, were investigated through time-series analysis. Daily air-pollution data, meteorological data, and stroke incidence data of residents in Enshi city from 1 January 2015 to 31 December 2018 were collected. A time-series analysis using a generalised additive model (GAM) based on Poisson distribution was applied to explore the short-term effects of low-level NO2 exposure on the risk of incident stroke and stroke subtypes, as well as possible age, sex, and seasonal differences behind the effects. In the GAM model, potential confounding factors, such as public holidays, day of the week, long-term trends, and meteorological factors (temperature and relative humidity), were controlled. A total of 9122 stroke incident cases were included during the study period. We found that NO2 had statistically significant effects on the incidence of stroke and ischemic stroke, estimated by excess risk (ER) of 0.37% (95% CI: 0.04–0.70%) and 0.58% (95% CI: 0.18–0.98%), respectively. For the cumulative lag effects, the NO2 still had a statistically significant effect on incident ischemic stroke, estimated by ER of 0.61% (95% CI: 0.01–1.21%). The two-pollutant model showed that the effects of NO2 on incident total stroke were still statistically significant after adjusting for other air pollutants (PM2.5, PM10, SO2, CO, and O3). In addition, the effects of NO2 exposure on incident stroke were statistically significant in elderly (ER = 0.75%; 95% CI: 0.11–1.40%), males (ER = 0.47%; 95% CI: 0.05–0.89%) and cold season (ER = 0.83%; 95% CI: 0.15–1.51%) subgroups. Our study showed that, as commonly observed in high-pollution areas, short-term exposure to low-level NO2 was associated with an increased risk of incident stroke, including ischemic stroke. Males and elderly people were more vulnerable to the effects of NO2, and the adverse effects might be promoted in the cold season.
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13
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Hoffmann C, Maglakelidze M, von Schneidemesser E, Witt C, Hoffmann P, Butler T. Asthma and COPD exacerbation in relation to outdoor air pollution in the metropolitan area of Berlin, Germany. Respir Res 2022; 23:64. [PMID: 35307034 PMCID: PMC8935815 DOI: 10.1186/s12931-022-01983-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/11/2022] [Indexed: 01/05/2023] Open
Abstract
Background Ambient air pollution poses a major risk for the development and aggravation of respiratory diseases. Evidence suggests that even in low-level air pollution environments there is a risk for an increase in adverse respiratory symptoms. We examined whether variations in daily air pollution levels of nitrogen dioxide, ozone, or particulate matter in Berlin, Germany were associated with hospital admissions of chronic obstructive pulmonary disease (COPD) and asthma patients in a time series analysis. Methods We calculated single and multi-pollutant models, investigated possible lags in effect, and analysed the influence of meteorological variables on the results. Data from January 2005 through December 2015 were used to quantify the concentration–response. Results The risk ratio for asthma patients to be hospitalised on the same day of NO2 exposure was 1.101 per 10 µg/m3 NO2 increase (95% CI: 1.013 to 1.195), for COPD patients 1.123 (95% CI: 1.081 to 1.168). Neither the exposure to ozone (95% CI: 0.904 to 1.020), PM10 (95% CI: 0.990 to 1.127), nor PM2.5 (95% CI: 0.981 to 1.148) was associated with an increased risk ratio for asthma patients to be hospitalised. Risk ratios for the hospital admission of COPD patients were also not increased due to ozone (95% CI: 0.981 to 1.033), PM10 (95% CI: 0.988 to 1.032), or PM2.5 (95% CI: 0.966 to 1.019) exposure. The presented risk ratios and confidence intervals relate to the day of exposure. We found no increased hospitalisation risks with a delayed occurrence on subsequent days. Conclusions A quantifiable, statistically significant increase in risk for asthma and COPD exacerbations owing to NO2 exposure at levels well below European regulatory limit values was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01983-1.
