Influence of Selected Air Pollutants on Mortality and Pneumonia Burden in Three Polish Cities over the Years 2011-2018

The Effects of Environmental Factors on General Human Health: A Scoping Review

Background/Objectives: The external environment constantly influences human health through many factors, including air quality, access to green spaces, exposure to pollutants, and climate change. Contamination poses a substantial threat to human well-being; conversely, environmental factors also positively impact health. The purpose of this study is to provide a comprehensive review of the complex relationship between various environmental factors and human health. While individual studies have explored specific aspects, a broader integrative understanding is lacking. Methods: Through databases (PubMed, Cochrane, Copernicus), 4888 papers were identified, with 166 selected for detailed analysis. Results: We summarized recent research, identifying multiple associations between environmental factors such as air pollution, climate change, solar radiation, and meteorological conditions and their impact on various health outcomes, including respiratory, cardiovascular, metabolic and gastrointestinal, renal and urogenital, neurological and psychological health, infectious and skin diseases, and major cancers. We use chord diagrams to illustrate these links. We also show the interaction between different environmental factors. Findings begin with exploring the direct impact of environmental factors on human health; then, the interplay and combined effects of environmental factors, elucidating their (often indirect) interaction and collective contribution to human health; and finally, the implications of climate change on human health. Conclusions: Researchers and policymakers need to consider that individuals are exposed to multiple pollutants simultaneously, the "multipollutant exposure phenomenon". It is important to study and regulate environmental factors by considering the combined impact of various pollutants rather than looking at each pollutant separately. We emphasize actionable recommendations and solutions.

Air pollution, dysbiosis and diseases: pneumonia, asthma, COPD, lung cancer and irritable bowel syndrome

With substantial effects on human health, air pollution has become a major global concern. Air pollution has been linked to numerous gastrointestinal and respiratory diseases with increasing mortalities. The gut and respiratory dysbiosis brought about by air pollution has recently received much attention. This review attempts to provide an overview of the types of air pollutants, their sources, their impact on the respiratory and gut dysbiotic patterns and their correlation with five major diseases including pneumonia, asthma, COPD, lung cancer and irritable bowel syndrome. Deeper insights into the links between pollutants, dysbiosis and disease may pave the way for novel diagnostic biomarkers for prognosis and early detection of these diseases, as well as ways to ease the disease burden.

Air Pollution Increases Risk of Occurrence of Intracerebral Haemorrhage but Not of Subarachnoid Haemorrhage: Time-Series Cross-Sectional Study

(1) Background: Haemorrhagic strokes (HS), including intracerebral (ICH) and subarachnoid haemorrhages (SAH), account for approximately 10-15% of strokes worldwide but are associated with worse functional outcomes and higher rates of mortality, and financial burden than ischemic stroke. There is evidence that confirmed poor air quality may increase the incidence of haemorrhagic strokes. The aim of our study was to evaluate the association between individual ambient air pollutants and the risk of haemorrhagic stroke in an urban environment without high levels of air pollution. (2) Methods: A time-series cross-sectional study design was used. A daily air pollution concentration (Agency of Regional Air Quality Monitoring in the Gdansk Metropolitan Area) and incidence of haemorrhagic strokes (National Health Fund) were obtained and covered the time period from 1 January 2014 to 31 December 2018. A generalised additive model with Poisson regression was used to estimate the associations between 24-h mean concentrations of SO2, NO, NO2, NOx, CO, PM10, PM2.5, and O3 and a daily number of haemorrhagic strokes. (3) Results: The single-day lag model results showed that NO2, NO and NOx exposure was associated with increased risk of ICH (88% events) with RR of 1.059 (95% CI: 1.015-1.105 for lag0), 1.033 (95% CI: 1.007-1.060 for lag0) and 1.031 (95% CI: 1.005-1.056 for lag0), but not for SAH (12% events). Exposure to CO was related to a substantial and statistically significant increase in incidence for 1.031 (95% CI: 1.002-1.061 for lag0) but not for SAH. Higher SO2, PM10, PM2.5, and O3 exposures were not significantly related to both ISC and SAH. (4) Conclusions: In this time-series cross-sectional study, we found strong evidence that supports the hypothesis that transient elevations in ambient NO2, NO and CO are associated with a higher relative risk of intracerebral but not subarachnoid haemorrhage.

