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Wang Y, Chang J, Hu P, Deng C, Luo Z, Zhao J, Zhang Z, Yi W, Zhu G, Zheng G, Wang S, He K, Liu J, Liu H. Key factors in epidemiological exposure and insights for environmental management: Evidence from meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 362:124991. [PMID: 39303936 PMCID: PMC7616677 DOI: 10.1016/j.envpol.2024.124991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/14/2024] [Accepted: 09/17/2024] [Indexed: 09/22/2024]
Abstract
In recent years, the precision of exposure assessment methods has been rapidly improved and more widely adopted in epidemiological studies. However, such methodological advancement has introduced additional heterogeneity among studies. The precision of exposure assessment has become a potential confounding factors in meta-analyses, whose impacts on effect calculation remain unclear. To explore, we conducted a meta-analysis to integrate the long- and short-term exposure effects of PM2.5, NO2, and O3 on all-cause, cardiovascular, and respiratory mortality in the Chinese population. Literature was identified through Web of Science, PubMed, Scopus, and China National Knowledge Infrastructure before August 28, 2023. Sub-group analyses were performed to quantify the impact of exposure assessment precisions and pollution levels on the estimated risk. Studies achieving merely city-level resolution and population exposure are classified as using traditional assessment methods, while those achieving sub-kilometer simulations and individual exposure are considered finer assessment methods. Using finer assessment methods, the RR (under 10 μg/m3 increment, with 95% confidence intervals) for long-term NO2 exposure to all-cause mortality was 1.13 (1.05-1.23), significantly higher (p-value = 0.01) than the traditional assessment result of 1.02 (1.00-1.03). Similar trends were observed for long-term PM2.5 and short-term NO2 exposure. A decrease in short-term PM2.5 levels led to an increase in the RR for all-cause and cardiovascular mortality, from 1.0035 (1.0016-1.0053) and 1.0051 (1.0021-1.0081) to 1.0055 (1.0035-1.0075) and 1.0086 (1.0061-1.0111), with weak between-group significance (p-value = 0.13 and 0.09), respectively. Based on the quantitative analysis and literature information, we summarized four key factors influencing exposure assessment precision under a conceptualized framework: pollution simulation resolution, subject granularity, micro-environment classification, and pollution levels. Our meta-analysis highlighted the urgency to improve pollution simulation resolution, and we provide insights for researchers, policy-makers and the public. By integrating the most up-to-date epidemiological research, our study has the potential to provide systematic evidence and motivation for environmental management.
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Affiliation(s)
- Yongyue Wang
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Jie Chang
- National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100084, China; Centre for Clinical and Epidemiologic Research, Beijing an Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Piaopiao Hu
- Centre for Clinical and Epidemiologic Research, Beijing an Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Chun Deng
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Zhenyu Luo
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Junchao Zhao
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Zhining Zhang
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Wen Yi
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Guanlin Zhu
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Guangjie Zheng
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Shuxiao Wang
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Kebin He
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Jing Liu
- Centre for Clinical and Epidemiologic Research, Beijing an Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Huan Liu
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China.
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Ning Z, He S, Liu Q, Ma H, Ma C, Wu J, Ma Y, Zhang Y. Effects of the interaction between cold spells and fine particulate matter on mortality risk in Xining: a case-crossover study at high altitude. Front Public Health 2024; 12:1414945. [PMID: 38813422 PMCID: PMC11133570 DOI: 10.3389/fpubh.2024.1414945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Background With global climate change, the health impacts of cold spells and air pollution caused by PM2.5 are increasingly aggravated, especially in high-altitude areas, which are particularly sensitive. Exploring their interactions is crucial for public health. Methods We collected time-series data on meteorology, air pollution, and various causes of death in Xining. This study employed a time-stratified case-crossover design and conditional logistic regression models to explore the association between cold spells, PM2.5 exposure, and various causes of death, and to assess their interaction. We quantitatively analyzed the interaction using the relative excess odds due to interaction (REOI), attributable proportion due to interaction (AP), and synergy index (S). Moreover, we conducted stratified analyses by average altitude, sex, age, and educational level to identify potential vulnerable groups. Results We found significant associations between cold spells, PM2.5, and various causes of death, with noticeable effects on respiratory disease mortality and COPD mortality. We identified significant synergistic effects (REOI>0, AP > 0, S > 1) between cold spells and PM2.5 on various causes of death, which generally weakened with a stricter definition of cold spells and longer duration. It was estimated that up to 9.56% of non-accidental deaths could be attributed to concurrent exposure to cold spells and high-level PM2.5. High-altitude areas, males, the older adults, and individuals with lower educational levels were more sensitive. The interaction mainly varied among age groups, indicating significant impacts and a synergistic action that increased mortality risk. Conclusion Our study found that in high-altitude areas, exposure to cold spells and PM2.5 significantly increased the mortality risk from specific diseases among the older adults, males, and those with lower educational levels, and there was an interaction between cold spells and PM2.5. The results underscore the importance of reducing these exposures to protect public health.