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14
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Phuc NH, Oanh NTK. Large spatio-temporal variations of size-resolved particulate matter and volatile organic compounds in urban area with heavy traffic. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:21491-21507. [PMID: 34762245 DOI: 10.1007/s11356-021-16921-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
A monitoring campaign, the first of this kind for a heavy traffic urban area of Vietnam, was conducted which generated nearly 200 daily filter samples of PM2.5, PM10, and black carbon (BC), 1300 online hourly PMx (PM10, PM2.5, and PM1), 900 hourly/bi-hourly BTEX data, 700 h of traffic counts, and online meteorology records. PMx and BTEX levels show large horizontal gradients across this small urban area of 300 m width suggesting that the pollution data should be generated with sufficient spatial resolutions for assessment of the exposure and health effects. This paper focuses on analyzing PMx with reference to the previously published BTEX to provide a more complete picture of the traffic-related pollution in the area. Spatio-temporal variations of pollutants are analyzed in relation to traffic flows and fleet compositions, weekday-weekend effects, local and regional meteorology. PM10 and BTEX levels had larger variations between the sites indicating their stronger associations with the traffic activities than the finer particles. Twenty-four-hour (24 h) PM2.5 levels ranged between 19 and 191 µg/m3 with high PM1/PM2.5 ratios of above 0.8 at ambient site (AA) and above 0.7 at roadsides. Multivariate relationship analysis (PCA) for the bi-hourly datasets of meteorology, traffic flows, and pollutant levels indicated overwhelming influence of on-road traffic fleet compositions on the roadside pollutants levels. At AA, PCA results showed a complex interaction between local emissions, meteorological conditions, and regional/long-range transport. Higher pollution levels were associated with the airmass types having the continental origin and pathways.
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Affiliation(s)
- Nguyen Hong Phuc
- Environmental Engineering and Management, School of Environment, Resources and Development, Asian Institute of Technology, Pathumthani, Thailand
| | - Nguyen Thi Kim Oanh
- Environmental Engineering and Management, School of Environment, Resources and Development, Asian Institute of Technology, Pathumthani, Thailand.
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15
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Nhung NTT, Duc VT, Ngoc VD, Dien TM, Hoang LT, Ha TTT, Khue PM, Truong NX, Thanh NTN, Jegasothy E, Marks GB, Morgan G. Mortality benefits of reduction fine particulate matter in Vietnam, 2019. Front Public Health 2022; 10:1056370. [PMID: 36466445 DOI: 10.3389/fpubh.2022.743348/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Studies assessing the health benefits of air pollution reduction in Vietnam are scarce. This study quantified the annual mortality burden due to PM2.5 pollution in Vietnam above the World Health Organization recommendation for community health (AQG: 5 μg/m3) and the proposed National Technical Regulation on Ambient Air Quality (proposed QCVN: 15 μg/m3). METHODOLOGY This study applied a health impact assessment methodology with the hazard risk function for non-communicable diseases (NCDs) and lower respiratory infections (LRIs) in the Global Exposure Mortality Model (GEMM) to calculate attributable deaths, Years of Life lost, and Loss of Life expectancy at birth due to air pollution in the Vietnamese population above 25 years of age in 11 provinces. We obtained annual average PM2.5 concentrations for Vietnam in 2019 at a 3x3 km grid modeled using Mixed Linear regression and multi-data sources. Population and baseline mortality data were obtained from administrative data system in Vietnam. We reported the findings at both the provincial and smaller district levels. RESULTS Annual PM2.5 concentrations in all studied provinces exceeded both the AQG and the proposed QCVN. The maximum annual number of attributable deaths in the studied provinces if they had complied with WHO air quality guidelines was in Ha Noi City, with 5,090 (95%CI: 4,253-5,888) attributable deaths. At the district level, the highest annual rate of attributable deaths if the WHO recommendation for community health had been met was 104.6 (95%CI: 87.0-121.5) attributable deaths per 100,000 population in Ly Nhan (Ha Nam province). CONCLUSION A much larger number of premature deaths in Vietnam could potentially be avoided by lowering the recommended air quality standard. These results highlight the need for effective clean air action plans by local authorities to reduce air pollution and improve community health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vu Tri Duc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vo Duc Ngoc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Le Tu Hoang
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Thi Thuy Ha
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Pham Minh Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Ngo Xuan Truong
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Nguyen Thi Nhat Thanh
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Edward Jegasothy
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
| | - Guy B Marks
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
- Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
- Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
