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Horne BD, Johnson MM, Blagev DP, Haddad F, Knowlton KU, Bride D, Bair TL, Joy EA, Nadeau KC. Association of Short-Term Increases in Ambient Fine Particulate Matter With Hospitalization for Asthma or COPD During Wildfire Season and Other Time Periods. CHEST PULMONARY 2024; 2:100053. [PMID: 38993972 PMCID: PMC11238943 DOI: 10.1016/j.chpulm.2024.100053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Short-term increases in air pollution are associated with poor asthma and COPD outcomes. Short-term elevations in fine particulate matter (PM2.5) due to wildfire smoke are becoming more common. RESEARCH QUESTION Are short-term increases in PM2.5 and ozone in wildfire season and in winter inversion season associated with a composite of emergency or inpatient hospitalization for asthma and COPD? STUDY DESIGN AND METHODS Case-crossover analyses evaluated 63,976 and 18,514 patients hospitalized for primary discharge diagnoses of asthma and COPD, respectively, between January 1999 and March 2022. Patients resided on Utah's Wasatch Front where PM2.5 and ozone were measured by Environmental Protection Agency-based monitors. ORs were calculated using Poisson regression adjusted for weather variables. RESULTS Asthma risk increased on the same day that PM2.5 increased during wildfire season (OR, 1.057 per + 10 μg/m3; 95% CI, 1.019-1.097; P = .003) and winter inversions (OR, 1.023 per +10 μg/m3; 95% CI, 1.010-1.037; P = .0004). Risk decreased after 1 week, but during wildfire season risk rebounded at a 4-week lag (OR, 1.098 per +10 μg/m3; 95% CI, 1.033-1.167). Asthma risk for adults during wildfire season was highest in the first 3 days after PM2.5 increases, but for children, the highest risk was delayed by 3 to 4 weeks. PM2.5 exposure was weakly associated with COPD hospitalization. Ozone exposure was not associated with elevated risks. INTERPRETATION In a large urban population, short-term increases in PM2.5 during wildfire season were associated with asthma hospitalization, and the effect sizes were greater than for PM2.5 during inversion season.
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Affiliation(s)
- Benjamin D Horne
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Mary M Johnson
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Denitza P Blagev
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Francois Haddad
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Kirk U Knowlton
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Daniel Bride
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Tami L Bair
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Elizabeth A Joy
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Kari C Nadeau
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
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Byrwa-Hill BM, Morphew TL, Presto AA, Fabisiak JP, Wenzel SE. Living in environmental justice areas worsens asthma severity and control: Differential interactions with disease duration, age at onset, and pollution. J Allergy Clin Immunol 2023; 152:1321-1329.e5. [PMID: 37156327 PMCID: PMC10626048 DOI: 10.1016/j.jaci.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/24/2023] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Impoverished and historically marginalized communities often reside in areas with increased air pollution. OBJECTIVE We evaluated the association between environmental justice (EJ) track and asthma severity and control as modified by traffic-related air pollution (TRAP). METHODS We performed a retrospective study of 1526 adult asthma patients in Allegheny County, Pa, enrolled in an asthma registry during 2007-20. Asthma severity and control were determined using global guidelines. EJ tract designation was based on residency in census tracts with ≥30% non-White and/or ≥20% impoverished populations. TRAP exposures (NO2 and black carbon) for each census tract were normalized into pollution quartiles. Generalized linear model analyses determined the effect of EJ tract and TRAP on asthma. RESULTS TRAP exposure in the highest quartile range was more frequent among patients living in an EJ tract (66.4% vs 20.8%, P < .05). Living in an EJ tract increased the odds of severe asthma in later onset asthma. The odds of uncontrolled asthma increased with disease duration in all patients living in EJ tracts (P < .05). Living in the highest quartile of NO2 also increased the odds of uncontrolled asthma in patients with severe disease (P < .05), while there was no effect of TRAP on uncontrolled asthma in patients with less severe disease (P > .05). CONCLUSIONS Living in an EJ tract increased the odds of severe and uncontrolled asthma and was influenced by age at onset, disease duration, and potentially by TRAP exposure. This study underscores the need to better understand the complex environmental interactions that affect lung health in groups that have been economically and/or socially marginalized.
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Affiliation(s)
- Brandy M Byrwa-Hill
- Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pa.
| | - Tricia L Morphew
- Morphew Consulting, Bothell, Wash; Community Partners in Asthma Care, McMurray, Pa
| | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pa
| | - James P Fabisiak
- Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pa; University of Pittsburgh Asthma and Environmental Lung Health Institute@UPMC, Pittsburgh
| | - Sally E Wenzel
- Department of Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pa; University of Pittsburgh Asthma and Environmental Lung Health Institute@UPMC, Pittsburgh
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Kelly G, Idubor OI, Binney S, Schramm PJ, Mirabelli MC, Hsu J. The Impact of Climate Change on Asthma and Allergic-Immunologic Disease. Curr Allergy Asthma Rep 2023; 23:453-461. [PMID: 37284923 PMCID: PMC10613957 DOI: 10.1007/s11882-023-01093-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW This review discusses climate change-related impacts on asthma and allergic-immunologic disease, relevant US public health efforts, and healthcare professional resources. RECENT FINDINGS Climate change can impact people with asthma and allergic-immunologic disease through various pathways, including increased exposure to asthma triggers (e.g., aeroallergens, ground-level ozone). Climate change-related disasters (e.g., wildfires, floods) disrupting healthcare access can complicate management of any allergic-immunologic disease. Climate change disproportionately affects some communities, which can exacerbate disparities in climate-sensitive diseases like asthma. Public health efforts include implementing a national strategic framework to help communities track, prevent, and respond to climate change-related health threats. Healthcare professionals can use resources or tools to help patients with asthma and allergic-immunologic disease prevent climate change-related health impacts. Climate change can affect people with asthma and allergic-immunologic disease and exacerbate health disparities. Resources and tools are available to help prevent climate change-related health impacts at the community and individual level.
