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Ahmed Z, Chaudhary F, Agrawal DK. Epidemiology, Mechanisms and Prevention in the Etiology of Environmental Factor-Induced Cardiovascular Diseases. JOURNAL OF ENVIRONMENTAL SCIENCE AND PUBLIC HEALTH 2024; 8:59-69. [PMID: 38911615 PMCID: PMC11192553 DOI: 10.26502/jesph.96120206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Cardiovascular diseases are a significant cause of mortality worldwide, and their prevalence can be amplified by a range of environmental factors. This review article critically evaluated the published information on the epidemiology and pathophysiological mechanisms of various environmental factors such as air indoor and outdoor air pollution, water pollution, climate change, and soil pollution. Preventative measures to mitigate these effects including public health responses are discussed with gaps in our knowledge for future studies.
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Affiliation(s)
- Zubair Ahmed
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA
| | - Fihr Chaudhary
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA
| | - Devendra K Agrawal
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA
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Park DY, Bittar-Carlini G, Kumar M, Jamil Y, Nanna MG. Seasonal variations in admissions for atrial fibrillation or atrial flutter in the Northeast and the Midwest regions of the United States. Proc AMIA Symp 2024; 37:560-568. [PMID: 38910792 PMCID: PMC11188794 DOI: 10.1080/08998280.2024.2346050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/01/2024] [Indexed: 06/25/2024] Open
Abstract
Background Previous studies conflict on whether seasonal variability exists in atrial fibrillation (AF) admissions, and contemporary studies are lacking. Methods We identified admissions for AF or atrial flutter in the Midwest and Northeast regions of the US from the National Inpatient Database for 2016 to 2020, grouped them into the four seasons (spring, summer, fall, winter), and compared the number of admissions. Subgroup analyses were performed stratified to sex, age, race, AF alone, and geographical regions. Results A total of 955,320 admissions for AF or atrial flutter occurred. The number of admissions was highest during winter (243,990, 25.5% of the total), followed by fall (239,250, 25.0% of the total), summer (236,910, 24.8% of the total), and spring (235,170, 24.6% of the total). The differences were statistically significant (P < 0.001). An increasing trend in the number of admissions was observed from March to February of the next year (P trend <0.001). Admissions were most common in the winter and least common in the spring in subgroups of both sexes, age ≥65 years, Whites, non-Whites, AF alone, Northeast region, and Midwest region. Conclusion Contemporary analysis of a national database demonstrates seasonal variability in the number of admissions for AF, with a slight increase observed during the winter.
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Affiliation(s)
- Dae Yong Park
- Department of Medicine, Cook County Health, Chicago, Illinois, USA
| | | | - Manoj Kumar
- Department of Medicine, Cook County Health, Chicago, Illinois, USA
| | - Yasser Jamil
- Department of Medicine, Yale School of Medicine, Connecticut, USA
| | - Michael G. Nanna
- Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Wen B, Kliengchuay W, Suwanmanee S, Aung HW, Sahanavin N, Siriratruengsuk W, Kawichai S, Tawatsupa B, Xu R, Li S, Guo Y, Tantrakarnapa K. Association of cause-specific hospital admissions with high and low temperatures in Thailand: a nationwide time series study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101058. [PMID: 38596004 PMCID: PMC11000193 DOI: 10.1016/j.lanwpc.2024.101058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/20/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
Background Non-optimum temperatures are associated with a considerable mortality burden. However, evidence of temperature with all-cause and cause-specific hospital admissions in tropical countries like Thailand is still limited. Methods Daily all-cause and cause-specific hospital admissions for outpatient and inpatient visits were collected from 77 provinces in Thailand from January 2013 to August 2019. A two-stage time-series approach was applied to assess the association between non-optimum temperatures and hospital admission. We first fitted the province-specific temperature-morbidity association and then obtained the national association in the second stage using a random-effects meta-analysis regression. The attributable fraction (AF) of hospital admissions with 95% empirical confidence interval (eCI) was calculated. Findings A total of 878,513,460 all-cause outpatient admissions and 32,616,600 all-cause inpatient admissions were included in this study. We observed a J-shaped relationship with the risk of hospital admissions increasing for both cold and hot temperatures. The overall AFs of all-cause hospital admissions due to non-optimum temperatures were 7.57% (95% eCI: 6.47%, 8.39%) for outpatient visits and 6.17% (95% eCI: 4.88%, 7.20%) for inpatient visits. Hot temperatures were responsible for most of the AFs of hospital admissions, with 6.71% (95% eCI: 5.80%, 7.41%) for outpatient visits and 4.50% (95% eCI: 3.62%, 5.19%) for inpatient visits. The burden of hospital admissions was greater in females and in children and adolescents (0-19 years). The fractions of hospital admissions attributable to non-optimum temperatures exhibited variation among disease categories and geographical areas. Interpretation The results indicate that low and high temperature has a significant impact on hospital admissions, especially among the females, and children and adolescents (0-19 years). The current investigation could provide evidence for policymakers to develop adaptation strategies and mitigate the adverse effects of climate change on public health in Thailand and other tropical countries. Funding National Research Council of Thailand (NRCT): E-Asia Joint Research Program: Climate change impact on natural and human systems (N33A650979).