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Zhang P, Zhou X. Pricing air pollution: evidence from short-term exposure to air pollution on hospitalization of acute bronchitis and chronic obstructive pulmonary disease in southwestern China. Int Health 2021; 14:572-579. [PMID: 34849952 DOI: 10.1093/inthealth/ihab071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/24/2021] [Accepted: 10/15/2021] [Indexed: 11/14/2022] Open
Abstract
Existing evidence suggests that ambient air pollution has serious adverse effects on respiratory diseases, yet there is little direct evidence from China regarding corresponding economic losses. Here we quantified air pollution-related acute health effects and related economic losses of the most common two respiratory diseases in southwestern China, acute bronchitis and chronic obstructive pulmonary disease (COPD). We applied a distributed lag non-linear model to analyse the relationship between ambient air pollutants and hospital admissions of acute bronchitis and COPD, then applied the cost of illness method to explore the attributing economic burden. During the study period, 528 334 and 99 419 hospital admissions of acute bronchitis and COPD, respectively, were recorded. As a result, during the study period the total hospitalization economic losses attributable to air pollution were 486.40 and 254.74 million yuan for acute bronchitis and COPD, respectively, accounting for 0.015% of local gross domestic product. Our research provides intuitive evidence on the health and economic impacts of short-term exposure to air pollution, which is a key basis for the formulation of environmental policies.
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Affiliation(s)
- Pei Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoyuan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
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Sly PD, Vilcins D. Climate impacts on air quality and child health and wellbeing: Implications for Oceania. J Paediatr Child Health 2021; 57:1805-1810. [PMID: 34792251 DOI: 10.1111/jpc.15650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022]
Abstract
Despite the enormous gains in reducing child mortality resulting from the United Nations Millennium Development Goals, in some ways children's future wellbeing has never been under greater threat. Climate and environmental change, primarily driven by poor air quality, represents a major threat to child health and wellbeing, through both direct and indirect effects. Climate change has multiple environmental consequences impacting negatively on child health and wellbeing, including increases in ambient temperature, rising atmospheric carbon dioxide (CO2) , altered distribution of rainfall, ocean warming, rising sea level and more frequent and severe adverse weather events. Multiple pathways link these exposures to a wide variety of adverse health outcomes. Countries in Oceania are especially likely to be subjected to the effects of increases in ambient temperature, altered distribution of rainfall, ocean warming and sea level rise. These changes pose a significant risk to children and provide a moral imperative for us to act to protect child health.
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Affiliation(s)
- Peter D Sly
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Dwan Vilcins
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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18
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Usmani RSA, Pillai TR, Hashem IAT, Marjani M, Shaharudin R, Latif MT. Air pollution and cardiorespiratory hospitalization, predictive modeling, and analysis using artificial intelligence techniques. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:56759-56771. [PMID: 34075501 DOI: 10.1007/s11356-021-14305-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
Air pollution has a serious and adverse effect on human health, and it has become a risk to human welfare and health throughout the globe. One of the major effects of air pollution on health is hospitalizations associated with air pollution. Recently, the estimation and prediction of air pollution-based hospitalization is carried out using artificial intelligence (AI) and machine learning (ML) techniques, i.e., deep learning and long short-term memory (LSTM). However, there is ample room for improvement in the available applied methodologies to estimate and predict air pollution-based hospital admissions. In this paper, we present the modeling and analysis of air pollution and cardiorespiratory hospitalization. This study aims to investigate the association between cardiorespiratory hospitalization and air pollution, and predict cardiorespiratory hospitalization based on air pollution using the artificial intelligence (AI) techniques. We propose the enhanced long short-term memory (ELSTM) model and provide a comparison with other AI techniques, i.e., LSTM, DL, and vector autoregressive (VAR). This study was conducted at seven study locations in Klang Valley, Malaysia. The utilized dataset contains the data from January 2006 to December 2016 for five study locations, i.e., Klang (KLN), Shah Alam (SA), Putrajaya (PUJ), Petaling Jaya (PJ), and Cheras, Kuala Lumpur (CKL). The dataset for Banting contains data from April 2010 to December 2016, and the data for Batu Muda, Kuala Lumpur, contains data from January 2009 to December 2016. The prediction results show that the ELSTM model performed significantly better than other models in all study locations, with the best RMSE scores in Klang study location (ELSTM: 0.002, LSTM: 0.013, DL: 0.006, VAR: 0.066). The results also indicated that the proposed ELSTM model was able to detect and predict the trends of monthly hospitalization significantly better than the LSTM and other models in the study. Hence, we can conclude that we can utilize AI techniques to accurately predict cardiorespiratory hospitalization based on air pollution in Klang Valley, Malaysia.
