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Deng J, Yao D, Deng Y, Liu Z, Yang J, Gong D. Study on the impact of smart city construction on the health of the elderly population--A quasi-natural experiment in China. PLoS One 2024; 19:e0305897. [PMID: 38905258 PMCID: PMC11192306 DOI: 10.1371/journal.pone.0305897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/06/2024] [Indexed: 06/23/2024] Open
Abstract
In the context of global aging, promoting the health of the elderly has become a critical issue. However, whether the development of smart cities can impact the health of older adults remains to be further validated. In this paper, based on panel data from the China Health and Retirement Longitudinal Study (CHARLS), a difference in difference model is used to empirically investigate whether smart city construction improves the health of older people in the region. The results show that smart city construction enhances the health of the elderly. Specifically, the construction achieved a significant improvement in the physical health of the elderly who did not live with their children. The health promotion effect of the smart city was more significant for the urban elderly than for the rural elderly. The elucidated mechanisms of influence suggest that smart cities bring about their effects through the promotion of urban leisure infrastructure, enhancement of medical service provision, advancement in urban environmental protection and stimulation of urban information and communication technology infrastructure development.
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Affiliation(s)
- Juqiu Deng
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Dong Yao
- School of Economics, Sichuan University, Chengdu, Sichuan, China
- Chengdu Jincheng College, Chengdu, Sichuan, China
| | - Yue Deng
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Zhenyu Liu
- School of Economics, Sichuan University, Chengdu, Sichuan, China
| | - Jiayu Yang
- West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Dezhao Gong
- School of Economics, Sichuan University, Chengdu, Sichuan, China
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Okura T, Tanaka-Mizuno S, Ishii M, Takeuchi M, Kawakami K. Association Between Asian Dust Exposure and Pneumonia Hospitalization in Western Japan: A Case-Crossover Study. Asia Pac J Public Health 2024:10105395241260978. [PMID: 38880973 DOI: 10.1177/10105395241260978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Epidemiological studies have reported that Asian dust (AD), a type of desert dust, has harmful effects on human health. This study aimed to examine the association between AD exposure and hospitalization due to pneumonia. Data on patients in Western Japan admitted for pneumonia were included from a real-world database derived from electronic medical records. We used the meteorological observatory data of the most populous city in each prefecture, in which AD event was defined as a loss of visibility from a distance ≤10 km. A case-crossover design and conditional logistic regression model were used. Overall, 12 938 patients were included, and AD exposure events were observed for 557 days. Exposure to an AD event five days prior to hospitalization was significantly associated with hospitalization for pneumonia after adjusting for weather variables (odds ratio = 1.17; 95% confidence interval = [1.01, 1.36]). These findings suggest that AD exposure is associated with an increased rate of admission for pneumonia in Western Japan.
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Affiliation(s)
- Takayuki Okura
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
- Laboratory of Epidemiology and Prevention, Kobe Pharmaceutical University, Kobe, Japan
| | - Masanobu Ishii
- Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masato Takeuchi
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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Zhang Y, Li J, Wu C, Xiao Y, Wang X, Wang Y, Chen L, Ren L, Wang J. Impacts of environmental factors on the aetiological diagnosis and disease severity of community-acquired pneumonia in China: a multicentre, hospital-based, observational study. Epidemiol Infect 2024; 152:e80. [PMID: 38721832 PMCID: PMC11131030 DOI: 10.1017/s0950268824000700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Environmental exposures are known to be associated with pathogen transmission and immune impairment, but the association of exposures with aetiology and severity of community-acquired pneumonia (CAP) are unclear. A retrospective observational study was conducted at nine hospitals in eight provinces in China from 2014 to 2019. CAP patients were recruited according to inclusion criteria, and respiratory samples were screened for 33 respiratory pathogens using molecular test methods. Sociodemographic, environmental and clinical factors were used to analyze the association with pathogen detection and disease severity by logistic regression models combined with distributed lag nonlinear models. A total of 3323 CAP patients were included, with 709 (21.3%) having severe illness. 2064 (62.1%) patients were positive for at least one pathogen. More severe patients were found in positive group. After adjusting for confounders, particulate matter (PM) 2.5 and 8-h ozone (O3-8h) were significant association at specific lag periods with detection of influenza viruses and Klebsiella pneumoniae respectively. PM10 and carbon monoxide (CO) showed cumulative effect with severe CAP. Pollutants exposures, especially PM, O3-8h, and CO should be considered in pathogen detection and severity of CAP to improve the clinical aetiological and disease severity diagnosis.
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Affiliation(s)
- Yichunzi Zhang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Wu
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Xiao
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinming Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Chen
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lili Ren
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Pathogen Infection Prevention and Control (Ministry of Education), State Key Laboratory of Respiratory Health and Multimorbidity, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianwei Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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4
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Nakhjirgan P, Kashani H, Kermani M. Exposure to outdoor particulate matter and risk of respiratory diseases: a systematic review and meta-analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 46:20. [PMID: 38153542 DOI: 10.1007/s10653-023-01807-1] [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: 08/11/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
According to epidemiological studies, particulate matter (PM) is an important air pollutant that poses a significant threat to human health. The relationship between particulate matter and respiratory diseases has been the subject of numerous studies, but these studies have produced inconsistent findings. The purpose of this systematic review was to examine the connection between outdoor particulate matter (PM2.5 and PM10) exposure and respiratory disorders (COPD, lung cancer, LRIs, and COVID-19). For this purpose, we conducted a literature search between 2012 and 2022 in PubMed, Web of Science, and Scopus. Out of the 58 studies that were part of the systematic review, meta-analyses were conducted on 53 of them. A random effect model was applied separately for each category of study design to assess the pooled association between exposure to PM2.5 and PM10 and respiratory diseases. Based on time-series and cohort studies, which are the priorities of the strength of evidence, a significant relationship between the risk of respiratory diseases (COPD, lung cancer, and COVID-19) was observed (COPD: pooled HR = 1.032, 95% CI: 1.004-1.061; lung cancer: pooled HR = 1.017, 95% CI: 1.015-1.020; and COVID-19: pooled RR = 1.004, 95% CI: 1.002-1.006 per 1 μg/m3 increase in PM2.5). Also, a significant relationship was observed between PM10 and respiratory diseases (COPD, LRIs, and COVID-19) based on time-series and cohort studies. Although the number of studies in this field is limited, which requires more investigations, it can be concluded that outdoor particulate matter can increase the risk of respiratory diseases.
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Affiliation(s)
- Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
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Li J, Liang L, Lyu B, Cai YS, Zuo Y, Su J, Tong Z. Double trouble: The interaction of PM 2.5 and O 3 on respiratory hospital admissions. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 338:122665. [PMID: 37806428 DOI: 10.1016/j.envpol.2023.122665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
The co-occurrence of fine particulate matter (PM2.5) and ozone (O3) pollution during the warm season has become a growing public health concern. The interaction between PM2.5 and O3 and its contribution to disease burden associated with co-pollution has not been thoroughly examined. We collected data on hospital admissions for respiratory diseases from a city-wide hospital discharge database in Beijing between 2013 and 2019. City-wide 24-h mean PM2.5 and daily maximum 8-h mean O3 were averaged from 35 monitoring stations across Beijing. Conditional Poisson regression was employed to estimate the interaction between warm-season PM2.5 and O3 on respiratory admissions. A model incorporating a tensor product term was used to fit the non-linear interaction and estimate the number of respiratory admissions attributable to PM2.5 and O3 pollution. From January 18, 2013 to December 31, 2019, 1,191,308 respiratory admissions were recorded. We observed multiplicative interactions between warm-season PM2.5 and O3 on upper respiratory infections (P = 0.004), pneumonia (P = 0.002), chronic obstructive pulmonary disease (P = 0.041), and total respiratory disease (P < 0.001). PM2.5-O3 co-pollution during warm season exhibited a super-additive effect on respiratory admissions, with a relative excess risk due to interaction of 1.65% (95%CI: 0.46%-2.84%). There was a non-linear pattern of the synergistic effect between PM2.5 and O3 on respiratory admissions. Based on the World Health Organization global air quality guidelines, 12,421 respiratory admissions would be reduced if both daily PM2.5 and O3 concentrations had not exceeded the target (PM2.5 15 μg/m3, O3 100 μg/m3). The number of respiratory admissions attributable to either PM2.5 or O3 pollution decreased by 48.7% from 2013 to 2019. Prioritizing O3 control during the warm season is a cost-effective strategy for Beijing. These findings underscore the significance of concurrently addressing both PM2.5 pollution and O3 pollution during the warm season to alleviate the burden of respiratory diseases.
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Affiliation(s)
- Jiachen Li
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Lirong Liang
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Baolei Lyu
- Huayun Sounding Meteorology Technology Corporation, Beijing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Nanjing University of Information Science & Technology, Nanjing, China.
| | - Yutong Samuel Cai
- Centre for Environmental Health and Sustainability, Department of Population Health Sciences, University of Leicester, Leicester, UK.
| | - Yingting Zuo
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Jian Su
- School of Economics, Peking University, Beijing, China.
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao Yang Hospital, Capital Medical University, Beijing, China.
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6
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Reilly JP, Zhao Z, Shashaty MGS, Koyama T, Jones TK, Anderson BJ, Ittner CA, Dunn T, Miano TA, Oniyide O, Balmes JR, Matthay MA, Calfee CS, Christie JD, Meyer NJ, Ware LB. Exposure to ambient air pollutants and acute respiratory distress syndrome risk in sepsis. Intensive Care Med 2023; 49:957-965. [PMID: 37470831 PMCID: PMC10561716 DOI: 10.1007/s00134-023-07148-y] [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: 04/06/2023] [Accepted: 06/20/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE Exposures to ambient air pollutants may prime the lung enhancing risk of acute respiratory distress syndrome (ARDS) in sepsis. Our objective was to determine the association of short-, medium-, and long-term pollutant exposures and ARDS risk in critically ill sepsis patients. METHODS We analyzed a prospective cohort of 1858 critically ill patients with sepsis, and estimated short- (3 days), medium- (6 weeks), and long- (5 years) term exposures to ozone, nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particulate matter < 2.5 μm (PM2.5), and PM < 10 μm (PM10) using weighted averages of daily levels from monitors within 50 km of subjects' residences. Subjects were followed for 6 days for ARDS by the Berlin Criteria. The association between each pollutant and ARDS was determined using multivariable logistic regression adjusting for preselected confounders. In 764 subjects, we measured plasma concentrations of inflammatory proteins at presentation and tested for an association between pollutant exposure and protein concentration via linear regression. RESULTS ARDS developed in 754 (41%) subjects. Short- and long-term exposures to SO2, NO2, and PM2.5 were associated with ARDS risk (SO2: odds ratio (OR) for the comparison of the 75-25th long-term exposure percentile 1.43 (95% confidence interval (CI) 1.16, 1.77); p < 0.01; NO2: 1.36 (1.06, 1.74); p = 0.04, PM2.5: 1.21 (1.04, 1.41); p = 0.03). Long-term exposures to these three pollutants were also associated with plasma interleukin-1 receptor antagonist and soluble tumor necrosis factor receptor-1 concentrations. CONCLUSION Short and long-term exposures to ambient SO2, PM2.5, and NO2 are associated with increased ARDS risk in sepsis, representing potentially modifiable environmental risk factors for sepsis-associated ARDS.
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Affiliation(s)
- John P Reilly
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA.
