Associations of PM2.5 and Black Carbon with Hospital Emergency Room Visits during Heavy Haze Events: A Case Study in Beijing, China

Independent risk evaluation associated with short-term black carbon exposure on mortality in two megacities of Yangtze River Delta, China

The adverse health effects of PM_2.5 have been well demonstrated by many studies. However, as a component of PM_2.5, evidence on the mortality risk of black carbon (BC) is still limited. In this study, based on the data of daily mean PM_2.5 concentration, BC concentration, meteorological factors, total non-accidental (all-cause) and cardiovascular mortality in Shanghai and Nanjing during 2015-2016, a semi-parameter generalized additive model (GAM) in the time series and the constituent residual approach were employed to explore the exposure-response relationship between BC and human mortality in these two megacities of Yangtze River Delta, China. The main objective was to separate the health effects of BC from total PM_2.5, and compare the difference of mortality ER related to BC original concentration and adjusted concentration after controlling PM_2.5. Results showed that there were all significantly associated with daily mortality for PM_2.5 and BC. The percentage excess risk (ER) increases in all-cause and cardiovascular categories were 1.68 % (95 % s 1.28, 2.08) and 2.16 % (95 % CI: 1.54, 2.79) with 1 μg/m³ increment in original BC concentration in Shanghai. And the ER in Nanjing was smaller than that in Shanghai. After eliminating PM_2.5 confounding effects by a constituent residual approach, the BC residual concentration still had a strong significant ER. The ER for BC residual in Shanghai got an obvious increase, and ER of the cardiovascular mortality for all, females and males increased by 0.55 %, 1.46 % and 0.62 %, respectively, while the ER in Nanjing decreased slightly. It also revealed that females were more sensitive to the health risk associated with short-term BC exposure than males. Our findings provide additional important evidence and ER for mortality related to independent BC exposure. Therefore, BC emission reduction should be paid more attention in air pollution control strategies to reduce BC-related health burdens.

Acute effects of black carbon on mortality in nine megacities of China, 2008-2016: a time-stratified case-crossover study

Black carbon (BC) may have more adverse effects on human health than other constituents of PM_2.5. The daily mean concentrations of BC in China are much higher than those in developed countries and are estimated to account for more than a quarter of global anthropogenic BC emissions. However, reports on the health effects of BC in China have been limited. Thus, a time-stratified case-crossover study was conducted to evaluate the impacts of BC on daily mortality risk in nine Chinese megacities from 2008-2016. Our results show that for all-cause mortality, when compared to the interquartile range (IQR) of BC concentration increased, odds ratios (ORs) were in the range of 1.01-1.06 (95% CIs: 0.99-1.10). For cardiovascular mortality, ORs were in the range of 1.02-1.07 (95% CIs: 1.003-1.12), and for respiratory mortality, ORs were in the range of 1.01-1.15 (95% CIs: 1.00-1.18). The effects of BC in the nine cities were robust after adjusting for PM_2.5, or even became more prominent. Furthermore, BC had stronger effects in spring and winter in northern cities, whereas in mid-latitude cities, BC had stronger effects in the warm seasons. In southern cities, BC had stronger effects in the cool and dry seasons. Our findings support an association between residential exposure to BC and mortality and thus provide further evidence that BC negatively impacts human health and is helpful for decision-making.

NADPH oxidases regulate endothelial inflammatory injury induced by PM2.5 via AKT/eNOS/NO axis

Fine particulate matter (PM_2.5 )-induced detrimental cardiovascular effects have been widely concerned, especially for endothelial cells, which is the first barrier of the cardiovascular system. Among potential mechanisms involved, reactive oxidative species take up a crucial part. However, source of oxidative stress and its relationship with inflammatory response have been rarely studied in PM_2.5 -induced endothelial injury. Here, as a key oxidase that catalyzes redox reactions, NADPH oxidase (NOX) was investigated. Human umbilical vein endothelial cells (EA.hy926) were exposed to Standard Reference Material 1648a of urban PM_2.5 for 24 h, which resulted in NOX-sourced oxidative stress, endothelial dysfunction, and inflammation induction. These are manifested by the up-regulation of NOX, increase of superoxide anion and hydrogen peroxide, elevated endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA) level, reduced nitric oxide (NO) production, and down-regulation of phosphorylation of endothelial NO synthase (eNOS) with increased levels of inducible NO synthase, as well as the imbalance between tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1), and changes in the levels of pro-inflammatory and anti-inflammatory factors. However, administration of NOX1/4 inhibitor GKT137831 alleviated PM_2.5 -induced elevated endothelial dysfunction biomarkers (NO, ET-1, ADMA, iNOS, and tPA/PAI-1), inflammatory factors (IL-1β, IL-10, and IL-18), and adhesion molecules (ICAM-1, VCAM-1, and P-selectin) and also passivated NOX-dependent AKT and eNOS phosphorylation that involved in endothelial activation. In summary, PM_2.5 -induced NOX up-regulation is the source of ROS in EA.hy926, which activated AKT/eNOS/NO signal response leading to endothelial dysfunction and inflammatory damage in EA.hy926 cells.

