1
|
Wang J, Xu W, Tian X, Yang Y, Wang ST, Xu KF. Lung function and air pollution exposure in adults with asthma in Beijing: a 2-year longitudinal panel study. Front Med 2022; 16:574-583. [PMID: 35079979 DOI: 10.1007/s11684-021-0882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
The effect of air pollution on the lung function of adults with asthma remains unclear to date. This study followed 112 patients with asthma at 3-month intervals for 2 years. The pollutant exposure of the participants was estimated using the inverse distance weight method. The participants were divided into three groups according to their lung function level at every visit. A linear mixed-effect model was applied to predict the change in lung function with each unit change in pollution concentration. Exposure to carbon monoxide (CO) and particles less than 2.5 micrometers in diameter (PM2.5) was negatively associated with large airway function in participants. In the severe group, exposure to chronic sulfur dioxide (SO2) was negatively associated with post-bronchodilator forced expiratory flow at 50%, between 25% and 75% of vital capacity % predicted (change of 95% CI per unit: -0.34 (-0.55, -0.12), -0.24 (-0.44, -0.03), respectively). In the mild group, the effect of SO2 on the small airways was similar to that in the severe group, and it was negatively associated with large airway function. Exposure to CO and PM2.5 was negatively associated with the large airway function of adults with asthma. The negative effects of SO2 were more evident and widely observed in adults with severe and mild asthma than in adults with moderate asthma. Patients with asthma react differently to air pollutants as evidenced by their lung function levels.
Collapse
Affiliation(s)
- Jun Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Wenshuai Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xinlun Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yanli Yang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Shao-Ting Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Kai-Feng Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| |
Collapse
|
2
|
Rivera Rivera NY, Tamayo-Ortiz M, Mercado García A, Just AC, Kloog I, Téllez-Rojo MM, Wright RO, Wright RJ, Rosa MJ. Prenatal and early life exposure to particulate matter, environmental tobacco smoke and respiratory symptoms in Mexican children. ENVIRONMENTAL RESEARCH 2021; 192:110365. [PMID: 33223137 PMCID: PMC7736115 DOI: 10.1016/j.envres.2020.110365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Exposure to particulate matter <2.5 μm in diameter (PM2.5) and environmental tobacco smoke (ETS) are associated with respiratory morbidity starting in utero. However, their potential synergistic effects have not been completely elucidated. Here, we examined the joint effects of prenatal and early life PM2.5 and prenatal ETS exposure on respiratory outcomes in children. MATERIAL AND METHODS We studied 536 mother-child dyads in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study in Mexico City. Exposure to PM2.5 was estimated using residence in pregnancy and child's first year of life with a satellite-based spatio-temporal model. ETS exposure was assessed by caregiver's report of any smoker in the household during the second or third trimester. Outcomes included report of ever wheeze and wheeze in the past 12 months (current wheeze) assessed when children were 6-8 years old considered in separate models. Associations were modeled using distributed lag models (DLM) with daily PM2.5 averages for pregnancy and the first year of life, adjusting for child's sex, birth weight z-score, mother's age and education at enrollment, maternal asthma, season of conception and stratified by prenatal ETS exposure (yes/no). RESULTS We identified a sensitive window from gestational week 14 through postnatal week 18 during which PM2.5 was associated with higher risk of ever wheeze at age 6-8 years. We also observed a critical window of PM2.5 exposure between postnatal weeks 6-39 and higher risk of current wheeze. We found significant associations between higher prenatal and early life PM2.5 exposure and higher cumulative risk ratios of ever wheeze (RR:3.76, 95%CI [1.41, 10.0] per 5 μg/m3) and current wheeze in the past year (RR:7.91, 95%CI [1.5, 41.6] per 5 μg/m3) only among children born to mothers exposed to ETS in pregnancy when compared to mothers who were not exposed. CONCLUSIONS Exposure to prenatal ETS modified the association between prenatal and early life PM2.5 exposure and respiratory outcomes at age 6-8 years. It is important to consider concurrent chemical exposures to more comprehensively characterize children's environmental risk. Interventions aimed at decreasing passive smoking might mitigate the effects of ambient air pollution.