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Affiliation(s)
- Zhenxu Ning
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Shuzhen He
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Qiansheng Liu
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Haibin Ma
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Chunguang Ma
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Jing Wu
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Yanjun Ma
- Qinghai Institute of Health Sciences, Xining, China
| | - Youxia Zhang
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, Xining, China
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Cheng C, Liu Y, Han C, Fang Q, Cui F, Li X. Effects of extreme temperature events on deaths and its interaction with air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170212. [PMID: 38246371 DOI: 10.1016/j.scitotenv.2024.170212] [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: 09/27/2023] [Revised: 12/17/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Both extreme temperature events (ETEs) and air pollution affected human health, and their effects were often not independent. Previous studies have provided limited information on the interactions between ETEs and air pollution. METHODS We collected data on deaths (non-accidental, cardiovascular, and respiratory) in Zibo City along with daily air pollution and meteorological data from January 2015 to December 2019. Distributed lag non-linear model was used to explore the health effects of ETEs on deaths. Non-parametric binary response model, hierarchical model and joint effect model were used to further explore the interaction between ETEs and air pollution in different seasons. Meanwhile, subgroup analysis by gender and age (≥ 65 years old and < 65 years old) was conducted to identify the vulnerable population. RESULTS ETEs increased death risk, especially for cardiovascular and respiratory deaths. Heat waves had a stronger impact than cold spells. Cold spells had a longer lag and fluctuating trend. Heat waves had a short-term impact, followed by a decrease. Females and those aged ≥ 65 were more affected, but subgroup differences were not significant. During ETEs and non-ETEs, there were different effects on deaths with per IQR increase in air pollutant concentrations. Joint effect models revealed that there was a significant interaction between ETEs and air pollution on non-accidental deaths. The interaction between PM2.5 and cold spells was antagonistic in the cold season. In the warm season, the health effects of heat waves and high O3 concentration were enhanced. The relative excess risk due to interaction (RERI) of cold spells and PM2.5 in total population was -0.09 (95 % CI: -0.17, -0.01), and 9 % (95 % CI: 1 %, 17 %) of the total effect was attributable to interaction. Subgroup analysis confirmed the interactions in females and those aged ≥ 65. CONCLUSIONS Significant association observed between ETEs and deaths. Females and ≥ 65 age groups were vulnerable. There were interactions between ETEs and air pollution. The effect of PM2.5 on deaths decreased during cold spells, while the effect of O3 increased during heat waves. In addition to improving air quality, it is necessary to further strengthen the prevention and control of ETEs.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Ma'anshan Center for Disease Control and Prevention, Ma'anshan 243000, Anhui, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Liu B, Wang L, Zhang L, Liao Z, Wang Y, Sun Y, Xin J, Hu B. Analysis of severe ozone-related human health and weather influence over China in 2019 based on a high-resolution dataset. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111536-111551. [PMID: 37819470 DOI: 10.1007/s11356-023-30178-4] [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: 07/19/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April-July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China.
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Affiliation(s)
- Boya Liu
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lili Wang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China.
