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Álvaro-Meca A, Goez MDC, Resino R, Matías V, Sepúlveda-Crespo D, Martínez I, Resino S. Environmental factors linked to hospital admissions in young children due to acute viral lower respiratory infections: A bidirectional case-crossover study. ENVIRONMENTAL RESEARCH 2022; 212:113319. [PMID: 35447151 DOI: 10.1016/j.envres.2022.113319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/14/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the association of the short-term exposure to environmental factors (relative humidity, temperature, NO2, SO2, O3, PM10, and CO) with hospital admissions due to acute viral lower respiratory infections (ALRI) in children under two years before the COVID-19 era. METHODS We performed a bidirectional case-crossover study in 30,445 children with ALRI under two years of age in the Spanish Minimum Basic Data Set (MBDS) from 2013 to 2015. Environmental data were obtained from Spain's State Meteorological Agency (AEMET). The association was assessed by conditional logistic regression. RESULTS Lower temperature one week before the day of the event (hospital admission) (q-value = 0.012) and higher relative humidity one week (q-value = 0.003) and two weeks (q-value<0.001) before the day of the event were related to a higher odds of hospital admissions. Higher NO2 levels two weeks before the event were associated with hospital admissions (q-value<0.001). Moreover, higher concentrations on the day of the event for SO2 (compared to lag time of 1-week (q-value = 0.026) and 2-weeks (q-value<0.001)), O3 (compared to lag time of 3-days (q-value<0.001), 1-week (q-value<0.001), and 2-weeks (q-value<0.001)), and PM10 (compared to lag time of 2-weeks (q-value<0.001)) were related to an increased odds of hospital admissions for viral ALRI. CONCLUSION Short-term exposure to environmental factors (climatic conditions and ambient air contaminants) was linked to a higher likelihood of hospital admissions due to ALRI. Our findings emphasize the importance of monitoring environmental factors to assess the odds of ALRI hospital admissions and plan public health resources.
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Affiliation(s)
- Alejandro Álvaro-Meca
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rosa Resino
- Departamento de Geografía Humana, Facultad de Geografía e Historia, Universidad Complutense de Madrid. Madrid, Spain
| | - Vanesa Matías
- Servicio de Pedíatría, Hospital Clínico Universitario, Valladolid, Spain
| | - Daniel Sepúlveda-Crespo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Isidoro Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid. Spain.
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A Machine Learning-Based Study of the Effects of Air Pollution and Weather in Respiratory Disease Patients Visiting Emergency Departments. Emerg Med Int 2022; 2022:4462018. [PMID: 35154829 PMCID: PMC8828357 DOI: 10.1155/2022/4462018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background. To date, investigating respiratory disease patients visiting the emergency departments related with fined dust is limited. This study aimed to analyze the effects of two variable-weather and air pollution on respiratory disease patients who visited emergency departments. Methods. This study utilized the National Emergency Department Information System (NEDIS) database. The meteorological data were obtained from the National Climate Data Service. Each weather factor reflected the accumulated data of 4 days: a patient’s visit day and 3 days before the visit day. We utilized the RandomForestRegressor of scikit-learn for data analysis. Result. The study included 525,579 participants. This study found that multiple variables of weather and air pollution influenced the respiratory diseases of patients who visited emergency departments. Most of the respiratory disease patients had acute upper respiratory infections [J00–J06], influenza [J09–J11], and pneumonia [J12–J18], on which PM10 following temperature and steam pressure was the most influential. As the top three leading causes of admission to the emergency department, pneumonia [J12–J18], acute upper respiratory infections [J00–J06], and chronic lower respiratory diseases [J40–J47] were highly influenced by PM10. Conclusion. Most of the respiratory patients visiting EDs were diagnosed with acute upper respiratory infections, influenza, and pneumonia. Following temperature, steam pressure and PM10 had influential relations with these diseases. It is expected that the number of respiratory disease patients visiting the emergency departments will increase by day 3 when the steam pressure and temperature values are low, and the variables of air pollution are high. The number of respiratory disease patients visiting the emergency departments will increase by day 3 when the steam pressure and temperature values are low, and the variables of air pollution are high.
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Gladson LA, Cromar KR, Ghazipura M, Knowland KE, Keller CA, Duncan B. Communicating respiratory health risk among children using a global air quality index. ENVIRONMENT INTERNATIONAL 2022; 159:107023. [PMID: 34920275 DOI: 10.1016/j.envint.2021.107023] [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: 07/12/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Air pollution poses a serious threat to children's respiratory health around the world. Satellite remote-sensing technology and air quality models can provide pollution data on a global scale, necessary for risk communication efforts in regions without ground-based monitoring networks. Several large centers, including NASA, produce global pollution forecasts that may be used alongside air quality indices to communicate local, daily risk information to the public. Here we present a health-based, globally applicable air quality index developed specifically to reflect the respiratory health risks among children exposed to elevated outdoor air pollution. Additive, excess-risk air quality indices were developed using 51 different coefficients derived from time-series health studies evaluating the impacts of ambient fine particulate matter, nitrogen dioxide, and ozone on children's respiratory morbidity outcomes. A total of four indices were created which varied based on whether or not the underlying studies controlled for co-pollutants and in the adjustment of excess risks of individual pollutants. Combined with historical estimates of air pollution provided globally at a 25 × 25 km2 spatial resolution from the NASA's Goddard Earth Observing System composition forecast (GEOS-CF) model, each of these indices were examined in a global sample of 664 small and 140 large cities for study year 2017. Adjusted indices presented the most normal distributions of locally-scaled index values, which has been shown to improve associations with health risks, while indices based on coefficients controlling for co-pollutants had little effect on index performance. We provide the steps and resources need to apply our final adjusted index at the local level using freely-available forecasting data from the GEOS-CF model, which can provide risk communication information for cities around the world to better inform individual behavior modification to best protect children's respiratory health.
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Affiliation(s)
- Laura A Gladson
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA.
| | - Marya Ghazipura
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - K Emma Knowland
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Christoph A Keller
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Bryan Duncan
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
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Adams RI, Leppänen H, Karvonen AM, Jacobs J, Borràs-Santos A, Valkonen M, Krop E, Haverinen-Shaughnessy U, Huttunen K, Zock JP, Hyvärinen A, Heederik D, Pekkanen J, Täubel M. Microbial exposures in moisture-damaged schools and associations with respiratory symptoms in students: A multi-country environmental exposure study. INDOOR AIR 2021; 31:1952-1966. [PMID: 34151461 DOI: 10.1111/ina.12865] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/20/2021] [Accepted: 05/19/2021] [Indexed: 06/13/2023]
Abstract
Moisture-damaged buildings are associated with respiratory symptoms and underlying diseases among building occupants, but the causative agent(s) remain a mystery. We first identified specific fungal and bacterial taxa in classrooms with moisture damage in Finnish and Dutch primary schools. We then investigated associations of the identified moisture damage indicators with respiratory symptoms in more than 2700 students. Finally, we explored whether exposure to specific taxa within the indoor microbiota may explain the association between moisture damage and respiratory health. Schools were assessed for moisture damage through detailed inspections, and the microbial composition of settled dust in electrostatic dustfall collectors was determined using marker-gene analysis. In Finland, there were several positive associations between particular microbial indicators (diversity, richness, individual taxa) and a respiratory symptom score, while in the Netherlands, the associations tended to be mostly inverse and statistically non-significant. In Finland, abundance of the Sphingomonas bacterial genus and endotoxin levels partially explained the associations between moisture damage and symptom score. A few microbial taxa explained part of the associations with health, but overall, the observed associations between damage-associated individual taxa and respiratory health were limited.
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Affiliation(s)
- Rachel I Adams
- California Department of Public Health, Richmond, CA, USA
| | - Hanna Leppänen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Anne M Karvonen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - José Jacobs
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | - Alicia Borràs-Santos
- Barcelona Institute for Global Health (ISGlobal, Barcelona, Spain
- Escola Universitària d'Infermeria, Escoles Universitàries Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Spain
| | - Maria Valkonen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Esmeralda Krop
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | | | - Kati Huttunen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jan-Paul Zock
- Barcelona Institute for Global Health (ISGlobal, Barcelona, Spain
| | - Anne Hyvärinen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS, Utrecht University, Utrecht, The Netherlands
| | - Juha Pekkanen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Helsinki University, Helsinki, Finland
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
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Ho YN, Cheng FJ, Tsai MT, Tsai CM, Chuang PC, Cheng CY. Fine particulate matter constituents associated with emergency room visits for pediatric asthma: a time-stratified case-crossover study in an urban area. BMC Public Health 2021; 21:1593. [PMID: 34445977 PMCID: PMC8393716 DOI: 10.1186/s12889-021-11636-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/18/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Global asthma-related mortality tallies at around 2.5 million annually. Although asthma may be triggered or exacerbated by particulate matter (PM) exposure, studies investigating the relationship of PM and its components with emergency department (ED) visits for pediatric asthma are limited. This study aimed to estimate the impact of short-term exposure to PM constituents on ED visits for pediatric asthma. METHODS We retrospectively evaluated non-trauma patients aged younger than 17 years who visited the ED with a primary diagnosis of asthma. Further, measurements of PM with aerodynamic diameter of < 10 μm (PM10), PM with aerodynamic diameter of < 10 μm (PM2.5), and four PM2.5 components (i.e., nitrate (NO3-), sulfate (SO42-), organic carbon (OC), and elemental carbon (EC)) were collected between 2007 and 2010 from southern particulate matter supersites. These included one core station and two satellite stations in Kaohsiung City, Taiwan. A time-stratified case-crossover study was conducted to analyze the hazard effect of PM. RESULTS Overall, 1597 patients were enrolled in our study. In the single-pollutant model, the estimated risk increase for pediatric asthma incidence on lag 3 were 14.7% [95% confidence interval (CI), 3.2-27.4%], 13.5% (95% CI, 3.3-24.6%), 14.8% (95% CI, 2.5-28.6%), and 19.8% (95% CI, 7.6-33.3%) per interquartile range increments in PM2.5, PM10, nitrate, and OC, respectively. In the two-pollutant models, OC remained significant after adjusting for PM2.5, PM10, and nitrate. During subgroup analysis, children were more vulnerable to PM2.5 and OC during cold days (< 26 °C, interaction p = 0.008 and 0.012, respectively). CONCLUSIONS Both PM2.5 concentrations and its chemical constituents OC and nitrate are associated with ED visits for pediatric asthma. Among PM2.5 constituents, OC was most closely related to ED visits for pediatric asthma, and children are more vulnerable to PM2.5 and OC during cold days.
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Affiliation(s)
- Yu-Ni Ho
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan.,Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan. .,Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan.
| | - Ming-Ta Tsai
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan.,Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Chih-Min Tsai
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan.,Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan
| | - Po-Chun Chuang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan.,Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Chi-Yung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No.123, Dapi Rd, Niao-Sung Dist, Kaohsiung City, 833, Taiwan. .,Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan. .,Department of Computer Science and Engineering, National Sun Yat-sen University, No. 70, Lianhai Rd., Gushan Dist, Kaohsiung City, 804, Taiwan.
