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Wies B, Valls I, Fernandes A, Ubalde-López M, Rocabois A, Vrijheid M, Slama R, Nieuwenhuijsen M. Urban environment and children's health: An umbrella review of exposure response functions for health impact assessment. ENVIRONMENTAL RESEARCH 2024; 263:120084. [PMID: 39369784 DOI: 10.1016/j.envres.2024.120084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/13/2024] [Accepted: 09/27/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Urban settlements have become the main living environment. Understanding the impact of urban exposures on human health has therefore become a growing area of research. Up-to-date knowledge about the influence of urban exposures on pregnant women's and children's health is especially relevant, as they are particularly vulnerable to certain external influences. AIM This review aims to provide a synthesis of systematic reviews with meta-analyses reporting on an association between the urban environmental risk factors and health outcomes in pregnancy, infants, children and adolescents. METHODS We conducted an umbrella review, methodically analysing systematic reviews with meta-analyses, published between January 2016 and December 2022 in PubMed or Scopus. Adhering to the PRISMA checklist, we searched for free text using Medical Subject Headings (MeSH) terms related to air pollution, noise pollution, temperature, green space exposure, built and food environment, health outcomes, children (aged 0-18 years), pregnancy and systematic reviews with meta-analyses. We extracted key characteristics of each included study and assessed the quality of the included studies via the R-AMSTAR 2 tool. RESULTS Twenty-four studies met our inclusion criteria and identified 104 associations including 15 exposures and 60 health outcomes. The most frequently studied associations were related to air pollutants, followed by the built and food environment and noise. Birth outcomes (including low birth weight, pre-term birth or stillbirth) were the most commonly affected health outcomes, followed by respiratory outcomes such as asthma or respiratory infections. A total of 45 exposure-response function were reported to be statistically significant, including 10 exposures and 23 health effects. CONCLUSION This umbrella review provides an overview of the evidence and availability of exposure response functions between selected urban exposures and child health outcomes. This helps to identify research gaps and to build the basis for health impact assessment.
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Affiliation(s)
- Blanche Wies
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Inés Valls
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Amanda Fernandes
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mònica Ubalde-López
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Audrey Rocabois
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Martine Vrijheid
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rémy Slama
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Mark Nieuwenhuijsen
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Chen W, Puttock EJ, Schatz M, Crawford W, Vollmer WM, Xie F, Xu S, Lustigova E, Zeiger RS. Risk Factors for Acute Asthma Exacerbations in Adults With Mild Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2705-2716.e6. [PMID: 38821437 PMCID: PMC11464201 DOI: 10.1016/j.jaip.2024.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/07/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Although individuals with mild asthma account for 30% to 40% of acute asthma exacerbations (AAEs), relatively little attention has been paid to risk factors for AAEs in this population. OBJECTIVE To identify risk factors associated with AAEs in patients with mild asthma. METHODS This was a retrospective cohort study. We used administrative data from a large managed care organization to identify 199,010 adults aged 18 to 85 years who met study criteria for mild asthma between 2013 and 2018. An asthma-coded qualifying visit (index visit) was identified for each patient. We then used information at the index visit or from the year before the index visit to measure potential risk factors for AAEs in the subsequent year. An AAE was defined as either an asthma-coded hospitalization or emergency department visit, or an asthma-related systemic corticosteroid administration (intramuscular or intravenous) or oral corticosteroid dispensing. Poisson regression models with robust SEs were used to estimate the adjusted risk ratios for future AAEs. RESULTS In the study cohort, mean age was 44 years and 64% were female; 6.5% had AAEs within 1 year after the index visit. In multivariate models, age, sex, race, ethnicity, smoking status, body mass index, prior acute asthma care, and a variety of comorbidities and other clinical characteristics were significant predictors for future AAE risk. CONCLUSION Population-based disease management strategies for asthma should be expanded to include people with mild asthma in addition to those with moderate to severe disease.
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Affiliation(s)
- Wansu Chen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif.
| | - Eric J Puttock
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | - Michael Schatz
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif
| | - William Crawford
- Department of Allergy, Kaiser Permanente Southern California, Harbor City, Calif
| | | | - Fagen Xie
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | - Stanley Xu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | - Eva Lustigova
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | - Robert S Zeiger
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif
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Huang W, Schinasi LH, Kenyon CC, Auchincloss AH, Moore K, Melly S, Robinson LF, Forrest CB, De Roos AJ. Do respiratory virus infections modify associations of asthma exacerbation with aeroallergens or fine particulate matter? A time series study in Philadelphia PA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3206-3217. [PMID: 38164931 DOI: 10.1080/09603123.2023.2299249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Respiratory virus infections are related to over 80% of childhood asthma exacerbations. They enhance pro-inflammatory mediator release, especially for sensitized individuals exposed to pollens/molds. Using a time-series study design, we investigated possible effect modification by respiratory virus infections of the associations between aeroallergens/PM2.5 and asthma exacerbation rates. Outpatient, emergency department (ED), and inpatient visits for asthma exacerbation among children with asthma (28,540/24,444 [warm/cold season]), as well as viral infection counts were obtained from electronic health records of the Children's Hospital of Philadelphia from 2011 to 2016. Rate ratios (RRs, 90th percentile vs. 0) for late-season grass pollen were 1.00 (0.85-1.17), 1.04 (0.95-1.15), and 1.12 (0.96-1.32), respectively, for respiratory syncytial virus (RSV) counts within each tertile. However, similar trends were not observed for weed pollens/molds or PM2.5. Overall, our study provides little evidence supporting effect modification by respiratory viral infections.
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Affiliation(s)
- Wanyu Huang
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Chén C Kenyon
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Steven Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lucy F Robinson
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Christopher B Forrest
- The Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Rice JL, Collaco JM, Tracy MC, Sheils CA, Rhein LM, Popova AP, Moore PE, Miller AN, Manimtim WM, Lai K, Kaslow JA, Hayden LP, Fierro JL, Bansal M, Austin ED, Aoyama B, Alexiou S, Akangire G, Agarwal A, Villafranco N, Siddaiah R, Lagatta JM, Abul MH, Cristea AI, Baker CD, Abman SH, McGrath-Morrow SA. Parental Report of Indoor Air Pollution Is Associated with Respiratory Morbidities in Bronchopulmonary Dysplasia. J Pediatr 2024; 275:114241. [PMID: 39151604 DOI: 10.1016/j.jpeds.2024.114241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/30/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE To determine the association between indoor air pollution and respiratory morbidities in children with bronchopulmonary dysplasia (BPD) recruited from the multicenter BPD Collaborative. STUDY DESIGN A cross-sectional study was performed among participants <3 years old in the BPD Collaborative Outpatient Registry. Indoor air pollution was defined as any reported exposure to tobacco or marijuana smoke, electronic cigarette emissions, gas stoves, and/or wood stoves. Clinical data included acute care use and chronic respiratory symptoms in the past 4 weeks. RESULTS A total of 1011 participants born at a mean gestational age of 26.4 ± 2.2 weeks were included. Most (66.6%) had severe BPD. More than 40% of participants were exposed to ≥1 source of indoor air pollution. The odds of reporting an emergency department visit (OR, 1.7; 95% CI, 1.18-2.45), antibiotic use (OR, 1.9; 95% CI, 1.12-3.21), or a systemic steroid course (OR, 2.18; 95% CI, 1.24-3.84) were significantly higher in participants reporting exposure to secondhand smoke (SHS) compared with those without SHS exposure. Participants reporting exposure to air pollution (not including SHS) also had a significantly greater odds (OR, 1.48; 95% CI, 1.08-2.03) of antibiotic use as well. Indoor air pollution exposure (including SHS) was not associated with chronic respiratory symptoms or rescue medication use. CONCLUSIONS Exposure to indoor air pollution, especially SHS, was associated with acute respiratory morbidities, including emergency department visits, antibiotics for respiratory illnesses, and systemic steroid use.
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Affiliation(s)
- Jessica L Rice
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA
| | - Joseph M Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD.
| | - Michael C Tracy
- Division of Pediatric Pulmonary, Asthma and Sleep Medicine, Stanford University, Stanford, CA
| | - Catherine A Sheils
- Division of Pulmonary Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Lawrence M Rhein
- Neonatal-Perinatal Medicine/Pediatric Pulmonology, University of Massachusetts, Worcester, MA
| | | | - Paul E Moore
- Pulmonary Medicine, Vanderbilt University and Vanderbilt University Medical Center, Nashville, TN
| | - Audrey N Miller
- Division of Neonatology, Nationwide Children's Hospital and Ohio State University, Columbus, OH
| | - Winston M Manimtim
- Division of Neonatology, Children's Mercy-Kansas City and University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Khanh Lai
- Division of Pediatric Pulmonary and Sleep Medicine, University of Utah, Salt Lake City, UT
| | - Jacob A Kaslow
- Pulmonary Medicine, Vanderbilt University and Vanderbilt University Medical Center, Nashville, TN
| | - Lystra P Hayden
- Division of Pulmonary Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Julie L Fierro
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA
| | - Manvi Bansal
- Pulmonology and Sleep Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Eric D Austin
- Pulmonary Medicine, Vanderbilt University and Vanderbilt University Medical Center, Nashville, TN
| | - Brianna Aoyama
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD
| | - Stamatia Alexiou
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA
| | - Gangaram Akangire
- Division of Neonatology, Children's Mercy-Kansas City and University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Amit Agarwal
- Division of Pulmonary Medicine, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, AR
| | - Natalie Villafranco
- Pulmonary Medicine, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
| | | | - Joanne M Lagatta
- Department of Pediatrics, Medical College of Wisconsin Milwaukee, WI
| | | | - A Ioana Cristea
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Riley Children's Hospital and Indiana University, Indianapolis, IN
| | - Christopher D Baker
- Section of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Steven H Abman
- Section of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Sharon A McGrath-Morrow
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA
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Chambliss SE, Matsui EC, Zárate RA, Zigler CM. The Role of Neighborhood Air Pollution in Disparate Racial and Ethnic Asthma Acute Care Use. Am J Respir Crit Care Med 2024; 210:178-185. [PMID: 38412262 PMCID: PMC11273303 DOI: 10.1164/rccm.202307-1185oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/27/2024] [Indexed: 02/29/2024] Open
Abstract
Rationale: The share of Black or Latinx residents in a census tract remains associated with asthma-related emergency department (ED) visit rates after controlling for socioeconomic factors. The extent to which evident disparities relate to the within-city heterogeneity of long-term air pollution exposure remains unclear. Objectives: To investigate the role of intraurban spatial variability of air pollution in asthma acute care use disparity. Methods: An administrative database was used to define census tract population-based incidence rates of asthma-related ED visits. We estimate the associations between census tract incidence rates and 1) average fine and coarse particulate matter, nitrogen dioxide (NO2), and sulfur dioxide (SO2), and 2) racial and ethnic composition using generalized linear models controlling for socioeconomic and housing covariates. We also examine for the attenuation of incidence risk ratios (IRRs) associated with race/ethnicity when controlling for air pollution exposure. Measurements and Main Results: Fine and coarse particulate matter and SO2 are all associated with census tract-level incidence rates of asthma-related ED visits, and multipollutant models show evidence of independent risk associated with coarse particulate matter and SO2. The association between census tract incidence rate and Black resident share (IRR, 1.51 [credible interval (CI), 1.48-1.54]) is attenuated by 24% when accounting for air pollution (IRR, 1.39 [CI, 1.35-1.42]), and the association with Latinx resident share (IRR, 1.11 [CI, 1.09-1.13]) is attenuated by 32% (IRR, 1.08 [CI, 1.06-1.10]). Conclusions: Neighborhood-level rates of asthma acute care use are associated with local air pollution. Controlling for air pollution attenuates associations with census tract racial/ethnic composition, suggesting that intracity variability in air pollution could contribute to neighborhood-to-neighborhood asthma morbidity disparities.
