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Zhang Y, Yang X, Jiang W, Gao X, Yang B, Feng XL, Yang L. Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China. Front Public Health 2024; 12:1346914. [PMID: 38347929 PMCID: PMC10859495 DOI: 10.3389/fpubh.2024.1346914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
Background This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution. Methods We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach. Results The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively. Conclusion This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xi Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wanyanhan Jiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xi Gao
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Biao Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xing Lin Feng
- School of Public Health, Peking University, Beijing, China
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Nakhjirgan P, Kashani H, Kermani M. Exposure to outdoor particulate matter and risk of respiratory diseases: a systematic review and meta-analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 46:20. [PMID: 38153542 DOI: 10.1007/s10653-023-01807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
According to epidemiological studies, particulate matter (PM) is an important air pollutant that poses a significant threat to human health. The relationship between particulate matter and respiratory diseases has been the subject of numerous studies, but these studies have produced inconsistent findings. The purpose of this systematic review was to examine the connection between outdoor particulate matter (PM2.5 and PM10) exposure and respiratory disorders (COPD, lung cancer, LRIs, and COVID-19). For this purpose, we conducted a literature search between 2012 and 2022 in PubMed, Web of Science, and Scopus. Out of the 58 studies that were part of the systematic review, meta-analyses were conducted on 53 of them. A random effect model was applied separately for each category of study design to assess the pooled association between exposure to PM2.5 and PM10 and respiratory diseases. Based on time-series and cohort studies, which are the priorities of the strength of evidence, a significant relationship between the risk of respiratory diseases (COPD, lung cancer, and COVID-19) was observed (COPD: pooled HR = 1.032, 95% CI: 1.004-1.061; lung cancer: pooled HR = 1.017, 95% CI: 1.015-1.020; and COVID-19: pooled RR = 1.004, 95% CI: 1.002-1.006 per 1 μg/m3 increase in PM2.5). Also, a significant relationship was observed between PM10 and respiratory diseases (COPD, LRIs, and COVID-19) based on time-series and cohort studies. Although the number of studies in this field is limited, which requires more investigations, it can be concluded that outdoor particulate matter can increase the risk of respiratory diseases.
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Affiliation(s)
- Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
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陈 一, 胡 耀, 詹 宇, 孙 雅, 李 春, 辜 永, 曾 筱. [Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1176-1183. [PMID: 38162061 PMCID: PMC10752782 DOI: 10.12182/20231160504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Indexed: 01/03/2024]
Abstract
Objective To evaluate the association between short-term exposure to air pollutants of end-stage renal disease (ESRD) patients on maintenance hemodialysis and the number of daily hospital admissions. Methods The data on hospitalizations were obtained from the database of the municipal Urban Employees' Basic Medical Insurance and Urban Residents' Basic Medical Insurance of a city in Southwest China. Single and multiple pollutant generalized additive models were utilized to estimate the effect of air pollutants (CO, NO2, O3, PM10, PM2.5, and SO2) on patient admissions after the lag time of different numbers of days. In addition, subgroup analyses stratified by sex, age, PM2.5 and PM10 concentration thresholds, seasonality, and comorbidity status for cardiovascular diseases and hypertension were conducted. Results In the single pollutant models, the pollutants significantly associated with patient admissions and the corresponding lag time of the strongest association were as follows, every time CO increased by 0.1 mg/m3, there was a 2.39% increase (95% confidence interval [CI]: 0.96%-3.83%) in patient admissions after 7 days of lag time; every time NO2, O3, PM2.5, PM10, and SO2 increased by 10 μg/m3, patient admissions increased by 4.02% (95% CI: 1.21%-6.91%) after 7 days of lag time, 3.57% (95% CI: 0.78%-6.44%) after 0-4 days of lag time, 2.00% (95% CI: 1.07%-2.93%) after 6 days of lag time, 1.19% (95% CI: 0.51%-1.88%) after 7 days of lag time, and 8.37% (95% CI: 3.08%-13.93%) after 7 days of lag time, respectively. In the multiple pollutant model, every time O3 and PM2.5 increased by 10 μg/m3, there was an increase of 3.18% (95% CI: 0.34%-6.09%) in daily patient admissions after 0-4 days of lag time and an increase of 1.85% (95% CI: 0.44%-3.28%) after 7 days of lag time. Furthermore, subgroup analyses showed that seasonality, the severity of air pollution, and patients' comorbidities might be the effect modifiers for the association between ambient air pollution and hospital admissions in ESRD patients receiving maintenance hemodialysis. Conclusion Air pollution is closely associated with hospital admissions in ESRD patients undergoing maintenance hemodialysis and the strength of this association varies according to seasonality, the severity of air pollution, and patients' status of comorbidities.
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Affiliation(s)
- 一龙 陈
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
| | - 耀 胡
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
| | - 宇 詹
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 雅婧 孙
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
| | - 春漾 李
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
| | - 永红 辜
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
| | - 筱茜 曾
- 四川大学华西医院 肾脏内科与华西生物医学大数据中心 (成都 610041)Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学“医学+信息”中心 (成都 610041)Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
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Delavar MA, Jahani MA, Sepidarkish M, Alidoost S, Mehdinezhad H, Farhadi Z. Relationship between fine particulate matter (PM 2.5) concentration and risk of hospitalization due to chronic obstructive pulmonary disease: a systematic review and meta-analysis. BMC Public Health 2023; 23:2229. [PMID: 37953239 PMCID: PMC10641956 DOI: 10.1186/s12889-023-17093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Short-term exposure to PM2.5 has been associated with human health risks. However, evidence on the association between short-term exposure to PM2.5 and the risk of chronic obstructive pulmonary disease (COPD) remains limited and controversial. This study aimed to specifically assess the relationship between exposure to PM2.5 and the risk of hospitalization due to COPD. METHODS A systematic search was conducted in PubMed, Web of Science, and Google Scholar databases from January 1, 2010 to May 1, 2022. The odds ratio (OR) statistic was calculated as a common measure of effect size. Publication bias was also examined in all eligible studies on COPD hospitalization using funnel plots and Egger's test, as well as trim-and-fill method for missing studies on COPD hospitalization. RESULTS A total of 19 studies were included in this meta-analysis. Random-effects models were plotted to calculate the pooled effect size by measuring OR (χ2 = 349.95; df = 18; I2 = 94.86%; P = 0.007; Z = 2.68; P < 0.001). A 10-mg/m3 daily increase in PM2.5 concentration was associated with a 1.6% (95% CI: 0.4-2.9%) increase in COPD hospitalization. There was no publication bias regarding the association between COPD hospitalization and PM2.5 (bias = 1.508; 95% CI: -1.475, 4.491; t = 1.066; P = 0.301). The subgroups of age ≥ 65 years and Asian countries were associated with an increased risk of COPD hospitalization. Besides, higher risks were estimated in the subgroups of studies performed in the warm season, case-crossover studies, studies with three lag days, and studies without adjustments for humidity and temperature confounders, with very small heterogeneity. CONCLUSION Evidence suggests that short-term exposure to PM2.5 increases COPD hospitalization. Further studies are needed to understand the mechanism of the association between PM2.5 and COPD for reducing air pollution, which can be beneficial for COPD patients.
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Affiliation(s)
- Mouloud Agajani Delavar
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ali Jahani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahdi Sepidarkish
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Saeide Alidoost
- National Center for Strategic Research in Medical Education, Tehran, Iran
| | - Hamed Mehdinezhad
- Department of Internal Medicine, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Zeynab Farhadi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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5
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Bronte O, García-García F, Lee DJ, Urrutia I, Uranga A, Nieves M, Martínez-Minaya J, Quintana JM, Arostegui I, Zalacain R, Ruiz-Iturriaga LA, Serrano L, Menéndez R, Méndez R, Torres A, Cilloniz C, España PP. Impact of outdoor air pollution on severity and mortality in COVID-19 pneumonia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 894:164877. [PMID: 37331396 PMCID: PMC10275649 DOI: 10.1016/j.scitotenv.2023.164877] [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: 02/09/2023] [Revised: 05/23/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
The relationship between exposure to air pollution and the severity of coronavirus disease 2019 (COVID-19) pneumonia and other outcomes is poorly understood. Beyond age and comorbidity, risk factors for adverse outcomes including death have been poorly studied. The main objective of our study was to examine the relationship between exposure to outdoor air pollution and the risk of death in patients with COVID-19 pneumonia using individual-level data. The secondary objective was to investigate the impact of air pollutants on gas exchange and systemic inflammation in this disease. This cohort study included 1548 patients hospitalised for COVID-19 pneumonia between February and May 2020 in one of four hospitals. Local agencies supplied daily data on environmental air pollutants (PM10, PM2.5, O3, NO2, NO and NOX) and meteorological conditions (temperature and humidity) in the year before hospital admission (from January 2019 to December 2019). Daily exposure to pollution and meteorological conditions by individual postcode of residence was estimated using geospatial Bayesian generalised additive models. The influence of air pollution on pneumonia severity was studied using generalised additive models which included: age, sex, Charlson comorbidity index, hospital, average income, air temperature and humidity, and exposure to each pollutant. Additionally, generalised additive models were generated for exploring the effect of air pollution on C-reactive protein (CRP) level and SpO2/FiO2 at admission. According to our results, both risk of COVID-19 death and CRP level increased significantly with median exposure to PM10, NO2, NO and NOX, while higher exposure to NO2, NO and NOX was associated with lower SpO2/FiO2 ratios. In conclusion, after controlling for socioeconomic, demographic and health-related variables, we found evidence of a significant positive relationship between air pollution and mortality in patients hospitalised for COVID-19 pneumonia. Additionally, inflammation (CRP) and gas exchange (SpO2/FiO2) in these patients were significantly related to exposure to air pollution.