Collapse
Affiliation(s)
- Nadya Y Rivera Rivera
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marcela Tamayo-Ortiz
- National Council of Science and Technology (CONACYT) - National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Adriana Mercado García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. Beer Sheva, Israel; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
3
|
Gentile DA, Morphew T, Elliott J, Presto AA, Skoner DP. Asthma prevalence and control among schoolchildren residing near outdoor air pollution sites. J Asthma 2020; 59:12-22. [PMID: 33104451 DOI: 10.1080/02770903.2020.1840584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Outdoor air pollution (OAP) contributes to poor asthma outcomes and remains a public health concern in Pittsburgh. The purpose of this study was to determine the prevalence of childhood asthma and its rate of control among Pittsburgh schoolchildren residing near OAP sites. METHODS Participants were recruited from schools near OAP sites. Asthma prevalence and control were assessed using a validated survey. Demographics and socioeconomic status were collected by survey, BMI was calculated, secondhand smoke (SHS) exposure was assessed by salivary cotinine levels, and OAP was assessed by mobile platform monitoring. Multivariate analysis adjusted for confounders. RESULTS In 1202 Pittsburgh elementary school students surveyed, 50.9% were female, average age was 8.5 years (SD = 1.9), 52.2% were African American and 60.6% had public health insurance. SHS exposure was relatively high at 33.9%, 17.1% of students were obese, and 70% had exposure to particulate matter (PM2.5) greater than the World Health Organization standard of 10 μg/m3. Overall prevalence of asthma was 22.5% with PM2.5, nitric oxide (NOx), sulfur (S), and zinc (Zn) significantly related to odds of asthma. Among the 270 children previously diagnosed with asthma, 59.3% were not well controlled with PM2.5, black carbon, and silicon (Si) significantly related to odds of uncontrolled asthma. CONCLUSIONS These results demonstrate that asthma prevalence and poor disease control are significantly elevated in Pittsburgh schoolchildren exposed to high levels of OAP. Future efforts need to focus on primary prevention of asthma by reducing exposure to OAP in at risk populations.
Collapse
Affiliation(s)
- Deborah A Gentile
- Division of Clinical Research, Allergy and Asthma Wellness Centers, Butler, PA, USA
| | | | | | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - David P Skoner
- Division of Pediatric Allergy/Immunology, West Virginia University, Morgantown, WV, USA
| |
Collapse
|
4
|
Veremchuk LV, Mineeva EE, Vitkina TI, Grigorieva EA, Gvozdenko TA, Golokhvast KS. The response ranges of pulmonary function and the impact criteria of weather and industrial influence on patients with asthma living in Vladivostok. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:235-242. [PMID: 32399235 PMCID: PMC7203380 DOI: 10.1007/s40201-020-00458-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To determine the response of pulmonary function (PF) to the influence of environmental factors in patients with different levels of asthma control. MATERIALS AND METHODS Patients with controlled (136 people) and uncontrolled (96 people) asthma living in the conditions of monsoon climate and technogenic pollution in Vladivostok were examined. Discriminant analysis that provides the basis for dividing initial data into classes, as according to standards and expert estimates, was used to calculate ranges of PF response in asthma patients. The selection of discriminant functions with the highest values of constant and coefficient made it possible to identify the optimal quantitative ranges. RESULTS Analysis of the discriminant value of Wilks' lambda (α) has shown that the intensity of PF response to climatic and technogenic factors varies depending on level of disease control (controlled asthma - α = 0.67-0.79, uncontrolled asthma - α =0.05-0.44). The criteria and ranges of PF response also differ depending on level of disease control. In controlled asthma, PF response reflects an adaptive-compensatory dependence. The reaction to the environmental factors is rather weak; therefore, it could be detected by only more sensitive examination method (body plethysmography). In uncontrolled asthma, the response to the influence of environment quality is active and could be clearly identified by spirography. CONCLUSIONS The climatic and technogenic environment of Vladivostok causes strong pathogenic impact on patients with uncontrolled asthma. The effects of dust fraction 0-1 μm, deeply penetrating into respiratory organs, and day-to-day variability of wind speed, which induces weather sensitivity, are particularly adverse.
Collapse
Affiliation(s)
- Lyudmila V. Veremchuk
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena E. Mineeva
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Tatyana I. Vitkina
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena A. Grigorieva
- Institute for Complex Analysis of Regional Problems Far Eastern Branch of Russian Academy of Sciences, Birobidzhan, Russian Federation
| | - Tatyana A. Gvozdenko
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Kirill S. Golokhvast
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
- Far Eastern Federal University, Vladivostok, Russian Federation
| |
Collapse
|
5
|
Davila Cordova JE, Tapia Aguirre V, Vasquez Apestegui V, Ordoñez Ibarguen L, Vu BN, Steenland K, Gonzales Rengifo GF. Association of PM 2.5 concentration with health center outpatient visits for respiratory diseases of children under 5 years old in Lima, Peru. Environ Health 2020; 19:7. [PMID: 31941512 PMCID: PMC6964058 DOI: 10.1186/s12940-020-0564-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/07/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Lima is one of the more polluted cities in Latin America. High levels of PM2.5 have been shown to increase health center outpatient visits of respiratory diseases. METHODS Health center outpatient visits for children < 5 years for childhood respiratory disease (acute lower respiratory infections (ALRI), pneumonia and acute bronchiolitis/asthma) from 498 public clinics in Lima were available on a weekly basis from 2011 to 2015 from Peru's Ministry of Health (MINSA). The association between the average weekly concentrations of PM2.5 was evaluated in relation to the number of weekly health center outpatient visits for children. Weekly PM2.5 values were estimated using a recently developed model that combined data observed from ground monitors, with data from space satellite and meteorology. Ground monitoring data came from 10 fixed stations of the Peruvian National Service of Meteorology and Hydrology (SENAMHI) and from 6 mobile stations located in San Juan de Miraflores by Johns Hopkins University. We conducted a time-series analysis using a negative binomial model. RESULTS We found a significant association between exposure to PM2.5 and all three types of respiratory diseases, across all age groups. For an interquartile increase in PM2.5, we found an increase of 6% for acute lower respiratory infections, an increase of 16-19% for pneumonia, and an increase of 10% for acute bronchiolitis / asthma. CONCLUSIONS Higher emissions of environmental pollutants such as PM2,5 could be a trigger for the increase of health center outpatients visits for respiratory diseases (ALRI, pneumonia and asthma), which are themselves risk factors for mortality for children in Lima province, Peru.