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Affiliation(s)
- Grace Kelly
- Epidemiology Elective Program, National Center for STLT Public Health Infrastructure and Workforce, and Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Osatohamwen I Idubor
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
| | - Sophie Binney
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Paul J Schramm
- Climate and Health Program, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, Atlanta, GA, USA
| | - Maria C Mirabelli
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
| | - Joy Hsu
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA.
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Lin G, Wang Z, Zhang X, Stein A, Maji KJ, Cheng C, Osei F, Yang FF. Comparison of the association between different ozone indicators and daily respiratory hospitalization in Guangzhou, China. Front Public Health 2023; 11:1060714. [PMID: 36794065 PMCID: PMC9922759 DOI: 10.3389/fpubh.2023.1060714] [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: 10/03/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
Background Epidemiological studies have widely proven the impact of ozone (O3) on respiratory mortality, while only a few studies compared the association between different O3 indicators and health. Methods This study explores the relationship between daily respiratory hospitalization and multiple ozone indicators in Guangzhou, China, from 2014 to 2018. It uses a time-stratified case-crossover design. Sensitivities of different age and gender groups were analyzed for the whole year, the warm and the cold periods. We compared the results from the single-day lag model and the moving average lag model. Results The results showed that the maximum daily 8 h average ozone concentration (MDA8 O3) had a significant effect on the daily respiratory hospitalization. This effect was stronger than for the maximum daily 1 h average ozone concentration (MDA1 O3). The results further showed that O3 was positively associated with daily respiratory hospitalization in the warm season, while there was a significantly negative association in the cold season. Specifically, in the warm season, O3 has the most significant effect at lag 4 day, with the odds ratio (OR) equal to 1.0096 [95% confidence intervals (CI): 1.0032, 1.0161]. Moreover, at the lag 5 day, the effect of O3 on the 15-60 age group was less than that on people older than 60 years, with the OR value of 1.0135 (95% CI: 1.0041, 1.0231) for the 60+ age group; women were more sensitive than men to O3 exposure, with an OR value equal to 1.0094 (95% CI: 0.9992, 1.0196) for the female group. Conclusion These results show that different O3 indicators measure different impacts on respiratory hospitalization admission. Their comparative analysis provided a more comprehensive insight into exploring associations between O3 exposure and respiratory health.
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Affiliation(s)
- Geng Lin
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
| | - Zhuoqing Wang
- Department of Scientific Research and Discipline Development, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,*Correspondence: Zhuoqing Wang ✉
| | - Xiangxue Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China,Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands,Xiangxue Zhang ✉
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Kamal Jyoti Maji
- School of Civil and Environment Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Changxiu Cheng
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China,National Tibetan Plateau Data Center, Beijing, China
| | - Frank Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Fiona Fan Yang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
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Aslam R, Sharif F, Baqar M, Nizami AS, Ashraf U. Role of ambient air pollution in asthma spread among various population groups of Lahore City: a case study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:8682-8697. [PMID: 35220536 DOI: 10.1007/s11356-022-19086-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
Air pollution levels rise as a result of industrial and vehicular emissions, epidemiological issues such as asthma become more prevalent in Lahore, Punjab, Pakistan and cause adverse public health effects. Many studies explored the association between air pollutants and frequency of asthma hospital visits, although their effects are unclear. This study examined the link between air pollution, asthma, and socioeconomic and demographic factors. A questionnaire survey was administered among four age groups (15-25, 25-45, 45-60, and over 60 years old) in public and private hospitals of Lahore city. Daily average concentrations of five air pollutants including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter (PM2.5 and PM10) were recorded at ten fixed air monitoring sites in Lahore city. There were favorable connections between outpatient department (OPD) asthma visits (64%) and levels of outdoor air quality during winter season throughout the study period. The correlation between 1, 29, and 370 asthma patients and average daily air pollution levels found that the condition was more prevalent in females (53%) than males (47%). There was a significant correlation between PM10 exposure and asthma OPD visits in the city (p 0.001), as well as the elevated PM10 levels were substantially linked with OPD asthma visits over the winter season in the city. The hazard index (HI) for all adult population was estimated 0.001132. The study's findings indicate that exposure to ambient air pollution is a significant predictor of asthma hospital visits, particularly among the elderly. Strategies can be developed by policymakers in response to the worrying situation of allergic disease asthma in industrial cities due to air pollution.