| | - Lei Zhang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhiheng Liao
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, 100089, China
| | - Yuesi Wang
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yang Sun
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Jinyuan Xin
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Bo Hu
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
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Meng X, Jin J, Han X, Han B, Bai M, Zhang Z. Effect of Meteorological Factors and Air Pollutants on Daily Hospital Admissions for Ischemic Heart Disease in Lanzhou, China. Cardiology 2023; 149:396-408. [PMID: 37517404 DOI: 10.1159/000532069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Meteorological factors and air pollutants are believed to be associated with cardiovascular disease. Ischemic heart disease (IHD) is a major public health issue worldwide. Few studies have investigated the associations among meteorological factors, air pollutants, and IHD daily hospital admissions in Lanzhou, China. METHODS We conducted a distributed lag nonlinear model on the basis of 5-year data, aiming at disentangling the impact of meteorological factors and air pollutants on IHD hospital admissions. All IHD daily hospital admissions recorded from January 1, 2015, and December 31, 2019, were obtained from three hospitals in Lanzhou, China. Daily air pollutant concentrations and meteorological data were synchronously collected from Gansu Meteorological Administration and Lanzhou Environmental Protection Administration. Stratified analyses were performed by sex and two age groups. RESULTS A total of 23,555 IHD hospital admissions were recorded, of which 10,477 admissions were for coronary artery disease (CAD) and 13,078 admissions were for acute coronary syndrome. Our results showed that there was a nonlinear (J-shaped) relationship between temperature and IHD hospital admissions. The number of IHD hospital admissions was positively correlated with NO2, O3, humidity, and pressure, indicating an increased risk of hospital admissions for IHD under NO2, O3, humidity, and pressure exposure. Meanwhile, both extremely low (-12°C) and high (30°C) temperatures reduced IHD hospital admissions, but the harmful effect increased with the lag time in Lanzhou, China, while the cold effect was more pronounced and long-lasting than the heat effect. Subgroup analysis demonstrated that the risk on CAD hospital admissions increased significantly in females and <65 years of age at -12°C. CONCLUSION Our findings added to the growing evidence regarding the potential impact of meteorological factors and air pollutants on policymaking from the perspective of hospital management efficiency.
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Affiliation(s)
- Xiaoxue Meng
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, Lanzhou, China
| | - Jianjian Jin
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
| | - Xia Han
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, Lanzhou, China
| | - Bing Han
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, Lanzhou, China
| | - Ming Bai
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, Lanzhou, China
| | - Zheng Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, Lanzhou, China
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Xia Y, Liu Z, Hu B, Rangarajan S, Ah Tse L, Li Y, Wang J, Hu L, Wang Y, Xiang Q, Lin Y, Han G, Yusuf S, Li W. Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China). ENVIRONMENT INTERNATIONAL 2023; 174:107829. [PMID: 36934571 DOI: 10.1016/j.envint.2023.107829] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is lacking. This study aimed to investigate the associations between long-term exposure to ambient fine particulate matter<2.5 µm (PM2.5) concentrations and the risk of incidence and mortality of CVD in a large cohort study from 115 communities. METHODS In this cohort study, we followed 42 160 adults aged 35-75 years at baseline who enrolled in the Prospective Urban and Rural Epidemiology Study conducted in China (PURE-China) between 2005 and 2009 with ambient PM2.5 estimates, and followed up until August 2021. Cox proportional hazards frailty models were used to estimate the associations between long-term mean outdoor PM2.5 concentrations and CVD events, CVD mortality, and all-cause mortality. FINDINGS During a median follow-up period of 11.8 years, we documented 2 190 deaths, including 732 CVD deaths. There were 4 559 (10.8 %) of 42 160 participants who experienced incident total CVD, among them there were 861 myocardial infarctions (MI) and 2 338 S. The 3-year median concentration of ambient PM2.5 before the cohort commencement was 52.7 µg/m3 (interquartile range [IQR] 30.3-74.6). In full adjusted model, a 10 µg/m3 increase in PM2.5 was associated with a hazard ratio (HR) of 1.12 (95 % CI 1.11-1.14) for major CVD and 1.03 (95 % CI 1.01-1.05) for all-cause mortality. Besides, long-term PM2.5 concentrations had a significantly positive gradient association with total CVD and a similar pattern of associations with other CVD outcomes was observed. INTERPRETATION This study demonstrated that long-term ambient PM2.5 concentrations is positively associated with increased risks of CVD in adults aged 35-70 years from China. This finding reinforces the need for policymakers to adopt more effective strategies to improve air quality.
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Affiliation(s)
- Yanjie Xia
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiguang Liu
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Bo Hu
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lap Ah Tse
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yang Li
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junying Wang
- Balingqiao Community Health Service Center, Xinghualing District, Taiyuan, Shanxi Province, China
| | - Lihua Hu
- Nanchang County Center for Disease Control and Prevention, Nanchang, Jiangxi Province, China
| | - Yang Wang
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Quanyong Xiang
- Centers for Disease Control and Prevention in Jiangsu Province, Nanjing, Jiangsu Province, China
| | - Yang Lin
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Guoliang Han
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Wei Li
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Assessment of Low-Level Air Pollution and Cardiovascular Incidence in Gdansk, Poland: Time-Series Cross-Sectional Analysis. J Clin Med 2023; 12:jcm12062206. [PMID: 36983207 PMCID: PMC10054494 DOI: 10.3390/jcm12062206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO2, NO, NO2, NOx, CO, PM10, PM2.5, CO2, O3 and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdańsk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.019 (95%CI: 1.001–1.036), 1.036 (95%CI: 1.008–1.064) and 1.017 (95%CI: 1.000–1.034) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.030 (95%CI: 1.011–1.048), 1.053 (95%CI: 1.024–1.082) and 1.027 (95%CI: 1.010–1.045) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO2, SO2 and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.