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Lu C, Peng W, Kuang J, Wu M, Wu H, Murithi RG, Johnson MB, Zheng X. Preconceptional and prenatal exposure to air pollution increases incidence of childhood pneumonia: A hypothesis of the (pre-)fetal origin of childhood pneumonia. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 210:111860. [PMID: 33421724 DOI: 10.1016/j.ecoenv.2020.111860] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Increasing evidence has linked childhood pneumonia with early exposure to ambient air pollution. However, the impact of exposure to air pollutants before birth is unclear. OBJECTIVE To further clarify whether exposure to a particular pollutant during preconceptional and prenatal periods, may pose a higher risk of developing childhood pneumonia. METHODS This case-control cohort study consisted of 1510 children aged 0-14 years in Changsha, China between 2017 and 2019. Data of children's history of pneumonia and blood biomarkers were obtained from the XiangYa Hospital records. Each child's exposure to air pollutants, including nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter with an aerodynamic diameter ≤ 10 µm (PM10), was calculated using data from ten air pollution monitoring stations. A multivariate logistic regression model was used to quantify the relationship between childhood pneumonia and exposure to ambient air pollution during the preconceptional and prenatal periods. RESULTS Childhood pneumonia was significantly associated with preconceptional and prenatal exposure to the industrial-related air pollutant, SO2, for 1 year before conception, for 3 months before conception and for the entire pregnancy, with ORs(95% CI)= 4.01(3.17-5.07), 4.06(3.29-5.00) and 6.51(4.82-8.79). Also, children who were sick with pneumonia had higher white blood cell and neutrophil counts, and children with low eosinophil count or hemoglobin are likely to get pneumonia. Sensitivity analysis showed that boys, and children in high temperature area were susceptible to the effect of both preconceptional and prenatal exposure to industrial SO2. CONCLUSION Preconceptional and prenatal exposure to industrial-related air pollution plays a significant role in the incidence and progression of childhood pneumonia, supporting the hypothesis of "(pre-)fetal origin of childhood pneumonia".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Wang Peng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Jian Kuang
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Maolan Wu
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Haiyu Wu
- XiangYa School of Medicine, Central South University, Changsha, China
| | | | - Mcsherry B Johnson
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China.
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Nascimento MS, Baggio DM, Fascina LP, do Prado C. Impact of social isolation due to COVID-19 on the seasonality of pediatric respiratory diseases. PLoS One 2020; 15:e0243694. [PMID: 33306735 PMCID: PMC7732104 DOI: 10.1371/journal.pone.0243694] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction Respiratory tract diseases are the major cause of morbidity and mortality in children under the age of 5 years, constituting the highest rate of hospitalization in this age group. Objectives To determine the prevalence of hospitalizations for respiratory diseases in childhood in the last 5 years and to assess the impact of social isolation due to COVID-19 on the seasonal behavior of these diseases. Methods A cross-sectional clinical study was carried out, with a survey of all patients aged 0 to 17 years who were admitted with a diagnosis of respiratory diseases between January 2015 and July 2020. The database was delivered to the researchers anonymized. The variables used for analysis were date of admission, date of discharge, length of stay, age, sex and diagnosis. In order to make the analysis possible, the diagnoses were grouped into upper respiratory infection (URI), asthma / bronchitis, bronchiolitis and pneumonia. Results 2236 admissions were included in the study. Children under 5 years old account for 81% of hospitalizations for respiratory disease in our population. In the adjusted model, an average reduction of 38 hospitalizations was observed in the period of social isolation (coefficient: -37.66; 95% CI (- 68.17; -7.15); p = 0.016). Conclusion The social isolation measures adopted during the COVID-19 pandemic dramatically interfered with the seasonality of childhood respiratory diseases. This was reflected in the unexpected reduction in the number of hospitalizations in the pediatric population during this period.
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Affiliation(s)
| | - Diana Milena Baggio
- Department of Pediatrics, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Cristiane do Prado
- Department of Pediatrics, Hospital Israelita Albert Einstein, São Paulo, Brazil
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de Oliveira Fernandes MA, Andreão WL, Maciel FM, de Almeida Albuquerque TT. Avoiding hospital admissions for respiratory system diseases by complying to the final Brazilian air quality standard: an estimate for Brazilian southeast capitals. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:35889-35907. [PMID: 31993912 DOI: 10.1007/s11356-020-07772-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
According to the World Health Organization (WHO), in 2016, 91% of the global population was living in places where guidelines on air quality were not met, which results in an estimated figure of seven million deaths annually. The new Brazilian air quality standards, CONAMA 491/2018, was the first revision in over two decades and has as final target the WHO guidelines for air quality, although no deadline has been established for implementation. The goal of this work was to quantify public health gains of this new policy based on hospitalizations due to respiratory diseases, the most studied outcome in Brazilian time series studies, in four Brazilian Southeast capitals: São Paulo (SP), Rio de Janeiro (RJ), Belo Horizonte (MG), and Vitória (ES) for PM10, PM2,5, SO2, CO, and O3. Population and hospitalizations data for all respiratory diseases for people under 5 years old, over 64 years old, most vulnerable populations, and all ages were analyzed. The air quality monitoring data was analyzed in two different periods: 2016 to 2018 for São Paulo and Vitória; and between 2015 and 2017 for Belo Horizonte and Rio de Janeiro, according to available monitoring data. A literature review was carried out to determine the appropriate relative risk to be used in the estimations, and the public health gains were calculated based on the selected relative risks for each city. The highest estimate was for São Paulo, with 3454 avoidable respiratory hospital admissions (all ages). In total, the four cities accounted for 4148 avoidable hospitalizations, which was associated to $1.1 million public health gains. Results considering the day of exposure (lag 0) were superior to those with the 5-day moving average (lag 5). The results highlighted the importance of adopting more restrictive standards and called for public policies, the necessity of expanding the air quality monitoring network, mapping emission sources, and improve the knowledge about the interaction between air pollution and health outcomes beyond respiratory disease for the region.
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Affiliation(s)
| | - Willian Lemker Andreão
- Dept. of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, 31270-010, Brazil
| | - Felipe Marinho Maciel
- Dept. of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, 31270-010, Brazil
- ArcelorMittal Brasil Sustainability Management, Belo Horizonte, 30130-915, Brazil
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Luong LMT, Phung D, Dang TN, Sly PD, Morawska L, Thai PK. Seasonal association between ambient ozone and hospital admission for respiratory diseases in Hanoi, Vietnam. PLoS One 2018; 13:e0203751. [PMID: 30248114 PMCID: PMC6152873 DOI: 10.1371/journal.pone.0203751] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/01/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Many studies have indicated the detrimental effect of ambient ozone to respiratory health in different countries. The levels of ozone in Hanoi, Vietnam are frequently above the WHO guideline but very few studies on the effects of ambient ozone on human health have been conducted in this location. This study aimed to examine the effects of ozone on hospital admission for respiratory diseases in Hanoi, by diseases, ages and seasons. METHODS Hospital admissions, air pollutants and meteorological data were collected from January 2010 to June 2014. We used generalized linear models and distributed lag linear model to assess the association. In addition to full year analysis, we conducted restricted analysis of the data for two summer (from June-August) and winter (from December-February) seasons and grouped hospital admissions by diseases and ages (all ages, children 0 to 5 years and elderly >65 years). The delayed effect of ozone was assessed using lags of up to 5 days. RESULTS Ozone has a stronger effect on the risk of hospital admission for respiratory diseases and wheeze-associated disorders in the winter. For respiratory diseases, children were affected by ozone more than other age groups in both winter and summer. Each increase of 10 μg/m3 of ozone is associated with an increase of 6.2% risk of admission for respiratory disease among children in the winter and 1.2% in the summer. For wheeze-associated disorders, the elderly group seemed to be more affected by ozone in full year and winter but no significant association was found between ozone and admission for wheeze-associated diseases in any age group. CONCLUSIONS Ozone is a risk factor for respiratory admission, especially amongst children under 5 years old in Hanoi, and ozone has a stronger effect in the winter than in the summer in this city.
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Affiliation(s)
- Ly M. T. Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia
| | - Tran Ngoc Dang
- The Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Peter D. Sly
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
| | - Phong K. Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
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Missagia S, Amaral CASD, Jesus ASD, Arbex MA, Santos UDP, André CDSD, André PAD, Saldiva PHDN, Martins LC, Braga ALF, Pereira LAA. Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180009. [DOI: 10.1590/1980-549720180009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 08/14/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Introduction: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children’s and adolescents’ lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. Methodology: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. Results: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). Discussion: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. Conclusion: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.
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Froes Asmus CIR, Camara VM, Landrigan PJ, Claudio L. A Systematic Review of Children's Environmental Health in Brazil. Ann Glob Health 2018; 82:132-48. [PMID: 27325071 DOI: 10.1016/j.aogh.2016.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide range of environmental challenges, presents numerous hazards to children's health. The aim of this study was to systematically review the scientific literature that describes children's exposures to environmental pollutants in Brazil and their effects on Brazilian children's health. A systematic review of the scientific literature was performed without language restrictions and time of publication (years). The literature search was conducted in the following key resources: PubMed (MEDLINE), Scopus and Web of Science with the MeSH Terms: Environmental exposure AND Brazil (filters: Human, Child [birth to 18 years] and Affiliation Author). The Virtual Health Library was also employed to access the databases Scielo and Lilacs. The search strategy was [DeCS Terms]: Child OR adolescent AND Environmental exposure AND Brazil. Health effects in children associated with exposure to environmental pollutants in Brazil were reported in 74 studies, during the period between 1995 and 2015. The most frequently cited effect was hospital admission for respiratory causes including wheezing, asthma, and pneumonia among children living in areas with high concentrations of air pollutants. A broad spectrum of other health effects possibly linked to pollutants also was found such as prematurity, low birth weight, congenital abnormality (cryptorchidism, hypospadia, micropenis), poor performance in tests of psychomotor and mental development, and behavioral problems. Exposure to pesticides in utero and postnatally was associated with a high risk for leukemia in children <2 years old. These results show that there is a need in Brazil for stricter monitoring of pollutant emissions and for health surveillance programs especially among vulnerable populations such as pregnant women and young children.
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Affiliation(s)
- Carmen I R Froes Asmus
- Public Health Institute, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY.
| | - Volney M Camara
- Public Health Institute, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Philip J Landrigan
- Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY; Arnhold Global Health Institute, Icahn School of Medicine of Mount Sinai, New York, NY
| | - Luz Claudio
- Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY
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12
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Morawska L, Ayoko GA, Bae GN, Buonanno G, Chao CYH, Clifford S, Fu SC, Hänninen O, He C, Isaxon C, Mazaheri M, Salthammer T, Waring MS, Wierzbicka A. Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure. ENVIRONMENT INTERNATIONAL 2017; 108:75-83. [PMID: 28802170 DOI: 10.1016/j.envint.2017.07.025] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/27/2017] [Accepted: 07/29/2017] [Indexed: 05/10/2023]
Abstract
It has been shown that the exposure to airborne particulate matter is one of the most significant environmental risks people face. Since indoor environment is where people spend the majority of time, in order to protect against this risk, the origin of the particles needs to be understood: do they come from indoor, outdoor sources or both? Further, this question needs to be answered separately for each of the PM mass/number size fractions, as they originate from different sources. Numerous studies have been conducted for specific indoor environments or under specific setting. Here our aim was to go beyond the specifics of individual studies, and to explore, based on pooled data from the literature, whether there are generalizable trends in routes of exposure at homes, schools and day cares, offices and aged care facilities. To do this, we quantified the overall 24h and occupancy weighted means of PM10, PM2.5 and PN - particle number concentration. Based on this, we developed a summary of the indoor versus outdoor origin of indoor particles and compared the means to the WHO guidelines (for PM10 and PM2.5) and to the typical levels reported for urban environments (PN). We showed that the main origins of particle metrics differ from one type of indoor environment to another. For homes, outdoor air is the main origin of PM10 and PM2.5 but PN originate from indoor sources; for schools and day cares, outdoor air is the source of PN while PM10 and PM2.5 have indoor sources; and for offices, outdoor air is the source of all three particle size fractions. While each individual building is different, leading to differences in exposure and ideally necessitating its own assessment (which is very rarely done), our findings point to the existence of generalizable trends for the main types of indoor environments where people spend time, and therefore to the type of prevention measures which need to be considered in general for these environments.