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - Michael G S Shashaty
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - Tiffanie K Jones
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
- Center for Clinical Epidemiology and Biostatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Brian J Anderson
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Caroline A Ittner
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Thomas Dunn
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Todd A Miano
- Center for Clinical Epidemiology and Biostatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Oluwatosin Oniyide
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - John R Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, USA
- Department of Medicine, University of California, San Francisco, USA
| | - Michael A Matthay
- Department of Medicine, University of California, San Francisco, USA
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, USA
| | - Carolyn S Calfee
- Department of Medicine, University of California, San Francisco, USA
- Department of Anesthesia and Cardiovascular Research Institute, University of California, San Francisco, USA
| | - Jason D Christie
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
- Center for Clinical Epidemiology and Biostatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Nuala J Meyer
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Perelman School of Medicine, 5005 Gibson Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Center for Translational Lung Biology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Lorraine B Ware
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, USA
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Xu H, Song J, He X, Guan X, Wang T, Zhu Y, Xu X, Li M, Liu L, Zhang B, Fang J, Zhao Q, Song X, Xu B, Huang W. Ambient Anthropogenic Carbons and Pediatric Respiratory Infections: A Case-Crossover Analysis in the Megacity Beijing. GEOHEALTH 2023; 7:e2023GH000820. [PMID: 37534336 PMCID: PMC10392781 DOI: 10.1029/2023gh000820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023]
Abstract
Carbon loading in airway cells has shown to worsen function of antimicrobial peptides, permitting increased survival of pathogens in the respiratory tract; however, data on the impacts of carbon particles on childhood acute respiratory infection (ARI) is limited. We assembled daily health data on outpatient visits for ARI (bronchitis, pneumonia, and total upper respiratory infection [TURI]) in children aged 0-14 years between 2015 and 2019 in Beijing, China. Anthropogenic carbons, including black carbon (BC) and its emission sources, and wood smoke particles (delta carbon, ultra-violet absorbing particulate matter, and brown carbon) were continuously monitored. Using a time-stratified case-crossover approach, conditional logistic regression was performed to derive risk estimates for each outcome. A total of 856,899 children were included, and a wide range of daily carbon particle concentrations was observed, with large variations for BC (0.36-20.44) and delta carbon (0.48-57.66 μg/m3). Exposure to these particles were independently associated with ARI, with nearly linear exposure-response relationships. Interquartile range increases in concentrations of BC and delta carbon over prior 0-8 days, we observed elevation of the odd ratio of bronchitis by 1.201 (95% confidence interval, 1.180, 1.221) and 1.048 (95% CI, 1.039, 1.057), respectively. Stronger association was observed for BC from traffic sources, which increased the odd ratio of bronchitis by 1.298 (95% CI, 1.273, 1.324). Carbon particles were also associated with elevated risks of pneumonia and TURI, and subgroup analyses indicated greater risks among children older than 6 years. Our findings suggested that anthropogenic carbons in metropolitan areas may pose a significant threat to clinical manifestations of respiratory infections in vulnerable populations.
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Affiliation(s)
- Hongbing Xu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Jing Song
- The First Affiliated Hospital of Xiamen UniversityXiamenChina
| | - Xinghou He
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Xinpeng Guan
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Tong Wang
- Key Lab of Medical Protection for Electromagnetic RadiationMinistry of Education of ChinaInstitute of ToxicologyCollege of Preventive MedicineArmy Medical University (Third Military Medical University)ChongqingChina
| | - Yutong Zhu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Xin Xu
- China National Clinical Research Center of Respiratory DiseasesRespiratory Department of Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Mengyao Li
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Lingyan Liu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Bin Zhang
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Jiakun Fang
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Qian Zhao
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Xiaoming Song
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
| | - Baoping Xu
- China National Clinical Research Center of Respiratory DiseasesRespiratory Department of Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Wei Huang
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthPeking University Institute of Environmental MedicineBeijingChina
- State Key Laboratory of Vascular Homeostasis and RemodelingPeking UniversityBeijingChina
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8
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Bailie CR, Ghosh JKC, Kirk MD, Sullivan SG. Effect of ambient PM 2.5 on healthcare utilisation for acute respiratory illness, Melbourne, Victoria, Australia, 2014-2019. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2023; 73:120-132. [PMID: 36376253 DOI: 10.1080/10962247.2022.2146810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Ambient particulate matter (PM2.5) is an important component of natural and human-generated air pollution and a major contributor to the global burden of disease. Short-term effects of PM2.5 exposure on respiratory illness have been described but most evidence arises from high pollution settings. We used case-crossover methods to estimate effects of outdoor PM2.5 levels on emergency department (ED) presentations and hospital admissions for a range of acute respiratory illnesses and age groups in Melbourne, Australia from 2014-2019, with and without adjustment for other pollutants and weather conditions, using daily and one-week averaged lags. We estimated incidence rate ratios for a 10 μg/m3 increase in 7-day average ambient PM2.5 of 1.043 (95% confidence interval (CI): 1.000-1.089) on ED presentation and 1.013 (95% CI: 0.971-1.056) on hospital admissions for acute respiratory illnesses for patients of any age. We observed distinct temporal patterns in daily lag effect by disease. The largest effects on acute lower respiratory tract infection and asthma were observed in children. Ambient PM2.5 levels rarely exceeded standards in place at the time. Although uncertainty around most point estimates was relatively wide, these findings are most compatible with adverse health effects of ambient PM2.5 at levels below currently established Australian national standards.Implications: Understanding the health impacts of air pollution is important for setting air quality targets, as well as for informing robust health system planning. Adverse effects of exposure to outdoor fine particulate matter on human respiratory health have been consistently described. However, most studies have been done in higher-pollution settings. Further, many studies have assessed health effects in broad categories such as all-cause respiratory mortality or hospitalization, and thus lack the granularity to inform detailed health service planning. Our study aimed to estimate effects of outdoor fine particulate matter on emergency department (ED) presentations and hospital admissions for a range of acute respiratory illnesses and age groups in Melbourne, Australia, a city with relatively good air quality by international comparison. Our study estimated consistent effects on both ED presentations and hospital admissions compatible with distinct patterns of adverse health effects at levels at or below established Australian national (and many international) standards. These results will help to inform both air quality policy and public health policy in similar settings.
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Affiliation(s)
- Christopher R Bailie
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, Australia
| | - Jo Kay C Ghosh
- Heluna Health, City of Industry, Los Angeles County, CA, USA
| | - Martyn D Kirk
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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9
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Lin C, Jiang W, Gao X, He Y, Li J, Zhou C, Yang L. Attributable risk and economic burden of pneumonia among older adults admitted to hospital due to short-term exposure to airborne particulate matter: a time-stratified case-crossover study from China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:45342-45352. [PMID: 36705825 DOI: 10.1007/s11356-023-25530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
Many studies have proven the relationship between air pollutants and respiratory diseases, but few studies have assessed the impacts of air particulate matter exposure on older patients with pneumonia. This study aimed to reveal the impacts of short-term exposure to air particulate matter on the daily number of older adult patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure. We collected inpatient data from 9 city hospitals in Sichuan Province, China, from January 1, 2018, to December 31, 2019, and calculated odds ratios and 95% confidence intervals using a time-stratified case-crossover study design and an attributable risk model to calculate the economic burden due to particulate matter pollution. It was found that for every 10 μg/m3 increase in PM2.5 and PM10 concentrations, the daily number of older adult pneumonia inpatients increased by 1.5% (95% CI: 1.010-1.021) and 1.0% (95% CI: 1.006-1.014), respectively. Those 65 ~ 79 years old were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY (6.22%) and 16.03 million CNY (6.21%), respectively, with PM2.5 being the primary influencing factor. This study revealed the relationship between particulate matter pollution and pneumonia among older adults. The role of policies to limit particulate matter concentrations in reducing disease burden among older adults can be further explored.
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Affiliation(s)
- Chengwei Lin
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Wanyanhan Jiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xi Gao
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Yi He
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Jia Li
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, 250100, Shandong, China
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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10
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Peck A, Handy RG, Sleeth DK, Schaefer C, Zhang Y, Pahler LF, Ramsay J, Collingwood SC. Aerosol Measurement Degradation in Low-Cost Particle Sensors Using Laboratory Calibration and Field Validation. TOXICS 2023; 11:56. [PMID: 36668782 PMCID: PMC9862639 DOI: 10.3390/toxics11010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/22/2022] [Accepted: 12/25/2022] [Indexed: 06/17/2023]
Abstract
Increasing concern over air pollution has led to the development of low-cost sensors suitable for wide-scale deployment and use by citizen scientists. This project investigated the AirU low-cost particle sensor using two methods: (1) a comparison of pre- and post-deployment calibration equations for 24 devices following use in a field study, and (2) an in-home comparison between 3 AirUs and a reference instrument, the GRIMM 1.109. While differences (and therefore some sensor degradation) were found in the pre- and post-calibration equation comparison, absolute value changes were small and unlikely to affect the quality of results. Comparison tests found that while the AirU did tend to underestimate minimum and overestimate maximum concentrations of particulate matter, ~88% of results fell within ±1 μg/m3 of the GRIMM. While these tests confirm that low-cost sensors such as the AirU do experience some sensor degradation over multiple months of use, they remain a valuable tool for exposure assessment studies. Further work is needed to examine AirU performance in different environments for a comprehensive survey of capability, as well as to determine the source of sensor degradation.
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Affiliation(s)
- Angela Peck
- Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Rodney G. Handy
- Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Darrah K. Sleeth
- Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Camie Schaefer
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Yue Zhang
- Department of Internal Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Leon F. Pahler
- Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Joemy Ramsay
- Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
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11
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Kim H, Samet JM, Bell ML. Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:117006. [PMID: 36367781 PMCID: PMC9651183 DOI: 10.1289/ehp10836] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35 μg/m3); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7 μg/m3 or 70 parts per billion). An interquartile range (IQR) increase (5.2 μg/m3) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2 μg/m3) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. https://doi.org/10.1289/EHP10836.
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Affiliation(s)
- Honghyok Kim
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
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12
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Air Pollution-Related Respiratory Diseases and Associated Environmental Factors in Chiang Mai, Thailand, in 2011–2020. Trop Med Infect Dis 2022; 7:tropicalmed7110341. [DOI: 10.3390/tropicalmed7110341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
The unfavorable effects of global climate change, which are mostly the result of human activities, have had a particularly negative effect on human health and the planet’s ecosystems. This study attempted to determine the seasonality and association of air pollution, in addition to climate conditions, with two respiratory infections, influenza and pneumonia, in Chiang Mai, Thailand, which has been considered the most polluted city on Earth during the hot season. We used a seasonal-trend decomposition procedure based on loess regression (STL) and a seasonal cycle subseries (SCS) plot to determine the seasonality of the two diseases. In addition, multivariable negative binomial regression (NBR) models were used to assess the association between the diseases and environmental variables (temperature, precipitation, relative humidity, PM2.5, and PM10). The data revealed that influenza had a clear seasonal pattern during the cold months of January and February, whereas the incidence of pneumonia showed a weak seasonal pattern. In terms of forecasting, the preceding month’s PM2.5 and temperature (lag1) had a significant association with influenza incidence, while the previous month’s temperature and relative humidity influenced pneumonia. Using air pollutants as an indication of respiratory disease, our models indicated that PM2.5 lag1 was correlated with the incidence of influenza, but not pneumonia. However, there was a linear association between PM10 and both diseases. This research will help in allocating clinical and public health resources in response to potential environmental changes and forecasting the future dynamics of influenza and pneumonia in the region due to air pollution.
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Gutman L, Pauly V, Orleans V, Piga D, Channac Y, Armengaud A, Boyer L, Papazian L. Long-term exposure to ambient air pollution is associated with an increased incidence and mortality of acute respiratory distress syndrome in a large French region. ENVIRONMENTAL RESEARCH 2022; 212:113383. [PMID: 35569534 DOI: 10.1016/j.envres.2022.113383] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/18/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Air pollution exposure is suspected to alter both the incidence and mortality in acute respiratory distress syndrome (ARDS). The impact of chronic air pollutant exposure on the incidence and mortality of ARDS from various aetiologies in Europe remains unknown. The main objective of this study was to evaluate the incidence of ARDS in a large European region, 90-day mortality being the main secondary outcome. METHODS The study was performed in the Provence-Alpes-Cote-d'Azur (PACA) region. Nitrogen dioxide (NO2), particulate matter (PM2.5 and PM10) and ozone (O3) were measured. The Programme de Médicalisation des Systèmes d'Information (PMSI), which captures all patient hospital stays in France, was used to identify adults coded as ARDS in an intensive care unit. RESULTS From 2016 to 2018, 4733 adults with ARDS treated in intensive care units were analysed. The incidence rate ratios for 1-year average exposure to PM2.5 and PM10 were 1.207 ([95% confidence interval (95% CI), 1.145-1.390]; P < 0.01) and 1.168 (95% CI, 1.083-1.259; P < 0.001), respectively. The same trend was observed for both 2- and 3-year exposures, while only chronic 1- and 2-year exposure NO2 exposures were related to a higher incidence of ARDS. Increased PM2.5 exposure was associated with a higher 90-day mortality for both 1- and 3-year exposures (OR 1.096 (95% CI, 1.001-1.201) and 1.078 (95% CI, 1.009-1.152), respectively). O3 was not associated with either of incidence nor mortality. CONCLUSIONS While chronic exposure to NO2, PM2.5, and PM10 was associated with an increased ARDS incidence and a higher mortality rate (for PM2.5) in those patients presenting with ARDS, further research on this topic is required.