Particulate matter pollution and emergency room visits for respiratory diseases in a valley Basin city of Northwest China

Epidemiological studies have suggested that particulate matter (PM) pollution seriously affects human health, particularly it is closely associated with respiratory diseases. The aim of this study is to quantitatively evaluate the effect of PMs (PM₁₀ and PM_2.5) on emergency room (ER) visits for respiratory diseases in Lanzhou, a valley basin city in northwest China. Based on the data of the ER visits, daily concentration of particulate matters and daily meteorological elements from January 1, 2013, to July 31, 2017, we used a generalized additive model (GAM) of time series to evaluate the exposure-response relationship between PMs and respiratory ER visits. Seasonal modified effects of PM_2.5 and PM₁₀ on different age and gender groups were also performed. Results showed that the highest incidence of respiratory diseases occurred in winter. Respiratory ER visits for the total were significantly associated with PM_2.5 (at lag 0 day) and PM₁₀ (at lag 3 days), with relative risks (RRs) of 1.042 (95%CI: 1.036 -1.047) and 1.013 (95%CI: 1.011-1.016), respectively. Effects of PM pollutants on respiratory diseases are different among different age and gender groups. Children under 15 years and the elders over 60 years were the most sensitive to PM pollution, and males were more sensitive than females. The results obtained in the current study would provide a scientific evidence for local government to make policy decision for prevention of respiratory diseases.

Traffic Density-Related Black Carbon Distribution: Impact of Wind in a Basin Town

Black carbon is one of the riskiest particle matter pollutants that is harmful to human health. Although it has been increasingly investigated, factors that depend on black carbon distribution and concentration are still insufficiently researched. Variables, such as traffic density, wind speeds, and ground levels can lead to substantial variations of black carbon concentrations and potential exposure, which is even riskier for people living in less-airy sites. Therefore, this paper “fills the gaps” by studying black carbon distribution variations, concentrations, and oscillations, with special emphasis on traffic density and road segments, at multiple locations, in a small city located in a basin, with frequent temperature inversions and infrequent low wind speeds. As wind speed has a significant impact on black carbon concentration trends, it is critical to present how low wind speeds influence black carbon dispersion in a basin city, and how black carbon is dependent on traffic density. Our results revealed that when the wind reached speeds of 1 ms⁻¹, black carbon concentrations actually increased. In lengthy wind periods, when wind speeds reached 2 or 3 ms⁻¹, black carbon concentrations decreased during rush hour and in the time of severe winter biomass burning. By observing the results, it could be concluded that black carbon persists longer in higher altitudes than near ground level. Black carbon concentration oscillations were also seen as more pronounced on main roads with higher traffic density. The more the traffic decreases and becomes steady, the more black carbon concentrations oscillate.

Sulfur dioxide and exacerbation of allergic respiratory diseases: A time-stratified case-crossover study

Background:

Strong epidemiological evidence suggests that air pollution plays a significant role in the exacerbation of allergic respiratory diseases. This study aimed to assess the potential relationship between daily levels of sulfur dioxide (SO₂) and emergency department (ED) visits for allergic diseases.

Materials and Methods:

Data regarding ED visits for allergic respiratory diseases were routinely collected from the EDs in the Zlatibor district, and the General Hospital, Užice. The daily average concentrations of SO₂ were obtained from the regional automatic air quality monitoring stations. All data were collected from June 2012 to July 2014. A time-stratified case-crossover design was used. Crude odds ratios (ORs) and ORs adjusted for weather conditions were calculated using conditional logistic regression.

Results:

Statistically significant associations were seen between 0-day lagged exposure to SO₂ and ED visits for all allergic diseases (OR = 1.62; 95% confidence interval [CI]: 1.05–2.48; P = 0.028) and between 2-day lagged exposure to SO₂ and ED visits for asthma with allergic rhinitis (OR = 2.00; 95% CI: 1.03–3.88; P = 0.042). These results were adjusted for temperature, temperature², and humidity.

Conclusion:

Our results suggest that short-term exposure to SO₂ conferred an increased risk of ED visits for allergic respiratory diseases, particularly for asthma with concomitant allergic rhinitis.