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Affiliation(s)
- Sarah E. Chambliss
- Department of Population Health
- Center for Health and Environment: Education and Research, and
| | - Elizabeth C. Matsui
- Department of Population Health
- Center for Health and Environment: Education and Research, and
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas; and
| | | | - Corwin M. Zigler
- Center for Health and Environment: Education and Research, and
- Department of Statistics and Data Sciences, The University of Texas at Austin, Austin, Texas
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Yatera K, Nishida C. Contemporary Concise Review 2023: Environmental and occupational lung diseases. Respirology 2024; 29:574-587. [PMID: 38826078 DOI: 10.1111/resp.14761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
Air pollutants have various effects on human health in environmental and occupational settings. Air pollutants can be a risk factor for incidence, exacerbation/aggravation and death due to various lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), hypersensitivity pneumonitis or pneumonia (HP), pulmonary fibrosis such as pneumoconiosis and malignant respiratory diseases such as lung cancer and malignant pleural mesothelioma. Environmental and occupational respiratory diseases are crucial clinical and social issues worldwide, although the burden of respiratory disease due to environmental and occupational causes varies depending on country/region, demographic variables, geographical location, industrial structure and socioeconomic situation. The correct recognition of environmental and occupational lung diseases and taking appropriate measures are essential to their effective prevention.
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Affiliation(s)
- Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chinatsu Nishida
- Department of Environmental Health Engineering, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Horne BD, Johnson MM, Blagev DP, Haddad F, Knowlton KU, Bride D, Bair TL, Joy EA, Nadeau KC. Association of Short-Term Increases in Ambient Fine Particulate Matter With Hospitalization for Asthma or COPD During Wildfire Season and Other Time Periods. CHEST PULMONARY 2024; 2:100053. [PMID: 38993972 PMCID: PMC11238943 DOI: 10.1016/j.chpulm.2024.100053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Short-term increases in air pollution are associated with poor asthma and COPD outcomes. Short-term elevations in fine particulate matter (PM2.5) due to wildfire smoke are becoming more common. RESEARCH QUESTION Are short-term increases in PM2.5 and ozone in wildfire season and in winter inversion season associated with a composite of emergency or inpatient hospitalization for asthma and COPD? STUDY DESIGN AND METHODS Case-crossover analyses evaluated 63,976 and 18,514 patients hospitalized for primary discharge diagnoses of asthma and COPD, respectively, between January 1999 and March 2022. Patients resided on Utah's Wasatch Front where PM2.5 and ozone were measured by Environmental Protection Agency-based monitors. ORs were calculated using Poisson regression adjusted for weather variables. RESULTS Asthma risk increased on the same day that PM2.5 increased during wildfire season (OR, 1.057 per + 10 μg/m3; 95% CI, 1.019-1.097; P = .003) and winter inversions (OR, 1.023 per +10 μg/m3; 95% CI, 1.010-1.037; P = .0004). Risk decreased after 1 week, but during wildfire season risk rebounded at a 4-week lag (OR, 1.098 per +10 μg/m3; 95% CI, 1.033-1.167). Asthma risk for adults during wildfire season was highest in the first 3 days after PM2.5 increases, but for children, the highest risk was delayed by 3 to 4 weeks. PM2.5 exposure was weakly associated with COPD hospitalization. Ozone exposure was not associated with elevated risks. INTERPRETATION In a large urban population, short-term increases in PM2.5 during wildfire season were associated with asthma hospitalization, and the effect sizes were greater than for PM2.5 during inversion season.
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Affiliation(s)
- Benjamin D Horne
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Mary M Johnson
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Denitza P Blagev
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Francois Haddad
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Kirk U Knowlton
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Daniel Bride
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Tami L Bair
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Elizabeth A Joy
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
| | - Kari C Nadeau
- Intermountain Medical Center Heart Institute (B. D. H., K. U. K., D. B., and T. L. B.), Salt Lake City, UT; the Division of Cardiovascular Medicine, Department of Medicine (B. D. H. and F. H.) and the Cardiovascular Institute (B. D. H. and F. H.), Stanford University, Stanford, CA; the Department of Environmental Health (M. M. J. and K. C. N.), Harvard T.H. Chan School of Public Health, Boston, MA; the Division of Pulmonary and Critical Care Medicine (D. B. P.), Department of Internal Medicine, Intermountain Health, Salt Lake City, UT; the Division of Cardiology (K. U. K.), Department of Internal Medicine, University of Utah, Salt Lake City, UT; the Wellness & Nutrition (E. A. J.), Intermountain Health, Salt Lake City, UT; and the Department of Family and Preventive Medicine (E. A. J.), University of Utah, Salt Lake City, UT
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Mansouri R, Lavigne E, Talarico R, Smargiassi A, Rodriguez-Villamizar LA, Villeneuve PJ. Residential surrounding greenness and the incidence of childhood asthma: Findings from a population-based cohort in Ontario, Canada. ENVIRONMENTAL RESEARCH 2024; 249:118316. [PMID: 38301756 DOI: 10.1016/j.envres.2024.118316] [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: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Several epidemiological studies have investigated the possible role that living in areas with greater amounts of greenspace has on the incidence of childhood asthma. These findings have been inconsistent, and few studies explored the relevance of timing of exposure. We investigated the role of residential surrounding greenness on the risk of incident asthma using a population-based retrospective cohort study. We included 982,131 singleton births in Ontario, Canada between 2006 and 2013. Two measures of greenness, the Normalized Difference Vegetation Index (NDVI) and the Green View Index (GVI), were assigned to the residential histories of these infants from pregnancy through to 12 years of age. Longitudinally-based diagnoses of asthma were determined by using provincial administrative health data. The extended Cox hazards model was used to characterize associations between greenness measures and asthma (up to age 12 years) while adjusting for several risk factors. In a fully adjusted model, that included a term for traffic-related air pollution (NO2), we found no association between an interquartile range increase (0.08) of the NDVI during childhood and asthma incidence (HR = 0.99; 95 % CI = 0.99-1.01). In contrast, we found that an 0.08 increase in NDVI during childhood reduced the risk of asthma in children 7-12 years of age by 14 % (HR = 0.86, 95 % CI:0.79-0.95). Seasonal differences in the association between greenness and asthma were noted. Our findings suggest that residential proximity to greenness reduces the risk of asthma in children aged 7-12.
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Affiliation(s)
- Razieh Mansouri
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, 960 Carling Avenue, Ottawa, Ontario, Canada.
| | - Robert Talarico
- Institute for Clinical Evaluative Sciences, 1053 Carling Avenue, Ottawa, Ontario, Canada.
| | - Audrey Smargiassi
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS Du Centre-Sud-de-l'Île-de-Montréal, 7101 Av Du Parc, Montreal, Quebec, Canada.
| | - Laura A Rodriguez-Villamizar
- Department of Public Health, Universidad Industrial de Santander, Carrera 32 29-31, Bucaramanga, Colombia; Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
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9
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Cafora M, Rovelli S, Cattaneo A, Pistocchi A, Ferrari L. Short-term exposure to fine particulate matter exposure impairs innate immune and inflammatory responses to a pathogen stimulus: A functional study in the zebrafish model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 348:123841. [PMID: 38521398 DOI: 10.1016/j.envpol.2024.123841] [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: 10/20/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
Short-term exposure to fine particulate matter (PM2.5) is associated with the activation of adverse inflammatory responses, increasing the risk of developing acute respiratory diseases, such as those caused by pathogen infections. However, the functional mechanisms underlying this evidence remain unclear. In the present study, we generated a zebrafish model of short-term exposure to a specific PM2.5, collected in the northern metropolitan area of Milan, Italy. First, we assessed the immunomodulatory effects of short-term PM2.5 exposure and observed that it elicited pro-inflammatory effects by inducing the expression of cytokines and triggering hyper-activation of both neutrophil and macrophage cell populations. Moreover, we examined the impact of a secondary infectious pro-inflammatory stimulus induced through the injection of Pseudomonas aeruginosa lipopolysaccharide (Pa-LPS) molecules after exposure to short-term PM2.5. In this model, we demonstrated that the innate immune response was less responsive to a second pro-inflammatory infectious stimulus. Indeed, larvae exhibited dampened leukocyte activation and impaired production of reactive oxygen species. The obtained results indicate that short-term PM2.5 exposure alters the immune microenvironment and affects the inflammatory processes, thus potentially weakening the resistance to pathogen infections.
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Affiliation(s)
- Marco Cafora
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Sabrina Rovelli
- RAHH LAB, Department of Science and High Technology, University of Insubria, Como, Italy
| | - Andrea Cattaneo
- RAHH LAB, Department of Science and High Technology, University of Insubria, Como, Italy
| | - Anna Pistocchi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Luca Ferrari
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Unit of Occupational Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
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10
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Moore CM, Thornburg J, Secor EA, Hamlington KL, Schiltz AM, Freeman KL, Everman JL, Fingerlin TE, Liu AH, Seibold MA. Breathing zone pollutant levels are associated with asthma exacerbations in high-risk children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.22.23295971. [PMID: 37790375 PMCID: PMC10543064 DOI: 10.1101/2023.09.22.23295971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background Indoor and outdoor air pollution levels are associated with poor asthma outcomes in children. However, few studies have evaluated whether breathing zone pollutant levels associate with asthma outcomes. Objective Determine breathing zone exposure levels of NO 2 , O 3 , total PM 10 and PM 10 constituents among children with exacerbation-prone asthma, and examine correspondence with in-home and community measurements and associations with outcomes. Methods We assessed children's personal breathing zone exposures using wearable monitors. Personal exposures were compared to in-home and community measurements and tested for association with lung function, asthma control, and asthma exacerbations. Results 81 children completed 219 monitoring sessions. Correlations between personal and community levels of PM 10 , NO 2 , and O 3 were poor, whereas personal PM 10 and NO 2 levels correlated with in-home measurements. However, in-home monitoring underdetected brown carbon (Personal:79%, Home:36.8%) and ETS (Personal:83.7%, Home:4.1%) personal exposures, and detected black carbon in participants without these personal exposures (Personal: 26.5%, Home: 96%). Personal exposures were not associated with lung function or asthma control. Children experiencing an asthma exacerbation within 60 days of personal exposure monitoring had 1.98, 2.21 and 2.04 times higher brown carbon (p<0.001), ETS (p=0.007), and endotoxin (p=0.012), respectively. These outcomes were not associated with community or in-home exposure levels. Conclusions Monitoring pollutant levels in the breathing zone is essential to understand how exposures influence asthma outcomes, as agreement between personal and in-home monitors is limited. Inhaled exposure to PM 10 constituents modifies asthma exacerbation risk, suggesting efforts to limit these exposures among high-risk children may decrease their asthma burden. CLINICAL IMPLICATIONS In-home and community monitoring of environmental pollutants may underestimate personal exposures. Levels of inhaled exposure to PM 10 constituents appear to strongly influence asthma exacerbation risk. Therefore, efforts should be made to mitigate these exposures. CAPSULE SUMMARY Leveraging wearable, breathing-zone monitors, we show exposures to inhaled pollutants are poorly proxied by in-home and community monitors, among children with exacerbation-prone asthma. Inhaled exposure to multiple PM 10 constituents is associated with asthma exacerbation risk.