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Affiliation(s)
- L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia.
| | - G A Ayoko
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia
| | - G N Bae
- Center for Environment, Health and Welfare Research, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - G Buonanno
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Department of Engineering, University of Naples "Parthenope", Isola C4 Centro Direzionale, Naples, Italy; Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, via Di Biasio 43, Cassino (FR), Italy
| | - C Y H Chao
- Department of Mechanical and Aerospace Engineering, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - S Clifford
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Brisbane 4000, Australia
| | - S C Fu
- Department of Mechanical and Aerospace Engineering, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - O Hänninen
- National Institute for Health and Welfare, Department of Environmental Health, POB 95/Neulaniementie 4, FI-70701 Kuopio, Finland
| | - C He
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia
| | - C Isaxon
- Division of Ergonomics and Aerosol Technology, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - M Mazaheri
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia
| | - T Salthammer
- International Laboratory for Air Quality and Health, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia; Fraunhofer WKI, Department of Material Analysis and Indoor Chemistry, Bienroder Weg 54 E, 38108 Braunschweig, Germany
| | - M S Waring
- Drexel University, Department of Civil, Architectural and Environmental Engineering, 3141 Chestnut St., Philadelphia, PA 19104, USA
| | - A Wierzbicka
- Division of Ergonomics and Aerosol Technology, Lund University, Box 118, SE-221 00 Lund, Sweden
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13
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Nhung NTT, Amini H, Schindler C, Kutlar Joss M, Dien TM, Probst-Hensch N, Perez L, Künzli N. Short-term association between ambient air pollution and pneumonia in children: A systematic review and meta-analysis of time-series and case-crossover studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:1000-1008. [PMID: 28763933 DOI: 10.1016/j.envpol.2017.07.063] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 05/22/2023]
Abstract
Ambient air pollution has been associated with respiratory diseases in children. However, its effects on pediatric pneumonia have not been meta-analyzed. We conducted a systematic review and meta-analysis of the short-term association between ambient air pollution and hospitalization of children due to pneumonia. We searched the Web of Science and PubMed for indexed publications up to January 2017. Pollutant-specific excess risk percentage (ER%) and confidence intervals (CI) were estimated using random effect models for particulate matter (PM) with diameter ≤ 10 (PM10) and ≤2.5 μm (PM2.5), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). Results were further stratified by subgroups (children under five, emergency visits versus hospital admissions, income level of study location, and exposure period). Seventeen studies were included in the meta-analysis. The ER% per 10 μg/m3 increase of pollutants was 1.5% (95% CI: 0.6%-2.4%) for PM10 and 1.8% (95% CI: 0.5%-3.1%) for PM2.5. The corresponding values per 10 ppb increment of gaseous pollutants were 2.9% (95% CI: 0.4%-5.3%) for SO2, 1.7% (95% CI: 0.5%-2.8%) for O3, and 1.4% (95% CI: 0.4%-2.4%) for NO2. ER% per 1000 ppb increment of CO was 0.9% (95% CI: 0.0%-1.9%). Associations were not substantially different between subgroups. This meta-analysis shows a positive association between daily levels of ambient air pollution markers and hospitalization of children due to pneumonia. However, lack of studies from low-and middle-income countries limits the quantitative generalizability given that susceptibilities to the adverse effects of air pollution may be different in those populations. The meta-regression in our analysis further demonstrated a strong effect of country income level on heterogeneity.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Heresh Amini
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Meltem Kutlar Joss
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tran Minh Dien
- Vietnam National Children's Hospital, Dong Da, Hanoi, Viet Nam
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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14
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Chen G, Zhang Y, Zhang W, Li S, Williams G, Marks GB, Jalaludin B, Abramson MJ, Luo F, Yang D, Su X, Lin Q, Liu L, Lin J, Guo Y. Attributable risks of emergency hospital visits due to air pollutants in China: A multi-city study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 228:43-49. [PMID: 28511038 DOI: 10.1016/j.envpol.2017.05.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0-2 days [cumulative relative risk (RR) and 95% confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0-1 days [1.004 (1.002, 1.006)], NO2 at lag 0-1 days [1.015 (1.010, 1.019)] and SO2 at lag 0-2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34% of EHVs may result from exposure to ambient PM2.5, 3.96% to PM10, 5.90% to NO2 and 5.38% to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services.
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Affiliation(s)
- Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, University of Queensland, Brisbane, Australia
| | - Yongming Zhang
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Wenyi Zhang
- Center for Disease Surveillance & Research, Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, University of Queensland, Brisbane, Australia
| | - Gail Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, New South Wales, Australia
| | - Bin Jalaludin
- Health People and Places Unit, South Western Sydney Local Health District, New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Fengming Luo
- West China Hospital, Sichuan University, Chengdu, China
| | - Dong Yang
- Zhongshan Hospital of Fudan University, Shanghai, China
| | - Xin Su
- PLA General Hospital of Nanjing Military Region, Nanjing, China
| | - Qichang Lin
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Laiyu Liu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiangtao Lin
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, University of Queensland, Brisbane, Australia.
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15
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Kunikullaya KU, Vijayaraghava A, Asha P, Kunnavil R, MuraliMohan BV. Meteorological parameters and pollutants on asthma exacerbation in Bangalore, India - an ecological retrospective time-series study. J Basic Clin Physiol Pharmacol 2017; 28:133-141. [PMID: 28076315 DOI: 10.1515/jbcpp-2016-0074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Literature has shown a significant association between asthma exacerbations and pollutant levels during that time. There is very limited evidence in India, especially Bangalore, for impacts of meteorological changes and pollution on asthma hospital admissions in adults. The objective was to study the impact of air pollution and meteorological parameters on asthma exacerbation in Bangalore. METHODS This study quantitatively analyzed the relation between acute exacerbations of asthma and related admissions to the hospital with the air pollution and the meteorological conditions during that time. Data regarding the daily hospital admissions in about 13 tertiary care centers in Bangalore, Karnataka and air pollutant levels and the meteorological conditions prevailing during each day over a year were collected from the Karnataka State pollution control board and meteorology departments, respectively. RESULTS An average daily asthma admission of 4.84±2.91, with clear seasonal variation and autocorrelations between meteorological parameters and pollutants was observed. Multiple linear regression analysis revealed that average temperature (p=0.005) and nitrogen dioxide (NO2) (p=0.034) were the two factors that were affecting the number of admissions. Quasi-poisson regression analysis using multi-pollutants and meteorological variables showed that particulate matter and NO2 had significant lag effect for up to 5 days (p<0.05) and rainfall for 1 day (p<0.001). CONCLUSIONS In Bangalore city, levels of NO2 and particulate matter, temperature, rainfall, and season increase asthma exacerbations.
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16
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Zhu L, Ge X, Chen Y, Zeng X, Pan W, Zhang X, Ben S, Yuan Q, Xin J, Shao W, Ge Y, Wu D, Han Z, Zhang Z, Chu H, Wang M. Short-term effects of ambient air pollution and childhood lower respiratory diseases. Sci Rep 2017; 7:4414. [PMID: 28667279 PMCID: PMC5493680 DOI: 10.1038/s41598-017-04310-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/12/2017] [Indexed: 12/18/2022] Open
Abstract
The association between air pollution and childhood respiratory disease is inconsistent. In the present study, we investigated a short-term effect of ambient air pollutants and daily childhood lower respiratory diseases (CLRD). Daily air pollutants, weather data, and CLRD data were collected from January 2014 to April 2015 (452 days) in Nanjing, China. Time-series regression and generalized additive models were used to assess the effects of air pollutants (PM10, PM2.5, NO2, SO2, O3, and CO) on CLRD. We observed that an interquartile range (IQR) increase in concentrations of PM10, NO2, and SO2 significantly increased the daily CLRD with 6 days cumulative effects (difference of estimates: 2.8%, 95% CI: 0.6–5.0%; 4.1%, 1.2–7.0%; 5.6%, 2.6–8.6%, respectively). However, no significant association was found in IQR concentrations of PM2.5, O3, and CO. Specifically, elevated PM10, PM2.5, NO2, and SO2 significantly increased the numbers of CLRD in cool season (3.6%, 1.5–5.7%; 2.4%, 0.3–4.5%; 4.9%, 2.9–7.0%; 6.3%, 3.7–9.0%, respectively). Additionally, the effect estimates of PM10, NO2, and SO2 in female and age >27 months were more pronounced than in male and age ≤27 months. This study suggested that short-term exposure to ambient PM10, NO2, and SO2 were associated with the increased CLRD numbers.
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Affiliation(s)
- Liyang Zhu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.,Department of Statistics, School of Economics, Nanjing University Of Finance & Economics, Nanjing, China
| | - Xuhua Ge
- Department of Emergency, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yaoyao Chen
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Xinying Zeng
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wang Pan
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xu Zhang
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shuai Ben
- School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Qi Yuan
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Junyi Xin
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Wei Shao
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Yuqiu Ge
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Dongmei Wu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Zhong Han
- Department of Statistics, School of Economics, Nanjing University Of Finance & Economics, Nanjing, China
| | - Zhengdong Zhang
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
| | - Haiyan Chu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
| | - Meilin Wang
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
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17
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Schvartsman C, Pereira LAA, Braga ALF, Farhat SCL. Seven-day cumulative effects of air pollutants increase respiratory ER visits up to threefold. Pediatr Pulmonol 2017; 52:205-212. [PMID: 27575889 DOI: 10.1002/ppul.23555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/01/2016] [Accepted: 08/07/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Children are especially vulnerable to respiratory injury induced by exposure to air pollutants. In the present study, we investigate periods of up to 7 days, and evaluate the lagged effects of exposure to air pollutants on the daily number of children and adolescents visiting the emergency room (ER) for the treatment of lower respiratory obstructive diseases (LROD), in the city of São Paulo, Brazil. METHODS Daily records of LROD-related ER visits by children and adolescents under the age of 19, from January 2000 to December 2007 (2,922 days) were included in the study. Time-series regression models (generalized linear Poisson) were used to control for short- and long-term trends, as well as for temperature and relative humidity. Third-degree polynomial lag models were used to estimate both lag structures and the cumulative effects of air pollutants. Effects of air pollutants were expressed as the percentage increase in LROD-related ER visits. RESULTS We observed an acute effect at the same day of exposure to air pollutants; however, the cumulative effects of air pollutants on the number of LROD-related ER visits was almost threefold greater than the one observed at the same day of exposure to PM10 , SO2 , and NO2 mainly in children aged 5 years and under. The 7-day cumulative effect of SO2 reached 11.0% (95% CI: 5.0-16.7) increase in visits. Conclusion and Relevance: This study highlights the effects of intermediate-term exposure to air pollutants on LROD in children. Pediatr Pulmonol. 2017;52:205-212. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Cláudio Schvartsman
- Emergency Department, Children's Institute, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Luiz Alberto Amador Pereira
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.,Environmental Exposure and Risk Assessment Group, Collective Health Post-Graduation Program, Universidade Catolica de Santos, Sao Paulo, Brazil
| | - Alfésio Luiz Ferreira Braga
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.,Environmental Exposure and Risk Assessment Group, Collective Health Post-Graduation Program, Universidade Catolica de Santos, Sao Paulo, Brazil
| | - Sylvia Costa Lima Farhat
- Emergency Department, Children's Institute, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.,Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
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18
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Huttunen K, Tirkkonen J, Täubel M, Krop E, Mikkonen S, Pekkanen J, Heederik D, Zock JP, Hyvärinen A, Hirvonen MR. Inflammatory potential in relation to the microbial content of settled dust samples collected from moisture-damaged and reference schools: results of HITEA study. INDOOR AIR 2016; 26:380-390. [PMID: 25967114 DOI: 10.1111/ina.12223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
Aiming to identify factors causing the adverse health effects associated with moisture-damaged indoor environments, we analyzed immunotoxicological potential of settled dust from moisture-damaged and reference schools in relation to their microbiological composition. Mouse RAW264.7 macrophages were exposed to settled dust samples (n = 25) collected from moisture-damaged and reference schools in Spain, the Netherlands, and Finland. After exposure, we analyzed production of inflammatory markers [nitric oxide (NO), tumor necrosis factor-α (TNF-)α, interleukin (IL)-6, and macrophage inflammatory protein (MIP)2] as well as mitochondrial activity, viability, apoptosis, and cell cycle arrest. Furthermore, particle counts, concentration of selected microbial groups as well as chemical markers such as ergosterol, 3-hydroxy fatty acids, muramic acid, endotoxins, and glucans were measured as markers of exposure. Dust from moisture-damaged schools in Spain and the Netherlands induced stronger immunotoxicological responses compared to samples from reference schools; the responses to Finnish samples were generally lower with no difference between the schools. In multivariate analysis, IL-6 and apoptosis responses were most strongly associated with moisture status of the school. The measured responses correlated with several microbial markers and numbers of particles, but the most important predictor of the immunotoxicological potential of settled dust was muramic acid concentration, a marker of Gram-positive bacteria.