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Affiliation(s)
- Rabia Aslam
- Sustainable Development Study Center, Government College University, Lahore, 54000, Pakistan.
| | - Faiza Sharif
- Sustainable Development Study Center, Government College University, Lahore, 54000, Pakistan
| | - Mujtaba Baqar
- Sustainable Development Study Center, Government College University, Lahore, 54000, Pakistan
| | - Abdul-Sattar Nizami
- Sustainable Development Study Center, Government College University, Lahore, 54000, Pakistan
| | - Uzma Ashraf
- Department of Environmental Science and Policy, Lahore School of Economics, Lahore, 53200, Pakistan
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Connor EM, Zablotsky B. The association between air pollution and childhood asthma: United States, 2010-2015. J Asthma 2022; 59:2069-2080. [PMID: 34587862 PMCID: PMC9148369 DOI: 10.1080/02770903.2021.1988105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The current population-based study examines the association between county-level ambient air pollution and childhood asthma. METHODS Data from the nationally representative 2010-2015 National Health Interview Survey were linked to nationwide fine particulate matter (PM2.5) air pollution data at the county-level from the National Environmental Public Health Tracking Network which utilizes air quality monitoring stations and modeled PM2.5 measurements (Downscaler model data) and adjusted by county-level socioeconomic characteristics data from the 2010-2015 American Community Survey. Multilevel modeling techniques were used to assess the association between PM2.5 annual concentrations (quartiles < 8.11, 8.11-9.50, 9.51-10.59, ≥ 10.60 µg/m3) and current childhood asthma along with two asthma outcomes (episode in the past year, emergency room (ER) visit due to asthma). RESULTS From 2010 to 2015, there were significant declines in PM2.5 concentrations and asthma outcomes. In unadjusted models, children living in areas with higher PM2.5 concentrations were more likely to have current asthma, ≥1 asthma episode in the past year, and ≥1 ER visit due to asthma compared with children living in areas with the lowest quartile (< 8.11 µg/m3). After adjusting for characteristics at the county, geographic, and child and family-level, significant associations remained for asthma episode, and ER visit among children living in areas with PM2.5 annual concentrations between 9.51 and 10.59 µg/m3 (3rd quartile) compared with children living in areas with the lowest quartile. CONCLUSIONS This study adds to the limited literature by incorporating nationally representative county-, child-, and family-level data to provide a multi-level analysis of the associations between air pollution and childhood asthma in the U.S.
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Affiliation(s)
- Eric M Connor
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Benjamin Zablotsky
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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Review of Ground-Level Ozone Impact in Respiratory Health Deterioration for the Past Two Decades. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Ground-level ozone has been gaining notoriety with increasing evidence of its nefarious effects on health, especially respiratory diseases. Where do we stand on the solidity of this data and is there room for improvement? Objectives: Evaluate this evidence for incongruities or heterogeneity in this field of research. How is the exposure assessment conducted, where does Portugal stand in this field, and what can be improved? Health deterioration concerning asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) are analysed. Methods: A review of 1735 studies was conducted through PubMed and Google Scholar engines for the past two decades. We identified 59 eligible studies and included an array of variables, including O3 measurements, number of air-quality monitoring stations used, relative risks, odds ratios, hazard ratios, number of hospital admissions, visits, or mortality, and size of population dataset used. Results: Approximately 83% of data in this review presents significant correlations of ozone with asthma, COPD, and ARDS. Studies that report negative or not significant associations mention a lack of data or topographic differences as the main issue with these divergent results. Studies consistently report summer as a period of particular concern. Portuguese data in this field is lacking. Conclusions: This research field is growing in interest and there is evidence that ozone plays a non-negligible role in health deterioration. The few Portuguese studies in this field seem aligned with the literature reviewed but more research is needed. Suggested improvements are more and better data through denser air-quality networks to accurately depict personal exposure to ozone. Homogenization of the exposure assessment concerning averaging times of ozone to daily maximum 8 h averages whenever possible. Risk increments based on 10 ppb instead of interquartile ranges. Lastly, contrary to some studies in this review, the topographic effect on concentrations and health deterioration should not be underestimated and seasonality should always be checked.
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Gladson LA, Cromar KR, Ghazipura M, Knowland KE, Keller CA, Duncan B. Communicating respiratory health risk among children using a global air quality index. ENVIRONMENT INTERNATIONAL 2022; 159:107023. [PMID: 34920275 DOI: 10.1016/j.envint.2021.107023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Air pollution poses a serious threat to children's respiratory health around the world. Satellite remote-sensing technology and air quality models can provide pollution data on a global scale, necessary for risk communication efforts in regions without ground-based monitoring networks. Several large centers, including NASA, produce global pollution forecasts that may be used alongside air quality indices to communicate local, daily risk information to the public. Here we present a health-based, globally applicable air quality index developed specifically to reflect the respiratory health risks among children exposed to elevated outdoor air pollution. Additive, excess-risk air quality indices were developed using 51 different coefficients derived from time-series health studies evaluating the impacts of ambient fine particulate matter, nitrogen dioxide, and ozone on children's respiratory morbidity outcomes. A total of four indices were created which varied based on whether or not the underlying studies controlled for co-pollutants and in the adjustment of excess risks of individual pollutants. Combined with historical estimates of air pollution provided globally at a 25 × 25 km2 spatial resolution from the NASA's Goddard Earth Observing System composition forecast (GEOS-CF) model, each of these indices were examined in a global sample of 664 small and 140 large cities for study year 2017. Adjusted indices presented the most normal distributions of locally-scaled index values, which has been shown to improve associations with health risks, while indices based on coefficients controlling for co-pollutants had little effect on index performance. We provide the steps and resources need to apply our final adjusted index at the local level using freely-available forecasting data from the GEOS-CF model, which can provide risk communication information for cities around the world to better inform individual behavior modification to best protect children's respiratory health.
