Particulate matter exposure is highly correlated to pediatric asthma exacerbation

The Effects of Environmental Factors on General Human Health: A Scoping Review

Background/Objectives: The external environment constantly influences human health through many factors, including air quality, access to green spaces, exposure to pollutants, and climate change. Contamination poses a substantial threat to human well-being; conversely, environmental factors also positively impact health. The purpose of this study is to provide a comprehensive review of the complex relationship between various environmental factors and human health. While individual studies have explored specific aspects, a broader integrative understanding is lacking. Methods: Through databases (PubMed, Cochrane, Copernicus), 4888 papers were identified, with 166 selected for detailed analysis. Results: We summarized recent research, identifying multiple associations between environmental factors such as air pollution, climate change, solar radiation, and meteorological conditions and their impact on various health outcomes, including respiratory, cardiovascular, metabolic and gastrointestinal, renal and urogenital, neurological and psychological health, infectious and skin diseases, and major cancers. We use chord diagrams to illustrate these links. We also show the interaction between different environmental factors. Findings begin with exploring the direct impact of environmental factors on human health; then, the interplay and combined effects of environmental factors, elucidating their (often indirect) interaction and collective contribution to human health; and finally, the implications of climate change on human health. Conclusions: Researchers and policymakers need to consider that individuals are exposed to multiple pollutants simultaneously, the "multipollutant exposure phenomenon". It is important to study and regulate environmental factors by considering the combined impact of various pollutants rather than looking at each pollutant separately. We emphasize actionable recommendations and solutions.

Short-term exposure to fine particulate matter exposure impairs innate immune and inflammatory responses to a pathogen stimulus: A functional study in the zebrafish model

Short-term exposure to fine particulate matter (PM2.5) is associated with the activation of adverse inflammatory responses, increasing the risk of developing acute respiratory diseases, such as those caused by pathogen infections. However, the functional mechanisms underlying this evidence remain unclear. In the present study, we generated a zebrafish model of short-term exposure to a specific PM2.5, collected in the northern metropolitan area of Milan, Italy. First, we assessed the immunomodulatory effects of short-term PM2.5 exposure and observed that it elicited pro-inflammatory effects by inducing the expression of cytokines and triggering hyper-activation of both neutrophil and macrophage cell populations. Moreover, we examined the impact of a secondary infectious pro-inflammatory stimulus induced through the injection of Pseudomonas aeruginosa lipopolysaccharide (Pa-LPS) molecules after exposure to short-term PM2.5. In this model, we demonstrated that the innate immune response was less responsive to a second pro-inflammatory infectious stimulus. Indeed, larvae exhibited dampened leukocyte activation and impaired production of reactive oxygen species. The obtained results indicate that short-term PM2.5 exposure alters the immune microenvironment and affects the inflammatory processes, thus potentially weakening the resistance to pathogen infections.

The use of systemic corticosteroids in asthma management in Latin American countries

The stepwise treatment approach recommended by the Global Initiative for Asthma (GINA) includes systemic corticosteroids (SCS) suggested as a final step if asthma is severe and/or difficult to treat. Yet, despite the effectiveness of SCS, they are also associated with potentially irreversible adverse outcomes such as type 2 diabetes, adrenal suppression, and cardiovascular disease. Based on recent data indicating that the risk of developing these conditions can increase after as few as 4 short-term (burst) courses of SCS, even patients with mild asthma who receive SCS occasionally for exacerbations are also at risk of these events. As a result, recent updates by GINA and the Latin American Thoracic Society recommend decreasing SCS use by optimizing administration of non-SCS therapies and/or increasing the use of alternatives, such as biologic agents. Recent and ongoing studies characterizing treatment patterns among patients with asthma have revealed alarming trends suggesting the widespread overuse of SCS around the world. In Latin America, asthma prevalence is approximately 17%, and data suggest that the majority of patients have uncontrolled disease. In this review, we summarize currently available data on asthma treatment patterns in Latin America, which indicate that SCS are prescribed to 20-40% of patients with asthma considered to be well controlled and over 50% of patients with uncontrolled disease. We also offer potential strategies to help reduce SCS use for asthma in everyday clinical practice.

PM2 .5, PM10 and bronchiolitis severity: A cohort study

BACKGROUND

A few studies suggest that particulate matter (PM) exposure might play a role in bronchiolitis. However, available data are mostly focused on the risk of hospitalization and come from retrospective studies that provided conflicting results. This prospective study investigated the association between PM (PM_2.5 and PM₁₀ ) exposure and the severity of bronchiolitis.

METHODS

This prospective cohort study was conducted between November 2019 and February 2020 at the pediatric emergency department of the Fondazione IRCCS Ca' Ospedale Maggiore Policlinico, Milan, Italy. Infants <1 year of age with bronchiolitis were eligible. The bronchiolitis severity score was assessed in each infant and a nasal swab was collected to detect respiratory viruses. The daily PM₁₀ and PM_2.5 exposure in the 29 preceding days were considered. Adjusted regression models were employed to evaluate the association between the severity score and PM₁₀ and PM_2.5 exposure.

RESULTS

A positive association between the PM_2.5 levels and the severity score was found at day-2 (β 0.0214, 95% CI 0.0011-0.0417, p = .0386), day-5 (β 0.0313, 95% CI 0.0054-0.0572, p = .0179), day-14 (β 0.0284, 95% CI 0.0078-0.0490, p = .0069), day-15 (β 0.0496, 95% CI 0.0242-0.0750, p = .0001) and day-16 (β 0.0327, 95% CI 0.0080-0.0574, p = .0093).Similar figures were observed considering the PM₁₀ exposure and limiting the analyses to infants with respiratory syncytial virus.

CONCLUSION

This study shows for the first time a direct association between PM_2.5 and PM₁₀ levels and the severity of bronchiolitis.