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Affiliation(s)
- K Huttunen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- School of Bioscience, Cardiff University, Cardiff, UK
| | - J Tirkkonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - E Krop
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - S Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - J Pekkanen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - D Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - J-P Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Hyvärinen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - M-R Hirvonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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19
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Yu HL, Chien LC. Short-term population-based non-linear concentration-response associations between fine particulate matter and respiratory diseases in Taipei (Taiwan): a spatiotemporal analysis. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:197-206. [PMID: 25850562 DOI: 10.1038/jes.2015.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 12/11/2013] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
Fine particulate matter <2.5 μm (PM2.5) has been associated with human health issues; however, findings regarding the influence of PM2.5 on respiratory disease remain inconsistent. The short-term, population-based association between the respiratory clinic visits of children and PM2.5 exposure levels were investigated by considering both the spatiotemporal distributions of ambient pollution and clinic visit data. We applied a spatiotemporal structured additive regression model to examine the concentration-response (C-R) association between children's respiratory clinic visits and PM2.5 concentrations. This analysis was separately performed on three respiratory disease categories that were selected from the Taiwanese National Health Insurance database, which includes 41 districts in the Taipei area of Taiwan from 2005 to 2007. The findings reveal a non-linear C-R pattern of PM2.5, particularly in acute respiratory infections. However, a PM2.5 increase at relatively lower levels can elevate the same-day respiratory health risks of both preschool children (<6 years old) and schoolchildren (6-14 years old). In preschool children, same-day health risks rise when concentrations increase from 0.76 to 7.44 μg/m(3), and in schoolchildren, same-day health risks rise when concentrations increase from 0.76 to 7.52 μg/m(3). Changes in PM2.5 levels generally exhibited no significant association with same-day respiratory risks, except in instances where PM2.5 levels are extremely high, and these occurrences do exhibit a significant positive influence on respiratory health that is especially notable in schoolchildren. A significant high relative rate of respiratory clinic visits are concentrated in highly populated areas. We highlight the non-linearity of the respiratory health effects of PM2.5 on children to investigate this population-based association. The C-R relationship in this study can provide a highly valuable alternative for assessing the effects of ambient air pollution on human health.
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Affiliation(s)
- Hwa-Lung Yu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Lung-Chang Chien
- Department of Biostatistics, University of Texas School of Public Health at San Antonio Regional Campus, San Antonio, Texas, USA
- Research to Advance Community Health Center, University of Texas Health Science Center at San Antonio Regional Campus, San Antonio, Texas, USA
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Pereira BB, Limongi JE. Epidemiologia de desfechos na saúde humana relacionados à poluição atmosférica no Brasil: uma revisão sistemática. ACTA ACUST UNITED AC 2015. [DOI: 10.1590/1414-462x201400050103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ResumoO presente artigo revisa e discute aspectos da situação da pesquisa epidemiológica relacionados aos desfechos de saúde decorrentes da poluição atmosférica. Foi realizada uma revisão sistemática de estudos que avaliou os efeitos de poluentes do ar na saúde humana. A qualidade metodológica dos trabalhos também foi avaliada. A revisão identificou 432 estudos que abordaram a temática, dos quais 56 atendem aos critérios de inclusão previamente estabelecidos. Além de evidenciarem um cenário de pesquisa epidemiológica pautado na relação causa-efeito, os resultados apontam para a necessidade de revisão de parâmetros ambientais e expõem desafios e contribuições à pesquisa epidemiológica em saúde ambiental.
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21
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Zhang Y, Yan C, Kan H, Cao J, Peng L, Xu J, Wang W. Effect of ambient temperature on emergency department visits in Shanghai, China: a time series study. Environ Health 2014; 13:100. [PMID: 25424196 PMCID: PMC4258028 DOI: 10.1186/1476-069x-13-100] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 11/10/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND Many studies have examined the association between ambient temperature and mortality. However, less evidence is available on the temperature effects on gender- and age-specific emergency department visits, especially in developing countries. In this study, we examined the short-term effects of daily ambient temperature on emergency department visits (ED visits) in Shanghai. METHODS Daily ED visits and daily ambient temperatures between January 2006 and December 2011 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) was used to examine the associations between ambient temperature and gender- and age-specific ED visits. A moving average lag model was used to evaluate the lag effects of temperature on ED visits. RESULTS Low temperature was associated with an overall 2.76% (95% confidence interval (CI): 1.73 to 3.80) increase in ED visits per 1°C decrease in temperature at Lag1 day, 2.03% (95% CI: 1.04 to 3.03) and 2.45% (95% CI: 1.40 to 3.52) for males and females. High temperature resulted in an overall 1.78% (95% CI: 1.05 to 2.51) increase in ED visits per 1°C increase in temperature on the same day, 1.81% (95% CI: 1.08 to 2.54) among males and 1.75% (95% CI: 1.03 to 2.49) among females. The cold effect appeared to be more acute among younger people aged <45 years, whereas the effects were consistent on individuals aged ≥65 years. In contrast, the effects of high temperature were relatively consistent over all age groups. CONCLUSIONS These findings suggest a significant association between ambient temperature and ED visits in Shanghai. Both cold and hot temperatures increased the relative risk of ED visits. This knowledge has the potential to advance prevention efforts targeting weather-sensitive conditions.
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Affiliation(s)
- Yue Zhang
- />School of Public Health & Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
- />Fudan Tyndall Centre, Shanghai, China
| | - Chenyang Yan
- />Department of teaching and medical administration, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Haidong Kan
- />School of Public Health & Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
- />Fudan Tyndall Centre, Shanghai, China
| | - Junshan Cao
- />Shanghai Municipal Human Resources and Social Security Bureau, Shanghai, China
| | - Li Peng
- />Shanghai Center for Urban Environmental Meteorology, Shanghai, China
- />Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Jianming Xu
- />Shanghai Center for Urban Environmental Meteorology, Shanghai, China
- />Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Weibing Wang
- />School of Public Health & Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
- />Fudan Tyndall Centre, Shanghai, China
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22
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Carvalho GMC, Nagato LKDS, Fagundes SDS, Dos Santos FB, Calheiros AS, Malm O, Bozza PT, Saldiva PHN, Faffe DS, Rocco PRM, Zin WA. Time course of pulmonary burden in mice exposed to residual oil fly ash. Front Physiol 2014; 5:366. [PMID: 25309454 PMCID: PMC4174882 DOI: 10.3389/fphys.2014.00366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 09/07/2014] [Indexed: 01/15/2023] Open
Abstract
Residual oil fly ash (ROFA) is a common pollutant in areas where oil is burned. This particulate matter (PM) with a broad distribution of particle diameters can be inhaled by human beings and putatively damage their respiratory system. Although some studies deal with cultured cells, animals, and even epidemiological issues, so far a comprehensive analysis of respiratory outcomes as a function of the time elapsed after exposure to a low dose of ROFA is wanted. Thus, we aimed to investigate the time course of mechanical, histological, and inflammatory lung changes, as well as neutrophils in the blood, in mice exposed to ROFA until 5 days after exposure. BALB/c mice (25 ± 5 g) were randomly divided into 7 groups and intranasally instilled with either 10 μL of sterile saline solution (0.9% NaCl, CTRL) or ROFA (0.2 μg in 10 μL of saline solution). Pulmonary mechanics, histology (normal and collapsed alveoli, mononuclear and polymorphonuclear cells, and ultrastructure), neutrophils (in blood and bronchoalveolar lavage fluid) were determined at 6 h in CTRL and at 6, 24, 48, 72, 96, and 120 h after ROFA exposure. ROFA contained metal elements, especially iron, polycyclic aromatic hydrocarbons (PAHs), and organochlorines. Lung resistive pressure augmented early (6 h) in the course of lung injury and other mechanical, histological and inflammatory parameters increased at 24 h, returning to control values at 120 h. Blood neutrophilia was present only at 24 and 48 h after exposure. Swelling of endothelial cells with adherent neutrophils was detected after ROFA instillation. No neutrophils were present in the lavage fluid. In conclusion, the exposure to ROFA, even in low doses, induced early changes in pulmonary mechanics, lung histology and accumulation of neutrophils in blood of mice that lasted for 4 days and disappeared spontaneously.
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Affiliation(s)
| | - Lilian Katiê da Silva Nagato
- Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Sheila da Silva Fagundes
- Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Flávia Brandão Dos Santos
- Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Andrea Surrage Calheiros
- Laboratory of Immunopharmacology, Department of Physiology and Pharmacodynamics, Oswaldo Cruz Institute, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
| | - Olaf Malm
- Laboratory of Radioisotopes, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Patricia Torres Bozza
- Laboratory of Immunopharmacology, Department of Physiology and Pharmacodynamics, Oswaldo Cruz Institute, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
| | - Paulo Hilário N Saldiva
- Laboratory of Experimental Air Pollution, Department of Pathology, School of Medicine, Universidade de São Paulo São Paulo, Brazil
| | - Débora Souza Faffe
- Laboratory of Macromolecular Metabolism Firmino Torres de Castro, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Patricia Rieken Macedo Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Walter Araujo Zin
- Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
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Raun LH, Ensor KB, Persse D. Using community level strategies to reduce asthma attacks triggered by outdoor air pollution: a case crossover analysis. Environ Health 2014; 13:58. [PMID: 25012280 PMCID: PMC4108967 DOI: 10.1186/1476-069x-13-58] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 07/02/2014] [Indexed: 05/05/2023]
Abstract
BACKGROUND Evidence indicates that asthma attacks can be triggered by exposure to ambient air pollutants, however, detailed pollution information is missing from asthma action plans. Asthma is commonly associated with four criteria pollutants with standards derived by the United States Environmental Protection Agency. Since multiple pollutants trigger attacks and risks depend upon city-specific mixtures of pollutants, there is lack of specific guidance to reduce exposure. Until multi-pollutant statistical modeling fully addresses this gap, some guidance on pollutant attack risk is required. This study examines the risks from exposure to the asthma-related pollutants in a large metropolitan city and defines the city-specific association between attacks and pollutant mixtures. Our goal is that city-specific pollution risks be incorporated into individual asthma action plans as additional guidance to prevent attacks. METHODS Case-crossover analysis and conditional logistic regression were used to measure the association between ozone, fine particulate matter, nitrogen dioxide, sulfur dioxide and carbon monoxide pollution and 11,754 emergency medical service ambulance treated asthma attacks in Houston, Texas from 2004-2011. Both single and multi-pollutant models are presented. RESULTS In Houston, ozone and nitrogen dioxide are important triggers (RR = 1.05; 95% CI: 1.00, 1.09), (RR = 1.10; 95% CI: 1.05, 1.15) with 20 and 8 ppb increase in ozone and nitrogen dioxide, respectively, in a multi-pollutant model. Both pollutants are simultaneously high at certain times of the year. The risk attributed to these pollutants differs when they are considered together, especially as concentrations increase. Cumulative exposure for ozone (0-2 day lag) is of concern, whereas for nitrogen dioxide the concern is with single day exposure. Persons at highest risk are aged 46-66, African Americans, and males. CONCLUSIONS Accounting for cumulative and concomitant outdoor pollutant exposure is important to effectively attribute risk for triggering of an asthma attack, especially as concentrations increase. Improved asthma action plans for Houston individuals should warn of these pollutants, their trends, correlation and cumulative effects. Our Houston based study identifies nitrogen dioxide levels and the three-day exposure to ozone to be of concern whereas current single pollutant based national standards do not.