Impact of low-level fine particulate matter and ozone exposure on absences in K-12 students and economic consequences

High air pollution levels are associated with school absences. However, low level pollution impacts on individual school absences are under-studied. Understanding the variability of pollution at individual schools within an urban region could improve school recess decisions, better identify local pollution sources, and improve local economic impact assessments by providing granular information relevant to specific schools. We modelled PM_2.5 and ozone concentrations at 36 schools from July 2015 to June 2018 using data from a dense, research grade regulatory sensor network. We determined exposures and daily absences at each school. We used a generalized estimating equations model to retrospectively estimate rate ratios for association between outdoor pollutant concentrations and school absences. We estimated lost school revenue, productivity, and family economic burden. PM_2.5 and ozone concentrations and absence rates vary across the School District. Pollution exposure was associated with a rate ratio as high as 1.02 absences per μg m^-3 and 1.01 per ppb increase for PM_2.5 and ozone, respectively. Significantly, even PM_2.5 and ozone exposure below the air quality index breakpoints for good air quality (<12.1 μg m^-3 and <55 ppb, respectively) was associated with positive rate ratios of absences: 1.04 per μg m^-3 and 1.01 per ppb increase, respectively. Granular local measurements enabled demonstration of air pollution impacts that varied between schools and were undetectable with averaged pollution levels. Reducing pollution by 50% would save $426000 per year districtwide. Pollution reduction benefits would be greatest in schools located in socioeconomically disadvantaged areas. Heterogeneity in exposure, disproportionately affecting socioeconomically disadvantaged schools, points to the need for fine resolution exposure estimation. The economic cost of absences associated with air pollution is substantial even excluding indirect costs such as hospital visits and medication. These findings may help elucidate the differential burden on individual schools and inform local decisions about recess and regulatory considerations for localized pollution sources.

Study on the characteristics of black carbon during atmospheric pollution conditions in Beijing

Black carbon (BC), not only has a negative impact on human health, but also contributes to visibility degradation and the attenuation of solar radiation due to light absorption. In this paper, we investigated the variations of BC concentration, BC optical characteristics and its effects on the physical and optical properties of atmospheric aerosols based on AERONET data during atmospheric pollution conditions in Beijing from 2012 to 2017. The results indicated that the average annual ground-level BC concentration and BC/PM_2.5 were 8.9 μg m^-3 and 6.7%, respectively, from 2012 to 2017 during atmospheric pollution conditions in Beijing. The annual mean ground-level BC concentration showed weak variation, but the monthly variation was pronounced during atmospheric pollution conditions. Moreover, the BC column concentration had a higher correlation with absorptive aerosol optical thickness (AAOT) at 870 nm (R² = 0.93) than 440 nm (R² = 0.73). The difference in AAOT between 440 nm and 870 nm was more significant under high BC column concentration. The seasonal variation of the BC column concentration that contributed to the AAOT at 870 nm displayed a consistent monthly average variation tendency. The BC column concentrations were divided into three segments of low, moderate, and high according to the results of the approximately normal distribution of the BC column concentration. Compared with high BC concentration, the single scattering albedo (SSA) and asymmetry parameter were enhanced by 0.05 and 0.04 in low BC concentrations, respectively. On the contrary, the fine mode fraction (FMF) was dropped by 12.5% in low BC concentrations. A higher BC concentration contributed to the enhancement in the AAOT and the extinction ratio of the fine mode aerosol. Meanwhile, the atmospheric particles' forward scattering ability was also attenuated under a high BC concentration.

Evaluation of the Impact of Black Carbon on the Worsening of Allergic Respiratory Diseases in the Region of Western Serbia: A Time-Stratified Case-Crossover Study

Background and Objectives: Many epidemiological studies have shown a positive association between black carbon (BC) and the exacerbation of allergic rhinitis and allergic asthma. However, none of the studies in Serbia examined this relationship yet. The aim of this study was to examine the associations between BC and emergency department (ED) visits for allergic rhinitis and allergic asthma in the Užice region of Serbia. Materials and Methods: A time-stratified case-crossover design was applied to 523 ED visits for allergic rhinitis and asthma exacerbation that occurred in the Užice region of Serbia between 2012–2014. Data regarding ED visits were routinely collected in the Health Center of Užice. The daily average concentrations of BC were measured by automatic ambient air quality monitoring stations. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity, and air pressure). Results: Statistically significant associations were observed between ED visits for allergic rhinitis and 2-day lagged exposure to BC (OR = 3.20; CI = 1.00–10.18; p = 0.049) and allergic asthma and 3-day lagged exposure to BC (OR = 3.23; CI = 1.05–9.95; p = 0.041). Conclusion: Exposure to BC in the Užice region increases the risk of ED visits for allergic rhinitis and asthma, particularly during the heating season.

