Elderly Mortality and Exposure to Fine Particulate Matter and Ozone

Association Between Air Pollution and Viral Infection in Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

BACKGROUND

Respiratory pathogen infections and air pollution are main causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Air pollution has a direct effect on the airway epithelial barrier and the immune system, which can have an influence on infection. However, studies on the relationship between respiratory infections and air pollutants in severe AECOPD are limited. Thus, the objective of this study was to investigate the correlation between air pollution and respiratory pathogen in severe AECOPD.

METHODS

This multicenter observational study was conducted by reviewing electronic medical records of patients with AECOPD at 28 hospitals in South Korea. Patients were divided into four groups according to the comprehensive air-quality index (CAI) used in Korea. Identification rates of bacteria and viruses of each group were analyzed.

RESULTS

Viral pathogens were identified in 270 (36.7%) of 735 patients. Viral identification rate was different (P = 0.012) according to air pollution. Specifically, the virus detection rate was 55.9% in the group of CAI 'D' with the highest air pollution. It was 24.4% in the group of CAI 'A' with the lowest air pollution. This pattern was clearly seen for influenza virus A (P = 0.042). When further analysis was performed with particulate matter (PM), the higher/lower the PM level, the higher/lower the virus detection rate. However, no significant difference was found in the analysis related to bacteria.

CONCLUSION

Air pollution may make COPD patients more susceptible to respiratory viral infections, especially influenza virus A. Thus, on days with poor air quality, COPD patients need to be more careful about respiratory infections.

Decreased birth weight after prenatal exposure to wildfires on the eastern coast of Korea in 2000

OBJECTIVES

In April 2000, a series of wildfires occurred simultaneously in five adjacent small cities located on the eastern coast of Korea. These wildfires burned approximately 23,794 hectares of forestland over several days. We investigated the effects of prenatal exposure to the by-products generated by wildfire disasters on birth weight.

METHODS

Birth weight data were obtained for 1999-2001 from the birth registration database of the Korean National Statistical Office and matched with the zip code and exposed/unexposed pregnancy week for days of the wildfires. Generalized linear models were then used to assess the associations between birth weight and exposure to wildfires after adjusting for fetal sex, gestational age, parity, maternal age, maternal education, paternal education, and average exposed atmospheric temperature.

RESULTS

Compared with unexposed pregnancies before and after the wildfires, mean birth weight decreased by 41.4 g (95% confidence interval [CI], -72.4 to -10.4) after wildfire exposure during the first trimester, 23.2 g (95% CI, -59.3 to 13.0) for exposure during the second trimester, and 27.0 g (95% CI, -63.8 to 9.8) during the third trimester. In the adjusted model for infants exposed in utero during any trimester, the mean birth weight decreased by 32.5 g (95% CI, -53.2 to -11.7).

CONCLUSIONS

We observed a 1% reduction in birth weight after wildfire exposure. Thus, exposure to by-products generated during a wildfire disaster during pregnancy may slow fetal growth and cause developmental delays.

Effect of ambient O3 on mortality due to circulatory and respiratory diseases in a high latitude city of northeast China

In recent years, O₃ pollution had been worsening in China and became a major challenge for human health. To evaluate the O₃ effects on circulatory and respiratory mortality in Harbin, a high latitude city of northeast China, we applied a time-series study from 2014 to 2016. After collecting data and adjusting for the effects of confounders, we built the generalized additive model to assess the associations between O₃ and mortality at different lag days. The results showed that an interquartile-range (IQR) increase in O₃ concentration corresponded to excess risk (ER) of 2.00% (95%CI: - 0.25-4.30%) for circulatory mortality at lag 0 and 8.02% (95%CI: 4.18-12.01%) for respiratory mortality at lag 2 days in the single-pollutant model. Stratified analysis showed that O₃ had a greater effect on females than on males. The effect of O₃ exposure on circulatory mortality was stronger during the warm period, while the opposite trend was founded for respiratory mortality. The sensitivity analysis showed that the effects of O₃ were relatively independent and the major results were robust.