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Affiliation(s)
- Laura A Gladson
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA.
| | - Marya Ghazipura
- Marron Institute of Urban Management, New York University, New York, USA; New York University Grossman School of Medicine, New York, NY, USA
| | - K Emma Knowland
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Christoph A Keller
- Universities Space Research Association, Columbia, MD, USA; NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Bryan Duncan
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
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Huang J, Yang X, Fan F, Hu Y, Wang X, Zhu S, Ren G, Wang G. Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: a systematic review and meta-analysis. J Asthma 2021; 59:2322-2339. [PMID: 34809505 DOI: 10.1080/02770903.2021.2008429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: To synthesize evidence regarding the relationship between outdoor air pollution and risk of asthma exacerbations in single lag0 and lag1 exposure patterns.Methods: We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases. Articles published until August 1, 2020 and the reference lists of the relevant articles were reviewed. Two authors independently evaluated the eligible articles and performed structured extraction of the relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using random-effect models.Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with increased risk of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95% CI) (pollutants), 1.057(1.011, 1.103) (air quality index, AQI), 1.007 (1.005, 1.010) (particulate matter of diameter ≤ 2.5 μm, PM2.5), 1.009 (1.005, 1.012) (particulate matter of diameter, PM10), 1.010 (1.006, 1.014) (NO2), 1.030 (1.011, 1.048) (CO), 1.005 (1.002, 1.009) (O3); lag1:1.064(1.022, 1.106) (AQI), 1.005 (1.002, 1.008) (PM2.5), 1.007 (1.004, 1.011) (PM10), 1.008 (1.004, 1.012) (NO2), 1.025 (1.007, 1.042) (CO), 1.010 (1.006, 1.013) (O3)], except SO2 [lag0: RR (95% CI), 1.004 (1.000, 1.007); lag1: RR (95% CI), 1.003 (0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use).Conclusion: Outdoor air pollution increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.Trial registration: PROSPERO, CRD42020204097. https://www.crd.york.ac.uk/.Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2008429 .
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Affiliation(s)
- Junjun Huang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Yang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Hu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xi Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Guanhua Ren
- Department of Library, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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10
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Saygin H, Mercan Y, Yorulmaz F. The association between air pollution parameters and emergency department visits and hospitalizations due to cardiovascular and respiratory diseases: a time-series analysis. Int Arch Occup Environ Health 2021; 95:599-606. [PMID: 34617165 DOI: 10.1007/s00420-021-01769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/27/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE In this study, the association between cardiovascular and respiratory Emergency Department (ED) visits and hospitalizations and Sulfur Dioxide (SO2) and particulate matter with an aerodynamic diameter ≤ 10 µm (PM10) was determined. METHODS The records of a total of 632,223 people diagnosed with cardiovascular diseases (ICD-10 code I00-I99) and respiratory diseases (ICD-10 code J00-J99) at and over the age of 18 between 2012 and 2018 in three hospitals in Karaman in Turkey were examined in the present study. The daily 24-h averages for SO2 and PM10 concentrations were acquired in National Air Quality Monitoring. A time-series analysis with Poisson Generalized Linear Model was used. RESULTS Among the air pollution parameters, the mean ± standard deviation of SO2 and PM10 were 16.2 ± 22.1 and 75.8 ± 48.2 μg/m3, respectively. An increase of 10 μg/m3 in SO2 was associated with a 3% [Relative Risk (RR), 95% Confidence Interval (CI): 2-4)] increase in cardiovascular ED visit and 2% (RR, 95% CI 2-3) increase in respiratory ED visit, and 1% (RR, 95% CI 1-3) increase in respiratory hospitalizations. An increase of 10 μg/m3 in PM10 was associated with a 1% (RR, 95% CI 1-2) increase in cardiovascular hospitalizations. CONCLUSIONS Increases in SO2 are a risk factor for cardiovascular and respiratory ED visits, and respiratory hospitalizations. Increases in PM10 are a risk factor for cardiovascular hospitalizations.
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Affiliation(s)
- Hasan Saygin
- Department of Public Health, Kirklareli University Institute of Health Sciences, Kirklareli, Turkey.,Karaman Provincial Health Directorate Health Services Unit, 70110, Karaman, Turkey
| | - Yeliz Mercan
- Department of Public Health, Kirklareli University Institute of Health Sciences, Kirklareli, Turkey. .,Faculty of Health Science, Department of Health Management, Kirklareli University, 39000, Kirklareli, Turkey.
