Value Assessment of Health Losses Caused by PM2.5 in Changsha City, China

An extensive individual particle analysis of solid airborne particles collected in a moderately urbanized area

Detailed individual particle characterization of PM₁₀, in terms of particle size, morphology, and elemental composition, was done using scanning electron microscopy combined with energy-dispersive X-ray spectroscopy. The samples were collected in four localities in the Czech Republic (Central Europe), three of which are medium-sized cities, and one is a natural locality in the mountains. More than 1600 particles obtained from each locality were evaluated. During the sampling period (1.9.-8.9.2019), the atmospheric conditions were similar in the localities, which enabled the identification of PM₁₀ characteristics common to all the sampling sites. Some differences in the particles' morphology and composition, arising from site-specific conditions, were observed too. The most abundant elements in the PM₁₀ were C, O, Si, Fe, Al, Ca, Na, K, Mg, and S, but some toxic elements (Cr, Cu, and Ni) were also detected. The main component of the PM₁₀ is carbon, whose multimodal distribution indicates that the particles contain different carbonaceous chemical compounds. The distribution of carbon in the natural locality was different compared to the other sites, suggesting a specific character of the sources of carbonaceous compounds in this region. Last but not least, a relationship between Al, Si, and O concentrations was found, which implies the presence of aluminosilicates and silicon dioxide (possibly sand) of crustal origin in the particles.

Evaluation of Health Economic Loss Due to Particulate Matter Pollution in the Seoul Subway, South Korea

Evaluating an illness's economic impact is critical for developing and executing appropriate policies. South Korea has mandatory national health insurance in the form of NHIS that provides propitious conditions for assessing the national financial burden of illnesses. The purpose of our study is to provide a comprehensive assessment of the economic impact of PM_2.5 exposure in the subway and a comparative analysis of cause-specific mortality outcomes based on the prevalent health-risk assessment of the health effect endpoints (chronic obstructive pulmonary disease (COPD), asthma, and ischemic heart disease (IHD)). We used the National Health Insurance database to calculate the healthcare services provided to health-effect endpoints, with at least one primary diagnosis in 2019. Direct costs associated with health aid or medicine, treatment, and indirect costs (calculated based on the productivity loss in health effect endpoint patients, transportation, and caregivers, including morbidity and mortality costs) were both considered. The total cost for the exposed population for these endpoints was estimated to be USD 437 million per year. Medical costs were the largest component (22.08%), followed by loss of productivity and premature death (15.93%) and other costs such as transport and caregiver costs (11.46%). The total incurred costs (per 1000 persons) were accounted to be USD 0.1771 million, USD 0.42 million, and USD 0.8678 million for COPD, Asthma, and IHD, respectively. Given that the economic burden will rise as the prevalence of these diseases rises, it is vital to adopt effective preventative and management methods strategies aimed at the appropriate population.

Environmental Emissions Dispersion Modelling, Principles and Algorithms; Cross-Border CZ-PL Course for Master’s Students

Regular mathematical modelling of the dispersion of emissions from large sources is required by law in all EU countries. It is also used in risk analysis to predict releases of toxic substances from various technologies, from volcanic activity and possibly also terrorist acts. However, there is a shortage of experts in this very specific and demanding profession in the labour market in most EU countries. In a collaboration between academicians from neighbouring University of Hradec Králové and University of Opole and experts from important ecological companies of both regions we designed and verified as a part of a four-year pedagogical project supported by the EU a comprehensive education system in mathematical modelling of emission dispersion with exchange field trips and internships of students during cross-border Polish-Czech university education. The paper consists of two separate parts. The first part is focused on implementation of innovative lesson “Principles, algorithms, and differences of environmental dispersion emissions models”, used on both sides of Polish-Czech border region. An example of the use of the educational package of the Gaussian plume model with PC Templates, who was modified in cooperation between teachers from both cross-border universities and experts from professional companies is presented here too. Our four-year experience with student motivational field trips to professional companies in both border regions and exchange one-month professional internships for interested students to two Czech professional companies, where students learn to work with to the Gaussian plume model and one Polish professional company, where students are introduced to the Gaussian puff model is also discussed. The following separate second part will be focused on the innovative lesson of multivariate statistical methods of environmental data analysis, which are required for processing materials for modern mathematical modelling of the dispersion of emissions in practice. The target users of this two-part innovative courses are students of the MSc degree in Physical Measurement and Modelling at the University of Hradec Králové and students of the MSc degree in environmental studies at the University of Opole. However, it is also open to other Czech and foreign students and professionals.