Daily Mortality in Different Age Groups Associated with Exposure to Particles, Nitrogen Dioxide and Ozone in Two Northern European Capitals: Stockholm and Tallinn

Although the association between air pollution and mortality is well established, less is known about the effects in different age groups. This study analyzes the short-term associations between mortality in different age groups (0–14 years of age, 15–64 years of age, and 65+ years of age) and a number of air pollutants in two relatively clean northern European capitals: Stockholm and Tallinn. The concentrations in PM10 (particles with an aerodynamic diameter smaller than or equal to 10 µm), PM2.5–10 (coarse particles), PM2.5 (particles with an aerodynamic diameter smaller than or equal to 2.5 µm), BC (black carbon), PNC4 (particle number count of particles larger than or equal to 4 nm), NO2 (nitrogen dioxide), and O3 (ozone) were measured during the period of 2000–2016 in Stockholm and 2001–2018 in Tallinn (except for BC and PNC4 which were only measured in Stockholm). The excess risks in daily mortality associated with an interquartile range (IQR) increase in the measured air pollutants were calculated in both single- and multi-pollutant models for lag01 and lag02 (average concentration during the same and the previous day, and the same and the previous two days, respectively) using a quasi-Poisson regression model with a logistic link function. In general, the calculated excess risks per IQR increase were highest in the age group 0–14 years of age in both Stockholm and Tallinn. However, in Stockholm, a statistically significant effect was shown for PM2.5–10, and in Tallinn for O3. In the oldest age group (65+), statistically significant effects were shown for both PM2.5–10, PM10, and O3 in Stockholm, and for O3 in Tallinn.

Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea

OBJECTIVES

Although there is substantial evidence for the short-term effect of fine particulate matter (PM2.5) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM2.5. This study investigated how the magnitude of the mortality effect of PM2.5 exposure is modified by persistent exposure to high PM2.5 concentrations.

METHODS

We analyzed data on the daily mortality count, simulated daily PM2.5 level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM2.5.

RESULTS

The mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM2.5 concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM2.5 on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.

CONCLUSIONS

We found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM2.5 exposure on the day when exposure to high PM2.5 concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM2.5 exposure had a stronger effect on seniors.

Fear in a Handful of Dust: The Epidemiological, Environmental, and Economic Drivers of Death by PM2.5 Pollution

This study evaluates numerous epidemiological, environmental, and economic factors affecting morbidity and mortality from PM2.5 exposure in the 27 member states of the European Union. This form of air pollution inflicts considerable social and economic damage in addition to loss of life and well-being. This study creates and deploys a comprehensive data pipeline. The first step consists of conventional linear models and supervised machine learning alternatives. Those regression methods do more than predict health outcomes in the EU-27 and relate those predictions to independent variables. Linear regression and its machine learning equivalents also inform unsupervised machine learning methods such as clustering and manifold learning. Lower-dimension manifolds of this dataset's feature space reveal the relationship among EU-27 countries and their success (or failure) in managing PM2.5 morbidity and mortality. Principal component analysis informs further interpretation of variables along economic and health-based lines. A nonlinear environmental Kuznets curve may describe the fuller relationship between economic activity and premature death from PM2.5 exposure. The European Union should bridge the historical, cultural, and economic gaps that impair these countries' collective response to PM2.5 pollution.

Publication trends in research on particulate matter and health impact over a 10-year period: 2009-2018

Exposure to ambient particulate matter is a major health risk factor for numerous diseases, including those of the cardiovascular and respiratory varieties. The aim of this study was to estimate the latest global research activities regarding particulate matter and health impact. We performed a bibliometric analysis of this field's scientific publication trends over a decade (2009-2018). Publications were retrieved from the Scopus and Web of Science databases using the search terms "particulate matter," "fine particulate matter," "health impact," and their synonyms. The literature on health impact in the research fields of particulate matter (PM10) and fine particulate matter (PM2.5) trended to significantly increase over the decade in consideration. It appears to have been led by researchers of the United States and China. Worldwide research on particulate matter and health effects has focused primarily on respiratory and cardiovascular diseases. The precursors to and components of particulate matter (such as nitrogen dioxide, polycyclic aromatic hydrocarbon, sulfur dioxide, and black carbon) were also popular research topics in this field. Research on children, older adults, and pregnant women, who are most vulnerable to the health effects of air pollution, has increased dramatically over the past 10 years. Our findings provide the information necessary to predict unmet research topics and future research needs.