| | - Faruk Yorulmaz
- Faculty of Medicine, Department of Public Health, Trakya University, Edirne, Turkey
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11
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The Impact of an Urban Scrapyard Fire on Respiratory-Related Pediatric Emergency Department Visits. J Occup Environ Med 2021; 62:764-770. [PMID: 32890216 DOI: 10.1097/jom.0000000000001972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In Philadelphia, a scrapyard fire generated PM2.5 concentrations >1000 μg/m. We assessed whether this was associated with pediatric emergency department visits for respiratory diagnoses. DESIGN/METHODS Retrospective observational study using electronic health record data from a local, academic pediatric hospital. RESULTS Compared to the two-week period before the fire, patients living directly north of the fire (downwind) had a significant difference in all asthma diagnoses (OR = 3.02, P = 0.03); asthma and upper respiratory infection (OR = 17.3, P = 0.01); overall admissions (OR = 3.04, P = 01); asthma admissions (OR = 4.45, P = .01); and asthma and upper respiratory infection admissions (OR = 15.0, P = 0.01). We did not observe any significant differences among visits or admissions from patients residing in other adjacent zip codes. CONCLUSION A localized, transient increase in PM2.5 was associated with increased pediatric emergency department visits for asthma among patients living downwind of the fire.
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12
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Combined Effect of Hot Weather and Outdoor Air Pollution on Respiratory Health: Literature Review. ATMOSPHERE 2021. [DOI: 10.3390/atmos12060790] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Association between short-term exposure to ambient air pollution and respiratory health is well documented. At the same time, it is widely known that extreme weather events intrinsically exacerbate air pollution impact. Particularly, hot weather and extreme temperatures during heat waves (HW) significantly affect human health, increasing risks of respiratory mortality and morbidity. Concurrently, a synergistic effect of air pollution and high temperatures can be combined with weather–air pollution interaction during wildfires. The purpose of the current review is to summarize literature on interplay of hot weather, air pollution, and respiratory health consequences worldwide, with the ultimate goal of identifying the most dangerous pollution agents and vulnerable population groups. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, and Scopus, focusing only on peer-reviewed journal articles published in English from 2000 to 2021. The main findings demonstrate that the increased level of PM10 and O3 results in significantly higher rates of respiratory and cardiopulmonary mortality. Increments in PM2.5 and PM10, O3, CO, and NO2 concentrations during high temperature episodes are dramatically associated with higher admissions to hospital in patients with chronic obstructive pulmonary disease, daily hospital emergency transports for asthma, acute and chronic bronchitis, and premature mortality caused by respiratory disease. Excessive respiratory health risk is more pronounced in elderly cohorts and small children. Both heat waves and outdoor air pollution are synergistically linked and are expected to be more serious in the future due to greater climate instability, being a crucial threat to global public health that requires the responsible involvement of researchers at all levels. Sustainable urban planning and smart city design could significantly reduce both urban heat islands effect and air pollution.
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13
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van de Wetering C, Elko E, Berg M, Schiffers CHJ, Stylianidis V, van den Berge M, Nawijn MC, Wouters EFM, Janssen-Heininger YMW, Reynaert NL. Glutathione S-transferases and their implications in the lung diseases asthma and chronic obstructive pulmonary disease: Early life susceptibility? Redox Biol 2021; 43:101995. [PMID: 33979767 PMCID: PMC8131726 DOI: 10.1016/j.redox.2021.101995] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 01/01/2023] Open
Abstract
Our lungs are exposed daily to airborne pollutants, particulate matter, pathogens as well as lung allergens and irritants. Exposure to these substances can lead to inflammatory responses and may induce endogenous oxidant production, which can cause chronic inflammation, tissue damage and remodeling. Notably, the development of asthma and Chronic Obstructive Pulmonary Disease (COPD) is linked to the aforementioned irritants. Some inhaled foreign chemical compounds are rapidly absorbed and processed by phase I and II enzyme systems critical in the detoxification of xenobiotics including the glutathione-conjugating enzymes Glutathione S-transferases (GSTs). GSTs, and in particular genetic variants of GSTs that alter their activities, have been found to be implicated in the susceptibility to and progression of these lung diseases. Beyond their roles in phase II metabolism, evidence suggests that GSTs are also important mediators of normal lung growth. Therefore, the contribution of GSTs to the development of lung diseases in adults may already start in utero, and continues through infancy, childhood, and adult life. GSTs are also known to scavenge oxidants and affect signaling pathways by protein-protein interaction. Moreover, GSTs regulate reversible oxidative post-translational modifications of proteins, known as protein S-glutathionylation. Therefore, GSTs display an array of functions that impact the pathogenesis of asthma and COPD. In this review we will provide an overview of the specific functions of each class of mammalian cytosolic GSTs. This is followed by a comprehensive analysis of their expression profiles in the lung in healthy subjects, as well as alterations that have been described in (epithelial cells of) asthmatics and COPD patients. Particular emphasis is placed on the emerging evidence of the regulatory properties of GSTs beyond detoxification and their contribution to (un)healthy lungs throughout life. By providing a more thorough understanding, tailored therapeutic strategies can be designed to affect specific functions of particular GSTs.
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Affiliation(s)
- Cheryl van de Wetering
- Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Evan Elko
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Marijn Berg
- Pathology and Medical Biology, GRIAC Research Institute, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Caspar H J Schiffers
- Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Vasili Stylianidis
- Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Maarten van den Berge
- Pulmonology, GRIAC Research Institute, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Martijn C Nawijn
- Pathology and Medical Biology, GRIAC Research Institute, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Yvonne M W Janssen-Heininger
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
| | - Niki L Reynaert
- Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
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Abstract
Globally, exposure to ambient air pollutants is responsible for premature mortality and is implicated in the development and exacerbation of several acute and chronic lung disease across all ages. In this article, we discuss the source apportionment of ambient pollutants and the respiratory health effects in humans. We specifically discuss the evidence supporting ambient pollution in the development of asthma and chronic obstructive pulmonary disease and acute exacerbations of each condition. Practical advice is given to health care providers in how to promote a healthy environment and advise patients with chronic conditions to avoid unsafe air quality.