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Liu C, Chan KH, Lv J, Lam H, Newell K, Meng X, Liu Y, Chen R, Kartsonaki C, Wright N, Du H, Yang L, Chen Y, Guo Y, Pei P, Yu C, Shen H, Wu T, Kan H, Chen Z, Li L. Long-Term Exposure to Ambient Fine Particulate Matter and Incidence of Major Cardiovascular Diseases: A Prospective Study of 0.5 Million Adults in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:13200-13211. [PMID: 36044001 PMCID: PMC9494741 DOI: 10.1021/acs.est.2c03084] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Few cohort studies explored the long-term effects of ambient fine particulate matter (PM2.5) on incidence of cardiovascular diseases (CVDs), especially in countries with higher levels of air pollution. We aimed to evaluate the association between long-term exposure to PM2.5 and incidence of CVD in China. We performed a prospective cohort study in ten regions that recruited 512,689 adults during 2004-2008, with follow-up until 2017. Annual PM2.5 concentrations were estimated using a satellite-based model with national coverage and 1 x 1 km spatial resolution. Time-varying Cox proportional hazard regression models were used to estimate hazard ratios (HRs) for all-cause and cause-specific CVDs associated with PM2.5, adjusting for conventional covariates. During 5.08 million person-years of follow-up, 148,030 incident cases of CVD were identified. Long-term exposure to PM2.5 showed positive and linear association with incidence of CVD, without a threshold below any concentration. The adjusted HRs per 10 μg/m3 increase in PM2.5 was 1.04 (95%CI: 1.02, 1.07) for total CVD. The risk estimates differed between certain population subgroups, with greater HRs in men, in household with higher income, and in people using unclean heating fuels. This prospective study of large Chinese population provided essential epidemiological evidence for CVD incident risk associated with PM2.5.
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Affiliation(s)
- Cong Liu
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Ka Hung Chan
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
- Oxford
British Heart Foundation Center of Research Excellence, University of Oxford, Oxford OX3 7LF, UK
| | - Jun Lv
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
- Key Laboratory
of Molecular Cardiovascular Sciences (Peking University), Ministry
of Education, Beijing 100191, China
| | - Hubert Lam
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Katherine Newell
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Xia Meng
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Yang Liu
- Gangarosa
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Renjie Chen
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Christiana Kartsonaki
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Neil Wright
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Huaidong Du
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Ling Yang
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Yiping Chen
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Yu Guo
- Fuwai
Hospital Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Pei Pei
- Fuwai
Hospital Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Canqing Yu
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
| | - Hongbing Shen
- Department
of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tangchun Wu
- School
of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Haidong Kan
- School
of Public Health, Key Lab of Public Health Safety of the Ministry
of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE
on Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Zhengming Chen
- Clinical
Trial Service Unit & Epidemiological Studies Unit, Nuffield Department
of Population Health, University of Oxford, Oxford OX3 7LF, UK
- MRC
Population Health Research Unit, Nuffield Department of Population
Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Liming Li
- Department
of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Peking
University Center for Public Health and Epidemic Preparedness &
Response, Beijing 100191, China
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9
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Li J, Ma Y, Cheng B, Zhang Y, Guo Y, Zhao Y. Circulation weather types and hospital admissions for cardiovascular disease in Changchun, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:2799-2813. [PMID: 34453236 DOI: 10.1007/s10653-021-01077-9] [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: 03/09/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Epidemiological studies have reported significant associations between weather situations and health. Cardiovascular disease is a serious chronic non-communicable disease which causes mortality and morbidity, bringing large economic burden to patients' families. This study explored the relationship between cardiovascular disease (CVD) and weather conditions in Changchun, northeast China. The frequency distributions of 13 main circulation weather types (CWTs) were analyzed, and a comparison between air mass classification and hospital admissions was performed for various groups using an admission index (AI). The results indicated that women had a lower risk of CVD than men did. The risk of CVD for older people (aged ≥ 65 years) was lower than that for young people (aged < 65 years). Younger men had the highest risk. The risks of CVD were higher in all groups (i.e., men, women, older, and younger) under southwesterly (SW) and northerly (N) CWTs and were lowest under the anticyclone (A) CWT. The risk of CVD among men was higher than that for women under these CWTs. N type circulation is characterized by cold, dry weather and was most closely associated with an increased incidence of CVD. The most significant effect of N type circulation on AI was observed with a delay of 2 days. SW type circulation is characterized by humid, hot weather and was the CWT that was second most closely associated with an increased incidence of CVD, with a peak in AI on the day that SW type circulation occurred. The results of this study could be provided to local health authorities as scientific guidelines for controlling and preventing CVD in Changchun, China.