The health consequences of greenhouse gas emissions: a potential pathway

Excessive greenhouse gas emissions might be the major culprit for environmental degradation, which have direct and indirect adverse impacts in various ways. As the largest emitter of carbon emissions, China suffered great harm from climate change during the past 40 years. Therefore, it becomes necessary to study the impact of carbon emissions on health issues and their potential mechanism. Using the panel data from 30 provinces in China between 2002 and 2017, this study employes and extends the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model and mediating effect model to analyze the direct and indirect effects of carbon emissions. The main results are as follows: (1) Carbon emissions has a certain negative impact on public health, which would increase with the rise of temperature. (2) The increase in carbon emissions has a more significant negative effect on health with the average temperature exceeding 17.75 °C, indicating that the temperature has a threshold effect. (3) The potential health risks become higher with the development of urbanization, but there is no obvious spillover effect in the health consequences. The results remain robust after controlling other factors. This study supplements the literature of climate governance and human health, potentially contributing to the next stage of high-quality and sustainable development.

Impact of Particulate Matter on Hospitalizations for Respiratory Diseases and Related Economic Losses in Wuhan, China

Background

Prior studies have reported the effects of particulate matter (PM) on respiratory disease (RD) hospitalizations, but few have quantified PM-related economic loss in the central region of China. This investigation aimed to assess the impacts of PM pollution on the risk burden and economic loss of patients admitted with RD.

Methods

Daily cases of RD admitted to the hospital from 1 January 2015 to 31 December 2020 were collected from two class-A tertiary hospitals in Wuhan, China. Time series analysis incorporated with a generalized additive model (GAM) was adopted to assess the impacts of fine particulate matter (PM_2.5) and inhalable particulate matter (PM₁₀) exposures on patients hospitalized with RD. Stratified analyses were performed to investigate underlying effect modification of RD risk by sex, age, and season. The cost of illness (COI) approach was applied to evaluate the related economic losses caused by PM.

Results

A total of 51,676 inpatients with a primary diagnosis of RD were included for the analysis. PM_2.5 and PM₁₀ exposures were associated with increased risks of hospitalizations for RD. Subgroup analysis demonstrated that men and children in the 0–14 years age group were more vulnerable to PM, and the adverse effects were promoted by low temperature in the cold season. A 152.4 million China Yuan (CNY) economic loss could be avoided if concentrations of PM_2.5 and PM₁₀ declined to 10 and 20 μg/m³, respectively.

Conclusions

PM_2.5 and PM₁₀ concentrations were positively associated with RD hospitalization. Men and children were more vulnerable to PM. Effective air pollution control measures can reduce hospitalizations significantly and save economic loss substantially.

Mortality rate of mental disorder trends in China from 2002 to 2020

BACKGROUND

The number of people with mental disorders is increasing in China, but there are few studies on the temporal trends and population distribution of mental disorder mortality.

METHODS

The mortality of mental disorders were derived from the China Health Statistics Yearbook published by the National Health and Family Planning Commission. Temporal trends in mortality were examined with a joinpoint regression using annual percent change (APC) and average annual percent change (AAPC). A Poisson regression model was utilized to test the population-level risk factors associated with the death of people with mental disorders.

RESULTS

The mortality of mental disorders in rural Chinese residents showed a decreasing trend from 2002 to 2020 [AAPC -2.06%, 95% confidence interval (CI) -3.16 to -0.91%]. The mortality of mental disorders in urban Chinese residents declined between 2005 and 2011 (APC -13.01%, 95% CI -21.08 to -4.13%). The mortality rate of mental disorders has decreased for urban males with an APC of -2.71% (95% CI -4.52 to -0.71) from 2002 to 2020. Urban women showed an increase in mental disorder mortality from 2002 to 2005 and from 2012 to 2020 with APCs of 19.65% (95% CI 0.64-42.32%) and 6.16% (95% CI 2.22-10.33%), respectively. Age was a significant risk factor for mental disorder mortality (odds ratio 1.28, 95% CI 1.23-1.32).

CONCLUSION

The dissemination of medical and health information, investment in medical and health resources, and the modification and optimization of regulations have led to a decrease in mental disorder mortality in China. It is vital to devote greater attention to elderly individuals suffering from mental disorders.