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Affiliation(s)
- Raja Sher Afgun Usmani
- School of Computer Science and Engineering, Taylor's University, Subang Jaya, Selangor, Malaysia.
| | | | - Ibrahim Abaker Targio Hashem
- College of Computing and Informatics, Department of Computer Science, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Mohsen Marjani
- School of Computer Science and Engineering, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Rafiza Shaharudin
- Environmental Health Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Mohd Talib Latif
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
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Kobza J, Geremek M, Dul L. Ozone Concentration Levels in Urban Environments-Upper Silesia Region Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1473. [PMID: 33557260 PMCID: PMC7915919 DOI: 10.3390/ijerph18041473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Although ozone (O3) plays a crucial role in screening the Earth's surface and lower atmosphere layers from the ultraviolet radiation, troposphere ozone is proven to have negative health effects on the human body and is one of the greenhouse gases. The objective of this study was to perform a measurement-based assessment for determining whether the concentration of ozone is within admissible limits, or exceeded, in Silesia Province and does not pose a threat to the local population. The data provided by the Voivodship Inspectorate for Environmental Protection in Katowice were used in the analysis. The received data constitute the result of 8-h measurements of concentrations of ozone at selected air monitoring stations of the Silesian province. The locations of three monitoring stations were found to be useful for the aim of this research; one site is situated in a rural background area; another one is located in a medium-sized city and the Katowice station is representative for an urban background situation. We used cluster analysis, weighted pair group method using arithmetic averages (WPGMA) and Chebyshev distances to test the hypothesis and compare empirical distributions in the general population. The alarm level has not been exceeded in indicated measurements stations in Silesian Voivodship in the period 2015-2017 (averaging time 1 h: 240 µg/m3 for 3 h). The target level was exceeded in 2015 at all three measurements stations and in the following years at one station (in Zloty Potok, 2016, and in Katowice, 2017). Each year, the largest number of exceedances occurred in August. The results clearly indicate a lack of hazards for the general population's health in terms of increased concentrations of ozone in the city centers and outside. The results confirm that environmental conditions (i.e., landform, the area surrounding monitoring station) have a significant influence on the ozone level.
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Affiliation(s)
- Joanna Kobza
- Department of Public Health, School of Health Sciences, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland;
| | - Mariusz Geremek
- Department of Public Health, School of Health Sciences, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland;
| | - Lechosław Dul
- Department of Epidemiology and Biostatistics, School of Health Sciences, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland;
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Abstract
The burden imposed by pollution falls more on those living in low-income and middle-income countries, affecting children more than adults. Most air pollution results from incomplete combustion and contains a mixture of particulate matter and gases. Air pollution exposure has negative impacts on respiratory health. This article concentrates on air pollution in 2 settings, the child's home and the ambient environment. There is an inextricable 2-way link between air pollution and climate change, and the effects of climate change on childhood respiratory health also are discussed.