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wissanupong Kliengchuay
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Environment, Health and Social Impact Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - San Suwanmanee
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Htoo Wai Aung
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Narut Sahanavin
- Faculty of Physical Education, Srinakharnwirot University, Nakhon Nayok, Thailand
| | | | - Sawaeng Kawichai
- Research Institute of Health Science, Chiang Mai University, Chiang Rai, Thailand
| | | | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Environment, Health and Social Impact Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Abstract
Ubiquitous environmental exposures increase cardiovascular disease risk via diverse mechanisms. This review examines personal strategies to minimize this risk. With regard to fine particulate air pollution exposure, evidence exists to recommend the use of portable air cleaners and avoidance of outdoor activity during periods of poor air quality. Other evidence may support physical activity, dietary modification, omega-3 fatty acid supplementation, and indoor and in-vehicle air conditioning as viable strategies to minimize adverse health effects. There is currently insufficient data to recommend specific personal approaches to reduce the adverse cardiovascular effects of noise pollution. Public health advisories for periods of extreme heat or cold should be observed, with limited evidence supporting a warm ambient home temperature and physical activity as strategies to limit the cardiovascular harms of temperature extremes. Perfluoroalkyl and polyfluoroalkyl substance exposure can be reduced by avoiding contact with perfluoroalkyl and polyfluoroalkyl substance-containing materials; blood or plasma donation and cholestyramine may reduce total body stores of perfluoroalkyl and polyfluoroalkyl substances. However, the cardiovascular impact of these interventions has not been examined. Limited utilization of pesticides and safe handling during use should be encouraged. Finally, vasculotoxic metal exposure can be decreased by using portable air cleaners, home water filtration, and awareness of potential contaminants in ground spices. Chelation therapy reduces physiological stores of vasculotoxic metals and may be effective for the secondary prevention of cardiovascular disease.
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Affiliation(s)
- Luke J Bonanni
- Grossman School of Medicine (L.J.B.), NYU Langone Health, New York, NY
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Blaustein JR, Quisel MJ, Hamburg NM, Wittkopp S. Environmental Impacts on Cardiovascular Health and Biology: An Overview. Circ Res 2024; 134:1048-1060. [PMID: 38662864 PMCID: PMC11058466 DOI: 10.1161/circresaha.123.323613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Environmental stressors associated with human activities (eg, air and noise pollution, light disturbance at night) and climate change (eg, heat, wildfires, extreme weather events) are increasingly recognized as contributing to cardiovascular morbidity and mortality. These harmful exposures have been shown to elicit changes in stress responses, circadian rhythms, immune cell activation, and oxidative stress, as well as traditional cardiovascular risk factors (eg, hypertension, diabetes, obesity) that promote cardiovascular diseases. In this overview, we summarize evidence from human and animal studies of the impacts of environmental exposures and climate change on cardiovascular health. In addition, we discuss strategies to reduce the impact of environmental risk factors on current and future cardiovascular disease burden, including urban planning, personal monitoring, and mitigation measures.