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Affiliation(s)
- Loren H Raun
- Department of Statistics, Rice University, 6100 Main Street, Houston, TX 77005, USA
- City of Houston Health and Human Services Bureau of Pollution Control and Prevention, 7411 Park Place Blvd, Houston, TX 77087, USA
| | - Katherine B Ensor
- Department of Statistics, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - David Persse
- City of Houston Emergency Medical Services, 600 Jefferson Suite 800, Houston, TX 77002, USA
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza Houston, Houston, TX 77030, USA
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24
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Farhat SCL, Almeida MB, Silva-Filho LVRF, Farhat J, Rodrigues JC, Braga ALF. Ozone is associated with an increased risk of respiratory exacerbations in patients with cystic fibrosis. Chest 2014; 144:1186-1192. [PMID: 23493973 PMCID: PMC7172612 DOI: 10.1378/chest.12-2414] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Tropospheric oxidant pollutants may injure the respiratory tract. Cystic fibrosis (CF) respiratory disease involves significant inflammation and excessive oxidative stress, and exposure to air pollutants can magnify the lung damage. The objective of this study was to investigate the association between the short-term variation in the concentration of air pollutants in metropolitan São Paulo, Brazil, and the occurrence of respiratory exacerbations in children and adolescents with CF. Methods A longitudinal panel of repeated measurements was obtained from 103 patients attending the outpatient center of our institution from September 6, 2006 through September 4, 2007. Daily concentrations of inhaled particulate matter, sulfur dioxide, nitrogen dioxide, ozone (O3), carbon monoxide, and meteorologic variables, such as the minimum temperature and relative humidity, were evaluated. The generalized estimation equation model for binomial distribution was used to assess the impact of these measurements on the occurrence of acute respiratory exacerbations. Results In total, 103 patients with CF (median age, 8.9 years) made 408 visits, with a mean ± SD of 4 ± 1.74 visits per patient (range, 2-9). A respiratory disease exacerbation was diagnosed on 142 visits (38.4%). An interquartile range increase in the O3 concentration (45.62 μg/m3) had a positive, delayed (2 days after exposure) effect on the risk of a respiratory exacerbation (relative risk = 1.86; 95% CI, 1.14-3.02). Conclusions This study demonstrates that exposure to short-term air pollution in a large urban center increases the risk of a pulmonary exacerbation in patients with CF.
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Affiliation(s)
- Sylvia C L Farhat
- Emergency Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo.
| | - Marina B Almeida
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Luiz Vicente R F Silva-Filho
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Virology Laboratory, Tropical Medicine Institute, University of São Paulo, São Paulo
| | - Juliana Farhat
- Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Joaquim C Rodrigues
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Alfésio L F Braga
- Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Environmental Exposure and Risk Assessment, Collective Health Post-graduation Program, Catholic University of Santos, Santos, Brazil
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25
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Children living near chipboard and wood industries are at an increased risk of hospitalization for respiratory diseases: A prospective study. Int J Hyg Environ Health 2014; 217:95-101. [DOI: 10.1016/j.ijheh.2013.03.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 03/14/2013] [Accepted: 03/26/2013] [Indexed: 01/21/2023]
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26
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Morawska L, Afshari A, Bae GN, Buonanno G, Chao CYH, Hänninen O, Hofmann W, Isaxon C, Jayaratne ER, Pasanen P, Salthammer T, Waring M, Wierzbicka A. Indoor aerosols: from personal exposure to risk assessment. INDOOR AIR 2013; 23:462-87. [PMID: 23574389 DOI: 10.1111/ina.12044] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 03/26/2013] [Indexed: 05/06/2023]
Abstract
Motivated by growing considerations of the scale, severity, and risks associated with human exposure to indoor particulate matter, this work reviewed existing literature to: (i) identify state-of-the-art experimental techniques used for personal exposure assessment; (ii) compare exposure levels reported for domestic/school settings in different countries (excluding exposure to environmental tobacco smoke and particulate matter from biomass cooking in developing countries); (iii) assess the contribution of outdoor background vs indoor sources to personal exposure; and (iv) examine scientific understanding of the risks posed by personal exposure to indoor aerosols. Limited studies assessing integrated daily residential exposure to just one particle size fraction, ultrafine particles, show that the contribution of indoor sources ranged from 19% to 76%. This indicates a strong dependence on resident activities, source events and site specificity, and highlights the importance of indoor sources for total personal exposure. Further, it was assessed that 10-30% of the total burden of disease from particulate matter exposure was due to indoor-generated particles, signifying that indoor environments are likely to be a dominant environmental factor affecting human health. However, due to challenges associated with conducting epidemiological assessments, the role of indoor-generated particles has not been fully acknowledged, and improved exposure/risk assessment methods are still needed, together with a serious focus on exposure control.
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Affiliation(s)
- L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Qld, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
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Majestic BJ, Turner JA, Marcotte AR. Respirable antimony and other trace-elements inside and outside an elementary school in Flagstaff, AZ, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 435-436:253-261. [PMID: 22858533 DOI: 10.1016/j.scitotenv.2012.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 07/02/2012] [Accepted: 07/06/2012] [Indexed: 06/01/2023]
Abstract
Because people spend almost 90% of their time indoors, ambient air monitors may severely underestimate actual exposure to atmospheric particulate matter (PM). Therefore, it becomes increasingly important to better understand the microenvironments where people are spending their time. For preadolescent children, the best estimates of exposure may be inside of their school. In this study, 11 size fractions of PM were collected inside and outside of an elementary school in Flagstaff, AZ, USA. In particles<1 μm (PM1), the total mass indoors was similar to the mass outdoors (indoor:outdoor, I:O, ratio=0.92 ± 0.16). In the PM1-10 fraction, however, the mass concentration inside the school was highly elevated relative to outside the school (I:O ratios=13 ± 3). Mass concentrations of 27 elements were analyzed by ICP-MS. For all metals except for antimony (Sb), the PM1 and PM1-10 I:O ratios are found to be similar to the overall PM mass (near 1 and 13, respectively). In addition, indoor and outdoor particle size distributions reveal a crustal character for every element except Cu, Zn, Pb, and Sb. Therefore, we hypothesize that most of the PM mass inside the school is a result of transport from outside the school followed by resuspension from floors and clothing. In the PM1 fraction, the indoor mass of Sb was 86 times greater than the outdoor mass and had an air concentration of 17 ngm(-3) - greater than many urban areas around the world. Cu:Sb ratios and size distribution functions suggest that the excess source of PM1 indoor Sb results from the suspension of embedded Sb (used as a flame retardant) in the carpeting. This is the first study to observe elevated submicron Sb in schools and further studies are required to determine if this is a widespread health risk.
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Affiliation(s)
- Brian J Majestic
- Department of Chemistry and Biochemistry, University of Denver, Denver, CO 80208-9020, USA.
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Winquist A, Klein M, Tolbert P, Flanders WD, Hess J, Sarnat SE. Comparison of emergency department and hospital admissions data for air pollution time-series studies. Environ Health 2012; 11:70. [PMID: 22998927 PMCID: PMC3511882 DOI: 10.1186/1476-069x-11-70] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 09/06/2012] [Indexed: 05/19/2023]
Abstract
BACKGROUND Emergency department (ED) visit and hospital admissions (HA) data have been an indispensible resource for assessing acute morbidity impacts of air pollution. ED visits and HAs are types of health care visits with similarities, but also potentially important differences. Little previous information is available regarding the impact of health care visit type on observed acute air pollution-health associations from studies conducted for the same location, time period, outcome definitions and model specifications. METHODS As part of a broader study of air pollution and health in St. Louis, individual-level ED and HA data were obtained for a 6.5 year period for acute care hospitals in the eight Missouri counties of the St. Louis metropolitan area. Patient demographic characteristics and diagnostic code distributions were compared for four visit types including ED visits, HAs, HAs that came through the ED, and non-elective HAs. Time-series analyses of the relationship between daily ambient ozone and PM₂.₅ and selected cardiorespiratory outcomes were conducted for each visit type. RESULTS Our results indicate that, compared with ED patients, HA patients tended to be older, had evidence of greater severity for some outcomes, and had a different mix of specific outcomes. Consideration of 'HA through ED' appeared to more effectively select acute visits than consideration of 'non-elective HA'. While outcomes with the strongest observed temporal associations with air pollutants tended to show strong associations for all visit types, we found some differences in observed associations for ED visits and HAs. For example, risk ratios for the respiratory disease-ozone association were 1.020 for ED visits and 1.004 for 'HA through ED'; risk ratios for the asthma/wheeze-ozone association were 1.069 for ED visits and 1.106 for 'HA through ED'. Several factors (e.g. age) were identified that may be responsible, in part, for the differences in observed associations. CONCLUSIONS Demographic and diagnostic differences between visit types may lead to preference for one visit type over another for some questions and populations. The strengths of observed associations with air pollutants sometimes varied between different health care visit types, but the relative strengths of association generally were specific to the pollutant-outcome combination.
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Affiliation(s)
- A Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - M Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Tolbert
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - WD Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - J Hess
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
- Department of Emergency Medicine, School of Medicine, Emory University, 1648 Pierce Drive NE, Atlanta, GA, 30322, USA
| | - SE Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
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Oliveira BFAD, Ignotti E, Hacon SS. A systematic review of the physical and chemical characteristics of pollutants from biomass burning and combustion of fossil fuels and health effects in Brazil. CAD SAUDE PUBLICA 2012; 27:1678-98. [PMID: 21986597 DOI: 10.1590/s0102-311x2011000900003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 04/26/2011] [Indexed: 01/26/2023] Open
Abstract
The aim of this study was to carry out a review of scientific literature published in Brazil between 2000 and 2009 on the characteristics of air pollutants from different emission sources, especially particulate matter (PM) and its effects on respiratory health. Using electronic databases, a systematic literature review was performed of all research related to air pollutant emissions. Publications were analyzed to identify the physical and chemical characteristics of pollutants from different emission sources and their related effects on the respiratory system. The PM2.5 is composed predominantly of organic compounds with 20% of inorganic elements. Higher concentrations of metals were detected in metropolitan areas than in biomass burning regions. The relative risk of hospital admissions due to respiratory diseases in children was higher than in the elderly population. The results of studies of health effects of air pollution are specific to the region where the emissions occurred and should not be used to depict the situation in other areas with different emission sources.
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Vidotto JP, Pereira LAA, Braga ALF, Silva CA, Sallum AM, Campos LM, Martins LC, Farhat SCL. Atmospheric pollution: influence on hospital admissions in paediatric rheumatic diseases. Lupus 2012; 21:526-33. [DOI: 10.1177/0961203312437806] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the lag structure effects from exposure to atmospheric pollution in acute outbursts in hospital admissions of paediatric rheumatic diseases (PRDs). Methods: Morbidity data were obtained from the Brazilian Hospital Information System in seven consecutive years, including admissions due to seven PRDs (juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Henoch–Schönlein purpura, polyarteritis nodosa, systemic sclerosis and ankylosing spondylitis). Cases with secondary diagnosis of respiratory diseases were excluded. Daily concentrations of inhaled particulate matter (PM10), sulphur dioxide (SO2) nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO) were evaluated. Generalized linear Poisson regression models controlling for short-term trend, seasonality, holidays, temperature and humidity were used. Lag structures and magnitude of air pollutants’ effects were adopted to estimate restricted polynomial distributed lag models. Results: The total number of admissions due to acute outbursts PRD was 1,821. The SO2 interquartile range (7.79 µg/m3) was associated with an increase of 1.98% (confidence interval 0.25–3.69) in the number of hospital admissions due to outcome studied after 14 days of exposure. This effect was maintained until day 17. Of note, the other pollutants, with the exception of O3, showed an increase in the number of hospital admissions from the second week. Conclusion: This study is the first to demonstrate a delayed association between SO2 and PRD outburst, suggesting that oxidative stress reaction could trigger the inflammation of these diseases.