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Affiliation(s)
- Laëtitia Gutman
- Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015, Marseille, France; Aix-Marseille Université, Faculté de Médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France.
| | - Vanessa Pauly
- Aix-Marseille Université, Faculté de Médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France; Unité d'Analyse des données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France
| | - Veronica Orleans
- Unité d'Analyse des données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France
| | - Damien Piga
- AtmoSud, Observatoire de la qualité de l'air en région Sud Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Yann Channac
- Unité d'Analyse des données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France
| | - Alexandre Armengaud
- AtmoSud, Observatoire de la qualité de l'air en région Sud Provence-Alpes-Côte d'Azur, 13006, Marseille, France
| | - Laurent Boyer
- Aix-Marseille Université, Faculté de Médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France; Unité d'Analyse des données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France
| | - Laurent Papazian
- Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015, Marseille, France; Aix-Marseille Université, Faculté de Médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France
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14
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Xu H, Wang X, Tian Y, Tian J, Zeng Y, Guo Y, Song F, Xu X, Ni X, Feng G. Short-term exposure to gaseous air pollutants and daily hospitalizations for acute upper and lower respiratory infections among children from 25 cities in China. ENVIRONMENTAL RESEARCH 2022; 212:113493. [PMID: 35618009 DOI: 10.1016/j.envres.2022.113493] [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: 02/14/2022] [Revised: 04/29/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
To examine the short-term association between gaseous air pollutants (CO, NO2, SO2, and O3) and all-cause respiratory disease, acute upper respiratory infections (AURIs) as well as acute lower respiratory infections (ALRIs) among children, we conducted the study from 25 major cities in China. Hospitalization records of children aged 0-18 years due to all-cause respiratory diseases (889,926), AURIs (97,858), and ALRIs (642,154) from 2016 to 2019 were extracted. Concentrations of CO, NO2, SO2, and O3 were averaged across monitoring stations. Generalized additive models were used to estimate the associations between gaseous air pollutants and daily hospitalizations for all-cause respiratory disease, AURIs, and ALRIs. The meta-analysis was used to combine the city-specific estimates. A 10 mg/m3 increase in CO at lag01, and a 10 μg/m3 increase in NO2, SO2, and O3 at lag01 were associated with 1.65% (95%CI, 0.41-2.91), 0.54% (95%CI, 0.30-0.79), 0.60% (95%CI, 0.22-0.99), and 0.23% (95%CI, 0.06-0.39) increase of hospitalizations due to all-cause respiratory disease, respectively. For the disease subtype, O3 only had adverse effects on AURIs, CO and SO2 mainly on ALRIs, and NO2 on both AURIs and ALRIs. Children aged 4-6years were more vulnerable to the effects of CO and NO2, but those aged <1year were more susceptible to SO2 and O3. Besides, the O3 effect was stronger in the warm season than in the cold season. The study indicated that short-term exposure to CO, NO2, SO2, and O3 was associated with increased hospitalization for pediatric respiratory disease, and the association may vary by position of the respiratory tract, age, and season.
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Affiliation(s)
- Hui Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinyu Wang
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Tian
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yueping Zeng
- Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Fei Song
- Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China; Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Guoshuang Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China.
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15
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Zheng D, Huang X, Guo Y. Spatiotemporal variation of ozone pollution and health effects in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:57808-57822. [PMID: 35355182 DOI: 10.1007/s11356-022-19935-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
With the rapid urbanization and industrialization in China, ozone pollution has become increasingly serious and poses a greater threat to human health. In this study, the spatiotemporal distribution of ozone pollution in China's cities and urban agglomerations from 2015 to 2019 was analyzed. The health effects and health economic costs of ozone pollution in China were estimated by applying the environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. The results are as follows: (1) ozone pollution was more serious in Chinese urban agglomerations from 2015 to 2019; (2) the hot spots of ozone concentration mainly distributed in the North China Plain, expanding from north to south; the cold spots decreased year by year and were located in the northeast, northwest, and southwest of China, shifting from northwest to southwest; (3) the seasonal average of ozone concentration in China was the highest in summer, followed by spring and autumn, and the lowest in winter; (4) the number of all-cause premature deaths of ozone pollution in China increased slowly from 2015 to 2019, and the average of urban agglomerations was significantly higher than cities, with similar spatial distribution characteristics as ozone concentration; (5) the health economic costs of ozone pollution from 2015 to 2019 slowly expanded to surrounding cities with Beijing, Shanghai, Xi'an, and Chongqing as the centers of high values, while the low value areas decreased year by year and were mainly concentrated in southwest and northeast China. The health economic costs of ozone pollution at urban agglomerations scale were higher in the eastern coastal regions and lower in the northwest inland regions. Thus, this study presents policy recommendations to provide decision-making reference for realizing the inter-regional prevention and control of ozone pollution.
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Affiliation(s)
- Dianyuan Zheng
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China
| | - Xiaojun Huang
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China.
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, Xi'an, 710127, China.
- Shaanxi Xi'an Urban Forest Ecosystem Research Station, Xi'an, 710127, China.
| | - Yuhui Guo
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China
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Keswani A, Akselrod H, Anenberg SC. Health and Clinical Impacts of Air Pollution and Linkages with Climate Change. NEJM EVIDENCE 2022; 1:EVIDra2200068. [PMID: 38319260 DOI: 10.1056/evidra2200068] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Air Pollution Impacts and Climate Change LinksAs part of the NEJM Group series on climate change, Keswani and colleagues review the linkages between climate change and air pollution and suggest strategies that clinicians may use to mitigate the adverse health impacts of air pollution.
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Affiliation(s)
- Anjeni Keswani
- Division of Allergy/Immunology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Hana Akselrod
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Susan C Anenberg
- George Washington University Milken Institute School of Public Health, Washington, DC
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17
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Yang L, Yang J, Liu M, Sun X, Li T, Guo Y, Hu K, Bell ML, Cheng Q, Kan H, Liu Y, Gao H, Yao X, Gao Y. Nonlinear effect of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China: A time-series analysis. ENVIRONMENTAL RESEARCH 2022; 209:112754. [PMID: 35074347 DOI: 10.1016/j.envres.2022.112754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Many studies have illustrated adverse effects of short-term exposure to air pollution on human health, which usually assumes a linear exposure-response (E-R) function in the delineation of health effects due to air pollution. However, nonlinearity may exist in the association between air pollutant concentrations and health outcomes such as adult pneumonia hospital visits, and there is a research gap in understanding the nonlinearity. Here, we utilized both the distributed lag model (DLM) and nonlinear model (DLNM) to compare the linear and nonlinear impacts of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China. While both models show adverse effects of air pollutants on adult pneumonia hospital visits, the DLNM shows an attenuation of E-R curves at high concentrations. Moreover, the DLNM may reveal delayed health effects that may be missed in the DLM, e.g., ozone exposure and pneumonia hospital visits. With the stratified analysis of air pollutants on adult pneumonia hospital visits, both models consistently reveal that the influence of air pollutants is higher during the cold season than during the warm season. Nevertheless, they may behave differently in terms of other subgroups, such as age, gender and visit types. For instance, while no significant impact due to PM2.5 in any of the subgroups abovementioned emerges based on DLM, the results from DLNM indicate statistically significant impacts for the subgroups of elderly, female and emergency department (ED) visits. With respect to adjustment by two-pollutants, PM10 effect estimates for pneumonia hospital visits were the most robust in both DLM and DLNM, followed by NO2 and SO2 based on the DLNM. Considering the estimated health effects of air pollution relying on the assumed E-R functions, our results demonstrate that the traditional linear association assumptions may overlook some potential health risks.
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Affiliation(s)
- Lingyue Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Jiuli Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Mingyang Liu
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China
| | - Xiaohui Sun
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, 266100, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing,100021, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, 06511, USA
| | - Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200433, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huiwang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Xiaohong Yao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Yang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China.
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18
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Association between Ambient Air Pollutants and Pneumonia in Wuhan, China, 2014–2017. ATMOSPHERE 2022. [DOI: 10.3390/atmos13040578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objectives: To assess associations between short-time air pollution exposure and outpatient visits for pneumonia by the distributed lag nonlinear model (DLNM). Methods: Daily outpatient visits for pneumonia and air pollutant data were collected from Wuhan Basic Medical Insurance Database in China and 10 national air quality monitoring stations in Wuhan from 2014 to 2017, respectively. Taking the first percentile of the concentration as the reference, DLNM was used to estimate the impact of moderate (50th) and high levels (99th) of pollutants on pneumonia. Results: A total of 133,882 outpatient visits were identified during the period of the study. Moderate-level (P50) fine particulate matter (PM2.5) or sulfur dioxide (SO2) and high-level nitrogen dioxide (NO2) (P99) can increase the risk of pneumonia. The maximum RR was 1.198 (95% CI: 1.094–1.311) at lag0-11, 1.304 (95% CI: 1.166–1.458) at lag0-13, and 1.286 (95% CI: 1.060–1.561) at lag0-14, respectively. Females and children had greater risks. Conclusions: Short-time PM2.5, SO2, and NO2 exposure were associated with outpatient visits for pneumonia in Wuhan, China.
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Lavigne E, Ryti N, Gasparrini A, Sera F, Weichenthal S, Chen H, To T, Evans GJ, Sun L, Dheri A, Lemogo L, Kotchi SO, Stieb D. Short-term exposure to ambient air pollution and individual emergency department visits for COVID-19: a case-crossover study in Canada. Thorax 2022; 78:459-466. [PMID: 35361687 PMCID: PMC8983401 DOI: 10.1136/thoraxjnl-2021-217602] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/09/2022] [Indexed: 12/23/2022]
Abstract
Background Ambient air pollution is thought to contribute to increased risk of COVID-19, but the evidence is controversial. Objective To evaluate the associations between short-term variations in outdoor concentrations of ambient air pollution and COVID-19 emergency department (ED) visits. Methods We conducted a case-crossover study of 78 255 COVID-19 ED visits in Alberta and Ontario, Canada between 1 March 2020 and 31 March 2021. Daily air pollution data (ie, fine particulate matter with diameter less than 2.5 µm (PM2.5), nitrogen dioxide (NO2) and ozone were assigned to individual case of COVID-19 in 10 km × 10 km grid resolution. Conditional logistic regression was used to estimate associations between air pollution and ED visits for COVID-19. Results Cumulative ambient exposure over 0–3 days to PM2.5 (OR 1.010; 95% CI 1.004 to 1.015, per 6.2 µg/m3) and NO2 (OR 1.021; 95% CI 1.015 to 1.028, per 7.7 ppb) concentrations were associated with ED visits for COVID-19. We found that the association between PM2.5 and COVID-19 ED visits was stronger among those hospitalised following an ED visit, as a measure of disease severity, (OR 1.023; 95% CI 1.015 to 1.031) compared with those not hospitalised (OR 0.992; 95% CI 0.980 to 1.004) (p value for effect modification=0.04). Conclusions We found associations between short-term exposure to ambient air pollutants and COVID-19 ED visits. Exposure to air pollution may also lead to more severe COVID-19 disease.