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Affiliation(s)
- Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jahred Liddie
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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15
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Bergmann S, Li B, Pilot E, Chen R, Wang B, Yang J. Effect modification of the short-term effects of air pollution on morbidity by season: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:136985. [PMID: 32044481 DOI: 10.1016/j.scitotenv.2020.136985] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O3, SO2 and NO2 on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001-1.0018), 1.0080 (95% CI: 1.0021-1.0138), 0.9828 (95% CI: 0.9697-0.9962) and 0.9896 (95% CI: 0.9824-0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO2 on cardiovascular disease, the effect of PM10 on stroke, and the effect of O3 on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18 years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity.
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Affiliation(s)
- Stéphanie Bergmann
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Bixia Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Eva Pilot
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Renchao Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China.
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16
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Fabisiak JP, Jackson EM, Brink LL, Presto AA. A risk-based model to assess environmental justice and coronary heart disease burden from traffic-related air pollutants. Environ Health 2020; 19:34. [PMID: 32178683 PMCID: PMC7075037 DOI: 10.1186/s12940-020-00584-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/26/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Communities need to efficiently estimate the burden from specific pollutants and identify those most at risk to make timely informed policy decisions. We developed a risk-based model to estimate the burden of black carbon (BC) and nitrogen dioxide (NO2) on coronary heart disease (CHD) across environmental justice (EJ) and non-EJ populations in Allegheny County, PA. METHODS Exposure estimates in census tracts were modeled via land use regression and analyzed in relation to US Census data. Tracts were ranked into quartiles of exposure (Q1-Q4). A risk-based model for estimating the CHD burden attributed to BC and NO2 was developed using county health statistics, census tract level exposure estimates, and quantitative effect estimates available in the literature. RESULTS For both pollutants, the relative occurrence of EJ tracts (> 20% poverty and/or > 30% non-white minority) in Q2 - Q4 compared to Q1 progressively increased and reached a maximum in Q4. EJ tracts were 4 to 25 times more likely to be in the highest quartile of exposure compared to the lowest quartile for BC and NO2, respectively. Pollutant-specific risk values (mean [95% CI]) for CHD mortality were higher in EJ tracts (5.49 × 10- 5 [5.05 × 10- 5 - 5.92 × 10- 5]; 5.72 × 10- 5 [5.44 × 10- 5 - 6.01 × 10- 5] for BC and NO2, respectively) compared to non-EJ tracts (3.94 × 10- 5 [3.66 × 10- 5 - 4.23 × 10- 5]; 3.49 × 10- 5 [3.27 × 10- 5 - 3.70 × 10- 5] for BC and NO2, respectively). While EJ tracts represented 28% of the county population, they accounted for about 40% of the CHD mortality attributed to each pollutant. EJ tracts are disproportionately skewed toward areas of high exposure and EJ residents bear a greater risk for air pollution-related disease compared to other county residents. CONCLUSIONS We have combined a risk-based model with spatially resolved long-term exposure estimates to predict CHD burden from air pollution at the census tract level. It provides quantitative estimates of effects that can be used to assess possible health disparities, track temporal changes, and inform timely local community policy decisions. Such an approach can be further expanded to include other pollutants and adverse health endpoints.
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Affiliation(s)
- James P Fabisiak
- Center for Healthy Environments & Communities, Department of Environmental & Occupational Health, University of Pittsburgh Graduate School of Public Health, PUBHL-4132, 130 DeSoto Street Pittsburgh, Pittsburgh, PA, 15261, USA.