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Affiliation(s)
- O Bronte
- Galdakao-Usansolo University Hospital, Pulmonology Department, Galdakao, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain.
| | | | - D-J Lee
- Basque Center for Applied Mathematics (BCAM), Bilbao, Spain
| | - I Urrutia
- Galdakao-Usansolo University Hospital, Pulmonology Department, Galdakao, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | - A Uranga
- Galdakao-Usansolo University Hospital, Pulmonology Department, Galdakao, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | - M Nieves
- Galdakao-Usansolo University Hospital, Pulmonology Department, Galdakao, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | | | - J M Quintana
- Galdakao-Usansolo University Hospital, Research Unit, Galdakao, Spain
| | - I Arostegui
- University of the Basque Country (UPV/EHU), Department of Applied Mathematics, Statistics and Operative Research, Leioa, Spain; Basque Center for Applied Mathematics (BCAM), Bilbao, Spain
| | - R Zalacain
- Cruces University Hospital, Pulmonology Department, Baracaldo, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | - L A Ruiz-Iturriaga
- Cruces University Hospital, Pulmonology Department, Baracaldo, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | - L Serrano
- Cruces University Hospital, Pulmonology Department, Baracaldo, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
| | - R Menéndez
- Hospital Universitari i Politècnic La Fe de Valencia, Pulmonology Department, Valencia, Spain
| | - R Méndez
- Hospital Universitari i Politècnic La Fe de Valencia, Pulmonology Department, Valencia, Spain
| | - A Torres
- Hospital Clínic i Provincial de Barcelona, Pulmonology Department, University of Barcelona, Barcelona, Spain
| | - C Cilloniz
- Hospital Clínic i Provincial de Barcelona, Pulmonology Department, University of Barcelona, Barcelona, Spain; Faculty of Health Sciences, Continental University, Huancayo, Peru
| | - P P España
- Galdakao-Usansolo University Hospital, Pulmonology Department, Galdakao, Spain; BioCruces Bizkaia Health Research Institute, Baracaldo, Spain
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Squires E. Effects of climate change on patients with respiratory and cardiovascular conditions. Nurs Stand 2023; 38:57-61. [PMID: 37259785 DOI: 10.7748/ns.2023.e12087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 06/02/2023]
Abstract
Climate change is one of the most significant global challenges and is already having detrimental effects on people's health. Pollution levels and ambient temperatures continue to increase, resulting in higher levels of humidity and pollen production. These environmental threats can affect many vulnerable patients, particularly those with respiratory and cardiovascular conditions, and nurses have a crucial role in raising awareness of the health implications of climate change. This article explores the pathophysiological effects of climate change on patients with asthma, chronic obstructive pulmonary disease and cardiovascular disease, and aims to enhance nurses' understanding of the health challenges of climate change.
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Affiliation(s)
- Eleanor Squires
- School of Health and Social Work, University of Hertfordshire, Hatfield, England
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Zhu R, Chen J. Long-term effects of air pollution on hospital admissions and mortality for chronic obstructive pulmonary disease in Beijing, China. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:672-683. [PMID: 37392082 PMCID: PMC10363839 DOI: 10.1111/crj.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE We aimed to clarify the association between air pollution and hospital admissions for chronic obstructive pulmonary disease (COPD) and mortality in Beijing, China. METHODS In this retrospective study, we recruited 510 COPD patients from 1 January 2006 to 31 December 2009. The patient data were obtained from the electronic medical records of Peking University Third Hospital in Beijing. Air pollution and meteorological data were obtained from the Institute of Atmospheric Physics of the Chinese Academy of Sciences. Monthly COPD hospital admissions, mortality and air pollution data were analysed using Poisson regression in generalised additive models adjusted for mean temperature, pressure and relative humidity. RESULTS There were positive correlations between sulfur dioxide (SO2 ), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10 ) and COPD hospital admissions in the single-pollutant model. An increase of 10 μg/m3 in SO2 and PM10 were associated with an increase of 4.053% (95% CI: 1.470-5.179%) and 1.401% (95%CI: 0.6656-1.850%) in COPD hospital admissions. In the multiple-pollutant model [SO2 and nitrogen dioxide (NO2 ) combinations], there was only a positive correlation between SO2 and COPD hospital admissions. An increase of 10 μg/m3 in SO2 were associated with an increase of 1.916% (95% CI: 1.118-4.286%) in COPD hospital admissions. There was no correlation between three pollutant combinations and COPD hospital admissions. We did not find correlations between air pollution and COPD mortality in either single- or multiple-pollutant models. CONCLUSIONS SO2 and PM10 may be important factors for the increase in COPD hospital admissions in Beijing, China.
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Affiliation(s)
- Rui‐xia Zhu
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
| | - Jin Chen
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
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8
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Trickey KS, Chen Z, Sanghavi P. Hospitalisations for cardiovascular and respiratory disease among older adults living near unconventional natural gas development: a difference-in-differences analysis. Lancet Planet Health 2023; 7:e187-e196. [PMID: 36889860 DOI: 10.1016/s2542-5196(23)00009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND During 2008-15, the Marcellus shale region of the US state of Pennsylvania experienced a boom in unconventional natural gas development (UNGD) or "fracking". However, despite much public debate, little is known about the effects of UNGD on population health in local communities. Among other mechanisms, air pollution from UNGD might affect individuals living nearby through cardiovascular or respiratory disease, and older adults could be particularly susceptible. METHODS To study the health impacts of Pennsylvania's fracking boom, we exploited the ban on UNGD in neighbouring New York state. Using 2002-15 Medicare claims, we conducted difference-in-differences analyses over multiple timepoints to estimate the risk of living near UNGD for hospitalisation with acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD) and bronchiectasis, heart failure, ischaemic heart disease, and stroke among older adults (aged ≥65 years). FINDINGS Pennsylvania ZIP codes that started UNGD in 2008-10 were associated with more hospitalisations for cardiovascular diseases in 2012-15 than would be expected in the absence of UNGD. Specifically, in 2015, we estimated an additional 11·8, 21·6, and 20·4 hospitalisations for AMI, heart failure, and ischaemic heart disease, respectively, per 1000 Medicare beneficiaries. Hospitalisations increased even as UNGD growth slowed. Results were robust in sensitivity analyses. INTERPRETATION Older adults living near UNGD could be at high risk of poor cardiovascular outcomes. Mitigation policies for existing UNGD might be needed to address current and future health risks. Future consideration of UNGD should prioritise local population health. FUNDING University of Chicago and Argonne National Laboratories.
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Affiliation(s)
- Kevin S Trickey
- Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Zihan Chen
- Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Prachi Sanghavi
- Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, IL, USA.
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9
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Song J, Qiu W, Huang X, Guo Y, Chen W, Wang D, Zhang X. Association of ambient carbon monoxide exposure with hospitalization risk for respiratory diseases: A time series study in Ganzhou, China. Front Public Health 2023; 11:1106336. [PMID: 36866098 PMCID: PMC9972102 DOI: 10.3389/fpubh.2023.1106336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
Background Ambient carbon monoxide (CO) exposure is associated with increased mortality and hospitalization risk for total respiratory diseases. However, evidence on the risk of hospitalization for specific respiratory diseases from ambient CO exposure is limited. Methods Data on daily hospitalizations for respiratory diseases, air pollutants, and meteorological factors from January 2016 to December 2020 were collected in Ganzhou, China. A generalized additive model with the quasi-Poisson link and lag structures was used to estimate the associations between ambient CO concentration and hospitalizations of total respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), and influenza-pneumonia. Possible confounding co-pollutants and effect modification by gender, age, and season were considered. Results A total of 72,430 hospitalized cases of respiratory diseases were recorded. Significant positive exposure-response relationships were observed between ambient CO exposure and hospitalization risk from respiratory diseases. For each 1 mg/m3 increase in CO concentration (lag0-2), hospitalizations for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia increased by 13.56 (95% CI: 6.76%, 20.79%), 17.74 (95% CI: 1.34%, 36.8%), 12.45 (95% CI: 2.91%, 22.87%), 41.25 (95% CI: 18.19%, 68.81%), and 13.5% (95% CI: 3.41%, 24.56%), respectively. In addition, the associations of ambient CO with hospitalizations for total respiratory diseases and influenza-pneumonia were stronger during the warm season, while women were more susceptible to ambient CO exposure-associated hospitalizations for asthma and LRTI (all P < 0.05). Conclusion In brief, significant positive exposure-response relationships were found between ambient CO exposure and hospitalization risk for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia. Effect modification by season and gender was found in ambient CO exposure-associated respiratory hospitalizations.