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11
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Kelly G, Idubor OI, Binney S, Schramm PJ, Mirabelli MC, Hsu J. The Impact of Climate Change on Asthma and Allergic-Immunologic Disease. Curr Allergy Asthma Rep 2023; 23:453-461. [PMID: 37284923 PMCID: PMC10613957 DOI: 10.1007/s11882-023-01093-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW This review discusses climate change-related impacts on asthma and allergic-immunologic disease, relevant US public health efforts, and healthcare professional resources. RECENT FINDINGS Climate change can impact people with asthma and allergic-immunologic disease through various pathways, including increased exposure to asthma triggers (e.g., aeroallergens, ground-level ozone). Climate change-related disasters (e.g., wildfires, floods) disrupting healthcare access can complicate management of any allergic-immunologic disease. Climate change disproportionately affects some communities, which can exacerbate disparities in climate-sensitive diseases like asthma. Public health efforts include implementing a national strategic framework to help communities track, prevent, and respond to climate change-related health threats. Healthcare professionals can use resources or tools to help patients with asthma and allergic-immunologic disease prevent climate change-related health impacts. Climate change can affect people with asthma and allergic-immunologic disease and exacerbate health disparities. Resources and tools are available to help prevent climate change-related health impacts at the community and individual level.
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Affiliation(s)
- Grace Kelly
- Epidemiology Elective Program, National Center for STLT Public Health Infrastructure and Workforce, and Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Osatohamwen I Idubor
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
| | - Sophie Binney
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Paul J Schramm
- Climate and Health Program, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, Atlanta, GA, USA
| | - Maria C Mirabelli
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA
| | - Joy Hsu
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC, 4770 Buford Highway Mailstop S106-6, Atlanta, GA, 30341, USA.
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12
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Bi J, D’Souza RR, Moss S, Senthilkumar N, Russell AG, Scovronick NC, Chang HH, Ebelt S. Acute Effects of Ambient Air Pollution on Asthma Emergency Department Visits in Ten U.S. States. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47003. [PMID: 37011135 PMCID: PMC10069759 DOI: 10.1289/ehp11661] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/05/2023] [Accepted: 03/02/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Previous studies of short-term ambient air pollution exposure and asthma morbidity in the United States have been limited to a small number of cities and/or pollutants and with limited consideration of effects across ages. OBJECTIVES To estimate acute age group-specific effects of fine and coarse particulate matter (PM), major PM components, and gaseous pollutants on emergency department (ED) visits for asthma during 2005-2014 across the United States. METHODS We acquired ED visit and air quality data in regions surrounding 53 speciation sites in 10 states. We used quasi-Poisson log-linear time-series models with unconstrained distributed exposure lags to estimate site-specific acute effects of air pollution on asthma ED visits overall and by age group (1-4, 5-17, 18-49, 50-64, and 65 + y), controlling for meteorology, time trends, and influenza activity. We then used a Bayesian hierarchical model to estimate pooled associations from site-specific associations. RESULTS Our analysis included 3.19 million asthma ED visits. We observed positive associations for multiday cumulative exposure to all air pollutants examined [e.g., 8-d exposure to PM 2.5 : rate ratio of 1.016 with 95% credible interval (CI) of (1.008, 1.025) per 6.3 - μ g / m 3 increase, PM 10 - 2.5 : 1.014 (95% CI: 1.007, 1.020) per 9.6 - μ g / m 3 increase, organic carbon: 1.016 (95% CI: 1.009, 1.024) per 2.8 - μ g / m 3 increase, and ozone: 1.008 (95% CI: 0.995, 1.022) per 0.02 -ppm increase]. PM 2.5 and ozone showed stronger effects at shorter lags, whereas associations of traffic-related pollutants (e.g., elemental carbon and oxides of nitrogen) were generally stronger at longer lags. Most pollutants had more pronounced effects on children (< 18 y old) than adults; PM 2.5 had strong effects on both children and the elderly (> 64 y old); and ozone had stronger effects on adults than children. CONCLUSIONS We reported positive associations between short-term air pollution exposure and increased rates of asthma ED visits. We found that air pollution exposure posed a higher risk for children and older populations. https://doi.org/10.1289/EHP11661.
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Affiliation(s)
- Jianzhao Bi
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Rohan R. D’Souza
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Shannon Moss
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Niru Senthilkumar
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Armistead G. Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Noah C. Scovronick
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
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13
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Luo J, Liu H, Hua S, Song L. The Correlation of PM2.5 Exposure with Acute Attack and Steroid Sensitivity in Asthma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2756147. [PMID: 36033576 PMCID: PMC9410784 DOI: 10.1155/2022/2756147] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Bronchial asthma is a common chronic inflammatory disease of the respiratory system. Asthma primarily manifests in reversible airflow limitation and airway inflammation, airway remodeling, and persistent airway hyperresponsiveness. PM2.5, also known as fine particulate matter, is the main component of air pollution and refers to particulate matter with an aerodynamic diameter of ≤2.5 μm. PM2.5 can be suspended in the air for an extensive time and, in addition, can contain or adsorb heavy metals, toxic gases, polycyclic aromatic hydrocarbons, bacterial viruses, and other harmful substances. Epidemiological studies have demonstrated that, in addition to increasing the incidence of asthma, PM2.5 exposure results in a significant increase in the incidence of hospital visits and deaths due to acute asthma attacks. Furthermore, PM2.5 was reported to induce glucocorticoid resistance in asthmatic individuals. Although various countries have implemented strict control measures, due to the wide range of PM2.5 sources, complex components, and unknown pathogenic mechanisms involving the atmosphere, environment, chemistry, and toxicology, PM2.5 damage to human health still cannot be effectively controlled. In this present review, we summarized the current knowledge base regarding the relationship between PM2.5 toxicity and the onset, acute attack prevalence, and steroid sensitivity in asthma.
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Affiliation(s)
- Jingjing Luo
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Han Liu
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Shucheng Hua
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Lei Song
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
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14
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Markozannes G, Pantavou K, Rizos EC, Sindosi OΑ, Tagkas C, Seyfried M, Saldanha IJ, Hatzianastassiou N, Nikolopoulos GK, Ntzani E. Outdoor air quality and human health: An overview of reviews of observational studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119309. [PMID: 35469927 DOI: 10.1016/j.envpol.2022.119309] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NOX, NO2, O3, PM10, PM2.5, and SO2 and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM2.5, PM10, NO2, and SO2 concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM2.5, PM10, O3, NO2, and SO2 concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Evangelos C Rizos
- Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece; School of Medicine, European University Cyprus, Nicosia, Cyprus; Hellenic Open University, Patra, Greece
| | - Ourania Α Sindosi
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | - Christos Tagkas
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maike Seyfried
- Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA
| | - Nikos Hatzianastassiou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | | | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA.
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15
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Juskiene I, Prokopciuk N, Franck U, Valiulis A, Valskys V, Mesceriakova V, Kvedariene V, Valiulyte I, Poluzioroviene E, Sauliene I, Valiulis A. Indoor air pollution effects on pediatric asthma are submicron aerosol particle-dependent. Eur J Pediatr 2022; 181:2469-2480. [PMID: 35312840 DOI: 10.1007/s00431-022-04443-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/08/2022] [Accepted: 03/12/2022] [Indexed: 02/01/2023]
Abstract
The school environment is crucial for the child's health and well-being. On the other hand, the data about the role of school's aerosol pollution on the etiology of chronic non-communicable diseases remain scarce. This study aims to evaluate the level of indoor aerosol pollution in primary schools and its relation to the incidence of doctor's diagnosed asthma among younger school-age children. The cross-sectional study was carried out in 11 primary schools of Vilnius during 1 year of education from autumn 2017 to spring 2018. Particle number (PNC) and mass (PMC) concentrations in the size range of 0.3-10 µm were measured using an Optical Particle Sizer (OPS, TSI model 3330). The annual incidence of doctor's diagnosed asthma in each school was calculated retrospectively from the data of medical records. The total number of 6-11 years old children who participated in the study was 3638. The incidence of asthma per school ranged from 1.8 to 6.0%. Mean indoor air pollution based on measurements in classrooms during the lessons was calculated for each school. Levels of PNC and PMC in schools ranged between 33.0 and 168.0 particles/cm3 and 1.7-6.8 µg/m3, respectively. There was a statistically significant correlation between the incidence of asthma and PNC as well as asthma and PMC in the particle size range of 0.3-1 µm (r = 0.66, p = 0.028) and (r = 0.71, p = 0.017) respectively. No significant correlation was found between asthma incidence and indoor air pollution in the particle size range of 0.3-2.5 and 0.3-10 µm. Conclusion: We concluded that the number and mass concentrations of indoor air aerosol pollution in primary schools in the particle size range of 0.3-1 µm are primarily associated with the incidence of doctor's diagnosed asthma among younger school-age children. What is Known: • Both indoor and outdoor aerosol pollution is associated with bronchial asthma in children. What is New: • The incidence of bronchial asthma among younger school age children is related to indoor air quality in primary schools. • Aerosol pollutants in the size range of 0.3-1 µm in contrast to larger size range particles can play major role in the etiology of bronchial asthma in children.
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Affiliation(s)
- Izabele Juskiene
- Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Antakalnio Str. 57, Vilnius, LT-10207, Lithuania
| | - Nina Prokopciuk
- Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Antakalnio Str. 57, Vilnius, LT-10207, Lithuania. .,Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania.
| | - Ulrich Franck
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany
| | - Algirdas Valiulis
- Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Vaidotas Valskys
- Center of Life Sciences, Institute of Biosciences, Vilnius University, Vilnius, Lithuania
| | | | - Violeta Kvedariene
- Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Clinic of Chest Diseases and Allergology, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Indre Valiulyte
- Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Kantonsspital Thurgau, Frauenfeld, Switzerland
| | - Edita Poluzioroviene
- Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Antakalnio Str. 57, Vilnius, LT-10207, Lithuania
| | | | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Antakalnio Str. 57, Vilnius, LT-10207, Lithuania.,Department of Public Health, Institute of Health Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania
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16
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Increasing Prevalence of Allergic Disease and Its Impact on Current Practice. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00406-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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New Homogeneous Spatial Areas Identified Using Case-Crossover Spatial Lag Grid Differences between Aerosol Optical Depth-PM2.5 and Respiratory-Cardiovascular Emergency Department Visits and Hospitalizations. ATMOSPHERE 2022; 13:1-33. [PMID: 36003277 PMCID: PMC9393882 DOI: 10.3390/atmos13050719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Optimal use of Hierarchical Bayesian Model (HBM)-assembled aerosol optical depth (AOD)-PM2.5 fused surfaces in epidemiologic studies requires homogeneous temporal and spatial fused surfaces. No analytical method is available to evaluate spatial heterogeneity. The temporal case-crossover design was modified to assess the spatial association between four experimental AOD-PM2.5 fused surfaces and four respiratory–cardiovascular hospital events in 12 km2 grids. The maximum number of adjacent lag grids with significant odds ratios (ORs) identified homogeneous spatial areas (HOSAs). The largest HOSA included five grids (lag grids 04; 720 km2) and the smallest HOSA contained two grids (lag grids 01; 288 km2). Emergency department asthma and inpatient asthma, myocardial infarction, and heart failure ORs were significantly higher in rural grids without air monitors than in urban grids with air monitors at lag grids 0, 1, and 01. Rural grids had higher AOD-PM2.5 concentration levels, population density, and poverty percentages than urban grids. Warm season ORs were significantly higher than cold season ORs for all health outcomes at lag grids 0, 1, 01, and 04. The possibility of elevated fine and ultrafine PM and other demographic and environmental risk factors synergistically contributing to elevated respiratory–cardiovascular chronic diseases in persons residing in rural areas was discussed.