Mitochondria damage in ambient particulate matter induced cardiotoxicity: Roles of PPAR alpha/PGC-1 alpha signaling

Particulate matter (PM) had been associated with cardiotoxicity, while the mechanism of toxicity has yet to be elucidated, with mitochondria dysfunction as a potential candidate. To investigate the potential cardiotoxic effects of ambient PM exposure and assess the damage to cardiac mitochondria, C57/B6 mice were exposed to filtered air or real ambient PM for three or six weeks. Furthermore, to reveal the role of peroxisome proliferators-activated receptor alpha (PPAR alpha) in PM exposure induced cardiotoxicity/mitochondria damage, animals were also co-treated with PPAR alpha agonist WY 14,643 or PPAR alpha antagonist GW 6471. Cardiotoxicity was assessed with echocardiography and histopathology, while mitochondria damage was evaluated with mitochondria membrane potential measurement and transmission electron microscopy. Potential impacts of PM exposure to PPAR alpha signaling were detected with co-immunoprecipitation and western blotting. The results indicated that exposure to ambient PM exposure induced cardiotoxicity in C57/B6 mice, including altered cardiac functional parameters and morphology. Cardiac mitochondria damage is detected, in the form of compromised mitochondria membrane potential and morphology. Molecular investigations revealed disruption of PPAR alpha interaction with peroxisome proliferator-activated receptor gamma coactivator-1A (PGC-1a) as well as altered expression levels of PPAR alpha downstream genes. Co-treatment with WY 14,643 alleviated the observed toxicities, while co-treatment with GW 6471 had mixed results, exaggerating most cardiotoxicity and mitochondrial damage endpoints but alleviating some cardiac functional parameters. Interestingly, WY 14,643 and GW 6471 co-treatment seemed to exhibit similar regulative effects towards PPAR alpha signaling in animals exposed to PM. In conclusion, ambient PM exposure indeed induced cardiotoxicity in C57/B6 mice, in which cardiac mitochondria damage and disrupted PPAR alpha signaling are contributors.

Insight into monsoon for shaping the air quality of Islamabad, Pakistan: Comparing the magnitude of health risk associated with PM10 and PM2.5 exposure

Monsoon plays a determinant role in defining the air quality of many Asian countries. Filter-based 24 h ambient PM₁₀ and PM_2.5 sampling was performed by using two paralleled medium volume air samplers during pre-and post-monsoon periods. A negligible change in PM_2.5 mass concentration from 45.77 to 44.46 µg/m³ compared to PM₁₀ from 74.34 to 142.49 µg/m³ was observed after the monsoon season. The air quality index (AQI) results showed that the air quality of the city retained from good to slightly polluted in both periods, where PM_2.5 remained as the main detrimental to air quality in 95% of the total days. The NOAA HYSPLIT model analysis and wind rose patterns showed air trajectories, especially in post-monsoon originated from relatively polluted areas transported higher PM₁₀. Meteorological attributes indicated a more conducive atmospheric condition for secondary pollution in the pre-monsoon. Evidence showed post-monsoon as a more polluted period, compared to the pre-monsoon and would pose an extra 1.07 × 10^-3 lifetime risk to the local population. Similarly, a higher level of PM₁₀ in the post-monsoon caused 43% more premature mortality and 41% more deaths from all-cause mortality compare to the pre-monsoon period, respectively. Implications: Pakistan is an under-developing country where pollution monitoring studies are decidedly limited. Notably, studies, concise PM_2.5 and health assessment are deficient. The present study may contribute to evaluating the air quality in special events such as monsoon and can also provide scientific and technical support for subsequent air pollution research. Moreover, the results help to develop adequate prevention and pollution control strategies and offer policy suggestions for monsoon observing countries in general and in particular, in Islamabad, Pakistan. These findings provide essential arguments in favor of educating people and raising awareness about the detrimental health effects of air pollution. Improving the quality of life of people with cardiovascular and respiratory disorders requires an immediate and substantial reduction of air pollution.