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Affiliation(s)
- Eric Lavigne
- Air Sectors Assessment and Exposure Science Division, Health Canada, Ottawa, Ontario, Canada .,School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.,Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK.,Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Scott Weichenthal
- Air Sectors Assessment and Exposure Science Division, Health Canada, Ottawa, Ontario, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Montreal, Montreal, Quebec, Canada
| | - Hong Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Teresa To
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital For Sick Children, Toronto, Ontario, Canada
| | - Greg J Evans
- Department of Chemical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Liu Sun
- Air Sectors Assessment and Exposure Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Aman Dheri
- Air Sectors Assessment and Exposure Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Lionnel Lemogo
- Environment and Climate Change Canada Montreal Office, Montreal, Ontario, Canada
| | - Serge Olivier Kotchi
- National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Ontario, Canada
| | - Dave Stieb
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
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20
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Lu W, Tian Q, Xu R, Zhong C, Qiu L, Zhang H, Shi C, Liu Y, Zhou Y. Short-term exposure to ambient air pollution and pneumonia hospital admission among patients with COPD: a time-stratified case-crossover study. Respir Res 2022; 23:71. [PMID: 35346202 PMCID: PMC8962484 DOI: 10.1186/s12931-022-01989-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pneumonia is a major contributor to hospital admission for patients with chronic obstructive pulmonary disease (COPD). However, evidence for acute effects of ambient air pollution exposure on pneumonia hospital admission among patients with COPD is scarce. We aimed to examine the association between short-term exposure to ambient air pollution and pneumonia hospital admission among patients with COPD. Methods We enrolled COPD cases aged ≥ 60 years old and further filtered those who were admitted into hospitals from pneumonia during 2016–2019 in Guangdong province, China for main analysis. A time-stratified case-crossover design was applied to investigate the association and conditional logistic regression model was used for data analysis. We performed inverse distance weighting method to estimate daily individual-level exposure on particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) based on personal residential addresses. Results We included 6473 pneumonia hospital admissions during the study period. Each interquartile range (IQR) increase in PM2.5 (lag 2; IQR, 22.1 μg/m3), SO2 (lag 03; IQR, 4.2 μg/m3), NO2 (lag 03; IQR, 21.4 μg/m3), and O3 (lag 04; IQR, 57.9 μg/m3) was associated with an odds ratio in pneumonia hospital admission of 1.043 (95% CI: 1.004–1.083), 1.081 (95% CI: 1.026–1.140), 1.045 (95% CI: 1.005–1.088), and 1.080 (95% CI: 1.018–1.147), respectively. Non-linear trends for PM2.5, PM10, and SO2 were observed in the study. Sex, age at hospital admission, and season at hospital admission did not modify the associations. Conclusions We found significantly positive associations of short-term exposure to PM2.5, SO2, NO2, and O3 with pneumonia hospital admission among COPD patients. It provides new insight for comprehensive pneumonia prevention and treatment among COPD patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01989-9.
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Affiliation(s)
- Wenfeng Lu
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.,School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Qi Tian
- Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, 510080, Guangdong, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Chenghui Zhong
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Lan Qiu
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Han Zhang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Chunxiang Shi
- National Meteorological Information Center, China Meteorological Administration, Beijing, 100081, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China. .,School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China.
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21
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Feng X, Shao L, Jones T, Li Y, Cao Y, Zhang M, Ge S, Yang CX, Lu J, BéruBé K. Oxidative potential and water-soluble heavy metals of size-segregated airborne particles in haze and non-haze episodes: Impact of the "Comprehensive Action Plan" in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 814:152774. [PMID: 34986423 DOI: 10.1016/j.scitotenv.2021.152774] [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: 10/19/2021] [Revised: 12/14/2021] [Accepted: 12/25/2021] [Indexed: 05/17/2023]
Abstract
Air pollution is a major environmental health challenge in megacities, and as such a Comprehensive Action Plan (CAP) was issued in 2017 for Beijing, the capital city of China. Here we investigated the size-segregated airborne particles collected after the implementation of the CAP, intending to understand the change of oxidative potential and water-soluble heavy metal (WSHM) levels in 'haze' and 'non-haze' days. The DNA damage and the levels of WSHM were analyzed by Plasmid Scission Assay (PSA) and High-Resolution Inductively Coupled Plasma Mass Spectrometry (HR-ICP-MS) techniques. The PM mass concentration was higher in the fine particle size (0.43-2.1 μm) during haze days, except for the samples affected by mineral dust. The particle-induced DNA damage caused by fine sized particles (0.43-2.1 μm) exceeded that caused by the coarse sized particles (4.7-10 μm). The DNA damage from haze day particles significantly exceeded those collected on non-haze days. Prior to the instigation of the CAP, the highest value of DNA damage decreased, and DNA damage was seen in the finer size (0.43-1.1 μm). The Pearson correlation coefficient between the concentrations of water-soluble Pb, Cr, Cd and Zn were positively correlated with DNA damage, suggesting that these WSHM had significant oxidative potential. The mass concentrations of water-soluble trace elements (WSTE) and individual heavy metals were enriched in the finer particles between 0.43 μm to 1.1 μm, implying that smaller sized particles posed higher health risks. In contrast, the significant reduction in the mass concentration of water-soluble Cd and Zn, and the decrease of the maximum and average values of DNA damage after the CAP, demonstrated its effectiveness in restricting coal-burning emissions. These results have demonstrated that the Beijing CAP policy has been successful in reducing the toxicity of 'respirable' ambient particles.
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Affiliation(s)
- Xiaolei Feng
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Longyi Shao
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China.
| | - Tim Jones
- School of Earth and Environmental Sciences, Cardiff University, Park Place, Cardiff CF10 3AT, Wales, UK
| | - Yaowei Li
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Yaxin Cao
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Mengyuan Zhang
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Shuoyi Ge
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Cheng-Xue Yang
- Institute of Earth Sciences, China University of Geosciences (Beijing), Beijing 100083, China
| | - Jing Lu
- State Key Laboratory of Coal Resources and Safe Mining, and College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Kelly BéruBé
- School of Biosciences, Cardiff University, Museum Avenue, Cardiff CF10 3AX, Wales, UK
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Czechowski PO, Piksa K, Da̧browiecki P, Oniszczuk-Jastrząbek AI, Czermański E, Owczarek T, Badyda AJ, Cirella GT. Financing Costs and Health Effects of Air Pollution in the Tri-City Agglomeration. Front Public Health 2022; 10:831312. [PMID: 35309195 PMCID: PMC8931043 DOI: 10.3389/fpubh.2022.831312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/02/2022] [Indexed: 02/01/2023] Open
Abstract
This paper examines the relationship between the presence of air pollution and incidence of selected respiratory diseases in the urban population of the Tri-City agglomeration. The study takes into consideration the specific character of the region, relating to coastal, and port-based shipping. Three research hypotheses formulated the study. General regression models were used to identify the health effects of air pollution and developed health costs were calculated in relation to the treatment of diseases. The findings have shown that air pollution and climatic conditions in the Tri-City aggravate the symptoms of bronchial asthma, while also increasing the number of cases of exacerbated chronic obstructive pulmonary disease and pneumonia. The evidence demonstrates the negative impact of shipping on the health condition of the inhabitants. The calculations have shown the extent of financial losses incurred in connection with the treatment of diseases found to have been caused by air pollution. The estimated health costs turned out to be significant for each of the examined diseases. The financial inefficiency of the Polish health care system has also been demonstrated. All the models have been identified for monthly data for the first time.
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Affiliation(s)
- Piotr O. Czechowski
- Faculty of Management and Quality Science, Gdynia Maritime University, Gdynia, Poland
| | - Konstancja Piksa
- Faculty of Management and Economics, Gdansk University of Technology, Gdansk, Poland
| | - Piotr Da̧browiecki
- Clinic of Infectious Diseases and Allergology, Military Institute of Medicine, Warsaw, Poland
| | | | | | - Tomasz Owczarek
- Faculty of Management and Quality Science, Gdynia Maritime University, Gdynia, Poland
| | - Artur J. Badyda
- Department of Informatics and Environment Quality Research, Faculty of Building Services, Hydro- and Environmental Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Giuseppe T. Cirella
- Faculty of Economics, University of Gdansk, Sopot, Poland
- *Correspondence: Giuseppe T. Cirella
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23
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Renzi M, Scortichini M, Forastiere F, De' Donato F, Michelozzi P, Davoli M, Gariazzo C, Viegi G, Stafoggia M, Ancona C, Bucci S, De' Donato F, Michelozzi P, Renzi M, Scortichini M, Stafoggia M, Bonafede M, Gariazzo C, Marinaccio A, Argentini S, Sozzi R, Bonomo S, Fasola S, Forastiere F, La Grutta S, Viegi G, Cernigliaro A, Scondotto S, Baldacci S, Maio S, Licitra G, Moro A, Angelini P, Bonvicini L, Broccoli S, Ottone M, Rossi PG, Colacci A, Parmagnani F, Ranzi A, Galassi C, Migliore E, Bisceglia L, Chieti A, Brusasca G, Calori G, Finardi S, Nanni A, Pepe N, Radice P, Silibello C, Tinarelli G, Uboldi F, Carlino G. A nationwide study of air pollution from particulate matter and daily hospitalizations for respiratory diseases in Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:151034. [PMID: 34666080 DOI: 10.1016/j.scitotenv.2021.151034] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND/AIM The relationship between air pollution and respiratory morbidity has been widely addressed in urban and metropolitan areas but little is known about the effects in non-urban settings. Our aim was to assess the short-term effects of PM10 and PM2.5 on respiratory admissions in the whole country of Italy during 2006-2015. METHODS We estimated daily PM concentrations at the municipality level using satellite data and spatiotemporal predictors. We collected daily counts of respiratory hospital admissions for each Italian municipality. We considered five different outcomes: all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), lower and upper respiratory tract infections (LRTI and URTI). Meta-analysis of province-specific estimates obtained by time-series models, adjusting for temperature, humidity and other confounders, was applied to extrapolate national estimates for each outcome. At last, we tested for effect modification by sex, age, period, and urbanization score. Analyses for PM2.5 were restricted to 2013-2015 cause the goodness of fit of exposure estimation. RESULTS A total of 4,154,887 respiratory admission were registered during 2006-2015, of which 29% for LRTI, 12% for COPD, 6% for URTI, and 3% for asthma. Daily mean PM10 and PM2.5 concentrations over the study period were 23.3 and 17 μg/m3, respectively. For each 10 μg/m3 increases in PM10 and PM2.5 at lag 0-5 days, we found excess risks of total respiratory diseases equal to 1.20% (95% confidence intervals, 0.92, 1.49) and 1.22% (0.76, 1.68), respectively. The effects for the specific diseases were similar, with the strongest ones for asthma and COPD. Higher effects were found in the elderly and in less urbanized areas. CONCLUSIONS Short-term exposure to PM is harmful for the respiratory system throughout an entire country, especially in elderly patients. Strong effects can be found also in less urbanized areas.
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Affiliation(s)
- Matteo Renzi
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy.
| | - Matteo Scortichini
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Francesco Forastiere
- CNR Institute of Biomedical Research and Innovation (IRIB), Palermo, Italy; Environmental Research Group, School of Public Health, Imperial College, London, UK
| | - Francesca De' Donato
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Paola Michelozzi
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Marina Davoli
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Monteporzio Catone (RM), Italy
| | - Giovanni Viegi
- CNR Institute of Biomedical Research and Innovation (IRIB), Palermo, Italy; CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
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24
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Ha S, Martinez V, Chan-Golston AM. Air pollution and preterm birth: A time-stratified case-crossover study in the San Joaquin Valley of California. Paediatr Perinat Epidemiol 2022; 36:80-89. [PMID: 34872160 DOI: 10.1111/ppe.12836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Air pollution is linked to preterm birth (PTB), but existing studies are primarily focused on chronic exposures, conducted in areas with moderate pollution, and/or subject to confounding. OBJECTIVES We investigated short-term associations between two pollutants [particulate matter <2.5 microns (PM2.5 ) and ozone] and PTB, and estimated excess PTB cases potentially attributed to these pollutants. METHODS This time-stratified case-crossover study includes 196,970 singleton pregnancies affected by PTB and early term birth from the San Joaquin Valley (SJV), California, USA (2007-2015). Daily ozone and PM2.5 concentrations were estimated by the SJV Air Pollution Control District and geospatially linked to maternal zip code. We used conditional logistic regression models to estimate the odds ratio (OR) and 95% confidence intervals (CI) for the associations between an interquartile range (IQR) increase in pollutants and very preterm (VPTB, 20-34 weeks), moderate preterm (MPTB, 34-36 weeks) and early term births (ETB, 37-38 weeks). We adjusted all models for co-pollutants and meteorological factors. RESULTS During warm seasons (May-October), an IQR increase in ozone was associated with 9-11% increased odds of VPTB from lag 0 (ORlag0 1.09, 95% CI 1.04,1.16) to lag 7 (ORlag7 1.11, 95% CI 1.04,1.16). Findings were consistent for MPTB and ETB. Ozone was potentially responsible for an excess of 3-6 VPTBs, 7-9 PTBs and 24-42 ETBs per 1,000 singleton deliveries. During cold seasons (November-April), increased PM2.5 exposure was associated with 5-6% increased odds of VPTB beginning at lag 3 (ORlag3 1.06, 95% CI 1.02,1.11). PM2.5 was associated with an excess of 1-3 VPTBs, 0-3 MPTBs and 6-18 ETBs per 1,000 singleton deliveries. CONCLUSIONS PM2.5 and ozone are associated with increased risk of VPTB, MPTB and ETB within one week of exposure and are potential contributors to the increasing PTB trend. More research is needed to further understand the role of air pollution on PTB risk.