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Pambianchi E, Ferrara F, Pecorelli A, Woodby B, Grace M, Therrien JP, Lila MA, Valacchi G. Blueberry Extracts as a Novel Approach to Prevent Ozone-Induced Cutaneous Inflammasome Activation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:9571490. [PMID: 32855770 PMCID: PMC7443250 DOI: 10.1155/2020/9571490] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/24/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
The World Health Organization estimates that 7 million people die every year due to pollution exposure. Among the different pollutants to which living organism are exposed, ozone (O3) represents one of the most toxic, because its location which is the skin is one of the direct tissues exposed to the outdoor environment. Chronic exposure to outdoor stressors can alter cutaneous redox state resulting in the activation of inflammatory pathways. Recently, a new player in the inflammation mechanism was discovered: the multiprotein complex NLRP1 inflammasome, which has been shown to be also expressed in the skin. The topical application of natural compounds has been studied for the last 40 years as a possible approach to prevent and eventually cure skin conditions. Recently, the possibility to use blueberry (BB) extract to prevent pollution-induced skin toxicity has been of great interest in the cosmeceutical industry. In the present study, we analyzed the cutaneous protective effect of BB extract in several skin models (2D, 3D, and human skin explants). Specifically, we observed that in the different skin models used, BB extracts were able to enhance keratinocyte wound closure and normalize proliferation and migration responses previously altered by O3. In addition, pretreatment with BB extracts was able to prevent ozone-induced ROS production and inflammasome activation measured as NRLP1-ASC scaffold formation and also prevent the transcripts of key inflammasome players such as CASP1 and IL-18, suggesting that this approach as a possible new technology to prevent cutaneous pollution damage. Our data support the hypothesis that BB extracts can effectively reduce skin inflammation and be a possible new technology against cutaneous pollution-induced damage.
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Affiliation(s)
- Erika Pambianchi
- Plants for Human Health Institute, Animal Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
| | - Francesca Ferrara
- Plants for Human Health Institute, Animal Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandra Pecorelli
- Plants for Human Health Institute, Animal Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
| | - Brittany Woodby
- Plants for Human Health Institute, Animal Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
| | - Mary Grace
- Plants for Human Health Institute, Food Bioprocessing & Nutrition Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
| | | | - Mary Ann Lila
- Plants for Human Health Institute, Food Bioprocessing & Nutrition Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
| | - Giuseppe Valacchi
- Plants for Human Health Institute, Animal Sciences Dept., NC Research Campus Kannapolis, NC State University, 28081, NC, USA
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
- Department of Food and Nutrition, Kyung Hee University, Seoul, Republic of Korea
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Ortega-García JA, Martínez-Hernández I, Boldo E, Cárceles-Álvarez A, Solano-Navarro C, Ramis R, Aguilar-Ros E, Sánchez-Solis M, López-Hernández F. Urban air pollution and hospital admissions for asthma and acute respiratory disease in Murcia city (Spain). An Pediatr (Barc) 2020. [DOI: 10.1016/j.anpede.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bergmann S, Li B, Pilot E, Chen R, Wang B, Yang J. Effect modification of the short-term effects of air pollution on morbidity by season: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:136985. [PMID: 32044481 DOI: 10.1016/j.scitotenv.2020.136985] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O3, SO2 and NO2 on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001-1.0018), 1.0080 (95% CI: 1.0021-1.0138), 0.9828 (95% CI: 0.9697-0.9962) and 0.9896 (95% CI: 0.9824-0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO2 on cardiovascular disease, the effect of PM10 on stroke, and the effect of O3 on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18 years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity.
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Affiliation(s)
- Stéphanie Bergmann
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Bixia Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Eva Pilot
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Renchao Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China.