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Affiliation(s)
- Jiahao Song
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuezan Huang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - You Guo
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China,School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Dongming Wang ✉
| | - Xiaokang Zhang
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China,School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China,Xiaokang Zhang ✉
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10
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Aranburu-Imatz A, Jiménez-Hornero JE, Morales-Cané I, López-Soto PJ. Environmental pollution in North-Eastern Italy and its influence on chronic obstructive pulmonary disease: time series modelling and analysis using visibility graphs. AIR QUALITY, ATMOSPHERE, & HEALTH 2023; 16:793-804. [PMID: 36714016 PMCID: PMC9875196 DOI: 10.1007/s11869-023-01310-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/16/2023] [Indexed: 06/01/2023]
Abstract
The impact on human health from environmental pollution is receiving increasing attention. In the case of respiratory diseases such as chronic obstructive pulmonary disease (COPD), the relationship is now well documented. However, few studies have been carried out in areas with low population density and low industrial production, such as the province of Belluno (North-Eastern Italy). The aim of the study was to analyze the effect of exposure to certain pollutants on the temporal dynamics of hospital admissions for COPD in the province of Belluno. Daily air pollution concentration, humidity, precipitations, and temperature were collected from the air monitoring stations in Belluno. Generalized additive mixed models (GAMM) and visibility graphs were used to determine the effects of the short-term exposure to environmental agents on hospital admissions associated to COPD. In the case of the city of Belluno, the GAMM showed that hospital admissions were associated with NO2, PM10, date, and temperature, while for the city of Feltre, GAMM produced no associated variables. Several visibility graph indices (average edge overlap and interlayer mutual information) showed a significant overlap between environmental agents and hospital admission for both cities. Our study has shown that visibility graphs can be useful in establishing associations between environmental agents and COPD hospitalization in sparsely populated areas.
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Affiliation(s)
- Alejandra Aranburu-Imatz
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Outpatient Clinic, Hospital Giovanni Paolo II, ULSS1 Dolomiti, Veneto, Italy
| | | | - Ignacio Morales-Cané
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - Pablo Jesús López-Soto
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
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11
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Hosseini SA, Shateri Z, Abolnezhadian F, Maraghi E, Haddadzadeh Shoushtari M, Zilaee M. Does pomegranate extract supplementation improve the clinical symptoms of patients with allergic asthma? A double-blind, randomized, placebo-controlled trial. Front Pharmacol 2023; 14:1109966. [PMID: 36762119 PMCID: PMC9905411 DOI: 10.3389/fphar.2023.1109966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Asthma essentially represents a chronic inflammatory disease that manifests as a lifelong condition with different severity throughout the life of patients with asthma. Pomegranate holds three times the antioxidant activity compared to other polyphenol-rich food sources like green tea, which may positively impact asthma. Aim of the study: This research aimed to investigate the pomegranate supplementation influences clinical symptoms, eosinophil, basophil, and neutrophil counts in patients with allergic asthma. Materials and Methods: Participants (n = 64) suffering from mild to moderate allergic asthma were randomly divided into two groups: The control group received placebo capsules and the intervention group received 250 mg pomegranate extract capsules twice a day (for 8 weeks). To analyze the data, we used SPSS software (version 22). The significance level of p-value was considered less than 0.05. Results: The findings showed that the pomegranate extract improved patients' clinical symptoms like daily breath shortness, nocturnal breath shortness, and limitation of asthma-related activity in the intervention group compared to the control group. Furthermore, eosinophil, basophil, and neutrophil counts were significantly decreased in the intervention group. Also, by comparing the two groups, the levels of change in neutrophils and eosinophils were statistically significant. Conclusion: It appears that the pomegranate extract can ameliorate some clinical symptoms and reduce neutrophils, basophils, and eosinophils in allergic asthma patients. Clinical Trial Registration: https://www.irct.ir/trial/45612; identifier: IRCT20200205046384N1.
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Affiliation(s)
- Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Clinical Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,*Correspondence: Zainab Shateri,
| | - Farhad Abolnezhadian
- Division of Immunology and Allergy, Department of Pediatrics, Abuzar Children’s Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Haddadzadeh Shoushtari
- Air Pollution and Respiratory Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzie Zilaee
- Nutrition and Metabolic Diseases Research Center, Clinical Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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12
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Ünal E, Özdemir A, Khanjani N, Dastoorpoor M, Özkaya G. Air pollution and pediatric respiratory hospital admissions in Bursa, Turkey: A time series study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2767-2780. [PMID: 34641701 DOI: 10.1080/09603123.2021.1991282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
We aimed to investigate the relation between air pollution and the number of daily hospitalizations due to pneumonia, asthma, bronchitis in children aged 0-18 in Bursa city of Turkey, between the years 2013-2018. The daily values of air pollutants (PM10, SO2, NO2, NOx, CO, and O3) from 2013 until 2018, were obtained. Adjusted Quasi-Poisson regression models including distributed lags, controlled for climate variables were used for data analysis. Increases in SO2, ozone, PMs, and nitrogen oxides were associated with pneumonia hospitalizations, increases in SO2 NOx and PMs were associated with asthma hospitalizations, and increases in SO2 and ozone were associated with bronchitis hospitalizations. Male hospitalization was related with SO2, ozone, and NOx; while female hospitalization was only related with SO2. This study showed that short-term exposure to air pollution is associated with an increased risk of pneumonia, asthma, and bronchitis hospitalization among children in Bursa.
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Affiliation(s)
- Eda Ünal
- Department of Nursing, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Aysel Özdemir
- Department of Public Health Nursing, Bursa Uludag University, Faculty of Health Sciences, Bursa, Turkey
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Güven Özkaya
- Department of Biostatistics, Bursa Uludag University Medical Faculty, Bursa, Turkey
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13
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Shateri Z, Hosseini SA, Abolnezhadian F, Maraghi E, Haddadzadeh Shoushtari M, Zilaee M. Pomegranate extract supplementation improves lung function parameters and IL-35 expression in participants with mild and moderate persistent allergic asthma: A randomized, double-blind, placebo-controlled trial. Front Nutr 2022; 9:1026343. [PMID: 36330147 PMCID: PMC9623269 DOI: 10.3389/fnut.2022.1026343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Existing asthma treatments are associated with side effects and limitations, which has led to an interest in alternative and complementary therapies. Given the anti-inflammatory properties of pomegranate, the present study aimed to determine the impact of pomegranate extract supplementation on lung function parameters evaluated through spirometry, high-sensitivity C-reactive protein (hs-CRP), pro-oxidant antioxidant balance, and interleukin 35) (IL-35) in participants with mild and moderate allergic asthma (based on forced expiratory volume in 1 second (FEV1) and clinical symptoms). Participants with mild and moderate allergic asthma (n = 64) were randomly assigned to two groups: the intervention group, which received two pomegranate extract capsules (500 mg/day), or the control group for eight weeks. Also, the physician prescribed similar drugs to the participants in the study. Independent samples T-test and Mann-Whitney U were used to compare the quantitative outcomes between the intervention group and the comparison group. The Wilcoxon test and the paired T-test were applied for within-group comparisons. A p-value <0.05 was considered significant. At the end of the study, the change levels of IL-35 in the intervention group increased significantly compared to the control group. In terms of the lung function parameters, FEV1/ forced vital capacity (FVC) (FEV1/FVC) ratio enhanced significantly in the intervention group compared to the control group. Also, the pomegranate extract significantly improved forced expiratory flow 25-75% (FEF25-75%), FEV1/FVC ratio, and FEV1 in the intervention group. No significant changes in FEV1 values were observed between the two groups at the end of the study. Also, no significant changes were seen in other indicators. It seems that pomegranate extract can improve lung function parameters and IL-35 expression in mild and moderate allergic asthma. Clinical trial registration https://www.irct.ir/trial/45612; identifier: IRCT20200205046384N1.
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Affiliation(s)
- Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition Department, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition Department, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farhad Abolnezhadian
- Division of Immunology and Allergy, Department of Pediatrics, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Haddadzadeh Shoushtari
- Air Pollution and Respiratory Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzie Zilaee
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition Department, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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14
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Tran HM, Chen TT, Lu YH, Tsai FJ, Chen KY, Ho SC, Wu CD, Wu SM, Lee YL, Chung KF, Kuo HP, Lee KY, Chuang HC. Climate-mediated air pollution associated with COPD severity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:156969. [PMID: 35760178 DOI: 10.1016/j.scitotenv.2022.156969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Air pollution has been reported to be associated with chronic obstructive pulmonary disease (COPD). Our study aim was to examine the mediating effects of air pollution on climate-associated health outcomes of COPD patients. A cross-sectional study of 117 COPD patients was conducted in a hospital in Taiwan. We measured the lung function, 6-min walking distance, oxygen desaturation, white blood cell count, and percent emphysema (low attenuation area, LAA) and linked these to 0-1-, 0-3-, and 0-5-year lags of individual-level exposure to relative humidity (RH), temperature, and air pollution. Linear regression models were conducted to examine associations of temperature, RH, and air pollution with severity of health outcomes. A mediation analysis was conducted to examine the mediating effects of air pollution on the associations of RH and temperature with health outcomes. We observed that a 1 % increase in the RH was associated with increases in forced expiratory volume in 1 s (FEV1), eosinophils, and lymphocytes, and a decrease in the total-lobe LAA. A 1 °C increase in temperature was associated with decreases in oxygen desaturation, and right-, left-, and upper-lobe LAA values. Also, a 1 μg/m3 increase in PM2.5 was associated with a decrease in the FEV1 and an increase in oxygen desaturation. A 1 μg/m3 increases in PM10 and PM2.5 was associated with increases in the total-, right-, left, upper-, and lower-lobe (PM2.5 only) LAA. A one part per billion increase in NO2 was associated with a decrease in the FEV1 and an increase in the upper-lobe LAA. Next, we found that NO2 fully mediated the association between RH and FEV1. We found PM2.5 fully mediated associations of temperature with oxygen saturation and total-, right-, left-, and upper-lobe LAA. In conclusion, climate-mediated air pollution increased the risk of decreasing FEV1 and oxygen saturation and increasing emphysema severity among COPD patients. Climate change-related air pollution is an important public health issue, especially with regards to respiratory disease.