The Relationship between Daily Concentration of Fine Particulate Matter in Ambient Air and Exacerbation of Respiratory Diseases in Silesian Agglomeration, Poland

The relationship between the worsening of air quality during the colder season of the year and respiratory health problems among the exposed population in many countries located in cold climates has been well documented in numerous studies. Silesian Voivodeship, a region located in southern Poland, is one of the most polluted regions in Europe. The aim of this study was to assess the relationship between daily concentration of particulate matter (PM: PM_2.5 and PM₁₀) in ambient air and exacerbations of respiratory diseases during the period from 1 January 2016 to 31 August 2017 in the central agglomeration area of Silesian Voivodeship. The study results confirmed a significant increase of daily fine particulate matter concentration in ambient air during the cold season in Silesian Voivodeship with a simultaneous increase of the number of outpatient visits and hospitalizations due to respiratory diseases. The moving average concentration was better suited for the modelling of biological response as a result of PM_2.5 or PM₁₀ exposure than the temporal lag of health effects. Each increase of dose expressed in the form of moving average concentration over a longer time leads to an increase in the daily number of respiratory effects. The highest risk of hospitalization due to respiratory diseases was related to longer exposure of PM expressed by two to four weeks of exposure; outpatient visits was related to a shorter exposure duration of 3 days.

Satellite-based short- and long-term exposure to PM2.5 and adult mortality in urban Beijing, China

Severe and persistent haze accompanied by high concentrations of fine particulate matter (PM_2.5) has become a great public health concern in urban China. However, research on the health effects of PM_2.5 in China has been hindered by the lack of high-quality exposure estimates. In this study, we assessed the excess mortality associated with both short- and long-term exposure to ambient PM_2.5 simultaneously using satellite-derived exposure data at a high spatiotemporal resolution. Adult registries of non-accidental, respiratory and cardiovascular deaths in urban Beijing in 2013 were collected. Exposure levels were estimated from daily satellite-based PM_2.5 concentrations at 1 km spatial resolution from 2004 to 2013. Mixed Poisson regression models were fitted to estimate the cause-specific mortality in association with PM_2.5 exposures. With the mutual adjustment of short- and long-term exposure of PM_2.5, the percent increases associated with every 10 μg/m³ increase in short-term PM_2.5 exposure were 0.09% (95% CI: -0.14%, 0.33%; lag 01), 1.02% (95% CI: 0.08%, 1.97%; lag 04) and 0.09% (95% CI: -0.23%, 0.42%; lag 01) for non-accidental, respiratory and cardiovascular mortality, respectively; those attributable to every 10 μg/m³ increase in long-term PM_2.5 exposure (9-year moving average) were 16.78% (95% CI: 10.58%, 23.33%), 44.14% (95% CI: 20.73%, 72.10%) and 3.72% (95% CI: -3.75%, 11.77%), respectively. Both associations of short- and long-term exposure with the cause-specific mortality decreased after they were mutually adjusted. Associations between short-term exposure to satellite-based PM_2.5 and cause-specific mortality were larger than those estimated using fixed measurements. Satellite-based PM_2.5 predictions help to improve the spatiotemporal resolution of exposure assessments and the mutual adjustment model provide better estimation of PM_2.5 associated health effects. Effects attributable to long-term exposure of PM_2.5 were larger than those of short-term exposure, which should be more concerned for public health.

Impacts of air pollution wave on years of life lost: A crucial way to communicate the health risks of air pollution to the public

Limited studies have explored the impacts of exposure to sustained high levels of air pollution (air pollution wave) on mortality. Given that the frequency, intensity and duration of air pollution wave has been increasing in highly polluted regions recently, understanding the impacts of air pollution wave is crucial. In this study, air pollution wave was defined as 2 or more consecutive days with air pollution index (API) > 100. The impacts of air pollution wave on years of life lost (YLL) due to non-accidental, cardiovascular and respiratory deaths were evaluated by considering both consecutive days with high levels of air pollution and daily air pollution levels in Tianjin, China, from 2006 to 2011. The results showed the durational effect of consecutive days with high levels of air pollution was substantial in addition to the effect of daily air pollution. For instance, the durational effect was related to an increase in YLL of 116.6 (95% CI: 4.8, 228.5) years from non-accidental deaths when the air pollution wave was sustained for 4 days, while the corresponding daily air pollution's effect was 121.2 (95% CI: 55.2, 187.1) years. A better interpretation of the health risks of air pollution wave is crucial for air pollution control policy making and public health interventions.