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Affiliation(s)
- Jacob R. Blaustein
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
| | - Matthew J. Quisel
- Department of Medicine, Boston University Chobanian and Avedision School of Medicine
| | - Naomi M. Hamburg
- Section of Vascular Biology, Whitaker Cardiovascular Institute, Chobanian and Avedisian School of Medicine, Boston University, Boston, USA
| | - Sharine Wittkopp
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
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Chen Z, Liu P, Xia X, Cao C, Ding Z, Li X. Low ambient temperature exposure increases the risk of ischemic stroke by promoting platelet activation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169235. [PMID: 38097078 DOI: 10.1016/j.scitotenv.2023.169235] [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: 08/13/2023] [Revised: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Accumulating epidemiological evidence suggests the association between low ambient temperature exposure and the risk of ischemic stroke, but the underlying mechanisms remain unclear. OBJECTIVE Given the crucial role of platelet activation and thrombosis in ischemic stroke, this study aims to investigate the effect of ambient temperature on platelet activation through multi-center clinical data in Tianjin as well as animal experiments. METHODS From 2018 to 2020, nearly 3000 ischemic stroke patients from three stroke centers in Tianjin were included in the analysis, among them the ADP induced platelet aggregation rate was available. Meteorological data from the same period had also been collected. After controlling for confounding factors, the generalized additive mixed model (GAMM) was used to evaluate the correlation between environmental temperature and platelet aggregation rate. In further animal experiments, platelet function assessments were conducted on mice from the cold exposure group and the normal temperature group, including platelet aggregation, spreading, and clot retraction. Additionally, tail bleeding and mesentery thrombosis were also tested to monitor hemostasis and thrombosis in vivo. RESULT A nonlinear "S" shaped relationship between outdoor temperature and platelet aggregation was found. Each 1 °C decrease of mean temperature was associated with an increase of 7.77 % (95 % CI: 2.06 % - 13.48 %) in platelet aggregation. The ambient temperature is not related to other platelet parameters. Subgroup analysis found that males, people aged ≥65 years, and hypertensive individuals are more susceptible to temperature changes. Furthermore, animal experiments demonstrated that the increased CIRBP levels and subsequent activation of p-AKT/p-ERK may be one of the reasons for cold exposure induced platelets activation. CONCLUSION Both clinical data and basic research support that low ambient temperature exposure has the potential to increase platelet activation. These results provide a basis for understanding the potential mechanism of temperature variations on the pathogenesis of cerebrovascular diseases.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Chen Cao
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhongren Ding
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; School of Pharmacy, Tianjin Medical University, China.
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China.
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Pei Z, Xiong Y, Jiang S, Guo R, Jin W, Tao J, Zhang Z, Zhang Y, Zou Y, Gong Y, Ren J. Heavy Metal Scavenger Metallothionein Rescues Against Cold Stress-Evoked Myocardial Contractile Anomalies Through Regulation of Mitophagy. Cardiovasc Toxicol 2024; 24:85-101. [PMID: 38356081 DOI: 10.1007/s12012-023-09823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/24/2023] [Indexed: 02/16/2024]
Abstract
Cold stress prompts an increased prevalence of cardiovascular morbidity yet the underneath machinery remains unclear. Oxidative stress and autophagy appear to contribute to cold stress-induced cardiac anomalies. Our present study evaluated the effect of heavy metal antioxidant metallothionein on cold stress (4 °C)-induced in cardiac remodeling and contractile anomalies and cell signaling involved including regulation of autophagy and mitophagy. Cold stress (3 weeks) prompted interstitial fibrosis, mitochondrial damage (mitochondrial membrane potential and TEM ultrastructure), oxidative stress (glutathione, reactive oxygen species and superoxide), lipid peroxidation, protein injury, elevated left ventricular (LV) end systolic and diastolic diameters, decreased fractional shortening, ejection fraction, Langendorff heart function, cardiomyocyte shortening, maximal velocities of shortening/relengthening, and electrically stimulated intracellular Ca2+ rise along with elongated relaxation duration and intracellular Ca2+ clearance, the responses of which were overtly attenuated or mitigated by metallothionein. Levels of apoptosis, cell death (Bax and loss of Bcl2, IL-18), and autophagy (LC3BII-to-LC3BI ratio, Atg7 and Beclin-1) were overtly upregulated with comparable p62 under cold stress. Cold stress also evoked elevated mitophagy (decreased TOM20, increased Parkin and FUNDC1 with unaltered BNIP3). Cold stress overtly dampened phosphorylation of autophagy/mitophagy inhibitory molecules Akt and mTOR, stimulated and suppressed phosphorylation of ULK1 and eNOS, respectively, in the absence of altered pan protein levels. Cold stress-evoked responses in cell death, autophagy, mitophagy and their regulatory domains were overtly attenuated or ablated by metallothionein. Suppression of autophagy and mitophagy with 3-methyladenine, bafilomycin A1, cyclosporine A, and liensinine rescued hypothermia-instigated cardiomyocyte LC3B puncta formation and mechanical anomalies. Our findings support a protective nature for metallothionein in deep hypothermia-evoked cardiac abnormalities associated with regulation of autophagy and mitophagy.