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Affiliation(s)
- Sandie Ha
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced
| | - Valerie Martinez
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced
| | - Alec M Chan-Golston
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, California, USA
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25
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Kim KN, Lim YH, Bae S, Song IG, Kim S, Hong YC. Age-specific effects of ozone on pneumonia in Korean children and adolescents: A nationwide time-series study. Epidemiol Health 2021; 44:e2022002. [PMID: 34990535 PMCID: PMC8989473 DOI: 10.4178/epih.e2022002] [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: 07/31/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents. METHODS We performed quasi-Poisson regression analyses for individuals of 0-4 years, 5-9 years, 10-14 years, and 15-19 years of age using nationwide time-series data from the Korea (2011-2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants. RESULTS A 10.0-parts per billion increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0-4 (relative risk [RR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 5-9 years of age (RR, 1.06; 95% CI, 1.04 to 1.08), but not at 10-14 (RR, 1.01; 95% CI, 0.98 to 1.04) or 15-19 years of age (RR, 1.01; 95% CI, 0.97 to 1.06). The association between ozone and hospital admissions due to pneumonia was stronger in cool seasons (from November to April) than in warm seasons (from May to October), but was similar between boys and girls. CONCLUSIONS Short-term exposure to ozone was associated with a higher risk of pneumonia at 0-4 years and 5-9 years of age, but not at 10-14 years or 15-19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.
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Affiliation(s)
| | | | | | - In Gyu Song
- Korea University Guro Hospital, Seoul, Korea
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26
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Kumar A, Patel VS, Harding JN, You D, Cormier SA. Exposure to combustion derived particulate matter exacerbates influenza infection in neonatal mice by inhibiting IL22 production. Part Fibre Toxicol 2021; 18:43. [PMID: 34906172 PMCID: PMC8670221 DOI: 10.1186/s12989-021-00438-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023] Open
Abstract
Background Particulate matter (PM) containing environmentally persistent free radicals (EPFRs) are formed during various combustion processes, including the thermal remediation of hazardous wastes. Exposure to PM adversely affects respiratory health in infants and is associated with increased morbidity and mortality due to acute lower respiratory tract infections. We previously reported that early-life exposure to PM damages the lung epithelium and suppresses immune responses to influenza virus (Flu) infection, thereby enhancing Flu severity. Interleukin 22 (IL22) is important in resolving lung injury following Flu infection. In the current study, we determined the effects of PM exposure on pulmonary IL22 responses using our neonatal mouse model of Flu infection. Results Exposure to PM resulted in an immediate (0.5–1-day post-exposure; dpe) increase in IL22 expression in the lungs of C57BL/6 neonatal mice; however, this IL22 expression was not maintained and failed to increase with either continued exposure to PM or subsequent Flu infection of PM-exposed mice. This contrasts with increased IL22 expression in age-matched mice exposed to vehicle and Flu infected. Activation of the aryl hydrocarbon receptor (AhR), which mediates the induction and release of IL22 from immune cells, was also transiently increased with PM exposure. The microbiome plays a major role in maintaining epithelial integrity and immune responses by producing various metabolites that act as ligands for AhR. Exposure to PM induced lung microbiota dysbiosis and altered the levels of indole, a microbial metabolite. Treatment with recombinant IL22 or indole-3-carboxaldehyde (I3A) prevented PM associated lung injury. In addition, I3A treatment also protected against increased mortality in Flu-infected mice exposed to PMs. Conclusions Together, these data suggest that exposure to PMs results in failure to sustain IL22 levels and an inability to induce IL22 upon Flu infection. Insufficient levels of IL22 may be responsible for aberrant epithelial repair and immune responses, leading to increased Flu severity in areas of high PM.
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Affiliation(s)
- Avinash Kumar
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA.,Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, USA
| | - Vivek S Patel
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - Jeffrey N Harding
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - Dahui You
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Stephania A Cormier
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA. .,Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, USA.
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27
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Wang Y, Deng K. Environmental Risk Factors for Talaromycosis Hospitalizations of HIV-Infected Patients in Guangzhou, China: Case Crossover Study. Front Med (Lausanne) 2021; 8:731188. [PMID: 34881254 PMCID: PMC8645774 DOI: 10.3389/fmed.2021.731188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Talaromycosis is a fatal opportunistic infection prevalent in human immunodeficiency virus (HIV)-infected patients, previous studies suggest environmental humidity is associated with monthly talaromycosis hospitalizations of HIV-infected patients, but the acute risk factor remains uncertain. In this study, we evaluated the associations between talaromycosis hospitalizations of HIV-infected patients (n = 919) and environmental factors including meteorological variables and air pollutants at the event day (assumed "lag 0" since the exact infection date is hard to ascertain) and 1-7 days prior to event day (lag 1-lag 7) in conditional logistics regression models based on a case crossover design. We found that an interquartile range (IQR) increase in temperature at lag 0-lag 7 (odds ratio [OR] [95% CI] ranged from 1.748 [1.345-2.273] to 2.184 [1.672-2.854]), and an IQR increase in humidity at lag 0 (OR [95% CI] = 1.192 [1.052-1.350]), and lag 1 (OR [95% CI] = 1.199 [1.056-1.361]) were significantly associated with talaromycosis hospitalizations of HIV-infected patients. Besides, temperature was also a common predictor for talaromycosis in patients with co-infections including candidiasis (n = 386), Pneumocystis pneumonia (n = 183), pulmonary tuberculosis (n = 141), and chronic hepatitis (n = 158), while humidity was a specific risk factor for talaromycosis in patients with candidiasis, and an air pollutant, SO2, was a specific risk factor for talaromycosis in patients with Pneumocystis pneumonia. In an age stratified evaluation (cutoff = 50 years old), temperature was the only variable positively associated with talaromycosis in both younger and older patients. These findings broaden our understanding of the epidemiology and pathogenesis of talaromycosis in HIV-infected patients.
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Affiliation(s)
- Yaping Wang
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Kai Deng
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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Sherris AR, Begum BA, Baiocchi M, Goswami D, Hopke PK, Brooks WA, Luby SP. Associations between ambient fine particulate matter and child respiratory infection: The role of particulate matter source composition in Dhaka, Bangladesh. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 290:118073. [PMID: 34496331 DOI: 10.1016/j.envpol.2021.118073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
Air pollution in the form of fine particulate matter (PM2.5) has been linked to adverse respiratory outcomes in children. However, the magnitude of this association in South Asia and sources of PM2.5 that drive adverse health effects are largely unknown. This study evaluates associations between short-term variation in ambient PM2.5 and incidence of pneumonia and upper respiratory infections among children in Dhaka, Bangladesh. We also perform an exploratory analysis of the PM2.5 source composition that is most strongly associated with health endpoints. We leveraged data from health surveillance of children less than five years of age between 2005 and 2014 in Kamalapur, Bangladesh, including daily physician-confirmed diagnoses of pneumonia and upper respiratory infection. Twice-weekly source-apportioned ambient PM2.5 measurements were obtained for the same period, and Poisson regression adjusted for time-varying covariates was used to estimate lagged associations between ambient PM2.5 and respiratory infection. We use complementary matching and stratification approaches to evaluate whether these associations vary across PM2.5 source composition. Total PM2.5 mass was associated with a modest increase in incidence of pneumonia, with a peak effect size two days after exposure (rate ratio = 1.032; 95% confidence interval = 1.008-1.056). We did not identify a significant association between PM2.5 and upper respiratory infection. Stratified and matching analyses suggested this association was stronger among days when ambient PM2.5 had a higher mass percent associated with brick kiln and fugitive lead emissions.: This study suggests that elevated ambient PM2.5 contributes to increased incidence of child pneumonia in urban Dhaka, and that this relationship varies among days with different source composition of PM2.5.
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Affiliation(s)
- Allison R Sherris
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, USA.
| | - Bilkis A Begum
- Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh
| | - Michael Baiocchi
- Department of Epidemiology and Population Health, Stanford University, USA
| | - Doli Goswami
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, USA
| | | | - Stephen P Luby
- Center for Innovation in Global Health, Stanford University, USA
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Mendoza DL, Benney TM, Bares R, Crosman ET. Intra-city variability of fine particulate matter during COVID-19 lockdown: A case study from Park City, Utah. ENVIRONMENTAL RESEARCH 2021; 201:111471. [PMID: 34102162 PMCID: PMC8178539 DOI: 10.1016/j.envres.2021.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
Urban air quality is a growing concern due a range of social, economic, and health impacts. Since the SARS-CoV-19 pandemic began in 2020, governments have produced a range of non-medical interventions (NMIs) (e.g. lockdowns, stay-at-home orders, mask mandates) to prevent the spread of COVID-19. A co-benefit of NMI implementation has been the measurable improvement in air quality in cities around the world. Using the lockdown policy of the COVID-19 pandemic as a natural experiment, we traced the changing emissions patterns produced under the pandemic in a mid-sized, high-altitude city to isolate the effects of human behavior on air pollution. We tracked air pollution over time periods reflecting the Pre-Lockdown, Lockdown, and Reopening stages, using high quality, research grade sensors in both commercial and residential areas to better understand how each setting may be uniquely impacted by pollution downturn events. Based on this approach, we found the commercial area of the city showed a greater decrease in air pollution than residential areas during the lockdown period, while both areas experienced a similar rebound post lockdown. The easing period following the lockdown did not lead to an immediate rebound in human activity and the air pollution increase associated with reopening, took place nearly two months after the lockdown period ended. We hypothesize that differences in heating needs, travel demands, and commercial activity, are responsible for the corresponding observed changes in the spatial distribution of pollutants over the study period. This research has implications for climate policy, low-carbon energy transitions, and may even impact local policy due to changing patterns in human exposure that could lead to important public health outcomes, if left unaddressed.
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Affiliation(s)
- Daniel L Mendoza
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA; Department of City & Metropolitan Planning, University of Utah, 375 S 1530 E, Suite 220, Salt Lake City, UT 84112, USA; University of Utah School of Medicine, Pulmonary Division, 26 N 1900 E, Salt Lake City, UT 84132, USA.
| | - Tabitha M Benney
- Department of Political Science and Environmental Studies Program, University of Utah, 260 S Central Campus Drive, Salt Lake City, UT 84112, USA
| | - Ryan Bares
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA
| | - Erik T Crosman
- Department of Life, Earth and Environmental Sciences, West Texas A&M University, Natural Sciences Building 324, Canyon, TX 79016, USA
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Croft DP, Burton DS, Nagel DJ, Bhattacharya S, Falsey AR, Georas SN, Hopke PK, Johnston CJ, Kottmann RM, Litonjua AA, Mariani TJ, Rich DQ, Thevenet-Morrison K, Thurston SW, Utell MJ, McCall MN. The effect of air pollution on the transcriptomics of the immune response to respiratory infection. Sci Rep 2021; 11:19436. [PMID: 34593881 PMCID: PMC8484285 DOI: 10.1038/s41598-021-98729-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022] Open
Abstract
Combustion related particulate matter air pollution (PM) is associated with an increased risk of respiratory infections in adults. The exact mechanism underlying this association has not been determined. We hypothesized that increased concentrations of combustion related PM would result in dysregulation of the innate immune system. This epidemiological study includes 111 adult patients hospitalized with respiratory infections who underwent transcriptional analysis of their peripheral blood. We examined the association between gene expression at the time of hospitalization and ambient measurements of particulate air pollutants in the 28 days prior to hospitalization. For each pollutant and time lag, gene-specific linear models adjusting for infection type were fit using LIMMA (Linear Models For Microarray Data), and pathway/gene set analyses were performed using the CAMERA (Correlation Adjusted Mean Rank) program. Comparing patients with viral and/or bacterial infection, the expression patterns associated with air pollution exposure differed. Adjusting for the type of infection, increased concentrations of Delta-C (a marker of biomass smoke) and other PM were associated with upregulation of iron homeostasis and protein folding. Increased concentrations of black carbon (BC) were associated with upregulation of viral related gene pathways and downregulation of pathways related to antigen presentation. The pollutant/pathway associations differed by lag time and by type of infection. This study suggests that the effect of air pollution on the pathogenesis of respiratory infection may be pollutant, timing, and infection specific.