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Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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15
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Dastoorpoor M, Khodadadi N, Madadizadeh F, Raji H, Shahidizadeh E, Idani E, Shoushtari MH. Assessing the prevalence and severity of asthma, rhinitis, and eczema among schoolchildren (6-7 and 13-14 years old) in Khuzestan, Iran: a cross-sectional survey. BMC Pediatr 2022; 22:463. [PMID: 35918674 PMCID: PMC9344770 DOI: 10.1186/s12887-022-03520-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Asthma and allergic complications are the most common chronic disorders in children and adolescents. This study aimed to determine the prevalence and severity of asthma, allergic rhinitis, eczema among schoolchildren, and some related risk factors. Methods The cross-sectional study was performed in 2019 and involved 4000 students aged 6–7 years and 4000 students aged 13–14 years (both girls and boys) from urban schools in Khuzestan Province, southwestern Iran. We used the multi-stage sampling method. Data were collected using the Persian version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results The prevalence of current wheeze, wheeze ever and asthma ever in the age group of 6–7 years was 3.8, 4.5, and 1.8%, respectively; in the age group of 13–14 years, it was 4.4, 5.9, and 3.4, respectively. In terms of gender, males (4.9, 6.0, and 2.7 percent, respectively) had substantially higher rates of current wheeze, wheeze ever, and asthma ever compared to the girls (2.8, 3.6, and 2.0 percent, respectively) (p < 0.001). The prevalence of rhinitis, Hay fever, and eczema among young people was 5.3%, 3.5%, and 1.0%, respectively. Current wheeze was more common in children with allergic rhinitis in the last 12 months (30.3% vs. 2.7%, p < 0.001), Hay fever (32.8% vs. 0.3%, p < 0.001) and eczema (27.8% vs 3.8%, p < 0.001), compared to children who did not. Conclusions The prevalence and severity of asthma symptoms were significantly associated with allergic rhinitis, eczema, and gender. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03520-x.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farzan Madadizadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Shahidizadeh
- Department of Environmental Health Engineering, Faculty of Medical Sciences, School of Health, Abadan, Iran
| | - Esmaeil Idani
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Haddadzadeh Shoushtari
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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16
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Bălă GP, Timar B, Gorun F, Motisan R, Pescaru C, Tudorache E, Marc M, Manolescu D, Citu C, Oancea C. The Impact of Air Pollution on Frequent Exacerbations among COPD Patients: An Observational Study on the Population of Western Romania. J Clin Med 2022; 11:jcm11154352. [PMID: 35955970 PMCID: PMC9369358 DOI: 10.3390/jcm11154352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 01/25/2023] Open
Abstract
Patients with respiratory pathologies are the risk group most affected by air pollution, being directly exposed, especially those diagnosed with chronic obstructive pulmonary disease (COPD). In this observational study, which included 79 patients, we evaluated whether COPD patients with the frequent exacerbating phenotype or the infrequent exacerbating phenotype live in residences with higher values of air pollution. An air quality monitoring station was installed in each patient’s house for at least 24 h and PM 1.0, PM 2.5, and PM 10 were measured. Average PM 1.0, PM 2.5, and PM 10 values were lower in the group of infrequently exacerbating patients compared to the frequently exacerbating ones. For every 1 µg/m3 increase in the average values of PM 1.0, PM 2.5, and PM 10, there is an increase of 1.7%, 1.8% and 1%, respectively, in the risk of developing exacerbations. More importantly, an average value of PM 1.0, PM 2.5, and PM 10 above 32.21 µg/m3, 82.32 µg/m3 and 42.89 µg/m3 increases the probability of developing an exacerbation by 3.83, 10.14, and 4.12 times, respectively. Our analysis showed that COPD patients with a frequently exacerbating phenotype live in residences with high levels of air pollution compared to infrequently exacerbating ones.
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Affiliation(s)
- Gabriel-Petrică Bălă
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (G.-P.B.); (C.P.); (E.T.); (M.M.); (C.O.)
| | - Bogdan Timar
- Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Florin Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 1-3 Alexandru Odobescu Street, 300202 Timisoara, Romania;
| | - Radu Motisan
- MagnaSCI SRL, 7 Luceafarul Street, 300414 Timisoara, Romania;
| | - Camelia Pescaru
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (G.-P.B.); (C.P.); (E.T.); (M.M.); (C.O.)
| | - Emanuela Tudorache
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (G.-P.B.); (C.P.); (E.T.); (M.M.); (C.O.)
| | - Monica Marc
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (G.-P.B.); (C.P.); (E.T.); (M.M.); (C.O.)
| | - Diana Manolescu
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (G.-P.B.); (C.P.); (E.T.); (M.M.); (C.O.)
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17
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A Review of Studies Using Air Q Software for Prediction of Air Pollution Health Effects in Iran. Curr Environ Health Rep 2022; 9:386-405. [PMID: 35729411 DOI: 10.1007/s40572-022-00362-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Exposure to air pollutants may lead to various health effects and is a major public health issue. Concerns about these effects exist in both developed and developing countries. The Air Q software was developed to estimate the health impacts of air pollution based on reported levels of air pollutants in real world studies. In Iran several studies have been conducted to estimate human morbidity and mortality based on this software. We conducted this review to summarize articles which have predicted the effects of air pollution on human health in Iran using Air Q. We conducted a systematic search for relevant studies published until 24 April 2021 in Web of Science, PubMed, Scopus, and SID (Scientific Information Database which includes articles in Farsi language). We applied no time or language restrictions. RECENT FINDINGS A total of 44 studies out of 525 identified articles met our inclusion criteria. The main air pollutants under investigation were particulate matter (PM), NO2, O3, and SO2. Most studies were conducted in metropolitan areas, such as Ahvaz (9 studies), Tehran (9 studies), and Shiraz (7 studies). In all studies, the levels of most air pollutants were higher than the 2005 WHO guideline levels and were predicted to be related to considerable health effects. However, it was not possible to aggregate the results and report the total number of casualties during these years, because studies were done in different cities with fluctuating levels of multiple pollutants and in different years and time frames. This systematic review showed that air pollution remains at unacceptably high levels resulting in substantial detrimental health effects in various Iranian cities. Using clean renewable energies, increasing human capital, and increasing green spaces and vegetation can help improve air pollution and decrease human casualties in Iran.
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Zhou X, Li C, Gao Y, Zhou C, Huang L, Zhang X. Ambient air pollutants relate to hospital admissions for chronic obstructive pulmonary disease in Ganzhou, China. Rev Saude Publica 2022; 56:46. [PMID: 35703601 PMCID: PMC9165633 DOI: 10.11606/s1518-8787.2022056004324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between ambient air pollutants and chronic obstructive pulmonary disease in relatively low-polluted areas in China. METHODS Atmospheric pollutants levels and meteorological data were obtained from January 2016 to December 2020. The medical database including daily hospital admissions for chronic obstructive pulmonary disease (ICD10: J44) was derived from the First Affiliated Hospital of Gannan Medical University. The generalized additive model was used to analyze the percentage change with 95% confidence interval in daily hospital admissions for chronic obstructive pulmonary disease associated with a 10 µg/m3 increase in atmospheric pollutants levels. RESULTS In total, occurred 4,980 chronic obstructive pulmonary disease hospital admissions (not including emergency department visits) during 2016-2020. The mean concentrations of daily PM2.5, PM10, SO2, NO2, O3, and CO were 37.5 μg/m3, 60.1 μg/m3, 18.7 μg/m3, 23.5 μg/m3, 70.0 μg/m3, and 1.2 mg/m3 in Ganzhou. Each 10 µg/m3 increment of PM2.5, PM10, NO2, and O3 were significantly associated with 2.8% (95%CI: 1.0-4.7), 1.3% (95%CI: 0.3-2.4), 2.8% (95%CI: 0.4-5.4), and 1.5% (95%CI: 0.2-2.7) elevation in daily chronic obstructive pulmonary disease hospital admissions. The estimates of delayed effects of PM2.5, PM10, NO2, and O3 were observed at lag6, lag6, lag8, lag1, respectively. The health effects of particulate pollutants (PM2.5 and PM10) may be independent of other pollutants. The adverse effects of air pollutants were more evident in the warm season (May-Oct) than in the cold season (Nov-Apr). CONCLUSION Our study demonstrated that elevated concentrations of atmospheric pollutant (PM2.5, PM10, NO2, and O3), especially particulate pollutants, can be associated with increased daily count of hospital admissions for chronic obstructive pulmonary disease , which may promote further understanding of the potential hazards of relatively low levels of air pollution on chronic obstructive pulmonary disease and other respiratory disorders.
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Affiliation(s)
- Xingye Zhou
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
| | - Chenwei Li
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
| | - Yanfang Gao
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
| | - Chuanfei Zhou
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
| | - Lei Huang
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
| | - Xiaokang Zhang
- Gannan Medical University. School of Public Health and Health Management. Ganzhou, China
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Hua Y, Yuan X, Wang J, Zeng K, Zhi S, Liu L. Association between air pollution and hospital admissions for chronic respiratory disease in people aged over 65 years: a time series analysis in Ningbo, China, 2015-2017. Int Arch Occup Environ Health 2022; 95:1293-1304. [PMID: 35661917 DOI: 10.1007/s00420-022-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide essential information of environmental triggers leading to CRD. METHODS We investigated the short-term effects of ambient air pollutants on CRD-related hospitalizations in people aged ≥ 65 years in Ningbo. Data on 23,610 cases of CRD requiring hospitalization were collected from January 2015 to August 2017. After adjusting for temporal trends, seasonality, meteorological conditions, day of week (DOW), and public holidays, we used generalized additive Poisson distribution models to calculate the excess risks (ERs) and 95% confidence intervals (95% CIs) of CRD related hospitalizations. RESULTS Our results showed that fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were associated with CRD-related hospitalizations in people aged ≥ 65 years. We observed that each 10 μg/m3 increase (except for each 0.1 mg/m3 increase in CO) in the concentration of air pollutants, the percentage of CRD-related hospitalizations due to PM2.5, PM10, and SO2 exposure at lag 07, NO2 exposure at lag 03, and CO exposure at lag 0 increased by 2.13% (95% CI: 0.55%, 3.74%), 1.76% (95% CI: 0.70%, 2.83%), 8.24% (95% CI: 0.92%, 16.09%), 2.16% (95% CI: 0.26%, 4.05%), and 1.19% (95% CI: 0.26%, 2.12%), respectively. In addition, we found stronger effects of particulate matter in 75-84 years age group, on warmer days, and in asthmatics. CONCLUSION In conclusion, air pollution may have adverse effects on CRD-related hospitalizations among people aged ≥ 65 years in Ningbo. Therefore, public health measures should be taken to improve air quality.