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24
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Ortega-García JA, Martínez-Hernández I, Boldo E, Cárceles-Álvarez A, Solano-Navarro C, Ramis R, Aguilar-Ros E, Sánchez-Solis M, López-Hernández F. [Urban air pollution and hospital admissions for asthma and acute respiratory disease in Murcia city (Spain)]. An Pediatr (Barc) 2020; 93:95-102. [PMID: 32115374 DOI: 10.1016/j.anpedi.2020.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Urban air pollution is a major threat to child and adolescent health. Children are more vulnerable to its effects, being associated with higher morbidity and mortality due to acute and chronic diseases, especially respiratory ones. A study is performed on the relationship between urban air pollution and the rate of hospital admissions due to acute respiratory diseases. PATIENTS AND METHODS An ecological study was conducted on young people under 17 years-old in the city of Murcia, who had visited hospital emergency departments due to respiratory diseases (ICD-9) during 2015. A logistic regression was performed on the risk of hospital admission that included consultations in relation to the average daily levels of environmental pollutants (NO2, O3, PM10, SO2) obtained from the Air Quality Surveillance and Control network of the Region of Murcia. Other control variables, such as gender, age, average daily ambient temperature, and season of the year. RESULTS A total of 12,354 (56% boys and 44% girls) children consulted in the emergency department for respiratory disease. Of those, 3.5% were admitted, with a mean age of 2.54 (95% CI; 2.16-2.91) years. The odds ratio (OR) of hospital admission for respiratory diseases: NO2 1.02 (95% CI; 1.01-1.04; P<.01), O3 1.01 (95% CI; 1.00-1.03; P<.01) male 1.4 (95% CI 1.11-1.79; P<.01) and winter 2.10 (95% CI 1.40-3.21; P<.01). Admissions for asthma: PM10 1.02 (95% CI; 1.01-1.04; P<.05), O3 1.04 (95% CI; 1.01-1.06; P<.01). Admissions for bronchiolitis: Age 0.69 (95% CI; 0.48-0.99; P<.05); NO2 1.03 (95% CI; 1.01-1.05; P<.01). CONCLUSIONS Urban air pollution increases hospital admissions in children due to acute respiratory diseases, especially asthma and bronchiolitis. Implementing preventive measures, expanding time series and collaborative studies with open data, would help improve public health and air quality in the cities.
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Affiliation(s)
- Juan Antonio Ortega-García
- Comité de Salud Medioambiental, Asociación Española de Pediatría (AEP); Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España.
| | - Indra Martínez-Hernández
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Elena Boldo
- Unidad de Epidemiología Ambiental y del Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España. CIBER en Epidemiología y Salud Pública-CIBERESP, Madrid, España
| | - Alberto Cárceles-Álvarez
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Carmen Solano-Navarro
- Sección de Urgencias, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Rebeca Ramis
- Unidad de Epidemiología Ambiental y del Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España. CIBER en Epidemiología y Salud Pública-CIBERESP, Madrid, España
| | - Estefanía Aguilar-Ros
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Manuel Sánchez-Solis
- Sección de Neumología Pediátrica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Fernando López-Hernández
- Departamento de Métodos Cuantitativos, Universidad Politécnica de Cartagena, Cartagena, Murcia, España
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25
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Luong LMT, Sly PD, Thai PK, Phung D. Impact of ambient air pollution and wheeze-associated disorders in children in Southeast Asia: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2019; 34:125-139. [PMID: 30753165 DOI: 10.1515/reveh-2018-0079] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/09/2019] [Indexed: 06/09/2023]
Abstract
Several systematic reviews have been conducted so far to examine the effect of air pollution on respiratory diseases, but there has not been a corresponding meta-analysis to estimate the effect sizes for wheeze-associated diseases/disorders, which is one of the leading causes of emergency department visits and hospitalizations for children worldwide. The aim of this review is to systematically evaluate the relationship between air pollution and risk of wheeze-associated disorders in children in Southeast Asia. We searched the relevant computerized databases (PubMed, EMBASE, Web of Science, Scopus and Cochrane library) for indexed publications up to July 2018. Finally, eight studies were qualified for performing a random-effect meta-analysis to compute the pooled effect sizes. The results show that each increase of 10 μg/m3 in concentrations of PM2.5, PM1 was associated with 1-2% increase in risk of wheeze-associated disorders. Positive associations were found for PM10, SO2, NO2, NOx but no association was found for CO and O3. We confirmed the strong effect of fine particulate matters on respiratory health and recommend an updated meta-analysis should be done when more studies are available.
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Affiliation(s)
- Ly M T Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Queensland, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Peter D Sly
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Queensland, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
| | - Dung Phung
- Centre for Environment and Population Health, School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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