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Affiliation(s)
- Daniel P Croft
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA.
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA.
| | - David S Burton
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - David J Nagel
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Soumyaroop Bhattacharya
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Ann R Falsey
- Department of Medicine, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY, USA
| | - Steve N Georas
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Philip K Hopke
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Institute for a Sustainable Environment, and Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, USA
| | - Carl J Johnston
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - R Matthew Kottmann
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Augusto A Litonjua
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Thomas J Mariani
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally W Thurston
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Mark J Utell
- Department of Medicine, Pulmonary and Critical Care Medicine Division, University of Rochester Medical Center, 601 Elmwood Avenue Box 692, Rochester, NY, 14642, USA
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Matthew N McCall
- Environmental Health Science Center, University of Rochester Medical Center, Rochester, NY, USA
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
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Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021; 18:1087-1097. [PMID: 34242148 PMCID: PMC8328365 DOI: 10.1513/annalsats.202102-209st] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Pneumonia causes a significant burden of disease worldwide. Although all populations are at risk of pneumonia, those at extremes of age and those with immunosuppressive disorders, underlying respiratory disease, and critical illness are particularly vulnerable. Although clinical practice guidelines addressing the management and treatment of pneumonia exist, few of the supporting studies focus on the crucial contributions of the host in pneumonia pathogenesis and recovery. Such essential considerations include the host risk factors that lead to susceptibility to lung infections; biomarkers reflecting the host response and the means to pursue host-directed pneumonia therapy; systemic effects of pneumonia on the host; and long-term health outcomes after pneumonia. To address these gaps, the Pneumonia Working Group of the Assembly on Pulmonary Infection and Tuberculosis led a workshop held at the American Thoracic Society meeting in May 2018 with overarching objectives to foster attention, stimulate research, and promote funding for short-term and long-term investigations into the host contributions to pneumonia. The workshop involved participants from various disciplines with expertise in lung infection, pneumonia, sepsis, immunocompromised patients, translational biology, data science, genomics, systems biology, and clinical trials. This workshop report summarizes the presentations and discussions and important recommendations for future clinical pneumonia studies. These recommendations include establishing consensus disease and outcome definitions, improved phenotyping, development of clinical study networks, standardized data and biospecimen collection and protocols, and development of innovative trial designs.
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Mendoza DL, Benney TM, Boll S. Long-term analysis of the relationships between indoor and outdoor fine particulate pollution: A case study using research grade sensors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145778. [PMID: 33647662 PMCID: PMC9753328 DOI: 10.1016/j.scitotenv.2021.145778] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 05/03/2023]
Abstract
The growing concern of air quality and its associated health-related impacts has led to increased awareness of pollutant exposure. Most human populations spend the majority of their time indoors and the COVID-19 pandemic has likely exacerbated this behavior. While significant amounts of research have focused on outdoor air quality, to date there have been no studies that examined simultaneous long-term trends on indoor and outdoor air quality on a site using research-grade sensors. We measured fine particulate matter (PM2.5) for a year using sensors located on the rooftop, air handling room, and indoor office space in a building and captured the impacts of three types of regularly occurring elevated pollution events: wintertime atmospheric inversions, wildfires, and fireworks. The events had different magnitudes and durations, and infiltration rates varied for each event leading to dissimilar indoor air pollution levels. The building's air handling unit and different environmental conditions (lower indoor humidity and temperature during the winter) combined to reduce indoor pollution from inversion events however, particulate matter from wildfires and fireworks infiltrated at higher rates. Together, this suggests possible intervention strategies, such as ventilation rates and filter upgrades, that could be used to mitigate contaminant intrusion during elevated pollution events. This year-long study illustrates an array of ways that elevated pollution events interact with the protective effects that buildings have against air pollution for its occupants. Furthermore, we show that outdoor air pollution is an important variable to consider when studying indoor air quality as contaminant infiltration is strongly dependent on the specific pollution source.
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Affiliation(s)
- Daniel L Mendoza
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA; Department of City & Metropolitan Planning, University of Utah, 375 S 1530 E, Suite 220, Salt Lake City, Utah 84112, USA; University of Utah School of Medicine, Pulmonary Division, 26 N 1900 E, Salt Lake City, UT 84132, USA.
| | - Tabitha M Benney
- Department of Political Science, University of Utah, 260 S Central Campus Drive, Salt Lake City, UT 84112, USA
| | - Sarah Boll
- State of Utah, Division of Facilities Construction and Management, 4315 S 2700 W, Floor 3, Salt Lake City, UT 84129, USA
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Webb L, Sleeth DK, Handy R, Stenberg J, Schaefer C, Collingwood SC. Indoor Air Quality Issues for Rocky Mountain West Tribes. Front Public Health 2021; 9:606430. [PMID: 33748060 PMCID: PMC7973111 DOI: 10.3389/fpubh.2021.606430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Native American populations face considerable health disparities, especially among those who live on reservations, where access to healthcare, education, and safe housing can be limited. Previous research on tribal housing has raised concerns about housing construction, damage, and possible linkage to adverse health effects (e.g., asthma). This community-based participatory research (CBPR) project investigated indoor air quality issues on two Rocky Mountain west reservations. At the onset of the project, the research team formed a partnership with community advisory boards (CABs) consisting of representatives from tribal councils and community members. Research design, implementation, and dissemination all took place in full collaboration with the CABs following approval through official tribal resolutions. Residential homes were monitored for particulate matter with diameter <2.5 microns (PM2.5) and radon concentrations. Low-cost air quality sensors and activated charcoal radon test kits were placed in tribal households for 6-8 days. A large amount of data were below the sensor limit of quantification (LOQ), but several homes had daily averages that exceeded suggested PM2.5 guidelines, suggestive of the potential for high exposure. Additionally, nearly half of all homes sampled had radon levels above the EPA action level, with mitigation activities initiated for the most concerning homes. Findings from this study indicate the need for future community-wide assessments to determine the magnitude and patterns of indoor air quality issues.
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Affiliation(s)
- Logan Webb
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Darrah K Sleeth
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Rod Handy
- Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States
| | - Jared Stenberg
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Camie Schaefer
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Scott C Collingwood
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
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Kirwa K, Eckert CM, Vedal S, Hajat A, Kaufman JD. Ambient air pollution and risk of respiratory infection among adults: evidence from the multiethnic study of atherosclerosis (MESA). BMJ Open Respir Res 2021; 8:e000866. [PMID: 33664125 PMCID: PMC7934778 DOI: 10.1136/bmjresp-2020-000866] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution may affect the risk of respiratory infection, though research has focused on uncommon infections or infections in children. Whether ambient air pollutants increase the risk of common acute respiratory infections among adults is uncertain, yet this may help understand whether pollutants influence spread of pandemic respiratory infections like COVID-19. OBJECTIVE To estimate the association between ambient air pollutant exposures and respiratory infections in adults. METHODS During five study examinations over 12 years, 6536 participants in the multiethnic study of atherosclerosis (MESA) reported upper respiratory tract infections, bronchitis, pneumonia or febrile illness in the preceding 2 weeks. Using a validated spatiotemporal model, we estimated residential concentrations of ambient PM2.5, NOx and NO2 for the 2-6 weeks (short-term) and year (long-term) prior to each examination. RESULTS In this population aged 44-84 years at baseline, 10%-32% of participants reported a recent respiratory infection, depending on month of examination and study region. PM2.5, NOx and NO2 concentrations over the prior 2-6 weeks were associated with increased reporting of recent respiratory infection, with risk ratios (95% CIs) of 1.04 (1.00 to 1.09), 1.15 (1.10 to 1.20) and 1.21 (1.10 to 1.33), respectively, per increase from 25th to 75th percentile in residential pollutant concentration. CONCLUSION Higher short-term exposure to PM2.5 and traffic-related pollutants are associated with increased risk of symptomatic acute respiratory infections among adults. These findings may provide an insight into the epidemiology of COVID-19.
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Affiliation(s)
- Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Carly M Eckert
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA
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Zhang J, Ren D, Cao X, Wang T, Geng X, Li X, Tang J, Leng S, Wang H, Zheng Y. Ambient air pollutants and hospital visits for pneumonia: a case-crossover study in Qingdao, China. BMC Public Health 2021; 21:66. [PMID: 33413265 PMCID: PMC7791776 DOI: 10.1186/s12889-020-10065-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background Pneumonia is one of the principal reasons for incidence and death in the world. The former research mainly concentrated on specific sources of patients. Besides, due to the heterogeneity among regions, there are inconsistencies in the outcome of these surveys. To explore the relationship between atmospheric pollution and hospital visits for pneumonia under the climate and pollution conditions in Qingdao, we carried out this study. Methods The medical records of pneumonia patients were gathered from the affiliated hospital of Qingdao University during Jan 1st, 2014, and Dec 31st,2018. Daily concentrations of PM2.5, PM10, SO2, NO2, as well as CO, were collected from the national air quality monitoring stations in Qingdao. Case-crossover study design and conditional logistic regression model were used to estimate the associations. Daily temperature, relative humidity, and atmospheric pressure were adjusted as the covariates in all models. A principal component analysis was used to solve the multicollinearity between atmospheric pollutants and investigate the relationship between various air pollutants and pneumonia occurs. Results In the single pollutant model, with interquartile range increment of the density of PM2.5, PM10, NO2 and SO2 at the lag2 days, the odds ratio of hospital visits for pneumonia patients increased by 6.4% (95%CI, 2.3–10.7%), 7.7% (95%CI, 3.2–12.4%), 6.7% (95%CI, 1.0–12.7%), and 7.2% (95%CI, 1.1–13.5%). Stratified analysis showed that pollutants were more significant in the cold period. Besides, the impact of atmospheric particulates on different ages mainly occurs in the young child (0 to 3-year-old). The odds ratio was 1.042 (95%CI, 1.012–1.072) when the principal components of atmospheric pollutants were included in the conditional logistic model. Conclusions Our study found a significant relationship between short-term uncovering to PM2.5, PM10, NO2, SO2, and hospital visits for pneumonia in Qingdao. The effect of atmospheric pollutants mainly arose in a cold period. The particulate matter might be the principal reason in inducing hospital visits for pneumonia.
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Affiliation(s)
- Jianzhong Zhang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Dunqiang Ren
- Department of Respiratory Medicine and Critical care, The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, China
| | - Xue Cao
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Tao Wang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Xue Geng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Xin Li
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Jinglong Tang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Shuguang Leng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Hongmei Wang
- Department of Respiratory Medicine and Critical care, The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, China
| | - Yuxin Zheng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China.
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Zhou H, Geng H, Dong C, Bai T. The short-term harvesting effects of ambient particulate matter on mortality in Taiyuan elderly residents: A time-series analysis with a generalized additive distributed lag model. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 207:111235. [PMID: 32942099 DOI: 10.1016/j.ecoenv.2020.111235] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/17/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
The evaluation on mortality displacement and distributed lag effects of airborne particulate matter (PM) on death risks is important to understand the positive association of short-term pollution from both ambient PM10 and PM2.5 with daily mortality. Herein, short-term influences of urban PM10 and PM2.5 exposure on the mortality of respiratory diseases (RD) and cardiovascular diseases (CVD) were studied at Taiyuan, China, a typical inland city suffering from heavy ambient PM loading and having high morbidity of RD and CVD. Using a time-series analysis with generalized additive distributed lag model (DLM), the potential mortality displacement was determined and the single-day and cumulative lag-day effects of PM on mortality were estimated after the daily mass concentrations of urban PM2.5 and PM10 from January 2013 to October 2015 and the daily number of non-accidental death (NAD) and cause-specific mortality in the residents aged more than 65 years old were obtained. Results showed there were significant associations of PM2.5 and PM10 with daily mortality on the current day and within one week. And a statistically significant increase (P < 0.05) in the cumulative effect estimates of PM2.5 and PM10 on CVD, ischemic heart disease (IHD), and myocardial infarction (MI) mortality (as well as PM2.5 on NAD) was observed, while the associations of PM2.5 with RD and pneumonia mortality, PM10 with NAD and RD mortality were not statistically significant, when the exposure window was extended to lag 0-30 days. It was concluded that there were harvesting effects and cumulative effects of ambient PM2.5 and PM10 on the elderly residents' mortality due to RD and CVD at Taiyuan and they could be estimated quantitatively when the broader time window was used, suggesting that the underestimation on the association of ambient PM with non-accidental death can be avoided using the present method in our study.