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18
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PM2.5 Exposure and Asthma Development: The Key Role of Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3618806. [PMID: 35419163 PMCID: PMC9001082 DOI: 10.1155/2022/3618806] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/24/2022] [Indexed: 12/21/2022]
Abstract
Oxidative stress is defined as the imbalance between reactive oxygen species (ROS) production and the endogenous antioxidant defense system, leading to cellular damage. Asthma is a common chronic inflammatory airway disease. The presence of asthma tends to increase the production of reactive oxygen species (ROS), and the antioxidant system in the lungs is insufficient to mitigate it. Therefore, asthma can lead to an exacerbation of airway hyperresponsiveness and airway inflammation. PM2.5 exposure increases ROS levels. Meanwhile, the accumulation of ROS will further enhance the oxidative stress response, resulting in DNA, protein, lipid, and other cellular and molecular damage, leading to respiratory diseases. An in-depth study on the relationship between oxidative stress and PM2.5-related asthma is helpful to understand the pathogenesis and progression of the disease and provides a new direction for the treatment of the disease. This paper reviews the research progress of oxidative stress in PM2.5-induced asthma as well as highlights the therapeutic potentials of antioxidant approaches in treatment of asthma.
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19
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Nishida C, Yatera K. The Impact of Ambient Environmental and Occupational Pollution on Respiratory Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2788. [PMID: 35270479 PMCID: PMC8910713 DOI: 10.3390/ijerph19052788] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
Ambient pollutants and occupational pollutants may cause and exacerbate various lung and respiratory diseases. This review describes lung and respiratory diseases in relation to ambient pollutants, particularly particulate matter (PM2.5), and occupational air pollutants, excluding communicable diseases and indoor pollutants, including tobacco smoke exposure. PM2.5 produced by combustion is an important ambient pollutant. PM2.5 can cause asthma attacks and exacerbations of chronic obstructive pulmonary disease in the short term. Further, it not only carries a risk of lung cancer and death, but also hinders the development of lung function in children in the long term. It has recently been suggested that air pollution, such as PM2.5, is a risk factor for severe coronavirus disease (COVID-19). Asbestos, which causes asbestosis, lung cancer, and malignant mesothelioma, and crystalline silica, which cause silicosis, are well-known traditional occupational pollutants leading to pneumoconiosis. While work-related asthma (WRA) is the most common occupational lung disease in recent years, many different agents cause WRA, including natural and synthetic chemicals and irritant gases. Primary preventive interventions that increase awareness of pollutants and reduce the development and exacerbation of diseases caused by air pollutants are paramount to addressing ambient and occupational pollution.
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Affiliation(s)
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka 807-8555, Japan;
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20
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Xing Y, Wong GWK. Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:21-39. [PMID: 34983105 PMCID: PMC8724831 DOI: 10.4168/aair.2022.14.1.21] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/14/2021] [Indexed: 12/22/2022]
Abstract
Asia-Pacific is a populous region with remarkable variations in socioeconomic development and environmental exposure among countries. The prevalence rates of asthma and allergic rhinitis appear to have recently reached a plateau in Western countries, whereas they are still increasing in many Asian countries. Given the large population in Asia, even a slight increase in the prevalence rate will translate into an overwhelming number of patients. To reduce the magnitude of the increase in allergic diseases in next few decades in Asia, we must understand the potential factors leading to the occurrence of these disorders and the development of potential preventive strategies. The etiology of allergic disorders is likely due to complex interactions among genetic, epigenetic, and environmental factors for the manifestations of inappropriate immune responses. As urbanization and industrialization inevitably progress in Asia, there is an urgent need to curtail the upcoming waves of the allergy epidemic. Potentially modifiable risk exposure, such as air pollution, should be minimized through timely implementation of effective legislations. Meanwhile, re-introduction of protective factors that were once part of the traditional farming lifestyle might give new insight into primary prevention of allergy.
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Affiliation(s)
- Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gary Wing-Kin Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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21
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Kodros JK, O’Dell K, Samet JM, L’Orange C, Pierce JR, Volckens J. Quantifying the Health Benefits of Face Masks and Respirators to Mitigate Exposure to Severe Air Pollution. GEOHEALTH 2021; 5:e2021GH000482. [PMID: 34541439 PMCID: PMC8438762 DOI: 10.1029/2021gh000482] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 05/19/2023]
Abstract
Familiarity with the use of face coverings to reduce the risk of respiratory disease has increased during the coronavirus pandemic; however, recommendations for their use outside of the pandemic remains limited. Here, we develop a modeling framework to quantify the potential health benefits of wearing a face covering or respirator to mitigate exposure to particulate air pollution. This framework accounts for the wide range of available face coverings and respirators, fit factors and efficacy, air pollution characteristics, and exposure-response data. Our modeling shows that N95 respirators offer robust protection against different sources of particulate matter, reducing exposure by more than a factor of 14 when worn with a leak rate of 5%. Synthetic-fiber masks offer less protection with a strong dependence on aerosol size distribution (protection factors ranging from 4.4 to 2.2), while natural-fiber and surgical masks offer reductions in the exposure of 1.9 and 1.7, respectively. To assess the ability of face coverings to provide population-level health benefits to wildfire smoke, we perform a case study for the 2012 Washington state fire season. Our models suggest that although natural-fiber masks offer minor reductions in respiratory hospitalizations attributable to smoke (2%-11%) due to limited filtration efficiency, N95 respirators and to a lesser extent surgical and synthetic-fiber masks may lead to notable reductions in smoke-attributable hospitalizations (22%-39%, 9%-24%, and 7%-18%, respectively). The filtration efficiency, bypass rate, and compliance rate (fraction of time and population wearing the device) are the key factors governing exposure reduction potential and health benefits during severe wildfire smoke events.
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Affiliation(s)
- John K. Kodros
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - Katelyn O’Dell
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Jonathan M. Samet
- Department of Environmental & Occupational HealthColorado School of Public HealthAuroraCOUSA
| | - Christian L’Orange
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - Jeffrey R. Pierce
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - John Volckens
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
- Department of Environmental and Radiological Health SciencesColorado State UniversityFort CollinsCOUSA
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22
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Ahn K. Intervention of Particulate Matter: What Can We Do for Asthmatic Patients? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:677-680. [PMID: 34486253 PMCID: PMC8419650 DOI: 10.4168/aair.2021.13.5.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Kangmo Ahn
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Leung ASY, Tham EH, Li J, Pacharn P, Takizawa T, Lee E, Xing Y, Leung TF, Hong SJ, Wong GWK. The role of the environment in shaping the trends of childhood asthma - An Asian perspective. Pediatr Allergy Immunol 2021; 32:1152-1164. [PMID: 33760296 DOI: 10.1111/pai.13508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 12/15/2022]
Abstract
Asthma has now become one of the most common atopic disorders not only in developed countries but also in many developing countries. The etiology is likely due to a complex interaction between genetic and environmental factors. In many Asian countries, the prevalence of asthma has also been documented by validated instruments to be increasing rapidly over the past two decades. However, studies in rural areas in Asia with a traditional farming environment revealed markedly lower asthma prevalence when compared with residents in nearby cities despite having similar genetic background. Among the environmental factors implicated in the pathogenesis of asthma, air pollution, dietary patterns, viral infections, and early microbial exposure have been studied extensively around the world. Asia provides many opportunities to study these potential factors as there are many ethnic groups living in distinctly different environments. The understanding of the roles of these factors in affecting the early immune system and subsequent development of asthma will enable us to develop potential primary preventive strategies against a disease which affects millions worldwide.
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Affiliation(s)
- Agnes S Y Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Punchama Pacharn
- Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Takumi Takizawa
- Department of Pediatrics, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Ting-Fan Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Soo-Jong Hong
- Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gary W K Wong
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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24
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Shendell DG. The Multiple Benefits of Removing Major Outdoor Air Pollution Point Sources. Am J Public Health 2021; 111:770-772. [PMID: 33826378 PMCID: PMC8034008 DOI: 10.2105/ajph.2021.306248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Derek G Shendell
- Derek G. Shendell is with Department of Environmental and Occupational Health and Justice and the NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ
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25
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Byrwa-Hill BM, Presto AA, Wenzel S, Fabisiak JP. Impact of a pollution breach at a coke oven factory on asthma control in nearby vulnerable adults. J Allergy Clin Immunol 2021; 148:225-233. [PMID: 33894208 DOI: 10.1016/j.jaci.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies have related sulfur dioxide (SO2) exposure to asthma exacerbations. We utilized the University of Pittsburgh Asthma Institute registry to study associations of asthma exacerbations between 2 geographically distinct populations of adults with asthma. OBJECTIVE Our objective was to examine whether asthma symptoms worsened following a significant fire event that destroyed pollution control equipment at the largest coke works in the United States. METHODS Two groups of patients with asthma, namely, those residing within 10 miles of the coke works fire (the proximal group [n = 39]) and those residing beyond that range (the control group [n = 44]), were geocoded by residential address. Concentrations of ambient air SO2 were generated by using local University of Pittsburgh Asthma Institute registry air monitoring data. Factory emissions were also evaluated. Data from a patient historical acute exposure survey and in-person follow-up data were evaluated. Inferential statistics were used to compare the groups. RESULTS In the immediate postfire period (6-8 weeks), the level of emissions of SO2 from the factory emissions increased to 25 times more than the typical level. Following the pollution control breach, the proximal cohort self-reported an increase in medication use (risk ratio = 1.76; 95% CI = 1.1-2.8; P < .01) and more exacerbations. In a small subset of the follow-up cohort of those who completed the acute exposure survey only, asthma control metrics improved. CONCLUSIONS Real-world exposure to a marked increase in ambient levels of SO2 from a pollution control breach was associated with worsened asthma control in patients proximal to the event, with the worsened control improving following repair of the controls. Improved spatial resolution of air pollutant measurements would enable better examination of exposures and subsequent health impacts.
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Affiliation(s)
- Brandy M Byrwa-Hill
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa
| | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pa
| | - Sally Wenzel
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa; University of Pittsburgh Asthma Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa.
| | - James P Fabisiak
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa.