| | - Erica M Jackson
- Center for Healthy Environments & Communities, Department of Environmental & Occupational Health, University of Pittsburgh Graduate School of Public Health, PUBHL-4132, 130 DeSoto Street Pittsburgh, Pittsburgh, PA, 15261, USA
| | - LuAnn L Brink
- Allegheny County Health Department, Pittsburgh, PA, USA
| | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
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17
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Liu F, Qu F, Zhang H, Chao L, Li R, Yu F, Guan J, Yan X. The effect and burden modification of heating on adult asthma hospitalizations in Shijiazhuang: a time-series analysis. Respir Res 2019; 20:122. [PMID: 31200718 PMCID: PMC6570879 DOI: 10.1186/s12931-019-1092-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/05/2019] [Indexed: 12/25/2022] Open
Abstract
Background Previous studies have found associations between asthma morbidity and air pollution especially in young population, (PLoS One 12:e0180522, 2017; Can J Public Health 103:4-8, 2012; Environ Health Perspect 118:449-57, 2010; Am J Respir Crit Care Med 182:307-16, 2010; J Allergy Clin Immunol 104:717-22, 2008; J Allergy Clin Immunol 104:717-22, 1999; Environ Res 111:1137-47, 2011) but most of them were conducted in areas with relatively low air pollutant level. Moreover, very few studies have investigated the effect and burden modification of heating season during which the ambient air pollution level is significantly different from that during non-heating season in north China. Objectives This study aimed to evaluate the effect and burden modification of heating on short-term associations between adult asthma hospitalizations and ambient air pollution in the north China city of Shijiazhuang. Methods Generalized additive models combined with penalized distributed lag nonlinear models were used to model associations between daily asthma hospitalizations and ambient air pollutants from 1 January 2013 to 16 December 2016 in Shijiazhuang city, adjusting for long-term and seasonality trend, day of week, statutory holiday, daily mean air pressure and temperature. Attributable risks were calculated to evaluate the burden of asthma hospitalizations due to air pollutants exposure. The effect of pollutants on hospitalization and the attributable measures were estimated in heating and non-heating season separately and the comparisons between the two seasons were conducted. Results All pollutants demonstrated positive and significant impacts on asthma hospitalizations both in heating season and non-heating season, except for O3 in heating season where a negative association was observed. However, the differences of the pollutant-specific effects between the two seasons were not significant. SO2 and NO2 exposure were associated with the heaviest burden among all pollutants in heating season; meanwhile, PM10 and PM2.5 were associated with the heaviest burden in heating season. Conclusions In conclusion, we found evidence of the effect of ambient air pollutants on asthma hospitalizations in Shijiazhuang. The central heating period could modify the effects in terms of attributable risks. The disease burden modification of heating should be taken into consideration when planning intervention measures to reduce the risk of asthma hospitalization.
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Affiliation(s)
- Feifei Liu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Fangfang Qu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Huiran Zhang
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Lingshan Chao
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Rongqin Li
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Fengxue Yu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Jitao Guan
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Xixin Yan
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China.
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18
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Taylor MP, Isley CF, Glover J. Prevalence of childhood lead poisoning and respiratory disease associated with lead smelter emissions. ENVIRONMENT INTERNATIONAL 2019; 127:340-352. [PMID: 30954720 DOI: 10.1016/j.envint.2019.01.062] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The city of Port Pirie in South Australia has been a world leading centre for lead and zinc smelting and processing since 1889 that continues to cause contamination of its environment and resident population. This study quantifies the effect of lead and SO2 emissions from Nyrstar Port Pirie Pty Ltd's smelter on blood lead and respiratory health outcomes, respectively, and establishes what air quality values are required to better protect human health. METHOD Blood lead and emergency department presentation data collected by South Australia Health (SA Health) and lead in air and SO2 data collected by the South Australian Environment Protection Authority (SAEPA) were obtained and analysed to quantify health outcomes due to smelter emissions in Port Pirie. Regression analysis was used to assess the relationship between the concentration of lead in air and children's blood lead levels between the years of available data: 2003 to 2017. Ambient SO2 concentrations (SAEPA) measured continuously between 2008 and 2018 were 24-hour averaged and compared to daily local emergency department respiratory presentation rates (available from July 2012 to October 2018). Rates of emergency department respiratory presentations at Port Pirie and regional comparators were calculated as age-standardised rates. RESULTS The data show that increases in ambient SO2 concentrations are associated with increased rates of emergency department respiratory presentations of Port Pirie residents, in which children are over-represented. The 30-day rolling average of respiratory presentations was significantly associated (p < 0.05) with incremental increases in SO2. Analysis of the relationship between lead in air and blood lead shows that annual geometric mean air lead concentrations need to be <0.11 μg/m3 to ensure the geometric mean blood lead of Port Pirie children under 5 years is ≤5 μg/dL. For children aged 24 months, lead in air needs to be no greater than 0.082 μg/m3 (annual geometric mean) to ensure geometric mean blood lead does not exceed 5 μg/dL. CONCLUSION Current smelting emissions continue to pose a clear risk of harm to Port Pirie children. Allowable emissions must be lowered significantly to limit adverse childhood health outcomes including respiratory illness and IQ, academic achievement and socio-behavioural problems that are associated with lead exposure at levels experienced by Port Pirie children. Current SO2 levels are likely to be responsible for increased rates of emergency department respiratory presentations in Port Pirie compared with other South Australian locations. As a minimum, Australian SO2 air quality standards need to be enforced in Port Pirie to better protect human health. Lead in air needs to be approximately 80% lower than the current national standard (0.5 μg/m3) to ensure that the geometric blood lead of children under 5 years is less than or equal to 5 μg/dL.
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Affiliation(s)
- Mark Patrick Taylor
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia.
| | - Cynthia Faye Isley
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - John Glover
- Public Health Information Development Unit, Torrens University Australia, Adelaide, SA 5000, Australia
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Assessing the impact of air pollution on childhood asthma morbidity: how, when, and what to do. Curr Opin Allergy Clin Immunol 2019; 18:124-131. [PMID: 29493555 DOI: 10.1097/aci.0000000000000422] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Exposure to air pollutants is linked with poor asthma control in children and represents a potentially modifiable risk factor for impaired lung function, rescue medication use, and increased asthma-related healthcare utilization. Identification of the most relevant pollutants to asthma as well as susceptibility factors and strategies to reduce exposure are needed to improve child health. RECENT FINDINGS The current available literature supports the association between pollutants and negative asthma outcomes. Ethnicity, socioeconomic status, and presence of certain gene polymorphisms may impact susceptibility to the negative health effects of air pollution. Improved air quality standards were associated with better asthma outcomes. SUMMARY The link between air pollution and pediatric asthma morbidity is supported by the recent relevant literature. Continued efforts are needed to identify the most vulnerable populations and develop strategies to reduce exposures and improve air quality.