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Affiliation(s)
- Huan Zhou
- Institute of Environmental Science, Shanxi University, Taiyuan, 030006, China
| | - Hong Geng
- Institute of Environmental Science, Shanxi University, Taiyuan, 030006, China.
| | - Chuan Dong
- Institute of Environmental Science, Shanxi University, Taiyuan, 030006, China.
| | - Tao Bai
- Department of pathology, the First Hospital of Shanxi Medical University, Taiyuan, 030001, China
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37
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Abstract
Multiple social and environmental justice concerns are linked to the urban form such as the distribution of socioeconomic class populations, healthcare spending, air pollution exposure, and human mobility. Because of this, the implications of the relationships between built urban form, sociodemographic factors, and air quality warrant analysis at a high spatial resolution. This study used 1m resolved LiDAR data to characterize land use in Salt Lake County, Utah, and associate it with sociodemographic and air quality data at the census block group and zip code levels. We found that increasing tree cover was associated with higher per capita income and lower minority populations while increasing built cover was linked to lower per capita income and higher minority populations. Air quality showed less strong correlations, however, decreased non-irrigated cover, increased built cover, and higher amounts of households living under poverty were related to higher long-term PM2.5 exposure. Due to regional air pollution concerns, several policy efforts have been undertaken to improve air quality and reduce negative health outcomes in Utah which are being informed by regulatory and research-grade air quality sensors.
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38
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Abstract
Globally, exposure to ambient air pollutants is responsible for premature mortality and is implicated in the development and exacerbation of several acute and chronic lung disease across all ages. In this article, we discuss the source apportionment of ambient pollutants and the respiratory health effects in humans. We specifically discuss the evidence supporting ambient pollution in the development of asthma and chronic obstructive pulmonary disease and acute exacerbations of each condition. Practical advice is given to health care providers in how to promote a healthy environment and advise patients with chronic conditions to avoid unsafe air quality.
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Affiliation(s)
- Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jahred Liddie
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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39
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DeMarco AL, Hardenbrook R, Rose J, Mendoza DL. Air Pollution-Related Health Impacts on Individuals Experiencing Homelessness: Environmental Justice and Health Vulnerability in Salt Lake County, Utah. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8413. [PMID: 33202942 PMCID: PMC7697557 DOI: 10.3390/ijerph17228413] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022]
Abstract
Experiences of homelessness, although widely varied, are characterized by extensive time in public spaces, often outdoors. However, there has been little empirical research about the ways in which environmental factors affect individuals experiencing homelessness (IEHs). Therefore, the purpose of this study was to use an environmental justice approach to understand how cardiopulmonary health of IEHs is affected by episodic poor air quality in Salt Lake County. It was hypothesized that people who had experienced unsheltered homelessness and those who had been experiencing homelessness for longer periods of time would report greater health difficulties from poor air quality exposure. Through a combination of in-person semistructured interviews with IEHs (n = 138) and access to corresponding state-based service provider databases, researchers examined both overall descriptives of and relationships between types (sheltered and unsheltered) and duration (chronic and nonchronic) of homelessness. More than 61% of IEHs reported physical reactions to air pollution, 37% reported air pollution-related emotional stress, and more than 89% had sought medical attention for a condition related to air pollution. Findings indicate that while IEHs report a number of health effects related to poor air quality, there were no significant differences between individuals based on either sheltered status or duration of their experiences of homelessness. This study provides an initial empirical inquiry to understand how environmental disamenities negatively influence IEHs, as well as noting that sheltered status and duration of homelessness are less impactful than originally hypothesized.
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Affiliation(s)
- Angelina L. DeMarco
- Department of Anthropology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Rebecca Hardenbrook
- Department of Mathematics, University of Utah, Salt Lake City, UT 84112, USA;
| | - Jeff Rose
- Department of Parks, Recreation, and Tourism, University of Utah, Salt Lake City, UT 84112, USA;
| | - Daniel L. Mendoza
- Department of City & Metropolitan Planning, University of Utah, Salt Lake City, UT 84112, USA
- Department of Atmospheric Sciences, University of Utah, Salt Lake City, UT 84112, USA
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40
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Mendoza DL, Pirozzi CS, Crosman ET, Liou TG, Zhang Y, Cleeves JJ, Bannister SC, Anderegg WRL, Robert P. Impact of low-level fine particulate matter and ozone exposure on absences in K-12 students and economic consequences. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:114052. [PMID: 36284641 PMCID: PMC9590406 DOI: 10.1088/1748-9326/abbf7a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
High air pollution levels are associated with school absences. However, low level pollution impacts on individual school absences are under-studied. Understanding the variability of pollution at individual schools within an urban region could improve school recess decisions, better identify local pollution sources, and improve local economic impact assessments by providing granular information relevant to specific schools. We modelled PM2.5 and ozone concentrations at 36 schools from July 2015 to June 2018 using data from a dense, research grade regulatory sensor network. We determined exposures and daily absences at each school. We used a generalized estimating equations model to retrospectively estimate rate ratios for association between outdoor pollutant concentrations and school absences. We estimated lost school revenue, productivity, and family economic burden. PM2.5 and ozone concentrations and absence rates vary across the School District. Pollution exposure was associated with a rate ratio as high as 1.02 absences per μg m-3 and 1.01 per ppb increase for PM2.5 and ozone, respectively. Significantly, even PM2.5 and ozone exposure below the air quality index breakpoints for good air quality (<12.1 μg m-3 and <55 ppb, respectively) was associated with positive rate ratios of absences: 1.04 per μg m-3 and 1.01 per ppb increase, respectively. Granular local measurements enabled demonstration of air pollution impacts that varied between schools and were undetectable with averaged pollution levels. Reducing pollution by 50% would save $426000 per year districtwide. Pollution reduction benefits would be greatest in schools located in socioeconomically disadvantaged areas. Heterogeneity in exposure, disproportionately affecting socioeconomically disadvantaged schools, points to the need for fine resolution exposure estimation. The economic cost of absences associated with air pollution is substantial even excluding indirect costs such as hospital visits and medication. These findings may help elucidate the differential burden on individual schools and inform local decisions about recess and regulatory considerations for localized pollution sources.
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Affiliation(s)
- Daniel L Mendoza
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, RM 819, Salt Lake City, UT 84112, United States of America
| | - Cheryl S Pirozzi
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
| | - Erik T Crosman
- Department of Life, Earth, and Environmental Sciences, West Texas A&M University, Happy State Bank Academic & Research Building, Suite 262, Canyon, TX 79016, United States of America
| | - Theodore G Liou
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
- Center for Quantitative Biology, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, United States of America
| | - Jessica J Cleeves
- Center for Science and Mathematics Education, University of Utah, 155 S 1452 E, RM 452, Salt Lake City, UT 84112, United States of America
| | - Stephen C Bannister
- Department of Economics, University of Utah, 260 Central Campus Drive, RM 4100, Salt Lake City, UT 84112, United States of America
| | - William R L Anderegg
- School of Biological Sciences, University of Utah, 257 S 1400 E, Salt Lake City, UT 84112, United States of America
| | - Paine Robert
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
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41
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Pompilio A, Di Bonaventura G. Ambient air pollution and respiratory bacterial infections, a troubling association: epidemiology, underlying mechanisms, and future challenges. Crit Rev Microbiol 2020; 46:600-630. [PMID: 33059504 DOI: 10.1080/1040841x.2020.1816894] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The World Health Organization attributed more than four million premature deaths to ambient air pollution in 2016. Numerous epidemiologic studies demonstrate that acute respiratory tract infections and exacerbations of pre-existing chronic airway diseases can result from exposure to ambient (outdoor) air pollution. In this context, the atmosphere contains both chemical and microbial pollutants (bioaerosols), whose impact on human health remains unclear. Therefore, this review: summarises the findings from recent studies on the association between exposure to air pollutants-especially particulate matter and ozone-and onset or exacerbation of respiratory infections (e.g. pneumonia, cystic fibrosis lung infection, and tuberculosis); discusses the mechanisms underlying the relationship between air pollution and respiratory bacterial infections, which is necessary to define prevention and treatment strategies; demonstrates the relevance of air pollution modelling in investigating and preventing the impact of exposure to air pollutants on human health; and outlines future actions required to improve air quality and reduce morbidity and mortality related to air pollution.
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Affiliation(s)
- Arianna Pompilio
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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42
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Ou JY, Kirchhoff AC, Hanson HA. Air Pollution across the Cancer Continuum: Extending Our Understanding of the Relationship between Environmental Exposures and Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1876-1879. [PMID: 33004409 DOI: 10.1158/1055-9965.epi-19-1588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 12/18/2022] Open
Abstract
Previous studies of the environment and cancer have focused on etiology, showing that extrinsic factors in the environment contribute to 70% to 90% of cancers. Cancer patients and survivors often continue to live in the same neighborhoods they resided in before their cancer diagnosis. Thus, patients and survivors are exposed to the same environmental contexts that likely contributed to their original cancer, but little is known about the health effects of continued exposure to carcinogens after a cancer diagnosis. This commentary provides a summary of studies of the association between PM2.5 and cancer mortality among patients and PM2.5 and posttreatment morbidity among cancer survivors, and proposes new directions and opportunities for future research on such topics.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Judy Y Ou
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah School of Medicine, Salt Lake City, Utah.,Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Heidi A Hanson
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah School of Medicine, Salt Lake City, Utah.,Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
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43
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Ran J, Zhao S, Han L, Peng Z, Wang MH, Qiu Y, He D. Initial COVID-19 Transmissibility and Three Gaseous Air Pollutants (NO 2, SO 2, and CO): A Nationwide Ecological Study in China. Front Med (Lausanne) 2020; 7:575839. [PMID: 33072788 PMCID: PMC7541936 DOI: 10.3389/fmed.2020.575839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/13/2020] [Indexed: 01/12/2023] Open
Abstract
In this study, we conducted an ecological study to examine their effects in the early phase of the pandemic (from December 2019 to February 2020) in China. We found that the associations between the average concentrations of NO2, SO2, and CO and the COVID-19 transmissibility are not statistically clear.
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Affiliation(s)
- Jinjun Ran
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Zhao
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Lefei Han
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Maggie H Wang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Yulan Qiu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
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44
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Chen YW, Huang MZ, Chen CL, Kuo CY, Yang CY, Chiang-Ni C, Chen YYM, Hsieh CM, Wu HY, Kuo ML, Chiu CH, Lai CH. PM 2.5 impairs macrophage functions to exacerbate pneumococcus-induced pulmonary pathogenesis. Part Fibre Toxicol 2020; 17:37. [PMID: 32753046 PMCID: PMC7409448 DOI: 10.1186/s12989-020-00362-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 07/03/2020] [Indexed: 02/06/2023] Open
Abstract
Background Pneumococcus is one of the most common human airway pathogens that causes life-threatening infections. Ambient fine particulate matter (PM) with aerodynamic diameter ≤ 2.5 μm (PM2.5) is known to significantly contribute to respiratory diseases. PM2.5-induced airway inflammation may decrease innate immune defenses against bacterial infection. However, there is currently limited information available regarding the effect of PM2.5 exposure on molecular interactions between pneumococcus and macrophages. Results PM2.5 exposure hampered macrophage functions, including phagocytosis and proinflammatory cytokine production, in response to pneumococcal infection. In a PM2.5-exposed pneumococcus-infected mouse model, PM2.5 subverted the pulmonary immune response and caused leukocyte infiltration. Further, PM2.5 exposure suppressed the levels of CXCL10 and its receptor, CXCR3, by inhibiting the PI3K/Akt and MAPK pathways. Conclusions The effect of PM2.5 exposure on macrophage activity enhances pneumococcal infectivity and aggravates pulmonary pathogenesis.