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26
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Annesi-Maesano I, Forastiere F, Balmes J, Garcia E, Harkema J, Holgate S, Kelly F, Khreis H, Hoffmann B, Maesano CN, McConnell R, Peden D, Pinkerton K, Schikowski T, Thurston G, Van Winkle LS, Carlsten C. The clear and persistent impact of air pollution on chronic respiratory diseases: a call for interventions. Eur Respir J 2021; 57:57/3/2002981. [PMID: 33737377 DOI: 10.1183/13993003.02981-2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Dept, Institut Pierre Louis of Epidemiology and Public Health, Paris, France
| | | | - John Balmes
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA.,School of Public Health, University of California, Berkeley, CA, USA.,Dept of Medicine, School of Medicine, University of California, San Francisco, CA, USA
| | - Erika Garcia
- Dept of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jack Harkema
- Dept of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Stephen Holgate
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Frank Kelly
- Environmental Research Group, King's College, London, UK
| | - Haneen Khreis
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A&M Transportation Institute (TTI), College Station, TX, USA
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Cara Nichole Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Dept, Institut Pierre Louis of Epidemiology and Public Health, Paris, France
| | - Rob McConnell
- University of Southern California, Preventive Medicine, Los Angeles, CA, USA
| | - David Peden
- Center for Environmental Medicine, Asthma and Lung Biology and Division of Allergy, Immunology and Rheumatology, Dept of Pediatrics, the School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kent Pinkerton
- Center for Health and the Environment, John Muir Institute of the Environment, University of California, Davis, CA, USA
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - George Thurston
- New York University School of Medicine, Dept of Environmental Medicine, New York, NY, USA
| | - Laura S Van Winkle
- Dept of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Christopher Carlsten
- Air Pollution Exposure Laboratory, Dept of Medicine, Division of Respiratory Medicine, The University of British Columbia, Vancouver, BC, Canada
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Komisarow S, Pakhtigian EL. The Effect of Coal-Fired Power Plant Closures on Emergency Department Visits for Asthma-Related Conditions Among 0- to 4-Year-Old Children in Chicago, 2009-2017. Am J Public Health 2021; 111:881-889. [PMID: 33734848 PMCID: PMC8034013 DOI: 10.2105/ajph.2021.306155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To investigate the effects of coal-fired power plant closures on zip code-level rates of emergency department visits for asthma-related conditions among 0- to 4-year-old children in Chicago, Illinois.Methods. We used data on wind, population, PM2.5 (particulates measuring ≤ 2.5 µm in diameter), and zip code-level rates of emergency department visits for asthma-related conditions among 0- to 4-year-old children between 2009 and 2017 in Chicago. The difference-in-differences research design compared rates of emergency department visits in zip codes near 3 coal-fired power plants before and after their closures to rates in zip codes farther away during the same time period.Results. We found that emergency department visits for asthma-related conditions among 0- to 4-year-old children decreased by 12% in zip codes near the 3 coal-fired power plants following their closures relative to rates in zip codes farther away during the same period. The crude and age-specific rates of emergency department visits decreased by 2.41 visits per ten thousand inhabitants and 35.63 visits per ten thousand children aged 0 to 4 years, respectively.Conclusions. Our findings demonstrate that closing coal-fired power plants can lead to improvements in the respiratory health of young children.
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Affiliation(s)
- Sarah Komisarow
- Sarah Komisarow is with the Sanford School of Public Policy, Duke University, Durham, NC. Emily L. Pakhtigian is with the School of Public Policy, Pennsylvania State University, University Park
| | - Emily L Pakhtigian
- Sarah Komisarow is with the Sanford School of Public Policy, Duke University, Durham, NC. Emily L. Pakhtigian is with the School of Public Policy, Pennsylvania State University, University Park
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28
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Southerland VA, Anenberg SC, Harris M, Apte J, Hystad P, van Donkelaar A, Martin RV, Beyers M, Roy A. Assessing the Distribution of Air Pollution Health Risks within Cities: A Neighborhood-Scale Analysis Leveraging High-Resolution Data Sets in the Bay Area, California. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:37006. [PMID: 33787320 PMCID: PMC8011332 DOI: 10.1289/ehp7679] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/10/2021] [Accepted: 02/24/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Air pollution-attributable disease burdens reported at global, country, state, or county levels mask potential smaller-scale geographic heterogeneity driven by variation in pollution levels and disease rates. Capturing within-city variation in air pollution health impacts is now possible with high-resolution pollutant concentrations. OBJECTIVES We quantified neighborhood-level variation in air pollution health risks, comparing results from highly spatially resolved pollutant and disease rate data sets available for the Bay Area, California. METHODS We estimated mortality and morbidity attributable to nitrogen dioxide (NO2), black carbon (BC), and fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] using epidemiologically derived health impact functions. We compared geographic distributions of pollution-attributable risk estimates using concentrations from a) mobile monitoring of NO2 and BC; and b) models predicting annual NO2, BC and PM2.5 concentrations from land-use variables and satellite observations. We also compared results using county vs. census block group (CBG) disease rates. RESULTS Estimated pollution-attributable deaths per 100,000 people at the 100-m grid-cell level ranged across the Bay Area by a factor of 38, 4, and 5 for NO2 [mean=30 (95% CI: 9, 50)], BC [mean=2 (95% CI: 1, 2)], and PM2.5, [mean=49 (95% CI: 33, 64)]. Applying concentrations from mobile monitoring and land-use regression (LUR) models in Oakland neighborhoods yielded similar spatial patterns of estimated grid-cell-level NO2-attributable mortality rates. Mobile monitoring concentrations captured more heterogeneity [mobile monitoring mean=64 (95% CI: 19, 107) deaths per 100,000 people; LUR mean=101 (95% CI: 30, 167)]. Using CBG-level disease rates instead of county-level disease rates resulted in 15% larger attributable mortality rates for both NO2 and PM2.5, with more spatial heterogeneity at the grid-cell-level [NO2 CBG mean=41 deaths per 100,000 people (95% CI: 12, 68); NO2 county mean=38 (95% CI: 11, 64); PM2.5 CBG mean=59 (95% CI: 40, 77); and PM2.5 county mean=55 (95% CI: 37, 71)]. DISCUSSION Air pollutant-attributable health burdens varied substantially between neighborhoods, driven by spatial variation in pollutant concentrations and disease rates. https://doi.org/10.1289/EHP7679.
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Affiliation(s)
- Veronica A. Southerland
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Susan C. Anenberg
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Maria Harris
- Environmental Defense Fund, San Francisco, California, USA
| | - Joshua Apte
- Department of Civil & Environmental Engineering and School of Public Health, University of California, Berkeley, USA
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Energy, Environmental & Chemical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Randall V. Martin
- Energy, Environmental & Chemical Engineering, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Matt Beyers
- Alameda County Public Health Department, Oakland, California, USA
| | - Ananya Roy
- Environmental Defense Fund, San Francisco, California, USA
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29
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Li Z, Liang D, Ye D, Chang HH, Ziegler TR, Jones DP, Ebelt ST. Application of high-resolution metabolomics to identify biological pathways perturbed by traffic-related air pollution. ENVIRONMENTAL RESEARCH 2021; 193:110506. [PMID: 33245887 PMCID: PMC7855798 DOI: 10.1016/j.envres.2020.110506] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/09/2020] [Accepted: 11/17/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND Substantial research has investigated the adverse effects of traffic-related air pollutants (TRAP) on human health. Convincing associations between TRAP and respiratory and cardiovascular diseases are known, but the underlying biological mechanisms are not well established. High-resolution metabolomics (HRM) is a promising platform for untargeted characterization of molecular mechanisms between TRAP and health indexes. OBJECTIVES We examined metabolic perturbations associated with short-term exposures to TRAP, including carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), fine particulate matter (PM2.5), organic carbon (OC), and elemental carbon (EC) among 180 participants of the Center for Health Discovery and Well-Being (CHDWB), a cohort of Emory University-affiliated employees. METHODS A cross-sectional study was conducted on baseline visits of 180 CHDWB participants enrolled during 2008-2012, in whom HRM profiling was determined in plasma samples using liquid chromatography-high-resolution mass spectrometry with positive and negative electrospray ionization (ESI) modes. Ambient pollution concentrations were measured at an ambient monitor near downtown Atlanta. Metabolic perturbations associated with TRAP exposures were assessed following an untargeted metabolome-wide association study (MWAS) framework using feature-specific Tobit regression models, followed by enriched pathway analysis and chemical annotation. RESULTS Subjects were predominantly white (76.1%) and non-smokers (95.6%), and all had at least a high school education. In total, 7821 and 4123 metabolic features were extracted from the plasma samples by the negative and positive ESI runs, respectively. There are 3421 features significantly associated with at least one air pollutant by negative ion mode, and 1691 features by positive ion mode. Biological pathways enriched by features associated with the pollutants are primarily involved in nucleic acids damage/repair (e.g., pyrimidine metabolism), nutrient metabolism (e.g., fatty acid metabolism), and acute inflammation (e.g., histidine metabolism and tyrosine metabolism). NO2 and EC were associated most consistently with these pathways. We confirmed the chemical identity of 8 metabolic features in negative ESI and 2 features in positive ESI, including metabolites closely linked to oxidative stress and inflammation, such as histamine, tyrosine, tryptophan, and proline. CONCLUSIONS We identified a range of ambient pollutants, including components of TRAP, associated with differences in the metabolic phenotype among the cohort of 180 subjects. We found Tobit models to be a robust approach to handle missing data among the metabolic features. The results were encouraging of further use of HRM and MWAS approaches for characterizing molecular mechanisms underlying exposure to TRAP.
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Affiliation(s)
- Zhenjiang Li
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Dongni Ye
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Thomas R Ziegler
- Division of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, United States
| | - Stefanie T Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA.
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30
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Lee JT. Review of epidemiological studies on air pollution and health effects in children. Clin Exp Pediatr 2021; 64:3-11. [PMID: 32517422 PMCID: PMC7806407 DOI: 10.3345/cep.2019.00843] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/21/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022] Open
Abstract
There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children's health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.
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Affiliation(s)
- Jong-Tae Lee
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
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31
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Tiotiu AI, Novakova P, Nedeva D, Chong-Neto HJ, Novakova S, Steiropoulos P, Kowal K. Impact of Air Pollution on Asthma Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176212. [PMID: 32867076 PMCID: PMC7503605 DOI: 10.3390/ijerph17176212] [Citation(s) in RCA: 199] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022]
Abstract
Asthma is a chronic respiratory disease characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Evidence suggests that air pollution has a negative impact on asthma outcomes in both adult and pediatric populations. The aim of this review is to summarize the current knowledge on the effect of various outdoor and indoor pollutants on asthma outcomes, their burden on its management, as well as to highlight the measures that could result in improved asthma outcomes. Traffic-related air pollution, nitrogen dioxide and second-hand smoking (SHS) exposures represent significant risk factors for asthma development in children. Nevertheless, a causal relation between air pollution and development of adult asthma is not clearly established. Exposure to outdoor pollutants can induce asthma symptoms, exacerbations and decreases in lung function. Active tobacco smoking is associated with poorer asthma control, while exposure to SHS increases the risk of asthma exacerbations, respiratory symptoms and healthcare utilization. Other indoor pollutants such as heating sources and molds can also negatively impact the course of asthma. Global measures, that aim to reduce exposure to air pollutants, are highly needed in order to improve the outcomes and management of adult and pediatric asthma in addition to the existing guidelines.
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Affiliation(s)
- Angelica I. Tiotiu
- Department of Pulmonology, University Hospital of Nancy, 54395 Nancy, France
- Development of Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54395 Nancy, France
- Correspondence: ; Tel.: +33-383-154-299
| | - Plamena Novakova
- Clinic of Clinical Allergy, Medical University, 1000 Sofia, Bulgaria;
| | | | - Herberto Jose Chong-Neto
- Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba 80000-000, Brazil;
| | - Silviya Novakova
- Allergy Unit, Internal Consulting Department, University Hospital “St. George”, 4000 Plovdiv, Bulgaria;
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece;
| | - Krzysztof Kowal
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-037 Bialystok, Poland;
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Ambient Air Pollution and Variation in Multiple Domains of Asthma Morbidity among Peruvian Children. Ann Am Thorac Soc 2020; 16:348-355. [PMID: 30365919 DOI: 10.1513/annalsats.201807-448oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
RATIONALE A large portion of asthma morbidity occurs in low- and middle-income countries, and Peru suffers particularly high asthma prevalence. Ambient air exposures are also high, and likely play a role. Most studies of environmental exposures focus on understanding contributors to health care utilization or mortality risk; however, less severe outcomes may still impact quality of life (QOL). OBJECTIVES To study the association between multiple pollutants and several asthma domains in Peruvian children. METHODS A total of 484 children aged 9-19 years with asthma were followed for 6-9 months, and evaluated for asthma control, asthma-related QOL, missed school days, and health care utilization. We used geographically distributed monitors to estimate air pollutant concentrations and multivariable generalized linear mixed models to model asthma outcomes as a function of pollutants. RESULTS A total of 67% of children had moderate to severe persistent asthma. In multipollutant models, higher particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5), black carbon, and nitrogen dioxide concentrations were independently associated with worse asthma control. For each interquartile range increase in PM2.5 or nitrogen dioxide concentration, there was a 59% or 34% higher odds of uncontrolled asthma, respectively. If the proportion of PM2.5 that was black carbon increased, there were increased odds of uncontrolled asthma. Similarly, pollutants were independently associated with worse asthma-related QOL, and PM exposure was associated with increased risk of health care utilization. CONCLUSIONS Our study highlights the importance of pollutant exposures on multiple domains of asthma morbidity among Peruvian children, including not only acute exacerbations, but also on general asthma burden, such as worse asthma symptom control and QOL.