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Affiliation(s)
- Yuzhe Hua
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqi Yuan
- Ningbo Women and Children Hospital, Ningbo, China
| | - Jichao Wang
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Ke Zeng
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Shuai Zhi
- School of Medicine, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Medicine, Ningbo University, Ningbo, China.
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20
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Li N, Ma J, Ji K, Wang L. Association of PM2.5 and PM10 with Acute Exacerbation of Chronic Obstructive Pulmonary Disease at lag0 to lag7: A Systematic Review and Meta-Analysis. COPD 2022; 19:243-254. [PMID: 35616887 DOI: 10.1080/15412555.2022.2070062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to conduct a meta-analysis to investigate whether short-term exposure to fine (PM2.5) and coarse (PM10) particulate matter was associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalization, emergency room visit, and outpatient visit at different lag values. PubMed, Embase, and the Cochrane Library were searched for relevant papers published up to March 2021. For studies reporting results per 1-µg/m3 increase in PM2.5, the results were recalculated as per 10-µg/m3 increase. We manually calculated the RRs for these two studies and transferred the RRs to estimate 10 µg/m3 increases in PM2.5. Automation tools were initially used to remove ineligible studies. Two reviewers independently screened the remaining records and retrieved reports. Twenty-six studies (28 datasets; 7,018,419 patients) were included. There was a significant association between PM2.5 and AECOPD events on lag0 (ES = 1.01, 95%CI: 1.01-1.02, p < 0.001; I2=88.6%, Pheterogeneity<0.001), lag1 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=82.5%, Pheterogeneity<0.001), lag2 (ES = 1.01, 95%CI: 1.01-1.01, p < 0.001; I2=90.6%, Pheterogeneity<0.001), lag3 (ES = 1.01, 95%CI: 1.00-1.01, p < 0.001; I2=88.9%, Pheterogeneity<0.001), lag4 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I2=83.7%, Pheterogeneity<0.001), and lag7 (ES = 1.00, 95%CI: 1.00-1.00, p < 0.001; I2=0.0%, Pheterogeneity=0.743). The subgroup analyses showed that PM2.5 influenced the rates of hospitalization, emergency room visits, and outpatient visits. Similar trends were observed with PM10. The risk of AECOPD events (hospitalization, emergency room visit, and outpatient visit) was significantly increased with a 10-µg/m3 increment in PM2.5 and PM10 from lag0 to lag7.List Of Abbreviations: particulate matter (PM2.5 and PM10); acute exacerbation of chronic obstructive pulmonary disease (AECOPD); Chronic obstructive pulmonary disease (COPD); Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); Effect sizes [48]; confidence intervals (CIs).
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Affiliation(s)
- Niuniu Li
- Department of Respiration, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Jianling Ma
- Department of Respiration, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Kun Ji
- Department of Respiration, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Liyun Wang
- Department of Respiration, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
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21
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Qin G, Wang X, Wang T, Nie D, Li Y, Liu Y, Wen H, Huang L, Yu C. Impact of Particulate Matter on Hospitalizations for Respiratory Diseases and Related Economic Losses in Wuhan, China. Front Public Health 2022; 10:797296. [PMID: 35692312 PMCID: PMC9174547 DOI: 10.3389/fpubh.2022.797296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background Prior studies have reported the effects of particulate matter (PM) on respiratory disease (RD) hospitalizations, but few have quantified PM-related economic loss in the central region of China. This investigation aimed to assess the impacts of PM pollution on the risk burden and economic loss of patients admitted with RD. Methods Daily cases of RD admitted to the hospital from 1 January 2015 to 31 December 2020 were collected from two class-A tertiary hospitals in Wuhan, China. Time series analysis incorporated with a generalized additive model (GAM) was adopted to assess the impacts of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) exposures on patients hospitalized with RD. Stratified analyses were performed to investigate underlying effect modification of RD risk by sex, age, and season. The cost of illness (COI) approach was applied to evaluate the related economic losses caused by PM. Results A total of 51,676 inpatients with a primary diagnosis of RD were included for the analysis. PM2.5 and PM10 exposures were associated with increased risks of hospitalizations for RD. Subgroup analysis demonstrated that men and children in the 0–14 years age group were more vulnerable to PM, and the adverse effects were promoted by low temperature in the cold season. A 152.4 million China Yuan (CNY) economic loss could be avoided if concentrations of PM2.5 and PM10 declined to 10 and 20 μg/m3, respectively. Conclusions PM2.5 and PM10 concentrations were positively associated with RD hospitalization. Men and children were more vulnerable to PM. Effective air pollution control measures can reduce hospitalizations significantly and save economic loss substantially.
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Affiliation(s)
- Guiyu Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xuyan Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Dewei Nie
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine of Peking Union Medical College, Beijing, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Haoyu Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Lihong Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Chuanhua Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
- *Correspondence: Chuanhua Yu
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22
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Sousa AC, Pastorinho MR, Masjedi MR, Urrutia-Pereira M, Arrais M, Nunes E, To T, Ferreira AJ, Robalo-Cordeiro C, Borrego C, Teixeira JP, Taborda-Barata L. Issue 1 - "Update on adverse respiratory effects of outdoor air pollution" Part 2): Outdoor air pollution and respiratory diseases: Perspectives from Angola, Brazil, Canada, Iran, Mozambique and Portugal. Pulmonology 2022; 28:376-395. [PMID: 35568650 DOI: 10.1016/j.pulmoe.2021.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To analyse the GARD perspective on the health effects of outdoor air pollution, and to synthesise the Portuguese epidemiological contribution to knowledge on its respiratory impact. RESULTS Ambient air pollution has deleterious respiratory effects which are more apparent in larger, densely populated and industrialised countries, such as Canada, Iran, Brazil and Portugal, but it also affects people living in low-level exposure areas. While low- and middle-income countries (LMICs), are particularly affected, evidence based on epidemiological studies from LMICs is both limited and heterogeneous. While nationally, Portugal has a relatively low level of air pollution, many major cities face with substantial air pollution problems. Time series and cross-sectional epidemiological studies have suggested increased respiratory hospital admissions, and increased risk of respiratory diseases in people who live in urban areas and are exposed to even a relatively low level of air pollution. CONCLUSIONS Adverse respiratory effects due to air pollution, even at low levels, have been confirmed by epidemiological studies. However, evidence from LMICs is heterogeneous and relatively limited. Furthermore, longitudinal cohort studies designed to study and quantify the link between exposure to air pollutants and respiratory diseases are needed. Worldwide, an integrated approach must involve multi-level stakeholders including governments (in Portugal, the Portuguese Ministry of Health, which hosts GARD-Portugal), academia, health professionals, scientific societies, patient associations and the community at large. Such an approach not only will garner a robust commitment, establish strong advocacy and clear objectives, and raise greater awareness, it will also support a strategy with adequate measures to be implemented to achieve better air quality and reduce the burden of chronic respiratory diseases (CRDs).
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Affiliation(s)
- A C Sousa
- Comprehensive Health Research Centre (CHRC) and Department of Biology, University of Évora, Pólo da Mitra, Apartado 94, Évora 7002-554, Portugal; NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal
| | - M R Pastorinho
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal; Comprehensive Health Research Centre (CHRC), Department of Medical and Health Sciences, University of Évora, Colégio Luís António Verney, Rua Romão Ramalho, 59, Évora 7000-671, Portugal
| | - M R Masjedi
- Department of Pulmonary Medicine, Shahid Beheshti University of Medical Sciences, 7th Floor, Bldg n 2, SBUMS, Arabi Avenue, Daneshjoo Boulevard, Velenjak, Tehran 19839-63113, Iran
| | - M Urrutia-Pereira
- Universidade Federal do Pampa, BR 472 - Km 585, Caixa Postal 118, Uruguaiana (RS) CEP 97501-970, Brazil
| | - M Arrais
- Department of Pulmonology, Military Hospital, Rua 17 de Setembro, 27/29, Cidade Alta, Luanda, Angola; Centro de Investigação em Saúde de Angola - CISA, Caxito, Bengo, Angola
| | - E Nunes
- Department of Pulmonology, Central Hospital of Maputo, Agostinho Neto, 64, Maputo 1100, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Avenida Dr. Salvador Allende, Caixa Postal 257, Maputo, Mozambique
| | - T To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5G 1 × 8, Canada
| | - A J Ferreira
- Department of Pulmonology, Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra 3004-561, Portugal; Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, Coimbra 3000-548, Portugal
| | - C Robalo-Cordeiro
- Department of Pulmonology, Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra 3004-561, Portugal; Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, Coimbra 3000-548, Portugal
| | - C Borrego
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro 3810-193, Portugal; IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário de Santiago, Aveiro 3810-193, Portugal
| | - J P Teixeira
- EPIUnit - Instituto de Saúde Pública, University of Porto, Rua das Taipas, 135, Porto 4050-091, Portugal; Department of Environmental Health, Portuguese National Institute of Health, Rua Alexandre Herculano, 321, Porto 4000-055, Portugal
| | - L Taborda-Barata
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal; UBIAir-Clinical & Experimental Lung Centre, UBIMedical, University of Beira Interior, EM506 Covilhã 6200-000, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal.