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Affiliation(s)
- Zhaohui Pei
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China.
| | - Yayuan Xiong
- The First Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Shasha Jiang
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Rui Guo
- College of Life Sciences, Institute of Life Science and Green Development, Hebei University, Baoding, China
- The Key Laboratory of Zoological Systematics and Application, College of Life Sciences, Hebei University, Baoding, China
| | - Wei Jin
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Jun Tao
- Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Zhenzhong Zhang
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Yingmei Zhang
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China
| | - Yunzeng Zou
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China
| | - Yan Gong
- The Second Department of Cardiology, Nanchang City Renmin Hospital, Nanchang, 3330009, China
| | - Jun Ren
- Shanghai Institute for Cardiovascular Diseases, Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, 200032, China.
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Yu Y, Liu C, Zhou J, Zheng L, Shan X, He L, Zhang L, Guo J, Luo B. Global burden study of lower respiratory infections linked to low temperatures: an analysis from 1990 to 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:11150-11163. [PMID: 38217820 DOI: 10.1007/s11356-023-31587-1] [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: 10/11/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024]
Abstract
Low temperature conditions have been linked to a heightened susceptibility to lower respiratory infections (LRIs). Yet, our comprehension of the LRIs' disease burden due to such conditions remains limited, especially when considering the diverse socio-demographic indexes (SDIs) and climate types across various nations and regions. We examined the variations over time and space in the impact of LRIs due to low temperatures across a diverse set of 204 nations and regions, each with unique SDIs and climate types, spanning the years 1990 to 2019. Data from the Global Burden of Disease Study 2019 was used for this retrospective analysis. The burden of LRIs attributable to low temperatures was estimated by stratifying by sex, age, country, climate type, and SDI, including age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR). We employed Joinpoint models to compute the annual average percent changes (AAPCs) in order to evaluate the trends in LRIs burden due to low temperatures from 1990 to 2019. Furthermore, we utilized Poisson age-period-cohort models to forecast the global and income-specific trends in LRIs burden due to low temperatures for the period 2020-2044. Generalized additive mixed models were used to fit changes in the disease burden of different climate regions. The relationship between SDI and both ASMR and ASDR was determined using models grounded in Gaussian process regression. In general, since the year 1990, there has been a significant reduction in the worldwide impact of LRIs due to low temperatures. This decrease is particularly noticeable among infants and the elderly, as well as in regions with a boreal climate and those with an average SDI. In 2019, LRIs induced by low temperatures showed an ASMR of 2.2 (95% CI: 1.34, 3.07) and an ASDR of 53.73 (95% CI: 17.5, 93.22) for every 100,000 individuals. A global reduction was observed in the ASMR and ASDR for LRIs over the period from 1990 to 2019, showing a decrease of 60.27% and 77.5%, in that order. For ASMR and ASDR, the AAPC values were found to be - 3.3 (95% CI: - 3.4, - 3.1) and - 5 (95% CI: - 5.2, - 4.9), in that order. However, a contrasting pattern was observed in southern Latin America, where an increase was noted in the ASMR for LRIs induced by low temperatures [AAPC: 0.5; 95% CI: (0.3, 0.8)]. Low temperature has decreased as an environmental risk factor for LRIs globally over 30 years, especially in middle SDI regions and boreal climates, but remains important for infants and the elderly population.
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Affiliation(s)
- Yunhui Yu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ji Zhou
- Shanghai Meteorological Service, Yangtze River Delta Center for Environmental Meteorology Prediction and Warning, Shanghai, 200000, People's Republic of China
| | - Ling Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jingzhe Guo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China.
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