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Fabisiak JP, Jackson EM, Brink LL, Presto AA. A risk-based model to assess environmental justice and coronary heart disease burden from traffic-related air pollutants. Environ Health 2020; 19:34. [PMID: 32178683 PMCID: PMC7075037 DOI: 10.1186/s12940-020-00584-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/26/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Communities need to efficiently estimate the burden from specific pollutants and identify those most at risk to make timely informed policy decisions. We developed a risk-based model to estimate the burden of black carbon (BC) and nitrogen dioxide (NO2) on coronary heart disease (CHD) across environmental justice (EJ) and non-EJ populations in Allegheny County, PA. METHODS Exposure estimates in census tracts were modeled via land use regression and analyzed in relation to US Census data. Tracts were ranked into quartiles of exposure (Q1-Q4). A risk-based model for estimating the CHD burden attributed to BC and NO2 was developed using county health statistics, census tract level exposure estimates, and quantitative effect estimates available in the literature. RESULTS For both pollutants, the relative occurrence of EJ tracts (> 20% poverty and/or > 30% non-white minority) in Q2 - Q4 compared to Q1 progressively increased and reached a maximum in Q4. EJ tracts were 4 to 25 times more likely to be in the highest quartile of exposure compared to the lowest quartile for BC and NO2, respectively. Pollutant-specific risk values (mean [95% CI]) for CHD mortality were higher in EJ tracts (5.49 × 10- 5 [5.05 × 10- 5 - 5.92 × 10- 5]; 5.72 × 10- 5 [5.44 × 10- 5 - 6.01 × 10- 5] for BC and NO2, respectively) compared to non-EJ tracts (3.94 × 10- 5 [3.66 × 10- 5 - 4.23 × 10- 5]; 3.49 × 10- 5 [3.27 × 10- 5 - 3.70 × 10- 5] for BC and NO2, respectively). While EJ tracts represented 28% of the county population, they accounted for about 40% of the CHD mortality attributed to each pollutant. EJ tracts are disproportionately skewed toward areas of high exposure and EJ residents bear a greater risk for air pollution-related disease compared to other county residents. CONCLUSIONS We have combined a risk-based model with spatially resolved long-term exposure estimates to predict CHD burden from air pollution at the census tract level. It provides quantitative estimates of effects that can be used to assess possible health disparities, track temporal changes, and inform timely local community policy decisions. Such an approach can be further expanded to include other pollutants and adverse health endpoints.
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Affiliation(s)
- James P Fabisiak
- Center for Healthy Environments & Communities, Department of Environmental & Occupational Health, University of Pittsburgh Graduate School of Public Health, PUBHL-4132, 130 DeSoto Street Pittsburgh, Pittsburgh, PA, 15261, USA.
| | - Erica M Jackson
- Center for Healthy Environments & Communities, Department of Environmental & Occupational Health, University of Pittsburgh Graduate School of Public Health, PUBHL-4132, 130 DeSoto Street Pittsburgh, Pittsburgh, PA, 15261, USA
| | - LuAnn L Brink
- Allegheny County Health Department, Pittsburgh, PA, USA
| | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
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Chan SL, Ho AFW, Ding H, Liu N, Earnest A, Koh MS, Chuah JST, Lau ZY, Tan KB, Zheng H, Morgan GG, Ong MEH. Impact of Air Pollution and Trans-Boundary Haze on Nation-Wide Emergency
Department Visits and Hospital Admissions in Singapore. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2019209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction: Air pollution is associated with adverse health outcomes. However,
its impact on emergency health services is less well understood. We investigated the
impact of air pollution on nation-wide emergency department (ED) visits and hospital
admissions to public hospitals in Singapore. Materials and Methods: Anonymised
administrative and clinical data of all ED visits to public hospitals in Singapore from
January 2010 to December 2015 were retrieved and analysed. Primary and secondary
outcomes were defined as ED visits and hospital admissions, respectively. Conditional
Poisson regression was used to model the effect of Pollutant Standards Index (PSI)
on each outcome. Both outcomes were stratified according to subgroups defined a
priori based on age, diagnosis, gender, patient acuity and time of day. Results: There
were 5,791,945 ED visits, of which 1,552,187 resulted in hospital admissions. No
significant association between PSI and total ED visits (Relative risk [RR], 1.002; 99.2%
confidence interval [CI], 0.995–1.008; P = 0.509) or hospital admissions (RR, 1.005;
99.2% CI, 0.996–1.014; P = 0.112) was found. However, for every 30-unit increase in
PSI, significant increases in ED visits (RR, 1.023; 99.2% CI, 1.011–1.036; P = 1.24 ×
10˗6) and hospital admissions (RR, 1.027; 99.2% CI, 1.010–1.043; P = 2.02 × 10˗5) for
respiratory conditions were found. Conclusion: Increased PSI was not associated with
increase in total ED visits and hospital admissions, but was associated with increased
ED visits and hospital admissions for respiratory conditions in Singapore.
Key words: Epidemiology, Healthcare utilisation, PSI, Public health, Time series
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Affiliation(s)
| | - Andrew FW Ho
- NUS Medical School, Singapore.Singapore General Hospital, Singapore
| | | | - Nan Liu
- Singapore Health Services, Singapore. NUS Medical School, Singapore
| | - Arul Earnest
- Monash University School of Public Health and Preventive Medicine, Australia
| | - Mariko S Koh
- Singapore General Hospital, Singapore. NUS Medical School, Singapore
| | | | | | - Kelvin Bryan Tan
- Ministry of Health, Singapore. National University of Singapore, Singapor
| | | | | | - Marcus EH Ong
- Singapore Health Services, Singapore. NUS Medical School, Singapore. Singapore General Hospital, Singapore
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Weisenberg H, Zhao T, Heinrich J. Combinations of Epidemiological and Experimental Studies in Air Pollution Research: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020385. [PMID: 31936042 PMCID: PMC7014177 DOI: 10.3390/ijerph17020385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/03/2020] [Accepted: 01/04/2020] [Indexed: 02/06/2023]
Abstract
Scientific literature is evolving to include more systematic reviews that encompass epidemiological and experimental papers so that the whole picture can be examined. The aim of this narrative review is to bridge that gap by combining epidemiological and experimental studies based on the same setting: Examples of Bitterfeld, Utah Valley, Beijing Olympic Games, and Viadana. This review looks at four examples that incorporate multiple epidemiological and experimental papers about air pollution exposure and health effects. The Bitterfeld (spatial) and Utah Valley (temporal) examples showed that particle composition causes the biggest difference in lung injury. In Beijing, a temporal difference of before/after and during the Olympics showed that traffic and industry air pollution-related health effects like lung cancer and cardiovascular disease could be reduced by improvement of air quality. The Viadana example showed a spatial difference in respiratory injury caused by particle composition and interactions with genotoxicity. Combining experimental and epidemiological methods gives a more in-depth look into the whole picture of exposure and health effects. Our review exemplifies the strength of this strategy and encourages further use of it.
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Affiliation(s)
- Hannah Weisenberg
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, 80336 Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, 80336 Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, 85764 Neuherberg, Germany
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
- Correspondence: ; Tel.: +49-89-440053251
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Review of the effect of air pollution exposure from industrial point sources on asthma-related effects in childhood. Environ Epidemiol 2019; 3:e077. [PMID: 33778345 PMCID: PMC7939412 DOI: 10.1097/ee9.0000000000000077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/10/2019] [Indexed: 01/01/2023] Open
Abstract
We reviewed epidemiologic studies of the association between exposure to air pollution from industries and asthma-related outcomes in childhood. We searched bibliographic databases and reference lists of relevant articles to identify studies examining the association between children's exposure to air pollution from industrial point-sources and asthma-related outcomes, including asthma, asthma-like symptoms, wheezing, and bronchiolitis. We extracted key characteristics of each study and when appropriate we performed a random-effects meta-analysis of results and quantified heterogeneity (I 2). Thirty-six studies were included in this review. Meta-analysis was generally not possible and limited to a few studies because of substantial variation across design characteristics and methodologies. In case-crossover studies using administrative health data, pooled odds ratio (OR) of hospitalization for asthma and bronchiolitis in children <5 years were 1.02 [95% confidence intervals (CI): 0.96, 1.08; I 2 = 56%] and 1.01 (95% CI: 0.97, 1.05; I 2 = 64%) per 10 ppb increase in the daily mean and hourly maximum concentration of sulfur dioxide (SO2), respectively. For PM2.5, pooled ORs were 1.02 (95% CI: 0.93, 1.10; I 2 = 56%) and 1.01 (95% CI: 0.98, 1.03 I 2 = 33%) per 10 μg/m3 increment in the daily mean and hourly maximum concentration. In cross-sectional studies using questionnaires, pooled ORs for the prevalence of asthma and wheezing in relation to residential proximity to industry were 1.98 (95% CI: 0.87, 3.09; I 2 =71%) and 1.33 (95% CI: 0.86, 1.79; I 2= 65%), respectively. In conclusion, this review showed substantial heterogeneity across study designs and methods. Meta-analysis results suggested no evidence of an association for short-term asthma-related effects and an indication for long-term effects, but heterogeneity between results and limitations in terms of design and exposure assessment preclude drawing definite conclusions. Further well-conducted studies making use of a longitudinal design and of refined exposure assessment methods are needed to improve risk estimates.
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Borchers Arriagada N, Horsley JA, Palmer AJ, Morgan GG, Tham R, Johnston FH. Association between fire smoke fine particulate matter and asthma-related outcomes: Systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2019; 179:108777. [PMID: 31593836 DOI: 10.1016/j.envres.2019.108777] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Asthma-related outcomes are regularly used by studies to investigate the association between human exposure to landscape fire smoke and health. Robust summary effect estimates are required to inform health protection policy for fire smoke exposure. OBJECTIVE To conduct a systematic review and meta-analysis to estimate the association between short-term exposure to landscape fire smoke (LFS) fine particulate matter (PM2.5) and asthma-related outcomes. METHODS We conducted a systematic review and meta-analysis following PRISMA guidelines. Four databases (PubMed, Medline, EMBASE and Scopus) and reference lists of recent fire smoke and health reviews were searched. The Newcastle-Ottawa Scale was used to evaluate the quality of case-crossover studies, and a previously validated quality assessment framework was used for observational studies lacking control groups. Publication bias was assessed using funnel plots and Egger's Test. The trim and fill method was used when there was evidence of publication bias. Sensitivity and influence analyses were conducted on all endpoints to test the robustness of estimates. Summary estimates were obtained for hospitalisations and emergency department (ED) visits. A descriptive analysis was conducted for physician visits, medication use, and salbutamol dispensations. RESULTS From an initial 181 articles (after duplicate removal), 20 studies were included for quantitative assessment and descriptive synthesis. LFS PM2.5 levels were positively associated with asthma hospitalisations (RR = 1.06, 95% CI: 1.02-1.09) and emergency department visits (RR = 1.07, 95% CI: 1.04-1.09). Subgroup analyses found that females were more susceptible than males for ED visits, and that there was an increasing association by age groups for hospital admissions and ED visits. High heterogeneity between studies was observed, but results were robust to sensitivity analysis. CONCLUSIONS Females and all adults aged over 65 years appear to be the population groups most sensitive to asthma-related outcomes when exposed to LFS PM2.5. Overall, results were higher than those obtained for a typical PM2.5 mixture.