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Martínez-Rivera C, Garcia-Olivé I, Stojanovic Z, Radua J, Ruiz Manzano J, Abad-Capa J. Association between air pollution and asthma exacerbations in Badalona, Barcelona (Spain), 2008-2016. Med Clin (Barc) 2018; 152:333-338. [PMID: 30149947 DOI: 10.1016/j.medcli.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Air pollution has been widely associated with respiratory diseases. Nevertheless, association between air pollution and exacerbations of asthma in our area has been less studied. To analyse the effect of air pollution on exacerbations of asthma in Badalona. MATERIAL AND METHODS This was an observational study conducted in Badalona. The number of daily hospital admissions and accident and emergency visits related to exacerbation of asthma between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, atmospheric pressure, relative humidity, and NO2, SO2 and CO levels on asthma-related emergencies and hospitalisations the same day and 1-4 days after. All p-values were corrected for multiple comparisons. RESULTS The number of hospitalisations was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 0, 1, 2 and 4) and atmospheric pressure (lags 2 and 3). The number of accident and emergency visits was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 2, 3 and 4). CONCLUSIONS The number of accident and emergency visits and hospitalisations for exacerbation of asthma is associated with higher levels of NO2 and with lower temperatures.
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Affiliation(s)
- Carlos Martínez-Rivera
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Ignasi Garcia-Olivé
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España.
| | - Zoran Stojanovic
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Joaquim Radua
- Department of Statistics, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, España; Ciber de Salud Mental (CiberSam), Madrid, España; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Estocolmo, Suecia; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Juan Ruiz Manzano
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Jorge Abad-Capa
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
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Hasunuma H, Yamazaki S, Tamura K, Hwang YH, Ono R, Amimoto Y, Askew DJ, Odajima H. Association between daily ambient air pollution and respiratory symptoms in children with asthma and healthy children in western Japan. J Asthma 2018; 55:712-719. [PMID: 29309210 DOI: 10.1080/02770903.2017.1369988] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE In recent years, air pollutant concentrations in Japan have decreased slightly; however, there are growing concerns about the influences of transnational air pollution on respiratory illness. We aimed to clarify the short-term association between the ambient air pollution and respiratory symptoms among children without asthma, children with asthma not using long-term medications (CA-nonLTM), and those using them (CA-LTM). METHODS A total of 138 children attending 2 primary schools and 71 children with asthma regularly visiting cooperating medical institutions were recruited. Study participants measured peak expiratory flow (PEF) twice a day and recorded coughing, nasal symptoms, and medication use in a diary. Predicted associations between daily air pollutant concentrations and respiratory symptoms, and PEF were evaluated using case-crossover and generalized estimate equation models. RESULTS Changes in %maxPEF per 10 ppb oxidant (Ox) increase in children without asthma, CA-nonLTM, and CA-LTM were -0.26% (95% CI: -0.49, -0.03), -0.51% (95% CI: -0.89, -0.12), and -0.20% (95% CI: -0.42, 0.01), respectively. The odds ratios for coughing per 10 ppb Ox increase in the Lag0 model were 1.34 (95% CI: 1.11, 1.60), 1.52 (95% CI: 1.12, 2.07), and 1.06 (95% CI: 0.93, 1.20), respectively. These suggested that the Ox concentration has graded effects on %maxPEF and coughing, in the following descending order, CA-nonLTM, children without asthma, and CA-LTM. The Ox concentration was also positively associated with nasal symptoms in children without asthma and CA-LTM. CONCLUSION Our results suggest that using long-term medications to manage asthma may play an important role in preventing exacerbation of respiratory symptoms due to air pollution.
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Affiliation(s)
- Hideki Hasunuma
- a Center for Environmental Information Science , Tokyo , Japan
| | - Shin Yamazaki
- b National Institute for Environmental Studies , Tsukuba , Japan
| | - Kenji Tamura
- b National Institute for Environmental Studies , Tsukuba , Japan
| | | | - Rintaro Ono
- d National Hospital Organization Fukuoka Hospital , Fukuoka , Japan
| | - Yuko Amimoto
- e Hiroshima City Asa Hospital , Hiroshima , Japan
| | - David J Askew
- f University of Occupational and Environmental Health , Kitakyusyu , Japan
| | - Hiroshi Odajima
- d National Hospital Organization Fukuoka Hospital , Fukuoka , Japan
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22
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Lim H, Kwon HJ, Lim JA, Choi JH, Ha M, Hwang SS, Choi WJ. Short-term Effect of Fine Particulate Matter on Children's Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis. J Prev Med Public Health 2017; 49:205-19. [PMID: 27499163 PMCID: PMC4977771 DOI: 10.3961/jpmph.16.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/14/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies. METHODS Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger's test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3. RESULTS We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM2.5 on children's hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children's hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m3 increase in PM2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I2=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe. CONCLUSIONS We strengthened the evidence on the short-term effect of PM2.5 on children's hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.
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Affiliation(s)
- Hyungryul Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ji-Ae Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jong Hyuk Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Seung-Sik Hwang
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Won-Jun Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
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