An Assessment of Annual Mortality Attributable to Ambient PM2.5 in Bangkok, Thailand

Multiple studies indicate that PM2.5 is the most deleterious air pollutant for which there are ambient air quality standards. Daily concentrations of PM2.5 in Bangkok, Thailand, continuously exceed the World Health Organization (WHO) and the Thai National Ambient Air Quality Standards (NAAQSs). Bangkok has only recently begun to measure concentrations of PM2.5. To overcome this paucity of data, daily PM2.5/PM10 ratios were generated over the period 2012-2018 to interpolate missing values. Concentration-response coefficients (β values) for PM2.5 versus non-accidental, cardiopulmonary, and lung cancer mortalities were derived from the literature. Values were also estimated and were found to be comparable to those reported in the literature for a Chinese population, but considerably lower than those reported in the literature from the United States. These findings strongly suggest that specific regional β values should be used to accurately quantify the number of premature deaths attributable to PM2.5 in Asian populations. Health burden analysis using the Environmental Benefits Mapping and Analysis Program (BenMAP) showed that PM2.5 concentration in Bangkok contributes to 4240 non-accidental, 1317 cardiopulmonary, and 370 lung cancer mortalities annually. Further analysis showed that the attainment of PM2.5 levels to the NAAQSs and WHO guideline would reduce annual premature mortality in Bangkok by 33%and 75%, respectively.

Airborne Particulates Affect Corneal Homeostasis and Immunity

Purpose

To determine the effects of airborne particulate matter (PM) <2.5 µm in vitro and on the normal and Pseudomonas aeruginosa (PA)-infected cornea.

Methods

An MTT viability assay tested the effects of PM_2.5 on mouse corneal epithelial cells (MCEC) and human corneal epithelial cells (HCET). MCEC were tested for reactive oxygen species using a 2′,7′-dichlorodihydrofluorescein assay; RT-PCR determined mRNA levels of inflammatory and oxidative stress markers in MCEC (HMGB1, toll-like receptor 2, IL-1β, CXCL2, GPX1, GPX2, GR1, superoxide dismutase 2, and heme oxygenase 1) and HCET (high mobility group box 1, CXCL2, and IL-1β). C57BL/6 mice also were infected and after 6 hours, the PM_2.5 was topically applied. Disease was graded by clinical score and evaluated by histology, plate count, myeloperoxidase assay, RT-PCR, ELISA, and Western blot.

Results

After PM_2.5 (25–200 µg/mL), 80% to 90% of MCEC and HCET were viable and PM exposure increased reactive oxygen species in MCEC and mRNA expression levels for inflammatory and oxidative stress markers in mouse and human cells. In vivo, the cornea of PA+PM_2.5 exposed mice exhibited earlier perforation over PA alone (confirmed histologically). In cornea, plate counts were increased after PA+PM_2.5, whereas myeloperoxidase activity was significantly increased after PA+PM_2.5 over other groups. The mRNA levels for several proinflammatory and oxidative stress markers were increased in the cornea in the PA+PM_2.5 over other groups; protein levels were elevated for high mobility group box 1, but not toll-like receptor 4 or glutathione reductase 1. Uninfected corneas treated with PM_2.5 did not differ from normal.

Conclusions

PM_2.5 triggers reactive oxygen species, upregulates mRNA levels of oxidative stress, inflammatory markers, and high mobility group box 1 protein, contributing to perforation in PA-infected corneas.

Particulate Matter 2.5 Induced Developmental Cardiotoxicity in Chicken Embryo and Hatchling

Particulate matter poses health risk to developing organisms. To investigate particulate matters with a diameter smaller than 2.5 um (PM2.5)-induced developmental cardiotoxicity, fertile chicken eggs were exposed to PM2.5 via air cell injection at doses of 0.05, 0.2, 0.5, 2, and 5 mg/egg kg. Morphological changes in the embryonic day four (ED4) and hatchling hearts were assessed with histological techniques. Heart rates of hatchling chickens were measured with electrocardiography. The protein expression levels of nuclear factor kappa-light-chain-enhancer of activated B cells p65 (NF-kb p65), inducible nitric oxide synthase (iNOS), and matrix metallopeptidase 9 (MMP9) were assessed with immunohistochemistry or western blotting in hatchling hearts. PM2.5 exposure elevated areas of heart in ED4 embryo, increased heart rate, and thickened right ventricular wall thickness in hatchling chickens. Immunohistochemistry revealed enhanced NF-kb p65 expression in hatchling hearts. Western blotting results indicated that both iNOS and MMP9 expression were enhanced by lower doses of PM2.5 exposure (0.2 and 0.5 mg/kg) but not 2 mg/kg. In summary, developmental exposure to PM2.5 induced developmental cardiotoxicity in chicken embryo and hatchling chickens, which is associated with NF-kb p65, iNOS, and MMP9.