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Affiliation(s)
- Nicolas Borchers Arriagada
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia; New South Wales Bushfire Risk Management Research Hub, University of Tasmania, Tasmania, Australia.
| | - Joshua A Horsley
- Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia; Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Geoffrey G Morgan
- Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
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Song DJ, Choi SH, Song WJ, Park KH, Jee YK, Cho SH, Lim DH. The Effects of Short-Term and Very Short-Term Particulate Matter Exposure on Asthma-Related Hospital Visits: National Health Insurance Data. Yonsei Med J 2019; 60:952-959. [PMID: 31538430 PMCID: PMC6753342 DOI: 10.3349/ymj.2019.60.10.952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effects of short-term and very short-term exposure to particulate matter (PM) exceeding the daily average environmental standards for Korea (≤100 μg/m³ for PM10 and ≤50 μg/m³ for PM2.5) on on asthma-related hospital visits. MATERIALS AND METHODS This was a population-based, case-crossover study using National Health Insurance and air pollution data between January 1, 2014 and December 31, 2016. The event day was defined as a day when PM exceeded the daily average environmental standard (short-term exposure) or daily average environmental standard for 2 hours (very short-term exposure). The control day was defined as the same day of the week at 1 week prior to the event day. RESULTS Compared with control days, asthma-related hospital visits on the 24-hr event days and 2-hr event days increased by 4.10% and 3.45% for PM₁₀ and 5.66% and 3.74% for PM2.5, respectively. Asthma-related hospital visits increased from the 24-hr event day for PM₁₀ to 4 days after the event day, peaking on the third day after the event day (1.26, 95% confidence interval, 1.22-1.30). Hospitalizations also increased on the third day after the event. While there was a difference in magnitude, PM2.5 exposure showed similar trends to PM₁₀ exposure. CONCLUSION We found a significant association between short-term and very short-term PM exposure exceeding the current daily average environmental standards of Korea and asthma-related hospital visits. These results are expected to aid in establishing appropriate environmental standards and relevant policies for PM.
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Affiliation(s)
- Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center for Asthma, Korea University Anam Hospital, Seoul, Korea
| | - Sun Hee Choi
- Department of Pediatrics, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Woo Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Hee Park
- Department of Internal Medicine, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Young Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Sang Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Medical Research Center, Seoul National University, Seoul, Korea.
| | - Dae Hyun Lim
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
- Environmental Health Center for Allergic Diseases, Inha University Hospital, Incheon, Korea.
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Chau-Etchepare F, Hoerger JL, Kuhn BT, Zeki AA, Haczku A, Louie S, Kenyon NJ, Davis CE, Schivo M. Viruses and non-allergen environmental triggers in asthma. J Investig Med 2019; 67:1029-1041. [PMID: 31352362 PMCID: PMC7428149 DOI: 10.1136/jim-2019-001000] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2019] [Indexed: 12/23/2022]
Abstract
Asthma is a complex inflammatory disease with many triggers. The best understood asthma inflammatory pathways involve signals characterized by peripheral eosinophilia and elevated immunoglobulin E levels (called T2-high or allergic asthma), though other asthma phenotypes exist (eg, T2-low or non-allergic asthma, eosinophilic or neutrophilic-predominant). Common triggers that lead to poor asthma control and exacerbations include respiratory viruses, aeroallergens, house dust, molds, and other organic and inorganic substances. Increasingly recognized non-allergen triggers include tobacco smoke, small particulate matter (eg, PM2.5), and volatile organic compounds. The interaction between respiratory viruses and non-allergen asthma triggers is not well understood, though it is likely a connection exists which may lead to asthma development and/or exacerbations. In this paper we describe common respiratory viruses and non-allergen triggers associated with asthma. In addition, we aim to show the possible interactions, and potential synergy, between viruses and non-allergen triggers. Finally, we introduce a new clinical approach that collects exhaled breath condensates to identify metabolomics associated with viruses and non-allergen triggers that may promote the early management of asthma symptoms.
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Affiliation(s)
- Florence Chau-Etchepare
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
| | - Joshua L Hoerger
- Internal Medicine, University of California Davis, Sacramento, California, USA
| | - Brooks T Kuhn
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
| | - Amir A Zeki
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
- Center for Comparative Respiratory Biology and Medicine, University of California Davis, Davis, California, USA
| | - Angela Haczku
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
- Center for Comparative Respiratory Biology and Medicine, University of California Davis, Davis, California, USA
| | - Samuel Louie
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
| | - Nicholas J Kenyon
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
- Center for Comparative Respiratory Biology and Medicine, University of California Davis, Davis, California, USA
| | - Cristina E Davis
- Mechanical and Aerospace Engineering, University of California Davis, Davis, California, USA
| | - Michael Schivo
- Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA
- Center for Comparative Respiratory Biology and Medicine, University of California Davis, Davis, California, USA
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Cheng CY, Cheng SY, Chen CC, Pan HY, Wu KH, Cheng FJ. Ambient air pollution is associated with pediatric pneumonia: a time-stratified case-crossover study in an urban area. Environ Health 2019; 18:77. [PMID: 31462279 PMCID: PMC6714311 DOI: 10.1186/s12940-019-0520-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 08/22/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Pneumonia, the leading reason underlying childhood deaths, may be triggered or exacerbated by air pollution. To date, only a few studies have examined the association of air pollution with emergency department (ED) visits for pediatric pneumonia, with inconsistent results. Therefore, we aimed to elucidate the impact of short-term exposure to particulate matter (PM) and other air pollutants on the incidence of ED visits for pediatric pneumonia. METHODS PM2.5, PM10, and other air pollutant levels were measured at 11 air quality-monitoring stations in Kaohsiung City, Taiwan, between 2008 and 2014. Further, we extracted the medical records of non-trauma patients aged ≤17 years and who had visited an ED with the principal diagnosis of pneumonia. A time-stratified case-crossover study design was employed to determine the hazard effect of air pollution in a total of 4024 patients. RESULTS The single-pollutant model suggested that per interquartile range increment in PM2.5, PM10, nitrogen dioxide (NO2), and sulfur dioxide (SO2) on 3 days before the event increased the odds of pediatric pneumonia by 14.0% [95% confidence interval (CI), 5.1-23.8%], 10.9% (95% CI, 2.4-20.0%), 14.1% (95% CI, 5.0-24.1%), and 4.5% (95% CI, 0.8-8.4%), respectively. In two-pollutant models, PM2.5 and NO2 were significant after adjusting for PM10 and SO2. Subgroup analyses showed that older children (aged ≥4 years) were more susceptible to PM2.5 (interaction p = 0.024) and children were more susceptible to NO2 during warm days (≥26.5 °C, interaction p = 0.011). CONCLUSIONS Short-term exposure to PM2.5 and NO2 possibly plays an important role in pediatric pneumonia in Kaohsiung, Taiwan. Older children are more susceptible to PM2.5, and all children are more susceptible to NO2 during warm days.
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Affiliation(s)
- Chi-Yung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Shih-Yu Cheng
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
- Department of Emergency Medicine, Yunlin Chang Gung Memorial Hospital, No. 1500, Gongye Rd, Mailiao Township, Yunlin County, 638, Taiwan
| | - Chien-Chih Chen
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Kuan-Han Wu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong Township, Kaohsiung, County, 833, Taiwan.
- Chang Gung University College of Medicine, No.259, Wenhua 1st Road, Guishan District, Taoyuan City, 333, Taiwan.
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Air Pollution, Asthma, and Sleep Apnea: New Epidemiological Links? Ann Am Thorac Soc 2019; 16:307-308. [PMID: 31339334 DOI: 10.1513/annalsats.201812-924ed] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Fuller CH, Roblin D, Jones J. Using Syndromic Surveillance to Evaluate the Respiratory Effects of Fine Particulate Matter. Ann Am Thorac Soc 2019; 16:930-933. [PMID: 30840829 PMCID: PMC6600839 DOI: 10.1513/annalsats.201902-118rl] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Douglas Roblin
- Kaiser Permanente Mid-Atlantic StatesRockville, Maryland
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Lee WS, Kim WS, Lim YH, Hong YC. High Temperatures and Kidney Disease Morbidity: A Systematic Review and Meta-analysis. J Prev Med Public Health 2018; 52:1-13. [PMID: 30742756 PMCID: PMC6378387 DOI: 10.3961/jpmph.18.149] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/01/2018] [Indexed: 01/17/2023] Open
Abstract
Objectives In recent years, serious concerns have been raised regarding the impacts of rising temperatures on health. The present study was conducted to investigate the relationship between elevated temperatures and kidney disease through a systematic review and meta-analysis. Methods In October 2017, 2 researchers independently searched related studies in PubMed and Embase. A meta-analysis was conducted using a random-effects model, including only studies that presented odds ratios, relative risks, or percentage changes, along with 95% confidence intervals (CIs). The characteristics of each study were summarized, and the Egger test and funnel plots were used to evaluate publication bias. Results Eleven studies that met the criteria were included in the final analysis. The pooled results suggest an increase of 30% (95% CI, 20 to 40) in kidney disease morbidity with high temperatures. In a disease-specific subgroup analysis, statistically significant results were observed for both renal colic or kidney stones and other renal diseases. In a study design–specific subgroup analysis, statistically significant results were observed in both time-series analyses and studies with other designs. In a temperature measure–specific subgroup analysis, significant results were likewise found for both studies using mean temperature measurements and studies measuring heat waves or heat stress. Conclusions Our results indicate that morbidity due to kidney disease increases at high temperatures. We also found significant results in subgroup analyses. However, further time-series analyses are needed to obtain more generalizable evidence.
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Affiliation(s)
- Woo-Seok Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Woo-Sung Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea.,Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea.,Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
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Cho YM, Kim CB, Yeon KN, Lee ES, Kim K. Trends in the Prevalence of Childhood Asthma in Seoul Metropolitan City, Korea: The Seoul Atopy ∙ Asthma-friendly School Project. J Prev Med Public Health 2018; 51:275-280. [PMID: 30514057 PMCID: PMC6283737 DOI: 10.3961/jpmph.18.090] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/08/2018] [Indexed: 01/22/2023] Open
Abstract
Objectives The project Seoul Atopy ∙ Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors. Methods The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter (PM10) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed. Results The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the PM10 concentration. Conclusions This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.