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23
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Raqib R, Akhtar E, Sultana T, Ahmed S, Chowdhury MAH, Shahriar MH, Kader SB, Eunus M, Haq MA, Sarwar G, Islam T, Alam DS, Parvez F, Begum BA, Ahsan H, Yunus M. Association of household air pollution with cellular and humoral immune responses among women in rural Bangladesh. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 299:118892. [PMID: 35077836 PMCID: PMC9850293 DOI: 10.1016/j.envpol.2022.118892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/29/2021] [Accepted: 01/20/2022] [Indexed: 05/29/2023]
Abstract
Household air pollution (HAP) arising from combustion of biomass fuel (BMF) is a leading cause of morbidity and mortality in low-income countries. Air pollution may stimulate pro-inflammatory responses by activating diverse immune cells and cyto/chemokine expression, thereby contributing to diseases. We aimed to study cellular immune responses among women chronically exposed to HAP through use of BMF for domestic cooking. Among 200 healthy, non-smoking women in rural Bangladesh, we assessed exposure to HAP by measuring particulate matter 2.5 (PM2.5), black carbon (BC) and carbon monoxide (CO), through use of personal monitors RTI MicroPEM™ and Lascar CO logger respectively, for 48 h. Blood samples were collected following HAP exposure assessment and were analyzed for immunoprofiling by flow cytometry, plasma IgE by immunoassay analyzer and cyto/chemokine response from monocyte-derived-macrophages (MDM) and -dendritic cells (MDDC) by multiplex immunoassay. In multivariate linear regression model, a doubling of PM2.5 was associated with small increments in immature/early B cells (CD19+CD38+) and plasmablasts (CD19+CD38+CD27+). In contrast, a doubling of CO was associated with 1.20% reduction in CD19+ B lymphocytes (95% confidence interval (CI) = -2.36, -0.01). A doubling of PM2.5 and BC each was associated with 3.12% (95%CI = -5.85, -0.38) and 4.07% (95%CI = -7.96, -0.17) decrements in memory B cells (CD19+CD27+), respectively. Exposure to CO was associated with increased plasma IgE levels (beta(β) = 240.4, 95%CI = 3.06, 477.8). PM2.5 and CO exposure was associated with increased MDM production of CXCL10 (β = 12287, 95%CI = 1038, 23536) and CCL5 (β = 835.7, 95%CI = 95.5, 1576), respectively. Conversely, BC exposure was associated with reduction in MDDC-produced CCL5 (β = -3583, 95%CI = -6358, -807.8) and TNF-α (β = -15521, 95%CI = -28968, -2074). Our findings suggest that chronic HAP exposure through BMF use adversely affects proportions of B lymphocytes, particularly memory B cells, plasma IgE levels and functions of antigen presenting cells in rural women.
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Affiliation(s)
| | - Evana Akhtar
- Infectious Diseases Division, icddr,b, Bangladesh
| | | | - Shyfuddin Ahmed
- Health Systems and Population Studies Division, icddr,b, Dhaka, 1212, Bangladesh
| | | | | | - Shirmin Bintay Kader
- Health Systems and Population Studies Division, icddr,b, Dhaka, 1212, Bangladesh
| | - Mahbbul Eunus
- U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Tariqul Islam
- U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
| | | | - Faruque Parvez
- Mailman School of Public Health, Columbia University, New York, USA
| | | | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, USA
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Farahmandfard MA, Naghibzadeh-Tahami A, Khanjani N. Ambient air pollution and multiple sclerosis: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:535-544. [PMID: 34821118 DOI: 10.1515/reveh-2020-0079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/09/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Some studies have shown that environmental risk factors, including air pollution, might be related to the incidence or recurrence of multiple sclerosis (MS). This systematic review was conducted to investigate the relation between air pollution and MS. METHODS A systematic search was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science; until January 2020 with no restrictions. The search strategy was conducted with air pollution key words such as CO, PM2.5, PM10, SO2, and NO2, for exposure and the key word "Multiple sclerosis" as the outcome. RESULTS Eventually, after applying the inclusion and exclusion criteria, 17 articles were included. The methodologies and outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting a meta-analysis was not possible. Eight studies had analyzed the relation between particulate matter (PM) and the prevalence or relapse of MS and had observed a significant relation. NO2 and NOx were associated with recurrence or prevalence of MS in three studies. But, in three cohort studies, no association was observed between air pollution and recurrence or occurrence of MS. CONCLUSIONS The results of this systematic review show that outdoor air pollution, especially PM and nitrogen oxides might be related to the prevalence or relapse of MS.
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Affiliation(s)
- Mohammad Amin Farahmandfard
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Social Determinants of Health Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Perl S, Shteinberg M. Bronchiectasis Exacerbations: Definitions, Causes, and Acute Management. Semin Respir Crit Care Med 2021; 42:595-605. [PMID: 34261183 DOI: 10.1055/s-0041-1730944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pulmonary exacerbations (PExs) are events in the course of bronchiectasis which are defined as an increase in disease symptoms lasting a period of a few days. It is established that the tendency toward having PEx is stable throughout the course of the disease. Certain conditions were found to be associated with an increased risk of developing a PEx. Among these are chronic airway infection with Pseudomonas aeruginosa or Aspergillus species, concomitant airway diseases (asthma, chronic obstructive pulmonary disease, and chronic rhinosinusitis), genetic factors such as primary ciliary dyskinesia, and nutritional factors. The immediate events underlying the onset of a PEx are less clearly determined. Although acute changes in bacterial airway composition have been the paradigm for decades, recent microbiome-focused research has not uniformly established such acute changes at the onset of PEx. Other acute changes such as air pollution, viral infection, and changes in bacterial metabolic activity have also been implicated as causes of a PEx. Despite these gaps in our knowledge of the biology of PEx, antimicrobial therapy directed against the identified pathogens in sputum is currently the recommended therapeutic strategy. Various long-term therapies, including antimicrobial and anti-inflammatory strategies, have been proven effective in reducing the frequency of PEx, leading to a recommendation for the use of these strategies in people with frequent PEx.
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Affiliation(s)
- Sivan Perl
- Pulmonology Institute, Shamir Medical Center, Tel Aviv, Israel
| | - Michal Shteinberg
- Pulmonology Institute and CF Center, Carmel Medical Center, Technion-Israel Institute of Technology, Haifa, Israel
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26
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Detailleur S, Vos R, Goeminne P. The Deteriorating Patient: Therapies Including Lung Transplantation. Semin Respir Crit Care Med 2021; 42:623-638. [PMID: 34261186 DOI: 10.1055/s-0041-1730946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this review paper, we discuss the characteristics that define severe bronchiectasis and which may lead to deterioration of noncystic fibrosis bronchiectasis. These characteristics were used to establish the current severity scores: bronchiectasis severity index (BSI), FACED, and E-FACED (exacerbation frequency, forced expiratory volume in 1 second, age, colonization, extension and dyspnea score). They can be used to predict mortality, exacerbation rate, hospital admission, and quality of life. Furthermore, there are different treatable traits that contribute to severe bronchiectasis and clinical deterioration. When present, they can be a target of the treatment to stabilize bronchiectasis.One of the first steps in treatment management of bronchiectasis is evaluation of compliance to already prescribed therapy. Several factors can contribute to treatment adherence, but to date no real interventions have been published to ameliorate this phenomenon. In the second step, treatment in deteriorating patients with bronchiectasis should be guided by the predominant symptoms, for example, cough, sputum, difficulty expectoration, exacerbation rate, or physical impairment. In the third step, we evaluate treatable traits that could influence disease severity in the deteriorating patient. Finally, in patients who are difficult to treat despite maximum medical treatment, eligibility for surgery (when disease is localized), should be considered. In case of end-stage disease, the evaluation for lung transplantation should be performed. Noninvasive ventilation can serve as a bridge to lung transplantation in patients with respiratory failure.
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Affiliation(s)
- Stephanie Detailleur
- Department of Respiratory Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - Robin Vos
- Department of Respiratory Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - Pieter Goeminne
- Department of Respiratory Diseases, AZ Nikolaas, Sint-Niklaas, Belgium
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27
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Guttenberg MA, Vose AT, Tighe RM. Role of Innate Immune System in Environmental Lung Diseases. Curr Allergy Asthma Rep 2021; 21:34. [PMID: 33970346 PMCID: PMC8311569 DOI: 10.1007/s11882-021-01011-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 01/07/2023]
Abstract
The lung mucosa functions as a principal barrier between the body and inhaled environmental irritants and pathogens. Precise and targeted surveillance mechanisms are required at this lung-environment interface to maintain homeostasis and preserve gas exchange. This is performed by the innate immune system, a germline-encoded system that regulates initial responses to foreign irritants and pathogens. Environmental pollutants, such as particulate matter (PM), ozone (O3), and other products of combustion (NO2, SO3, etc.), both stimulate and disrupt the function of the innate immune system of the lung, leading to the potential for pathologic consequences. PURPOSE OF REVIEW: The purpose of this review is to explore recent discoveries and investigations into the role of the innate immune system in responding to environmental exposures. This focuses on mechanisms by which the normal function of the innate immune system is modified by environmental agents leading to disruptions in respiratory function. RECENT FINDINGS: This is a narrative review of mechanisms of pulmonary innate immunity and the impact of environmental exposures on these responses. Recent findings highlighted in this review are categorized by specific components of innate immunity including epithelial function, macrophages, pattern recognition receptors, and the microbiome. Overall, the review supports broad impacts of environmental exposures to alterations to normal innate immune functions and has important implications for incidence and exacerbations of lung disease. The innate immune system plays a critical role in maintaining pulmonary homeostasis in response to inhaled air pollutants. As many of these agents are unable to be mitigated, understanding their mechanistic impact is critical to develop future interventions to limit their pathologic consequences.