Exposure to ambient air pollutants and short-term risk for exacerbations of allergic rhinitis: a time-stratified, case-crossover study in the three largest urban agglomerations in Poland

Allergic rhinitis (AR) affects 10% of the world population, with an increased prevalence in regions with substantial air pollution, but the association between exposure to air pollutants and the short-term risk of AR exacerbations is unclear. We used a time-series approach to analyze the risk of hospital admissions due to AR over 8 days from exposure to various air pollutants. Distributed lag nonlinear models were used to analyze data gathered between 2012 and 2018 in the three largest urban agglomerations in Poland. The analyses were carried out separately for the warm (April - September) and cold seasons (October - March). Overall, there were 1407 admissions due to AR. In the warm season, the rate ratio (95% confidence interval) for admission per 10µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 microns (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 microns (PM2.5); 0.946 (0.826, 1.085) for nitrogen dioxide (NO₂); 0.837 (0.418, 1.677) for sulfur dioxide (SO₂); and 1.112 (1.011, 1.224) for ozone (O₃). In the cold season, the rate ratio for admission per 10µg/m3 was 1.035 (0.985, 1.088) for PM10; 1.041 (0.977, 1.108) for PM2.5; 1.252 (1.122, 1.398) for NO₂; 0.921 (0.717, 1.181) for SO₂; and 1.030 (1.011, 1.050) for O₃. In conclusion, the risk of admission due to AR increased significantly after exposure to O₃ in the warm and cold seasons. Exposure to PM10 was associated with a significantly increased risk of AR hospitalizations in the warm season only, whereas exposure to NO₂ was associated with a significantly increased risk of AR admission in the cold season.

Synergistic or Antagonistic Health Effects of Long- and Short-Term Exposure to Ambient NO2 and PM2.5: A Review

Studies on adverse health effects associated with air pollution mostly focus on individual pollutants. However, the air is a complex medium, and thus epidemiological studies face many challenges and limitations in the multipollutant approach. NO2 and PM2.5 have been selected as both originating from combustion processes and are considered to be the main pollutants associated with traffic; moreover, both elicit oxidative stress responses. An answer to the question of whether synergistic or antagonistic health effects of combined pollutants are demonstrated by pollutants monitored in ambient air is not explicit. Among the analyzed studies, only a few revealed statistical significance. Exposure to a single pollutant (PM2.5 or NO2) was mostly associated with a small increase in non-accidental mortality (HR:1.01-1.03). PM2.5 increase of <10 µg/m3 adjusted for NO2 as well as NO2 adjusted for PM2.5 resulted in a slightly lower health risk than a single pollutant. In the case of cardiovascular heart disease, mortality evoked by exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed an antagonistic effect on health risk compared to the single pollutant. Both short- and long-term exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed a synergistic effect appearing as higher mortality from respiratory diseases.

Temporal Heterogeneity of Short-Term Effects of Particulate Matter on Stroke Outpatients in Seven Major Cities of the Republic of Korea

Although particulate matter (PM) is a major risk factor for stroke, its effects on hospital outpatients admitted for stroke have not been documented in Korea. In addition, recent studies have reported that the effects of PM₁₀ on circulatory mortality changed over time. We aimed to estimate the effects of PM₁₀ on stroke and their temporal heterogeneity in seven major cities of Korea during the period 2002-2015. The study period was divided into five years of moving time windows, and city-specific PM₁₀ effects on ischemic and hemorrhagic stroke outpatients were calculated. We pooled the estimates using meta-analysis and plotted them into a sequence to identify their temporal trends. A 10 µg/m³ increase of PM₁₀ was significantly associated with increments in hospital outpatients admitted for ischemic stroke (0.24%, 95% CI: 0.04%, 0.44%), but not for hemorrhagic stroke (0.33%, 95% CI: -0.06%, 0.73%). Effect estimates for strokes increased during the period 2003-2013 but decreased after. For the first time, we have estimated the effects of PM₁₀ on hospital outpatients admitted for stroke in Korea. The observed temporal trend in PM₁₀ effects was similar to patterns of circulatory mortality, suggesting that the temporal heterogeneity in PM₁₀ effects might be due to systematic causes rather than random fluctuations.