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Affiliation(s)
- Yong Min Cho
- Institute for Life and Environment, SMARTIVE Co., Seoul, Korea
| | - Chea-Bong Kim
- Environmental Health Center for Asthma, Korea University Medical Center, Seoul, Korea
| | - Kyung Nam Yeon
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Korea
| | - Eun Sun Lee
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Korea
| | - KyooSang Kim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Korea
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Anenberg SC, Henze DK, Tinney V, Kinney PL, Raich W, Fann N, Malley CS, Roman H, Lamsal L, Duncan B, Martin RV, van Donkelaar A, Brauer M, Doherty R, Jonson JE, Davila Y, Sudo K, Kuylenstierna JCI. Estimates of the Global Burden of Ambient [Formula: see text], Ozone, and [Formula: see text] on Asthma Incidence and Emergency Room Visits. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:107004. [PMID: 30392403 PMCID: PMC6371661 DOI: 10.1289/ehp3766] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/26/2018] [Accepted: 09/24/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND Asthma is the most prevalent chronic respiratory disease worldwide, affecting 358 million people in 2015. Ambient air pollution exacerbates asthma among populations around the world and may also contribute to new-onset asthma. OBJECTIVES We aimed to estimate the number of asthma emergency room visits and new onset asthma cases globally attributable to fine particulate matter ([Formula: see text]), ozone, and nitrogen dioxide ([Formula: see text]) concentrations. METHODS We used epidemiological health impact functions combined with data describing population, baseline asthma incidence and prevalence, and pollutant concentrations. We constructed a new dataset of national and regional emergency room visit rates among people with asthma using published survey data. RESULTS We estimated that 9–23 million and 5–10 million annual asthma emergency room visits globally in 2015 could be attributable to ozone and [Formula: see text], respectively, representing 8–20% and 4–9% of the annual number of global visits, respectively. The range reflects the application of central risk estimates from different epidemiological meta-analyses. Anthropogenic emissions were responsible for [Formula: see text] and 73% of ozone and [Formula: see text] impacts, respectively. Remaining impacts were attributable to naturally occurring ozone precursor emissions (e.g., from vegetation, lightning) and [Formula: see text] (e.g., dust, sea salt), though several of these sources are also influenced by humans. The largest impacts were estimated in China and India. CONCLUSIONS These findings estimate the magnitude of the global asthma burden that could be avoided by reducing ambient air pollution. We also identified key uncertainties and data limitations to be addressed to enable refined estimation. https://doi.org/10.1289/EHP3766.
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Affiliation(s)
- Susan C Anenberg
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Daven K Henze
- University of Colorado Boulder, Boulder, Colorado, USA
| | - Veronica Tinney
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Patrick L Kinney
- School of Public Health, Boston University, Boston, Massachusetts, USA
| | - William Raich
- Industrial Economics, Inc., Cambridge, Massachusetts, USA
| | - Neal Fann
- Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | | | - Henry Roman
- Industrial Economics, Inc., Cambridge, Massachusetts, USA
| | - Lok Lamsal
- NASA Goddard Space Flight Center, Greenbelt, Maryland, USA
| | - Bryan Duncan
- NASA Goddard Space Flight Center, Greenbelt, Maryland, USA
| | - Randall V Martin
- Dalhousie University, Halifax, Nova Scotia, Canada
- Smithsonian Astrophysical Observatory, Cambridge, Massachusetts, USA
| | | | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | | | - Yanko Davila
- University of Colorado Boulder, Boulder, Colorado, USA
| | - Kengo Sudo
- Graduate School of Environmental Studies, Nagoya University, Nagoya, Japan
- Japan Agency for Marine-Earth Science and Technology (JAMSTEC), Yokohama, Japan
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Ferrazzi E, Romualdi C, Ocello M, Frighetto G, Turco M, Vigolo S, Fabris F, Angeli P, Vettore G, Costa R, Montagnese S. Changes in Accident & Emergency Visits and Return Visits in Relation to the Enforcement of Daylight Saving Time and Photoperiod. J Biol Rhythms 2018; 33:555-564. [PMID: 30056770 DOI: 10.1177/0748730418791097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Daylight saving time (DST) is a source of circadian disruption impinging on millions of people every year. Our aim was to assess modifications, if any, in the number, type, and outcome of Accident & Emergency (A&E) visits/return visits over the DST months. The study included 366,527 visits and 84,380 return visits to the A&E of Padova hospital (Northern Italy) over 3 periods between the years 2007 and 2016: period 1 (2 weeks prior to DST to 19 weeks after), period 2 (2 weeks prior to the return to "winter time" to 4 weeks after), and period 3 (5 consecutive non-DST weeks). For each A&E visit/return visit, information was obtained on triage severity code, main medical complaint, and outcome. Data were aggregated by day, cumulated over the years, and analyzed by generalized Poisson models. Generalized additive models for Poisson data were then used to include photoperiod as an additional covariate. An increase in A&E visits and return visits (mostly white codes, resulting in discharges) was observed a few weeks after the enforcement of DST and was significant over most weeks of period 1 (increase of ≈30 [2.8%] visits and ≈25 [10%] return visits per week per year). After the return to winter time, a decrease in absolute number of return visits was observed (mostly white codes, resulting in discharges), which was significant at weeks 3 and 4 of period 2 (decrease of ≅25 [10%] return visits per week per year). When photoperiod was taken into account, changes in A&E visits (and related white codes/discharges) were no longer significant, while changes in return visits (and related white codes/discharges) were still significant. In conclusion, changes in A&E visits/return visits were observed in relation to both DST and photoperiod, which are worthy of further study and could lead to modifications in A&E organization/staffing.
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Affiliation(s)
- Elena Ferrazzi
- 1. Emergency Department, Mestre Dell'Angelo Hospital, ULSS3 Serenissima, Mestre, Italy.,Department of Medicine, University of Padova, Padova, Italy.,Emergency Department, Padova University Hospital, Padova, Italy
| | | | - Michele Ocello
- Department of Medicine, University of Padova, Padova, Italy
| | - Giovanni Frighetto
- 2. Department of General Psychology, University of Padova, Padova, Italy.,Department of Medicine, University of Padova, Padova, Italy
| | - Matteo Turco
- Department of Medicine, University of Padova, Padova, Italy
| | - Stefania Vigolo
- Department of Medicine, University of Padova, Padova, Italy.,Emergency Department, Padova University Hospital, Padova, Italy
| | | | - Paolo Angeli
- Department of Medicine, University of Padova, Padova, Italy
| | - Gianna Vettore
- Emergency Department, Padova University Hospital, Padova, Italy
| | - Rodolfo Costa
- Department of Medicine, University of Padova, Padova, Italy
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The association of ambient PM 2.5 with school absence and symptoms in schoolchildren: a panel study. Pediatr Res 2018; 84:28-33. [PMID: 29795198 PMCID: PMC6581566 DOI: 10.1038/s41390-018-0004-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/01/2018] [Accepted: 03/10/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Children are a susceptible population to exposure of ambient fine particulate air pollution (PM2.5), and the associated symptoms are sensitive prevalent indicators of morbidity. However, few studies to date investigate the association between PM2.5 exposure and school absence and symptoms. METHODS In a panel study including 20,291 observations in 615 schoolchildren 8-13 years of age, we asked the participants to record their school absence and symptoms on every school day from 17 November to 31 December 2014 in Jinan, China. We used the generalized linear mixed effects models to examine the adverse effects of ambient PM2.5 on school absence and symptoms, adjusting for covariates including meteorological and individual factors. RESULTS The 3-day moving average of PM2.5 was significantly associated with school absence (1.37; 95% CI: 1.07-1.74) and increases in symptoms of the throat (1.03; 95% CI: 1.00-1.05), nose (1.03; 95% CI: 1.01-1.06), and skin (1.09; 95% CI: 1.06-1.12). High PM2.5 exposure also increased the risks of individual symptoms, especially for cough (1.02; 95% CI: 1.00-1.04), sneezing (1.03; 95% CI: 1.00-1.07), and stuffy nose (1.09; 95% CI: 1.02-1.17). CONCLUSION High PM2.5 exposure is a risk factor for the health of schoolchildren. Allocation of medical resources for children should take into account the ambient PM2.5 concentrations and be proportioned accordingly.
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A Review of Airborne Particulate Matter Effects on Young Children’s Respiratory Symptoms and Diseases. ATMOSPHERE 2018. [DOI: 10.3390/atmos9040150] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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49
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Bai L, Su X, Zhao D, Zhang Y, Cheng Q, Zhang H, Wang S, Xie M, Su H. Exposure to traffic-related air pollution and acute bronchitis in children: season and age as modifiers. J Epidemiol Community Health 2018; 72:426-433. [DOI: 10.1136/jech-2017-209948] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/28/2017] [Accepted: 01/17/2018] [Indexed: 12/22/2022]
Abstract
BackgroundAcute bronchitis (AB) is one of the principal causes of childhood morbidity. Increasing number of studies has shown that air pollution is an important environmental contributor of respiratory disease. However, evidence so far is scarce regarding the effects of air pollution on childhood AB, and it also remains unclear how the risk of AB will change by season and age.MethodsData on hospital visits for AB in children, air pollution and meteorological factors from 1 January 2015 to 31 December 2016 were collected in Hefei, China. Time-series analysis was applied to assess the short-term effects of traffic-related air pollution on childhood AB outpatient visits. A Poisson generalised linear regression model combined with a distributed lag non-linear model was used to estimate the relationships, controlling for long-term trends, seasonal patterns, meteorological factors and other possible confounders.ResultsWe found that an IQR increase in concentrations of nitrogen dioxide, particulate matter <2.5 µm and carbon monoxide significantly increased the daily hospital visits for childhood AB with 4-day cumulative effect estimates (relative risks: 1.03, 95% CI 1.01 to 1.05; 1.09, 95% CI 1.07 to 1.11; 1.07, 95% CI 1.05 to 1.09). Notably, the risk estimates during the cold season are pronounced; however, no significant association was observed during the warm season. Interestingly, children aged 6–14 years were more vulnerable to air pollutants than children aged less than 1 year and within 1–5 years. However, no gender difference was observed.ConclusionA significant association of traffic-related air pollution and increased department visits for childhood AB was observed, notably in school-age children and during the cold season.
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Impact of respiratory infections, outdoor pollen, and socioeconomic status on associations between air pollutants and pediatric asthma hospital admissions. PLoS One 2017; 12:e0180522. [PMID: 28719626 PMCID: PMC5515410 DOI: 10.1371/journal.pone.0180522] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/17/2017] [Indexed: 01/21/2023] Open
Abstract
Background Epidemiology studies have shown that ambient concentrations of ozone and fine particulate matter (PM2.5) are associated with increased emergency department (ED) visits and hospital admissions (HAs) for asthma. Objective Evaluate the impact of outdoor pollen, respiratory infections, and socioeconomic status (SES) on the associations between ambient ozone and PM2.5 and asthma HAs in New York City. Methods Daily ozone, PM2.5, meteorological factors, pollen, and hospitalization records during 1999 to 2009 were obtained for New York City residents. Daily counts of HAs for asthma and respiratory infections were calculated for all-age and specific age groups, and for high- and low-SES communities. Generalized additive models were used to examine ambient concentrations of ozone and PM2.5 and asthma HAs, potential confounding effects of outdoor pollen and HAs for respiratory infections, and potential effect modification by neighborhood SES. Results Both ozone and PM2.5 were statistically significantly associated with increased asthma HAs in children aged 6–18 years (per 10 ppb increase in ozone: RR = 1.0203, 95% CI: 1.0028–1.0382; per 10 μg/m3 increase in PM2.5: RR = 1.0218, 95% CI: 1.0007–1.0434), but not with total asthma HAs, or asthma HAs in other age groups. These associations were stronger for children living in the high-SES areas. Adjustment for respiratory infection HAs at various lags did not result in changes greater than 10% in the risk estimates for either ozone or PM2.5. In contrast, adjustment for outdoor pollen generally attenuated the estimated RRs for both ozone and PM2.5. Conclusions Ambient ozone and PM2.5 are associated with asthma HAs in school-age children, and these associations are not modified by SES. HAs for respiratory infections do not appear to be a confounder for observed ozone- and PM2.5-asthma HAs associations, but pollen may be a weak confounder.
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