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Affiliation(s)
| | | | - Robert M. Tighe
- Department of Medicine, Duke University, Durham, NC,Corresponding Author: Robert M Tighe, MD, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Box 2969, Durham, North Carolina 27710, Telephone: 919-684-4894, Fax: 919-684-5266,
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Abstract
Lung cancer is the most rapidly increasing malignancy worldwide with an estimated 2.1 million cancer cases in the latest, 2018 World Health Organization (WHO) report. The objective of this study was to investigate the association of air pollution and lung cancer, in Tehran, Iran. Residential area information of the latest registered lung cancer cases that were diagnosed between 2014 and 2016 (N = 1,850) were inquired from the population-based cancer registry of Tehran. Long-term average exposure to PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene (BTEX), and BTEX in 22 districts of Tehran were estimated using land use regression models. Latent profile analysis (LPA) was used to generate multi-pollutant exposure profiles. Negative binomial regression analysis was used to examine the association between air pollutants and lung cancer incidence. The districts with higher concentrations for all pollutants were mostly in downtown and around the railway station. Districts with a higher concentration for NOx (IRR = 1.05, for each 10 unit increase in air pollutant), benzene (IRR = 3.86), toluene (IRR = 1.50), ethylbenzene (IRR = 5.16), p-xylene (IRR = 9.41), o-xylene (IRR = 7.93), m-xylene (IRR = 2.63) and TBTEX (IRR = 1.21) were significantly associated with higher lung cancer incidence. Districts with a higher multiple air-pollution profile were also associated with more lung cancer incidence (IRR = 1.01). Our study shows a positive association between air pollution and lung cancer incidence. This association was stronger for, respectively, p-xylene, o-xylene, ethylbenzene, benzene, m-xylene and toluene.
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Daniel S, Pusadkar V, McDonald J, Mirpuri J, Azad RK, Goven A, Lund AK. Traffic generated emissions alter the lung microbiota by promoting the expansion of Proteobacteria in C57Bl/6 mice placed on a high-fat diet. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 213:112035. [PMID: 33581487 PMCID: PMC7989785 DOI: 10.1016/j.ecoenv.2021.112035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 05/23/2023]
Abstract
Air pollution has been documented to contribute to severe respiratory diseases like asthma and chronic obstructive pulmonary disorder (COPD). Although these diseases demonstrate a shift in the lung microbiota towards Proteobacteria, the effects of traffic generated emissions on lung microbiota profiles have not been well-characterized. Thus, we investigated the hypothesis that exposure to traffic-generated emissions can alter lung microbiota and immune defenses. Since a large population of the Western world consumes a diet rich in fats, we sought to investigate the synergistic effects of mixed vehicle emissions and high-fat diet consumption. We exposed 3-month-old male C57Bl/6 mice placed either on regular chow (LF) or a high-fat (HF: 45% kcal fat) diet to mixed emissions (ME: 30 µg PM/m3 gasoline engine emissions+70 µg PM/m3 diesel engine emissions) or filtered air (FA) for 6 h/d, 7 d/wk for 30 days. Levels of pulmonary immunoglobulins IgA, IgG, and IgM were analyzed by ELISA, and lung microbial profiling was done using qPCR and Illumina 16 S sequencing. We observed a significant decrease in lung IgA in the ME-exposed animals, compared to the FA-exposed animals, both fed a HF diet. Our results also revealed a significant decrease in lung IgG in the ME-exposed animals both on the LF diet and HF diet, in comparison to the FA-exposed animals. We also observed an expansion of Enterobacteriaceae belonging to the Proteobacteria phylum in the ME-exposed groups on the HF diet. Collectively, we show that the combined effects of ME and HF diet result in decreased immune surveillance and lung bacterial dysbiosis, which is of significance in lung diseases.
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Affiliation(s)
- Sarah Daniel
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA
| | - Vaidehi Pusadkar
- BioDiscovery Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA
| | - Jacob McDonald
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87108, USA
| | - Julie Mirpuri
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Rajeev K Azad
- BioDiscovery Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA; Department of Mathematics, University of North Texas, Denton, TX 76203, USA
| | - Art Goven
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA
| | - Amie K Lund
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA.
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Chen J, Shi C, Li Y, Ni H, Zeng J, Lu R, Zhang L. Effects of short-term exposure to ambient airborne pollutants on COPD-related mortality among the elderly residents of Chengdu city in Southwest China. Environ Health Prev Med 2021; 26:7. [PMID: 33435864 PMCID: PMC7805042 DOI: 10.1186/s12199-020-00925-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China. Methods Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 μm in aerodynamic diameter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were derived from 23 municipal environmental monitoring sites. Data on weather conditions, including daily mean temperature and relative humidity, were obtained from the Chengdu Meteorological Bureau. All data were collected from January 1, 2015, to December 31, 2018. A quasi-Poisson general additive model (GAM) was utilized to assess the effects of short-term exposure to airborne pollutants on COPD-related mortality among elderly people. Results A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM2.5 (43 μg/m3), SO2 (8 μg/m3), NO2 (18 μg/m3), CO (0.4 mg/m3), and O3 (78 μg/m3) were associated with 2.7% (95% CI 1.0–4.4%), 4.3% (95% CI 2.1–6.4%), 3.6% (95% CI 1.7–5.6%), 2.7% (95% CI 0.6–4.8%), and 7.4% (95% CI 3.6–11.3%) increases in COPD-related mortality in people aged 60 and older, respectively. The exposure-response curves between each pollutant and the log-relative risk of COPD-related mortality exhibited linear relationships. Statistically significant differences in the associations between pollutants and COPD-related mortality were not observed among sociodemographic factors including age, gender, and marital status. The effects of O3 remained steady after adjusting for PM2.5, SO2, NO2, and CO each time in the two-pollutant models. Conclusions Increased concentrations of ambient airborne pollutants composed of PM2.5, SO2, NO2, O3, and CO were significantly and positively associated with COPD-related mortality in the central Sichuan Basin, which is located in the hinterland of southwestern China. The adverse effects of O3 were stable, a finding that should receive more attention. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00925-x.
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Affiliation(s)
- Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China.
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Hongzhen Ni
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Jie Zeng
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Rong Lu
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, People's Republic of China.
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Copat C, Cristaldi A, Fiore M, Grasso A, Zuccarello P, Signorelli SS, Conti GO, Ferrante M. The role of air pollution (PM and NO 2) in COVID-19 spread and lethality: A systematic review. ENVIRONMENTAL RESEARCH 2020; 191:110129. [PMID: 32853663 PMCID: PMC7444490 DOI: 10.1016/j.envres.2020.110129] [Citation(s) in RCA: 207] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 05/19/2023]
Abstract
A new coronavirus (SARS-CoV-2) has determined a pneumonia outbreak in China (Wuhan, Hubei Province) in December 2019, called COVID-19 disease. In addition to the person-to person transmission dynamic of the novel respiratory virus, it has been recently studied the role of environmental factors in accelerate SARS-CoV-2 spread and its lethality. The time being, air pollution has been identified as the largest environmental cause of disease and premature death in the world. It affects body's immunity, making people more vulnerable to pathogens. The hypothesis that air pollution, resulting from a combination of factors such as meteorological data, level of industrialization as well as regional topography, can acts both as a carrier of the infection and as a worsening factor of the health impact of COVID-19 disease, has been raised recently. With this review, we want to provide an update state of art relating the role of air pollution, in particular PM2.5, PM10 and NO2, in COVID-19 spread and lethality. The Authors, who first investigated this association, often used different research methods or not all include confounding factors whenever possible. In addition, to date incidence data are underestimated in all countries and to a lesser extent also mortality data. For this reason, the cases included in the reviewed studies cannot be considered conclusive. Although it determines important limitations for direct comparison of results, and more studies are needed to strengthen scientific evidences and support firm conclusions, major findings are consistent, highlighting the important contribution of PM2.5 and NO2 as triggering of the COVID-19 spread and lethality, and with a less extent also PM10, although the potential effect of airborne virus exposure it has not been still demonstrated.