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Affiliation(s)
- Yu-Wen Chen
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Zi Huang
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chyi-Liang Chen
- Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chieh-Ying Kuo
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yu Yang
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chuan Chiang-Ni
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Ywan M Chen
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Ming Hsieh
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hui-Yu Wu
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Ling Kuo
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Hsun Chiu
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Ho Lai
- Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan. .,Department of Microbiology, School of Medicine, China Medical University, Taichung, Taiwan. .,Department of Nursing, Asia University, Taichung, Taiwan.
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45
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Wang C, Wolters PJ, Calfee CS, Liu S, Balmes JR, Zhao Z, Koyama T, Ware LB. Long-term ozone exposure is positively associated with telomere length in critically ill patients. ENVIRONMENT INTERNATIONAL 2020; 141:105780. [PMID: 32417614 PMCID: PMC7535086 DOI: 10.1016/j.envint.2020.105780] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/13/2020] [Accepted: 04/30/2020] [Indexed: 05/14/2023]
Abstract
RATIONALE Chronic air pollutant exposure has been associated with development of Acute Respiratory Distress Syndrome (ARDS) in patients at risk, particularly from severe trauma. We recently reported that shorter peripheral blood leukocyte (PBL) telomere length (TL) was associated with worse outcomes and higher severity of ARDS in critically ill patients. Since most major air pollutants are potent oxidants that can induce cellular oxidative stress, and oxidative stress can accelerate telomere shortening, we hypothesized that higher levels of chronic air pollutant exposure would be associated with shorter telomere length in critically ill patients including patients with ARDS. METHODS PBL-TL was measured in genomic DNA collected on the morning of ICU day 2 in 772 critically ill patients enrolled in a prospective observational study. Exposures to air pollutants including ozone (warm-season only), particulate matter < 2.5 µm (PM2.5), particulate matter < 10 µm (PM10), CO, NO2 and SO2, were estimated by weighted average of daily levels from all monitors within 50 km of each patient's residential address for the 3 years prior to admission. Associations of each air pollutant exposure and PBL-TL were investigated by multivariable linear regression models adjusting for age, ethnicity, sex, smoking history, alcohol abuse, insurance status, median household income, history of malignancy and APACHE II. RESULTS Contrary to our hypothesis, TL increased across exposure quartiles in both ozone and PM2.5 analyses (p < 0.05). In a regression model controlling for potential confounders, long term ozone exposure was significantly associated with an increase in TL in the entire cohort (0.31 kb per 10 ppb), as well as in subgroups with sepsis, trauma and ARDS (all p < 0.05). In multivariable models, entire-year exposure to PM2.5, PM10, CO, NO2 and SO2 was not associated with TL after adjustment for potential confounders. In an analysis restricted to warm-season levels to assess the effect of seasonality, higher warm-season PM2.5 and CO exposures were independently associated with longer TL. CONCLUSIONS Long-term exposure to ozone is associated with longer peripheral blood TL in critically ill patients. Further studies are needed to investigate the potential underlying mechanisms for this unexpected positive association between telomere length and air pollution exposure in critical illness.
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Affiliation(s)
- Chunxue Wang
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul J Wolters
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Carolyn S Calfee
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Shuo Liu
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Lorraine B Ware
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
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46
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Kim KN, Kim S, Lim YH, Song IG, Hong YC. Effects of short-term fine particulate matter exposure on acute respiratory infection in children. Int J Hyg Environ Health 2020; 229:113571. [PMID: 32554254 DOI: 10.1016/j.ijheh.2020.113571] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/14/2020] [Accepted: 05/25/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Previous studies on the association between fine particulate matter (PM2.5) exposure and acute respiratory infection in children are scarce and present inconsistent results. We estimated the association between short-term PM2.5 exposure and acute respiratory infection among children aged 0-4 years using a difference-in-differences approach. METHODS We used data on the daily PM2.5 concentrations, hospital admissions for acute respiratory infection, and meteorological factors of the 15 regions in the Republic of Korea (2013-2015). To estimate the cumulative effects, we used a difference-in-differences approach generalized to multiple spatial units (regions) and time periods (day) with distributed lag non-linear models. RESULTS With PM2.5 levels of 20.0 μg/m3 as a reference, PM2.5 levels of 30.0 μg/m3 were positively associated with the risk of acute upper respiratory infection (relative risk (RR) = 1.048, 95% confidence interval (CI): 1.028, 1.069) and bronchitis or bronchiolitis (RR = 1.060, 95% CI: 1.038, 1.082) but not with the risk of acute lower respiratory infection and pneumonia. PM2.5 levels of 40.0 μg/m3 were also positively associated with the risk of acute upper respiratory infection (RR = 1.083, 95% CI: 1.046, 1.122) and bronchitis or bronchiolitis (RR = 1.094, 95% CI: 1.054, 1.136). CONCLUSIONS We found the associations of short-term PM2.5 exposure with acute upper respiratory infection and bronchitis or bronchiolitis among children aged 0-4 years. As causal inference methods can provide more convincing evidence of the effects of PM2.5 levels on respiratory infections, public health policies and guidelines regarding PM2.5 need to be strengthened accordingly.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Public Health and Preventive Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soontae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, Republic of Korea
| | - Youn-Hee Lim
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - In Gyu Song
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Public Health and Preventive Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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47
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Huff RD, Carlsten C, Hirota JA. An update on immunologic mechanisms in the respiratory mucosa in response to air pollutants. J Allergy Clin Immunol 2020; 143:1989-2001. [PMID: 31176381 DOI: 10.1016/j.jaci.2019.04.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/16/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022]
Abstract
Every day, we breathe in more than 10,000 L of air that contains a variety of air pollutants that can pose negative consequences to lung health. The respiratory mucosa formed by the airway epithelium is the first point of contact for air pollution in the lung, functioning as a mechanical and immunologic barrier. Under normal circumstances, airway epithelial cells connected by tight junctions secrete mucus, airway surface lining fluid, host defense peptides, and antioxidants and express innate immune pattern recognition receptors to respond to inhaled foreign substances and pathogens. Under conditions of air pollution exposure, the defenses of the airway epithelium are compromised by reductions in barrier function, impaired host defense to pathogens, and exaggerated inflammatory responses. Central to the mechanical and immunologic changes induced by air pollution are activation of redox-sensitive pathways and a role for antioxidants in normalizing these negative effects. Genetic variants in genes important in epithelial cell function and phenotype contribute to a diversity of responses to air pollution in the population at the individual and group levels and suggest a need for personalized approaches to attenuate the respiratory mucosal immune responses to air pollution.
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Affiliation(s)
- Ryan D Huff
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Carlsten
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeremy A Hirota
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Firestone Institute for Respiratory Health, Division of Respirology, Department of Medicine, Hamilton, Ontario, Canada; McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Biology, University of Waterloo, Waterloo, Ontario, Canada.
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48
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Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, VanDerslice J, Kirchhoff AC. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev 2020; 29:1929-1939. [PMID: 32404444 DOI: 10.1158/1055-9965.epi-19-1363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/28/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM2.5) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM2.5. METHODS We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM2.5 and mortality. Among AYAs, we examined effect modification of PM2.5 and mortality by stage while controlling for cancer type. RESULTS Increases in PM2.5 per 5 μg/m3 were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR5-year = 1.32 (1.02-1.71)]. Among AYAs, PM2.5 per 5 μg/m3 was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR5-year = 1.06 (1.01-1.13)]. PM2.5 ≥12 μg/m3 was associated with cancer mortality among breast [HR5-year = 1.50 (1.29-1.74); HR10-year = 1.30 (1.13-1.50)] and colorectal cancers [HR5-year = 1.74 (1.29-2.35); HR10-year = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk. CONCLUSIONS PM2.5 was associated with mortality in pediatric and AYA patients with specific cancers. IMPACT Limiting PM2.5 exposure may be important for young cancer patients with certain cancers.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Judy Y Ou
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah.
| | - Heidi A Hanson
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joemy M Ramsay
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | - Heydon K Kaddas
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | | | - Claire L Leiser
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - James VanDerslice
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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The Association between Respiratory Infection and Air Pollution in the Setting of Air Quality Policy and Economic Change. Ann Am Thorac Soc 2020; 16:321-330. [PMID: 30398895 PMCID: PMC6394122 DOI: 10.1513/annalsats.201810-691oc] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Fine particulate matter air pollution of 2.5 μm or less in diameter (PM2.5) has been associated with an increased risk of respiratory disease, but assessments of specific respiratory infections in adults are lacking. OBJECTIVES To estimate the rate of respiratory infection healthcare encounters in adults associated with acute increases in PM2.5 concentrations. METHODS Using case-crossover methods, we studied 498,118 adult New York State residents with a primary diagnosis of influenza, bacterial pneumonia, or culture-negative pneumonia upon hospitalization or emergency department (ED) visit (2005-2016). We estimated the relative rate of healthcare encounters associated with increases in PM2.5 in the previous 1-7 days and explored differences before (2005-2007), during (2008-2013), and after (2014-2016) implementation of air quality policies and economic changes. RESULTS Interquartile range increases in PM2.5 over the previous 7 days were associated with increased excess rates (ERs) of culture-negative pneumonia hospitalizations (2.5%; 95% confidence interval [CI], 1.7-3.2%) and ED visits (2.5%; 95% CI, 1.4-3.6%), and increased ERs of influenza ED visits (3.9%; 95% CI, 2.1-5.6%). Bacterial pneumonia hospitalizations, but not ED visits, were associated with increases in PM2.5 and, though imprecise, were of a similar magnitude to culture-negative pneumonia (Lag Day 6 ER, 2.3%; 95% CI, 0.3-4.3). Increased relative rates of influenza ED visits and culture-negative pneumonia hospitalizations were generally larger in the "after" period (P < 0.025 for both outcomes), compared with the "during" period, despite reductions in overall PM2.5 concentrations. CONCLUSIONS Increased rates of culture-negative pneumonia and influenza were associated with increased PM2.5 concentrations during the previous week, which persisted despite reductions in PM2.5 from air quality policies and economic changes. Though unexplained, this temporal variation may reflect altered toxicity of different PM2.5 mixtures or increased pathogen virulence.
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Sun S, Sarkar C, Kumari S, James P, Cao W, Lee RSY, Tian L, Webster C. Air pollution associated respiratory mortality risk alleviated by residential greenness in the Chinese Elderly Health Service Cohort. ENVIRONMENTAL RESEARCH 2020; 183:109139. [PMID: 31999997 PMCID: PMC9847333 DOI: 10.1016/j.envres.2020.109139] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Although residing in lower surrounding greenness and transient exposure to air pollution are independently associated with higher risk of adverse health outcomes, little is known about their interactions. OBJECTIVES We examine whether residential neighborhood greenness modifies the short-term association between air pollution and respiratory mortality among the participants of Chinese Elderly Health Service Cohort in Hong Kong. METHODS We estimated residential surrounding greenness by measuring satellite-derived normalized difference vegetation index (NDVI) from Landsat within catchments of residential addresses of participants who died of respiratory diseases between 1998 and 2011. We first dichotomized NDVI into low and high greenness and used a time-stratified case-crossover approach to estimate the percent excess risk of respiratory mortality associated with fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), and ozone (O3). We further classified NDVI into greenness quartiles and introduced an interaction term between air pollution and the assigned median values of the NDVI quartiles into the models to assess the trend of greenness modification on the air pollution and respiratory mortality associations. RESULTS Among 3159 respiratory deaths during the follow-up, 2058 were from pneumonia and 947 from chronic obstructive pulmonary disease. Elders living in the low greenness areas were associated with a higher risk of pneumonia mortality attributed to NO2 (p = 0.049) and O3 (p = 0.025). The mortality risk of pneumonia showed a decreasing trend for NO2 (p for trend = 0.041), O3 (p for trend = 0.006), and PM2.5 (p for trend = 0.034) with greenness quartiles increasing from Quartile 1 (lowest) to Quartile 4 (highest). CONCLUSIONS Our findings suggest that elders living in higher greenness areas are less susceptible to pneumonia mortality associated with air pollution, which provides evidence for optimizing allocation, siting, and quality of urban green space to minimize detrimental health effects of air pollution.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Chinmoy Sarkar
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region.
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, 02906, USA
| | - Ruby Siu-Yin Lee
- Elderly Health Service, Department of Health, Hong Kong Special Administrative Region
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region
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