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Affiliation(s)
- JP Vidotto
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LAA Pereira
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - ALF Braga
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - CA Silva
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - AM Sallum
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LM Campos
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LC Martins
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - SCL Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Department, Hospital das Clínicas, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
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Jasinski R, Pereira LAA, Braga ALF. Poluição atmosférica e internações hospitalares por doenças respiratórias em crianças e adolescentes em Cubatão, São Paulo, Brasil, entre 1997 e 2004. CAD SAUDE PUBLICA 2011; 27:2242-52. [DOI: 10.1590/s0102-311x2011001100017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 08/29/2011] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi avaliar os efeitos dos poluentes atmosféricos e suas estruturas de defasagem sobre a morbidade respiratória de crianças e adolescentes, na cidade de Cubatão, São Paulo, Brasil, entre 1997 e 2004. Um estudo ecológico de séries temporais foi realizado, analisando internações nos hospitais do Sistema Único de Saúde por doenças respiratórias de crianças e adolescentes residentes no município. Foram utilizados modelos lineares generalizados de regressão de Poisson, controlando-se para sazonalidade, temperatura, umidade e tendência de curta duração. PM10 e ozônio estiveram positiva e estatisticamente associados com as internações por doenças respiratórias. No grupo de crianças, aumentos de um interquartil nas médias móveis de sete dias do PM10 (56,5µg/m³) e de cinco dias do ozônio (46,7µg/m³) levaram a aumentos nas internações hospitalares de 9,6% (IC95%: 3,0%-16,1%) e 2,4% (IC95%: 0,1%-4,7%), respectivamente. Esforços para redução das concentrações dos poluentes do ar ainda precisam ser implementados para minimizar os seus efeitos adversos sobre crianças e adolescentes em Cubatão.
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Fraga J, Botelho A, Sá A, Costa M, Quaresma M. The lag structure and the general effect of ozone exposure on pediatric respiratory morbidity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:4013-24. [PMID: 22073025 PMCID: PMC3210594 DOI: 10.3390/ijerph8104013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 11/16/2022]
Abstract
Up to now no study has investigated the lag structure of children's respiratory morbidity due to surface ozone. In the present study, we investigate the lag structure and the general effect of surface ozone exposure on children and adolescents' respiratory morbidity using data from a particularly well suited area in southern Europe to assess the health effects of surface ozone. The effects of surface ozone are estimated using the recently developed distributed lag non-linear models, allowing for a relatively long timescale, while controlling for weather effects, a range of other air pollutants, and long and short term patterns. The public health significance of the estimated effects is higher than has been previously reported in the literature, providing evidence contrary to the conjecture that the surface ozone-morbidity association is mainly due to short-term harvesting. In fact, our data analysis reveals that the effects of surface ozone at medium and long timescales (harvesting-resistant) are substantially larger than the effects at shorter timescales (harvesting-prone), a finding that is consistent with all children and adolescents being affected by high surface ozone concentrations, and not just the very frail.
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Affiliation(s)
- José Fraga
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Anabela Botelho
- University of Minho and NIMA, Campus de Gualtar, Braga 4710-057, Portugal
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +351-253-604-538; Fax: +351-253-601-380
| | - Aida Sá
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Margarida Costa
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Márcia Quaresma
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
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Riguera D, André PA, Zanetta DMT. Sugar cane burning pollution and respiratory symptoms in schoolchildren in Monte Aprazível, Southeastern Brazil. Rev Saude Publica 2011; 45:878-86. [PMID: 21829978 DOI: 10.1590/s0034-89102011005000052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 03/30/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of respiratory symptoms and to analyze associated factors as well as peak expiratory flow measurements in schoolchildren. METHODS This is a descriptive cross-sectional study with schoolchildren aged 10-14 from the city of Monte Aprazível (Southeastern Brazil). Questionnaires containing the asthma and rhinitis components of the International Study of Asthma and Allergies in Childhood were administered. The questionnaires also approached sociodemographic characteristics, predisposing factors, and family and personal medical history. Repeated measures of peak expiratory flow in the children, and of black carbon and particulate matter (PM2,5) concentration levels were carried out. RESULTS The prevalence of asthma and rhinitis symptoms was 11% and 33.2%, respectively. Among asthmatic children, 10.6% presented four or more wheezing attacks in the past 12 months. Past family history of bronchitis and rhinitis was associated with presence of asthma (p=0.002 and p <0.001) and rhinitis (p <0.001 and p<0.001, respectively). Regarding rhinitis, there was association with presence of mold or cracks on the house (p=0.009). Rhinitis was most frequent from June to October, a period that matches the sugarcane harvest season. Daily prevalence of peak expiratory flow below 20% of the median of each child's measurements was higher in days with greater PM2,5 concentration. CONCLUSIONS The prevalence of asthma symptoms is below and that of rhinitis is above the national average. Although within acceptable levels, pollution in the cane trash burn season may contribute to the exacerbation of asthma and rhinitis episodes.
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Affiliation(s)
- Denise Riguera
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil
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Farhat SCL, Silva CA, Orione MAM, Campos LMA, Sallum AME, Braga ALF. Air pollution in autoimmune rheumatic diseases: a review. Autoimmun Rev 2011; 11:14-21. [PMID: 21763467 DOI: 10.1016/j.autrev.2011.06.008] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 06/06/2011] [Indexed: 12/11/2022]
Abstract
Air pollution consists of a heterogeneous mixture of gasses and particles that include carbon monoxide, nitrates, sulfur dioxide, ozone, lead, toxic by-product of tobacco smoke and particulate matter. Oxidative stress and inflammation induced by inhaled pollutants may result in acute and chronic disorders in the respiratory system, as well as contribute to a state of systemic inflammation and autoimmunity. This paper reviews the mechanisms of air contaminants influencing the immune response and autoimmunity, and it focuses on studies of inhaled pollutants triggering and/or exacerbating rheumatic diseases in cities around the world. Remarkably, environmental factors contribute to the onset of autoimmune diseases, especially smoking and occupational exposure to silica in rheumatoid arthritis and systemic lupus erythematosus. Other diseases such as scleroderma may be triggered by the inhalation of chemical solvents, herbicides and silica. Likewise, primary vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA) may be triggered by silica exposure. Only few studies showed that air pollutants could trigger or exacerbate juvenile idiopathic arthritis and systemic lupus erythematosus. In contrast, no studies of tropospheric pollution triggering inflammatory myopathies and spondyloarthropathies were carried out. In conclusion, air pollution is one of the environmental factors involved in systemic inflammation and autoimmunity. Further studies are needed in order to evaluate air pollutants and their potentially serious effects on autoimmune rheumatic diseases and the mechanisms involved in the onset and the exacerbation of these diseases.
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Affiliation(s)
- Sylvia C L Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of Sao Paulo Faculty of Medical Sciences, Brazil
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Sisenando HA, Batistuzzo de Medeiros SR, Saldiva PHN, Artaxo P, Hacon SS. Genotoxic potential generated by biomass burning in the Brazilian Legal Amazon by Tradescantia micronucleus bioassay: a toxicity assessment study. Environ Health 2011; 10:41. [PMID: 21575274 PMCID: PMC3118318 DOI: 10.1186/1476-069x-10-41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 05/17/2011] [Indexed: 05/26/2023]
Abstract
BACKGROUND The Brazilian Amazon has suffered impacts from non-sustainable economic development, especially owing to the expansion of agricultural commodities into forest areas. The Tangará da Serra region, located in the southern of the Legal Amazon, is characterized by non-mechanized sugar cane production. In addition, it lies on the dispersion path of the pollution plume generated by biomass burning. The aim of this study was to assess the genotoxic potential of the atmosphere in the Tangará da Serra region, using Tradescantia pallida as in situ bioindicator. METHODS The study was conducted during the dry and rainy seasons, where the plants were exposed to two types of exposure, active and passive. RESULTS The results showed that in all the sampling seasons, irrespective of exposure type, there was an increase in micronucleus frequency, compared to control and that it was statistically significant in the dry season. A strong and significant relationship was also observed between the increase in micronucleus incidence and the rise in fine particulate matter, and hospital morbidity from respiratory diseases in children. CONCLUSIONS Based on the results, we demonstrated that pollutants generated by biomass burning in the Brazilian Amazon can induce genetic damage in test plants that was more prominent during dry season, and correlated with the level of particulates and elevated respiratory morbidity.
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Affiliation(s)
- Herbert A Sisenando
- Escola Nacional de Saúde Pública - ENSP, Fiocruz, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
- Departamento de Patologia, UFF, Niterói, CEP: 24033-900, RJ, Brazil
| | | | - Paulo HN Saldiva
- Departamento de Patologia, USP, São Paulo, CEP: 01246-903, SP, Brazil
| | - Paulo Artaxo
- Departamento de Física Aplicada, USP, São Paulo, CEP: 05508-900, SP, Brazil
| | - Sandra S Hacon
- Escola Nacional de Saúde Pública - ENSP, Fiocruz, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
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Ji M, Cohan DS, Bell ML. Meta-analysis of the Association between Short-Term Exposure to Ambient Ozone and Respiratory Hospital Admissions. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2011; 6:024006. [PMID: 21779304 PMCID: PMC3138529 DOI: 10.1088/1748-9326/6/2/024006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ozone is associated with health impacts including respiratory outcomes; however, results differ across studies. Meta-analysis is an increasingly important approach to synthesizing evidence across studies. We conducted meta-analysis of short-term ozone exposure and respiratory hospitalizations to evaluate variation across studies and explore some of the challenges in meta-analysis. We identified 136 estimates from 96 studies and investigated how estimates differed by age, ozone metric, season, lag, region, disease category, and hospitalization type. Overall results indicate associations between ozone and various types of respiratory hospitalizations; however, study characteristics affected risk estimates. Estimates were similar, but higher, for the elderly compared to all ages and for previous day exposure compared to same day exposure. Comparison across studies was hindered by variation in definitions of disease categories, as some (e.g., asthma) were identified through ≥3 different sets of ICD codes. Although not all analyses exhibited evidence of publication bias, adjustment for publication bias generally lowered overall estimates. Emergency hospitalizations for total respiratory disease increased 4.47% (95% interval 2.48, 6.50%) per 10ppb 24-hr ozone among the elderly without adjustment for publication bias and 2.97% (1.05, 4.94%) with adjustment. Comparison of multi-city study results and meta-analysis based on single-city studies further suggested publication bias.
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Affiliation(s)
- Meng Ji
- School of Forestry and Environmental Studies, School of Public Health, Yale University, New Haven, CT, U.S.A
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Olmo NRS, Saldiva PHDN, Braga ALF, Lin CA, Santos UDP, Pereira LAA. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy. Clinics (Sao Paulo) 2011; 66:681-90. [PMID: 21655765 PMCID: PMC3093800 DOI: 10.1590/s1807-59322011000400025] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 01/17/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.
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Affiliation(s)
- Neide Regina Simoes Olmo
- Laboratory of Experimental Air Pollution, Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, Brazil.
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Giovannini M, Sala M, Riva E, Radaelli G. Hospital admissions for respiratory conditions in children and outdoor air pollution in Southwest Milan, Italy. Acta Paediatr 2010; 99:1180-5. [PMID: 20219045 DOI: 10.1111/j.1651-2227.2010.01786.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To evaluate whether a relationship exists in hospital admissions for respiratory conditions in children with outdoor pollution in the Southwest Milan, Italy. METHODS Daily count of hospital admissions for asthma, upper or lower respiratory diseases (LRD) occurred among children aged < or =14 years at the San Paolo Hospital during 2007-2008 was recorded. Pollutants included the particular matter of <10 microm diameter, ozone, carbon monoxide (CO) and nitrogen dioxide (NO(2)), reported on the same day of admission and 1 up to 5 days before admission. The moving weekly average (MWA) was also considered. RESULTS Total respiratory admissions were associated with the same day level of CO (30.6% increase per 1 mg/m(3) increase, 95% confidence interval, 3.9-69.9%) and with the MWA of NO(2) (9.0% increase per 10 microg/m(3) increase, 1.2-16.8%). The effect of CO was stronger on upper respiratory diseases (URD) (lag 0, 21.3% increase, 6.4-38.3%). The effect of NO(2) was stronger on LRD (MWA, 5.3% increase, 0.9-10.2%). Multipollutant models confirmed the role of CO on URD and that of NO(2) on LRD. CONCLUSION Carbon monoxide and nitrogen dioxide may be associated with emergency hospital admissions for respiratory conditions among children in Southwest Milan.