Collapse
Affiliation(s)
- Jennifer Estefanía Davila Cordova
- Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Vilma Tapia Aguirre
- Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Vanessa Vasquez Apestegui
- Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Bryan N. Vu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | - Gustavo F. Gonzales Rengifo
- Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
6
|
Brakema EA, Tabyshova A, van der Kleij RMJJ, Sooronbaev T, Lionis C, Anastasaki M, An PL, Nguyen LT, Kirenga B, Walusimbi S, Postma MJ, Chavannes NH, van Boven JFM. The socioeconomic burden of chronic lung disease in low-resource settings across the globe - an observational FRESH AIR study. Respir Res 2019; 20:291. [PMID: 31864411 PMCID: PMC6925865 DOI: 10.1186/s12931-019-1255-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/05/2019] [Indexed: 01/01/2023] Open
Abstract
Background Low-resource settings are disproportionally burdened by chronic lung disease due to early childhood disadvantages and indoor/outdoor air pollution. However, data on the socioeconomic impact of respiratory diseases in these settings are largely lacking. Therefore, we aimed to estimate the chronic lung disease-related socioeconomic burden in diverse low-resource settings across the globe. To inform governmental and health policy, we focused on work productivity and activity impairment and its modifiable clinical and environmental risk factors. Methods We performed a cross-sectional, observational FRESH AIR study in Uganda, Vietnam, Kyrgyzstan, and Greece. We assessed the chronic lung disease-related socioeconomic burden using validated questionnaires among spirometry-diagnosed COPD and/or asthma patients (total N = 1040). Predictors for a higher burden were studied using multivariable linear regression models including demographics (e.g. age, gender), health parameters (breathlessness, comorbidities), and risk factors for chronic lung disease (smoking, solid fuel use). We applied identical models per country, which we subsequently meta-analyzed. Results Employed patients reported a median [IQR] overall work impairment due to chronic lung disease of 30% [1.8–51.7] and decreased productivity (presenteeism) of 20.0% [0.0–40.0]. Remarkably, work time missed (absenteeism) was 0.0% [0.0–16.7]. The total population reported 40.0% [20.0–60.0] impairment in daily activities. Breathlessness severity (MRC-scale) (B = 8.92, 95%CI = 7.47–10.36), smoking (B = 5.97, 95%CI = 1.73–10.22), and solid fuel use (B = 3.94, 95%CI = 0.56–7.31) were potentially modifiable risk factors for impairment. Conclusions In low-resource settings, chronic lung disease-related absenteeism is relatively low compared to the substantial presenteeism and activity impairment. Possibly, given the lack of social security systems, relatively few people take days off work at the expense of decreased productivity. Breathlessness (MRC-score), smoking, and solid fuel use are potentially modifiable predictors for higher impairment. Results warrant increased awareness, preventive actions and clinical management of lung diseases in low-resource settings from health policymakers and healthcare workers.
Collapse
Affiliation(s)
- Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands.
| | - Aizhamal Tabyshova
- Pulmonary Department, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.,Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rianne M J J van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Talant Sooronbaev
- Pulmonary Department, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Marilena Anastasaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Pham Le An
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Bruce Kirenga
- Department of Medicine and Makerere Lung Institute, Makerere University, Kampala, Uganda
| | - Simon Walusimbi
- Department of Medicine and Makerere Lung Institute, Makerere University, Kampala, Uganda
| | - Maarten J Postma
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Job F M van Boven
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | | |
Collapse
|
7
|
Air Pollution, Asthma, and Sleep Apnea: New Epidemiological Links? Ann Am Thorac Soc 2019; 16:307-308. [PMID: 31339334 DOI: 10.1513/annalsats.201812-924ed] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|