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Affiliation(s)
- Chiara Copat
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy.
| | - Antonio Cristaldi
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Alfina Grasso
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Pietro Zuccarello
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, Catania, 95123, Italy
| | - Gea Oliveri Conti
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 87, Catania, 95123, Italy
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Revalue associations of short-term exposure to air pollution with respiratory hospital admissions in Lanzhou, China after the control and treatment of current pollution. Int J Hyg Environ Health 2020; 231:113658. [PMID: 33166757 DOI: 10.1016/j.ijheh.2020.113658] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 02/01/2023]
Abstract
Significant progress has been made in air pollution control Lanzhou, China recently, however, there was only one study so far on the assessment on health gains from air quality improvement after adopting strict air pollution control measures. The present study aimed to estimate the short-term effects of six criteria air pollutants including PM2.5, PM10, NO2, SO2, CO and O3 on respiratory admissions in Lanzhou, China, then compare the results of our study with those earlier studies conducted in Lanzhou before the implementation of air pollution control measures. Data on daily hospital admissions from the three largest hospitals in Lanzhou and daily air pollution concentration and meteorological variable were collected during a 4-year period (2014-2017). A generalized additive model; adjusted for long-term trend, seasonality, and other potential confounders was done to quantitatively assess the influences of air pollutants on daily respiratory admissions and analyze the influences of different seasons, sexes, and age groups. The most apparent effects for PM2.5, PM10, SO2, CO and O3 on respiratory hospitalizations were observed at lag6, and lag7, respectively, and a 10μg/m3 increase in PM2.5, PM10, SO2, CO and O3 concentration were associated with 0.885% (95%CI: 0.414%~1.358%), 0.328% (95%CI: 0.145%~0.511%), 3.005% (95%CI: 1.689%~4.339%), 3.199% (95%CI: 0.912%~5.537%) for CO, 0.733% (95%Cl: 0.263%~1.205%) increase in respiratory admission, respectively. No remarkable association was found between NO2 and respiratory disease hospitalisation. Females and younger groups were more susceptible to air pollutant than males and elderly groups. Together, we demonstrated that the positive associations were more pronounced in the cold season than in the warm season. The findings in present study suggest that even in Lanzhou, where air quality has been improved dramatically, positive associations still exist between air pollution and daily number of total respiratory admission.
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Wang Z, Zhou Y, Zhang Y, Huang X, Duan X, Ou Y, Liu S, Hu W, Liao C, Zheng Y, Wang L, Xie M, Yang H, Xiao S, Luo M, Tang L, Zheng J, Liu S, Wu F, Deng Z, Tian H, Peng J, Wang X, Zhong N, Ran P. Association of hospital admission for bronchiectasis with air pollution: A province-wide time-series study in southern China. Int J Hyg Environ Health 2020; 231:113654. [PMID: 33157415 DOI: 10.1016/j.ijheh.2020.113654] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022]
Abstract
The relation of acute fluctuations of air pollution to hospital admission for bronchiectasis remained uncertain, and large-scale studies were needed. We collected daily concentrations of particulate matter (PM), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and daily hospitalizations for bronchiectasis for 21 cities across Guangdong Province from 2013 through 2017. We examined their association using two-stage time-series analysis. Our analysis was stratified by specific sub-diagnosis, sex and age group to assess potential effect modifications. Relative risks of hospitalization for bronchiectasis were 1.060 (95%CI 1.014-1.108) for PM10 at lag0-6, 1.067 (95%CI 1.020-1.116) for PM2.5 at lag0-6, 1.038 (95%CI 1.005-1.073) for PMcoarse at lag0-6, 1.058 (95%CI 1.015-1.103) for SO2 at lag0-4, 1.057 (95%CI 1.030-1.084) for NO2 at lag0 and 1.055 (95%CI 1.025-1.085) for CO at lag0-6 per interquartile range increase of air pollution. Specifically, acute fluctuations of air pollution might be a risk factor for bronchiectasis patients with lower respiratory infection but not with hemoptysis. Patients aged ≥65 years, and female patients appeared to be particularly susceptible to air pollution. Acute fluctuations of air pollution, particularly PM may increase the risk of hospital admission for bronchiectasis exacerbations, especially for the patients complicated with lower respiratory infection. This study strengthens the importance of reducing adverse impact on respiratory health of air pollution to protect vulnerable populations.
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Affiliation(s)
- Zihui Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yongbo Zhang
- Guangdong Provincial Academy of Environmental Science, Guangzhou, Guangdong Province, China
| | - Xiaoliang Huang
- Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Xianzhong Duan
- Department of Ecology and Environment of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Yubo Ou
- Guangdong Provincial Environment Monitoring Center, Guangzhou, Guangdong Province, China
| | - Shiliang Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Wei Hu
- Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Chenghao Liao
- Guangdong Provincial Academy of Environmental Science, Guangzhou, Guangdong Province, China
| | - Yijia Zheng
- Guangdong Provincial Academy of Environmental Science, Guangzhou, Guangdong Province, China
| | - Long Wang
- Guangdong Provincial Academy of Environmental Science, Guangzhou, Guangdong Province, China
| | - Min Xie
- Guangdong Provincial Environment Monitoring Center, Guangzhou, Guangdong Province, China
| | - Huajing Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Shan Xiao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Ming Luo
- School of Geography and Planning, Sun Yat Sen University, Guangzhou, Guangdong Province, China
| | - Longhui Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Jinzhen Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Sha Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Fan Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Heshen Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Jieqi Peng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xinwang Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Mercan Y, Babaoglu UT, Erturk A. Short-term effect of particular matter and sulfur dioxide exposure on asthma and/or chronic obstructive pulmonary disease hospital admissions in Center of Anatolia. ENVIRONMENTAL MONITORING AND ASSESSMENT 2020; 192:646. [PMID: 32939661 DOI: 10.1007/s10661-020-08605-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
We investigated the associations between the daily variations of coarse particulate matter (PM10) and/or sulfur dioxide (SO2) and hospital admissions for asthma and/or chronic obstructive pulmonary disease (COPD) diseases in Kirsehir, Center of Anatolia of Turkey. We analyzed the poison generalized linear model (GLM) to analyze the association between ambient air pollutants such as PM10 and SO2 and asthma and/or COPD admissions. We investigated single-lag days and multi-lag days for the risk increase in asthma, COPD, asthma, and/or COPD hospital admissions PM10, SO2, and PM10 with SO2 per 10 μg/m3. In single-lag day model a 10 μg/m3 increase in the current day (lag 0) concentrations of PM10 and SO2 corresponded to increase of 1.027 (95% CI:1.022-1.033) and 1.069 (95% CI:1.062, 1.077) for asthma. A 10 μg/m3 increase in the current day (lag 0) concentrations of PM10 and SO2 corresponded to increase of 1.029 (95% CI:1.022-1.035) and 1.065 (95% CI:1.056, 1.075) for COPD. A 10 μg/m3 increase in the current day (lag 0) concentrations of PM10 and SO2 corresponded to increase of 1.028 (95% CI:1.024-1.032) and 1.068 (95% CI:1.062, 1.074) for asthma and/or COPD. It was found that some lag structures were related with PM10 and SO2. Significant lags were detected in some lag structures from the previous first day until the previous eighth day (lag 1 to lag 7) in the asthma, COPD, and asthma and/or COPD hospital admissions in the model created with PM10 with SO2 both in the single-lag day model and in the multi-lag day model. Our study that used GLM in time series analysis showed that PM10 and/or SO2 short-term exposure in single-lag day and multi-lag day models was related with increased asthma, COPD, and asthma and/or COPD hospital admissions in the city between 2016 and 2019 until the previous-eighth day.
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Affiliation(s)
- Yeliz Mercan
- Kirklareli University Health Sciences Institute Department of Public Health, 39000, Kirklareli, Turkey.
- Kirklareli University School of Health Department of Health Management, 39000, Kirklareli, Turkey.
| | - Ulken Tunga Babaoglu
- Kirsehir Ahi Evran University Faculty of Medicine Department of Public Health, 40100, Kirsehir, Turkey
| | - Arzu Erturk
- Kirsehir Ahi Evran University Faculty of Medicine Department of Chest Diseases, Kirsehir, 40100, Turkey
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Chan KPF, Ma TF, Kwok WC, Leung JKC, Chiang KY, Ho JCM, Lam DCL, Tam TCC, Ip MSM, Ho PL. Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during coronavirus disease 2019 pandemic. Respir Med 2020; 171:106085. [PMID: 32917356 PMCID: PMC7354382 DOI: 10.1016/j.rmed.2020.106085] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022]
Abstract
Background Chronic respiratory diseases are risk factors for severe disease in coronavirus disease 2019 (COVID-19). Respiratory tract infection is one of the commonest causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There has not been evidence suggesting the link between COVID-19 and AECOPD, especially in places with dramatic responses in infection control with universal masking and aggressive social distancing. Methods This is a retrospective study to assess the number of admissions of AECOPD in the first three months of 2020 in Queen Mary Hospital with reference to the admissions in past five years. Log-linear model was used for statistical inference of covariates, including percentage of masking, air quality health index and air temperature. Results The number of admissions for AECOPD significantly decreased by 44.0% (95% CI 36.4%–52.8%, p < 0.001) in the first three months of 2020 compared with the monthly average admission in 2015–2019. Compare to same period of previous years, AECOPD decreased by 1.0% with each percent of increased masking (p < 0.001) and decreased by 3.0% with increase in 1 °C in temperature (p = 0.045). The numbers of admissions for control diagnoses (heart failure, intestinal obstruction and iron deficiency anaemia) in the same period in 2020 were not reduced. Conclusions The number of admissions for AECOPD decreased in first three months of 2020, compared with previous years. This was observed with increased masking percentage and social distancing in Hong Kong. We postulated universal masking and social distancing during COVID-19 pandemics both contributed in preventing respiratory tract infections hence AECOPD.
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Affiliation(s)
- King Pui Florence Chan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
| | - Ting Fung Ma
- Department of Statistics, University of Wisconsin-Madison, USA
| | - Wang Chun Kwok
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Jackson Ka Chun Leung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Ka Yan Chiang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - James Chung Man Ho
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - David Chi Leung Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Terence Chi Chun Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Mary Sau Man Ip
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Pak Leung Ho
- Department of Microbiology, The University of Hong Kong, Hong Kong SAR, China
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