Health and Economic Loss Assessment of PM2.5 Pollution during 2015-2017 in Gansu Province, China

Many studies have reported that air pollution, especially fine particulate matter (PM2.5), has a significant impact on health and causes economic loss. Gansu Province is in the northwest of China, which is a typical economically underdeveloped area. However, few studies have evaluated the economic loss of PM2.5 related to health effects in this province. In this study, a log-linear exposure-response function was used to estimate the health impact of PM2.5 in 14 cities in Gansu Province from 2015 to 2017, and the amended human capital (AHC) and cost of illness (COI) method were used to evaluate the related economic loss caused by the health impact from PM2.5. The results show that the estimated total number of health endpoints attributed to PM2.5 pollution were 1,644,870 (95%CI: 978,484-2,215,921), 1,551,447 (95%CI: 917,025-2,099,182) and 1,531,372 (95%CI: 899,769-2,077,772) in Gansu Province from 2015 to 2017, respectively. Correspondingly, the economic losses related to health damage caused by PM2.5 pollution were 42,699 (95%CI: 32,380-50,768) million Chinese Yuan (CNY), 43,982 (95%CI: 33,305-52,386) million CNY and 44,261 (95%CI: 33,306-52,954) million CNY, which were equivalent to 6.45% (95%CI: 4.89%-7.67%), 6.28% (95%CI: 4.75%-7.48%), and 5.93% (95%CI: 4.64%-7.10%) of the region Gross Domestic Product (GDP) from 2015 to 2017, respectively. It could be seen that the proportions of health economic loss to GDP were generally high, although the proportion had a slight downward trend. The economic loss from chronic bronchitis and all-cause mortality accounted for more than 94% of the total economic loss. The health impact, economic loss and per capita economic loss in Lanzhou, the provincial capital city of Gansu, were obviously higher than other cities from the same province. The economic loss in Linxia accounted for the highest proportion of GDP. The health impacts in the Hexi region, including the cities of Jiuquan, Jiayuguan, Zhangye, Jinchang and Wuwei, were generally lower, but the economic loss and per capita economic loss were still higher. We also found that urbanization and industrialization were highly correlated with health economic loss caused by PM2.5 pollution. In conclusion, the PM2.5-related health economic burden in Gansu Province was serious. As an economically underdeveloped region, it was very important to further adopt rigid and effective pollution control policies.

Health Risk and Resilience Assessment with Respect to the Main Air Pollutants in Sichuan

Rapid urbanization and industrialization in developing countries have caused an increase in air pollutant concentrations, and this has attracted public concern due to the resulting harmful effects to health. Here we present, through the spatial-temporal characteristics of six criteria air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃) in Sichuan, a human health risk assessment framework conducted to evaluate the health risk of different age groups caused by ambient air pollutants. Public health resilience was evaluated with respect to the risk resulting from ambient air pollutants, and a spatial inequality analysis between the risk caused by ambient air pollutants and hospital density in Sichuan was performed based on the Lorenz curve and Gini coefficient. The results indicated that high concentrations of PM_2.5 (47.7 μg m⁻³) and PM₁₀ (75.9 μg m⁻³) were observed in the Sichuan Basin; these two air pollutants posed a high risk to infants. The high risk caused by PM_2.5 was mainly distributed in Sichuan Basin (1.14) and that caused by PM₁₀ was principally distributed in Zigong (1.01). Additionally, the infants in Aba and Ganzi had high health resilience to the risk caused by PM_2.5 (3.89 and 4.79, respectively) and PM₁₀ (3.28 and 2.77, respectively), which was explained by the low risk in these two regions. These regions and Sichuan had severe spatial inequality between the infant hazard quotient caused by PM_2.5 (G = 0.518, G = 0.493, and G = 0.456, respectively) and hospital density. This spatial inequality was also caused by PM₁₀ (G = 0.525, G = 0.526, and G = 0.466, respectively), which is mainly attributed to the imbalance between hospital distribution and risk caused by PM_2.5 (PM₁₀) in these two areas. Such research could provide a basis for the formulation of medical construction and future air pollution control measures in Sichuan.