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Affiliation(s)
- Jiangping Li
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Bowen Cheng
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yongtao Guo
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxin Zhao
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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10
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Lederer AM, Fredriksen PM, Nkeh-Chungag BN, Everson F, Strijdom H, De Boever P, Goswami N. Cardiovascular effects of air pollution: current evidence from animal and human studies. Am J Physiol Heart Circ Physiol 2021; 320:H1417-H1439. [PMID: 33513082 DOI: 10.1152/ajpheart.00706.2020] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air pollution is a global health concern. Particulate matter (PM)2.5, a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM2.5, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.
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Affiliation(s)
- Agnes Maria Lederer
- Physiology Division, Otto Loewi Research Centre, Medical University of Graz, Graz, Austria
| | | | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Frans Everson
- Centre for Cardio-metabolic Research in Africa, Division of Medical Physiology, Stellenbosch University, Stellenbosch, South Africa
| | - Hans Strijdom
- Centre for Cardio-metabolic Research in Africa, Division of Medical Physiology, Stellenbosch University, Stellenbosch, South Africa
| | - Patrick De Boever
- Department of Biology, University of Antwerp, Wilrijk, Belgium.,Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Nandu Goswami
- Physiology Division, Otto Loewi Research Centre, Medical University of Graz, Graz, Austria.,Department of Health Sciences, Alma Mater Europaea Maribor, Maribor, Slovenia
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11
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Singh V, Singh S, Biswal A. Exceedances and trends of particulate matter (PM 2.5) in five Indian megacities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141461. [PMID: 32882489 PMCID: PMC7417276 DOI: 10.1016/j.scitotenv.2020.141461] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 05/04/2023]
Abstract
Fine particulate matter (PM2.5) is the leading environmental risk factor that requires regular monitoring and analysis for effective air quality management. This work presents the variability, trend, and exceedance analysis of PM2.5 measured at US Embassy and Consulate in five Indian megacities (Chennai, Kolkata, Hyderabad, Mumbai, and New Delhi) for six years (2014-2019). Among all cities, Delhi is found to be the most polluted city followed by Kolkata, Mumbai, Hyderabad, and Chennai. The trend analysis for six years for five megacities suggests a statistically significant decreasing trend ranging from 1.5 to 4.19 μg/m3 (2%-8%) per year. Distinct diurnal, seasonal, and monthly variations are observed in the five cities due to the different site locations and local meteorology. All cities show the highest and lowest concentrations in the winter and monsoon months respectively except for Chennai which observed the lowest levels in April. All the cities consistently show morning peaks (~08: 00-10:00 h) and the lowest level in late afternoon hours (~15:00-16:00 h). We found that the PM2.5 levels in the cities exceed WHO standards and Indian NAAQS for 50% and 33% of days in a year except for Chennai. Delhi is found to have more than 200 days of exceedances in a year and experiences an average 15 number of episodes per year when the level exceeds the Indian NAAQS. The trends in the exceedance with a varying threshold (20-380 μg/m3) suggest that not only is the annual mean PM2.5 decreasing in Delhi but also the number of exceedances is decreasing. This decrease can be attributed to the recent policies and regulations implemented in Delhi and other cities for the abatement of air pollution. However, stricter compliance of the National Clean Air Program (NCAP) policies can further accelerate the reduction of the pollution levels.
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Affiliation(s)
- Vikas Singh
- National Atmospheric Research Laboratory, Gadanki, AP, India.
| | - Shweta Singh
- National Atmospheric Research Laboratory, Gadanki, AP, India
| | - Akash Biswal
- National Atmospheric Research Laboratory, Gadanki, AP, India
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