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Affiliation(s)
- M Giovannini
- Department of Pediatrics, University of Milan, San Paolo Hospital, Milan, Italy
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Mazzoli-Rocha F, Fernandes S, Einicker-Lamas M, Zin WA. Roles of oxidative stress in signaling and inflammation induced by particulate matter. Cell Biol Toxicol 2010; 26:481-98. [PMID: 20340042 DOI: 10.1007/s10565-010-9158-2] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 03/01/2010] [Indexed: 12/14/2022]
Abstract
This review reports the role of oxidative stress in impairing the function of lung exposed to particulate matter (PM). PM constitutes a heterogeneous mixture of various types of particles, many of which are likely to be involved in oxidative stress induction and respiratory diseases. Probably, the ability of PM to cause oxidative stress underlies the association between increased exposure to PM and exacerbations of lung disease. Mostly because of their large surface area, ultrafine particles have been shown to cause oxidative stress and proinflammatory effects in different in vivo and in vitro studies. Particle components and surface area may act synergistically inducing lung inflammation. In this vein, reactive oxygen species elicited upon PM exposure have been shown to activate a number of redox-responsive signaling pathways and Ca(2+) influx in lung target cells that are involved in the expression of genes that modulate relevant responses to lung inflammation and disease.
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Affiliation(s)
- Flavia Mazzoli-Rocha
- Laboratório de Fisiologia da Respiração, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Martins LD, Martins JA, Freitas ED, Mazzoli CR, Gonçalves FLT, Ynoue RY, Hallak R, Albuquerque TTA, Andrade MDF. Potential health impact of ultrafine particles under clean and polluted urban atmospheric conditions: a model-based study. AIR QUALITY, ATMOSPHERE, & HEALTH 2010; 3:29-39. [PMID: 20376166 PMCID: PMC2844959 DOI: 10.1007/s11869-009-0048-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 06/17/2009] [Indexed: 05/29/2023]
Abstract
The main goal of this study was to improve the knowledge of ultrafine particle number distributions in large urban areas and also to call the attention to the importance of these particles on assessing health risks. Measurements of aerosol size distributions were performed during 2 weeks, with distinct pollutant concentrations (polluted and clean periods), on the rooftop of a building located in downtown of the megacity of São Paulo, Brazil. CO, NO(2), PM(10), SO(2), and O(3) concentrations and meteorological variables were also used. Aerosol size distribution measurements showed that geometric mean diameters of the size spectra in the polluted period are on average considerably larger than those in the clean one. Besides the fact that total number of ultrafine particles did not show significant differences, during the polluted period, geometric mean diameter was larger than during the clean one. The results of a mathematical model of particle deposition on human respiratory tract indicated a more significant effect of smaller particles fraction of the spectra, which predominate under clean atmospheric conditions. The results also indicated that urban environmental conditions usually considered good for air quality, under the criteria of low mass concentration, do not properly serve as air quality standard to very small particles. In the size range of ultrafine particles, this traditional clean atmospheric condition can offer a strong risk to pulmonary hazards, since the cleansing of the atmosphere creates good conditions to increase the concentration of nucleation mode particles.
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Affiliation(s)
- Leila Droprinchinski Martins
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Jorge A. Martins
- Department of Environmental Engineering, Federal University of Technology, Londrina, 86020-430 Paraná Brazil
| | - Edmilson D. Freitas
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Caroline R. Mazzoli
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Fabio Luiz T. Gonçalves
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Rita Y. Ynoue
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Ricardo Hallak
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Taciana Toledo A. Albuquerque
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
| | - Maria de Fatima Andrade
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo, 05508-900 São Paulo Brazil
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Grineski SE, Staniswalis JG, Peng Y, Atkinson-Palombo C. Children's asthma hospitalizations and relative risk due to nitrogen dioxide (NO2): effect modification by race, ethnicity, and insurance status. ENVIRONMENTAL RESEARCH 2010; 110:178-88. [PMID: 19944410 PMCID: PMC2819647 DOI: 10.1016/j.envres.2009.10.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 10/25/2009] [Accepted: 10/28/2009] [Indexed: 05/18/2023]
Abstract
BACKGROUND This study explores the role of race, ethnicity, and insurance status in modifying the effects of air pollution on children's asthma hospitalizations in Phoenix, Arizona (US) between 2001 and 2003. While controlling for weather, interactions between nitrous dioxide (NO(2)) and race, ethnicity, and insurance status are used to predict relative risk for subgroups of children. METHODS The generalized logit regression model for nominal categorical data within a multinomial likelihood framework was used. This model is specifically suited to small counts and the reporting of 95% confidence intervals for the odds ratio of hospital admission for one group as compared to another. The odds ratio is known to approximate relative risk for rare events. RESULTS Several significant findings were found for race, ethnicity, and insurance status as modulators for the effect of NO(2) on children's risk for asthma hospitalization: (1) children without insurance have 1.4 (95% CI: 1.1-1.8) times higher risk of asthma admissions than those with private insurance at exceedances of 0.02 parts per million (ppm) of NO(2) above the seasonal mean; the same finding holds for children without insurance as compared to those with Medicaid; (2) black children have 2.1 (95% CI: 1.3-3.3) times higher risk of hospitalization than Hispanic children at seasonal mean NO(2) levels, but this disproportionate risk shrinks to 1.7 with exceedances of 0.02 ppm of NO(2) above the seasonal mean. Specific to finding (1) among those children without health insurance, Hispanic children have 2.1 (95% CI: 1.1-3.8) times higher risk of hospitalization than white children. Among all Hispanic children, those without health insurance have 1.9 (95% CI: 1.3-3.0) times greater risk than those with private insurance; the same finding holds for Hispanic children without insurance as compared to Hispanic children with Medicaid. Specific to finding (2), among children with private insurance, the disproportionate risk of black children as compared to Hispanic children is magnified by a factor of 1.3 (95% CI: 1.0-1.8) for exceedances of 0.02 ppm of NO(2) above the seasonal mean. CONCLUSIONS Although we cannot confirm a cause-effect relationship, this analysis suggests that increasing insurance enrollment for all children, and specifically Hispanic children, may reduce their disproportionate risk from exceedances of air pollution. There are few black children in Phoenix, so further studies are needed to investigate the increasing risk of black children with private insurance as compared to Hispanics at exceedances of NO(2).
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Affiliation(s)
- Sara E Grineski
- Department of Sociology and Anthropology, University of Texas at El Paso, TX, USA.
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Damaceno-Rodrigues NR, Veras MM, Negri EM, Zanchi ACT, Rhoden CR, Saldiva PHN, Dolhnikoff M, Caldini EG. Effect of pre- and postnatal exposure to urban air pollution on myocardial lipid peroxidation levels in adult mice. Inhal Toxicol 2009; 21:1129-37. [DOI: 10.3109/08958370902798430] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moura M, Junger WL, Mendonça GAES, Leon APD. Air quality and emergency pediatric care for symptoms of bronchial obstruction categorized by age bracket in Rio de Janeiro, Brazil. CAD SAUDE PUBLICA 2009; 25:635-44. [PMID: 19300852 DOI: 10.1590/s0102-311x2009000300018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 03/28/2008] [Indexed: 05/25/2023] Open
Abstract
The objective of this study was to estimate the association between levels of air pollutants and respiratory symptoms in children. An ecological time-series study was conducted between April 2002 and March 2003 with daily data on PM10, SO2, CO, NO2, and O3 and paediatric care in emergency rooms due to symptoms indicating bronchial obstruction. The potential confounding factors considered were: time trend, seasonality, meteorological variables, respiratory infections and the effects of weekends and holidays. A semi-parametric Poisson regression was used to model the time series. Splines (data smoothing functions), indicator variables and cubic polynomials were used to adjust the effects of the confounding variables. A 5% significance level was adopted for the study. A statistically significant increase of 6.7% in paediatric visits of children of less than 2 years of age was associated with PM10. A 3% positive association with O3 showed borderline significance (p < 0.06) in this age bracket. Our findings highlight the existence of an acknowledged public health problem in Rio de Janeiro, Brazil, and also emphasize the need to identify the principal sources of air pollutants.
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Affiliation(s)
- Marisa Moura
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
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Stieb DM, Szyszkowicz M, Rowe BH, Leech JA. Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis. Environ Health 2009; 8:25. [PMID: 19515235 PMCID: PMC2703622 DOI: 10.1186/1476-069x-8-25] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 06/10/2009] [Indexed: 05/19/2023]
Abstract
BACKGROUND Relatively few studies have been conducted of the association between air pollution and emergency department (ED) visits, and most of these have been based on a small number of visits, for a limited number of health conditions and pollutants, and only daily measures of exposure and response. METHODS A time-series analysis was conducted on nearly 400,000 ED visits to 14 hospitals in seven Canadian cities during the 1990 s and early 2000s. Associations were examined between carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), and particulate matter (PM 10 and PM2.5), and visits for angina/myocardial infarction, heart failure, dysrhythmia/conduction disturbance, asthma, chronic obstructive pulmonary disease (COPD), and respiratory infections. Daily and 3-hourly visit counts were modeled as quasi-Poisson and analyses controlled for effects of temporal cycles, weather, day of week and holidays. RESULTS 24-hour average concentrations of CO and NO2 lag 0 days exhibited the most consistent associations with cardiac conditions (2.1% (95% CI, 0.0-4.2%) and 2.6% (95% CI, 0.2-5.0%) increase in visits for myocardial infarction/angina per 0.7 ppm CO and 18.4 ppb NO2 respectively; 3.8% (95% CI, 0.7-6.9%) and 4.7% (95% CI, 1.2-8.4%) increase in visits for heart failure). Ozone (lag 2 days) was most consistently associated with respiratory visits (3.2% (95% CI, 0.3-6.2%), and 3.7% (95% CI, -0.5-7.9%) increases in asthma and COPD visits respectively per 18.4 ppb). Associations tended to be of greater magnitude during the warm season (April - September). In particular, the associations of PM 10 and PM2.5 with asthma visits were respectively nearly three- and over fourfold larger vs. all year analyses (14.4% increase in visits, 95% CI, 0.2-30.7, per 20.6 microg/m3 PM 10 and 7.6% increase in visits, 95% CI, 5.1-10.1, per 8.2 microg/m3 PM2.5). No consistent associations were observed between three hour average pollutant concentrations and same-day three hour averages of ED visits. CONCLUSION In this large multicenter analysis, daily average concentrations of CO and NO2 exhibited the most consistent associations with ED visits for cardiac conditions, while ozone exhibited the most consistent associations with visits for respiratory conditions. PM 10 and PM2.5 were strongly associated with asthma visits during the warm season.
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Affiliation(s)
- David M Stieb
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Postal locator 4903C, 269 Laurier Ave West Ottawa, Ontario, K1A 0K9, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Room 3105, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Mieczyslaw Szyszkowicz
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Postal locator 4903C, 269 Laurier Ave West Ottawa, Ontario, K1A 0K9, Canada
| | - Brian H Rowe
- Department of Emergency Medicine, University of Alberta, Room 1G1.43 WMC, University of Alberta Hospital, 8440-112th Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Judith A Leech
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Postal locator 4903C, 269 Laurier Ave West Ottawa, Ontario, K1A 0K9, Canada
- Department of Medicine, University of Ottawa, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
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Cooper PJ, Rodrigues LC, Cruz AA, Barreto ML. Asthma in Latin America: a public heath challenge and research opportunity. Allergy 2009; 64:5-17. [PMID: 19076533 DOI: 10.1111/j.1398-9995.2008.01902.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Asthma has emerged as an important public health problem in many Latin American countries over the past decade. In Brazil and Costa Rica, the prevalence of asthma and associated morbidity is as great or greater as reported in traditional high prevalence countries such as the US, but remains neglected as a public health priority. Asthma in Latin America is associated particularly with underprivileged populations living in cities but remains relatively rare in many rural populations. The causes of asthma in Latin America are likely to be associated with urbanization, migration, and the adoption of a modern 'Westernized' lifestyle and environmental changes that follow these processes that include changes in diet, physical activity, hygiene, and exposures to allergens, irritants, and outdoor and indoor pollutants. Because of the enormous social, genetic, and environmental contrasts within and between Latin American countries, and the large differences in prevalence associated with these differences, the investigation of asthma in Latin America provides important research opportunities to identify the social and biological mechanisms that underlie asthma development. Asthma in Latin America poses enormous challenges for health policy makers, health services, and researchers to respond to and alleviate the growing burden of asthma disability, particularly among marginalized urban populations.
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Affiliation(s)
- P J Cooper
- Centro de Investigaciones FEPIS, Quininde, Esmeraldas Province Ecuador
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Zanchi AC, Venturini CD, Saiki M, Nascimento Saldiva PH, Tannhauser Barros HM, Rhoden CR. Chronic nasal instillation of residual-oil fly ash (ROFA) induces brain lipid peroxidation and behavioral changes in rats. Inhal Toxicol 2008; 20:795-800. [PMID: 18645718 DOI: 10.1080/08958370802009060] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several epidemiological studies have linked particulate matter exposure to numerous adverse health effects on the respiratory, cardiovascular, and reproductive systems (Braga et al., 1999; Zanobetti et al., 2000; Anderson et al., 2001; Farhat et al., 2005). More recently, ambient levels of black carbon were associated to impaired cognitive function in children (Suglia et al., 2008), suggesting that the central nervous system (CNS) may be a target of air pollutants. The present study was conducted to (a) determine whether chronic residual oil fly ash (ROFA) exposure promotes behavioral changes and lipid peroxidation in rat brain areas, and (b) determine whether N-acetylcysteine (NAC), a general antioxidant, prevents these effects. Forty-five-day-old male Wistar rats were exposed or not to ROFA by intranasal instillation and were treated or not with NAC (150 mg/kg) ip for 30 days. One day later, rats were submitted to the open field test to evaluate the motor/exploratory activities and emotionality followed by decapitation. Striatum and cerebellum were dissected to determine lipid peroxidation by the accumulation of thiobarbituric acid-reactive substances (TBARS). ROFA instillation induced an increase in lipid peroxidation level in striatum (p = .033) and cerebellum (p = .030), as compared with the control group. NAC treatment blocked these changes. ROFA promoted a decrease in the frequency of peripheral walking (p = .006) and a decrease in exploration (p = .001), which were not blocked by N-acetylcysteine. The present study provides evidence that toxic particles, administered by the respiratory route, induce oxidative stress in structures of the central nervous system, as well as behavioral alterations. The administration of NAC reduces lipid peroxidation at the striatum and cerebellum levels, but does not influence behavioral disturbances.
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Affiliation(s)
- Ana Claudia Zanchi
- Post-Graduation Course in Medical Sciences and Laboratory of Oxidative Stress and Atmospheric Pollution, Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Latza U, Gerdes S, Baur X. Effects of nitrogen dioxide on human health: systematic review of experimental and epidemiological studies conducted between 2002 and 2006. Int J Hyg Environ Health 2008; 212:271-87. [PMID: 18771952 DOI: 10.1016/j.ijheh.2008.06.003] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 06/19/2008] [Accepted: 06/24/2008] [Indexed: 11/29/2022]
Abstract
In order to assess health effects in humans caused by environmental nitrogen dioxide (NO(2)) a systematic review of studies in humans was conducted. MEDLINE database was searched for epidemiological studies and experiments on adverse effects of NO(2) published between 2002 and 2006. The evidence with regard to NO(2) exposure limits was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) grading system and the modified three star system. Of the 214 articles retrieved 112 fulfilled the inclusion criteria. There was limited evidence that short-term exposure to a 1-h mean value below 200 microg NO(2)/m(3) is associated with adverse health effects provided by only one study on mortality in patients with severe asthma (*2+). The effect remained after adjusting for other air pollutants. There was moderate evidence that short-term exposure below a 24-h mean value of 50 microg NO(2)/m(3) at monitor stations increases hospital admissions and mortality (**2+). Evidence was also moderate when the search was restricted to susceptible populations (children, adolescents, elderly, and asthmatics). There was moderate evidence that long-term exposure to an annual mean below 40 microg NO(2)/m(3) was associated with adverse health effects (respiratory symptoms/diseases, hospital admissions, mortality, and otitis media) provided by generally consistent findings in five well-conducted cohort and case-control studies with some shortcomings in the study quality (**2+). Evidence was also moderate when the search was restricted to studies in susceptible populations (children and adolescents) and for the combination with other air pollutants. The most frequent reasons for decreased study quality were potential misclassification of exposure and selection bias. None of the high-quality observational studies evaluated was informative for the key questions due to the choice of the dose parameter (e.g., 1-week mean) and exposure levels above the limit values. Inclusion of study designs unlisted in the SIGN grading system did not bring additional evidence regarding exposures below the current air quality limit values for NO(2). As several recent studies reported adverse health effects below the current exposure limits for NO(2) particularly among susceptible populations regarding long-term exposure further research is needed. Apart from high-quality epidemiological studies on causality and the interaction of NO(2) with other air pollutants there is a need for double-blinded randomized cross-over studies among susceptible populations for further evaluation of the short-term exposure limits.
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Affiliation(s)
- Ute Latza
- Institute for Occupational Medicine and Maritime Medicine (ZfAM), University of Hamburg, Hamburg State Department for Social Affairs, Family, Health, and Consumer Protection, Hamburg, Germany.
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Lin S, Bell EM, Liu W, Walker RJ, Kim NK, Hwang SA. Ambient ozone concentration and hospital admissions due to childhood respiratory diseases in New York State, 1991-2001. ENVIRONMENTAL RESEARCH 2008; 108:42-47. [PMID: 18656858 DOI: 10.1016/j.envres.2008.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 04/23/2008] [Accepted: 06/12/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Respiratory diseases constitute one of the leading causes of ill health among children in New York State (NYS). The current project, a component of the NYS Environmental Public Health Tracking Program, investigated a potential association between ambient ozone (O(3)) concentration and childhood respiratory hospital admissions over 11 years in NYS. METHODS We used a two-stage Bayesian hierarchical model to assess the exposure-disease associations within 11 geographic regions and statewide. The data included total daily hospital admissions due to respiratory diseases for children 0-17 years old from 1991 to 2001 in NYS (N=134,099) and daily ambient O(3) level with different single-day lags. These analyses adjusted for particulate matter 10 microm in size (PM(10)), meteorological conditions, day of the week, seasonality, long-term trends, and demographic characteristics. RESULTS In 5 of the 11 regions, including the Upper and Lower Adirondacks, Upper Hudson Valley, Staten Island, and New York City, positive associations were found between respiratory hospital admissions and ambient O(3) level 2 days prior to the admission. Applying different statistical methods and sensitivity analysis of PM(10) did not alter these findings. When region-specific results were combined, no statewide association was apparent. CONCLUSIONS Geographic differences were found in the associations between O(3) levels and respiratory hospital admissions among children. In addition, we found that the two-stage model may be an appropriate approach for tracking the health effects of air pollution over time in different geographic areas when heterogeneity of risk factors across regions is present.
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Affiliation(s)
- Shao Lin
- Center for Environmental Health, New York State Department of Health, Troy, NY 12180, USA.
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Rosa AM, Ignotti E, Hacon SDS, Castro HAD. Análise das internações por doenças respiratórias em Tangará da Serra - Amazônia Brasileira. J Bras Pneumol 2008; 34:575-82. [DOI: 10.1590/s1806-37132008000800006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Accepted: 11/26/2007] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Analisar as internações hospitalares por doenças respiratórias em menores de 15 anos de idade em uma área com elevados níveis de poluição ambiental. MÉTODOS: Estudo transversal da morbidade hospitalar por doenças respiratórias de residentes no município de Tangará da Serra (MT) na Amazônia brasileira, no período de 2000 a 2005, através de dados de internações hospitalares do Sistema Único de Saúde brasileiro e de estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: Em 2005, a taxa de internações por doenças respiratórias em menores de 15 anos foi de 70,1/1.000 crianças na microrregião de Tangará da Serra. Entre 2000 a 2005 ocorreram, no município de Tangará da Serra, 12.777 internações de crianças, das quais 8.142 (63,7%) por doenças respiratórias. No período da seca (maio a outubro) houve 10% mais internações por doenças respiratórias que no período da chuva (novembro a abril). As principais causas de internação foram: pneumonias (90,7%) e insuficiência respiratória (8,5%). Em menores de 5 anos de idade, as internações por pneumonia foram mais de 4 vezes o esperado para o município. Os menores de 12 meses de idade foram mais frequentemente internados, com incremento médio de 32,4 internações por 1.000 crianças a cada ano. CONCLUSÕES: Tangará da Serra tem apresentado elevado número de internações por doenças respiratórias, portanto, é coerente considerá-lo como área prioritária para investigação e monitoramento dos fatores de risco ambientais para tais doenças.
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Mauad T, Rivero DHRF, de Oliveira RC, Lichtenfels AJDFC, Guimarães ET, de Andre PA, Kasahara DI, Bueno HMDS, Saldiva PHN. Chronic exposure to ambient levels of urban particles affects mouse lung development. Am J Respir Crit Care Med 2008; 178:721-8. [PMID: 18596224 DOI: 10.1164/rccm.200803-436oc] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Chronic exposure to air pollution has been associated with adverse effects on children's lung growth. OBJECTIVES We analyzed the effects of chronic exposure to urban levels of particulate matter (PM) on selected phases of mouse lung development. METHODS The exposure occurred in two open-top chambers (filtered and nonfiltered) placed 20 m from a street with heavy traffic in São Paulo, 24 hours/day for 8 months. There was a significant reduction of the levels of PM(2.5) inside the filtered chamber (filtered = 2.9 +/- 3.0 microg/m(3), nonfiltered = 16.8 +/- 8.3 microg/m(3); P = 0.001). At this exposure site, vehicular sources are the major components of PM(2.5) (PM <or= 2.5 microm). Exposure of the parental generation in the two chambers occurred from the 10th to the 120th days of life. After mating and birth of offspring, a crossover of mothers and pups occurred within the chambers, resulting in four groups of pups: nonexposed, prenatal, postnatal, and pre+postnatal. Offspring were killed at the age of 15 (n = 42) and 90 (n = 35) days; lungs were analyzed by morphometry for surface to volume ratio (as an estimator of alveolization). Pressure-volume curves were performed in the older groups, using a 20-ml plethysmograph. MEASUREMENTS AND MAIN RESULTS Mice exposed to PM(2.5) pre+postnatally presented a smaller surface to volume ratio when compared with nonexposed animals (P = 0.036). The pre+postnatal group presented reduced inspiratory and expiratory volumes at higher levels of transpulmonary pressure (P = 0.001). There were no differences among prenatal and postnatal exposure and nonexposed animals. CONCLUSIONS Our data provide anatomical and functional support to the concept that chronic exposure to urban PM affects lung growth.
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Affiliation(s)
- Thais Mauad
- Department of Pathology, Sao Paulo University Medical School, São Paulo, SP, Brazil.
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