Mechanisms of Heightened Airway Sensitivity and Responses to Inhaled SO2 in Asthmatics

Environmental health risk assessment and acute effects of sulfur dioxide (SO2) inhalation exposure on traditional sulfur miners at Ijen Crater Volcano, Indonesia

The Ijen Crater volcano is one of the geological wonders recognized by UNESCO. Inside it is a blue lake with a high acidity level, and a blue fire phenomenon has formed due to the very high concentration of sulfur. This crater is also one of Indonesia's largest sources of sulfur and is used by locals as a traditional sulfur mine. This study aims to measure SO2 concentrations and assess the health risks of SO2 exposure in traditional sulfur mine workers. The SO2 measurements were taken using impingers at six sample points along the mine workers' path. In addition, anthropometric data, work activity patterns, and health complaints during work were collected through direct interviews with 30 respondents selected based on inclusion criteria. Short-Term Health Impact Method was carried out based on a comparison of threshold level values and acute effects obtained from interviews regarding health complaints. The Hazard Question Index (HQ Index) of SO2 exposure was calculated using the health risk assessment method. The SO2 concentrations between 3.14 and 18.24 mg/m3. All sample points were above the quality standard threshold set by the EPA of 1.97 mg/m3. The most common health complaints workers experienced were eye irritation and coughing while working, followed by headache, shortness of breath, and skin irritation. The HQ index of SO2 exposure in workers was 1.02 for real-time exposure and 2.15 for long-term exposure. An HQ index ≥ 1 indicates a potential health risk for workers. Therefore, it is important to control workers' SO2 exposure.

Achieving Sub-ppm Sensitivity in SO2 Detection with a Chemically Stable Covalent Organic Framework

We report the inaugural experimental investigation of covalent organic frameworks (COFs) to address the formidable challenge of SO2 detection. Specifically, an imine-functionalized COF (SonoCOF-9) demonstrated a modest and reversible SO2 sorption of 3.5 mmol g-1 at 1 bar and 298 K. At 0.1 bar (and 298 K), the total SO2 uptake reached 0.91 mmol g-1 with excellent reversibility for at least 50 adsorption-desorption cycles. An isosteric enthalpy of adsorption (ΔHads) for SO2 equaled -42.3 kJ mol-1, indicating a relatively strong interaction of SO2 molecules with the COF material. Also, molecular dynamics simulations and Møller-Plesset perturbation theory calculations showed the interaction of SO2 with π density of the rings and lone pairs of the N atoms of SonoCOF-9. The combination of experimental data and theoretical calculations corroborated the potential use of this COF for the selective detection and sensing of SO2 at the sub-ppm level (0.0064 ppm of SO2).

Release of ATP in the lung evoked by inhalation of irritant gases in rats

Adenosine triphosphate (ATP) can be released into the extracellular milieu from various types of cells in response to a wide range of physical or chemical stresses. In the respiratory tract, extracellular ATP is recognized as an important signal molecule and trigger of airway inflammation. Chlorine (Cl2), sulfur dioxide (SO2), and ammonia (NH3) are potent irritant gases and common industrial air pollutants due to their widespread uses as chemical agents. This study was carried out to determine if acute inhalation challenges of these irritant gases, at the concentration and duration simulating the accidental exposures to these chemical gases in industrial operations, triggered the release of ATP in the rat respiratory tract; and if so, whether the level of ATP in bronchoalveolar lavage fluid (BALF) evoked by inhalation challenge of a given irritant gas was elevated by chronic allergic airway inflammation. Our results showed: 1) inhalation of these irritant gases caused significant increases in the ATP level in BALF, and the magnitude of evoked ATP release was in the order of Cl2 > SO2 > NH3. 2) Chronic airway inflammation induced by ovalbumin-sensitization markedly elevated the ATP level in BALF during baseline (breathing room air) but did not potentiate the release of ATP in the lung triggered by inhalation challenges of these irritant gases. These findings suggested a possible involvement of the ATP release in the lung in the regulation of overall airway responses to acute inhalation of irritant gases and the pathogenesis of chronic allergic airway inflammation.NEW & NOTEWORTHY Extracellular adenosine triphosphate (ATP) is a contributing factor and signaling molecule of airway inflammation. This study demonstrated for the first time that the ATP release in the lung was markedly elevated after acute inhalation challenges of three common industrial air pollutants; the order of the response magnitude was chlorine > sulfur dioxide > ammonia. These findings provided new information and improved our understanding of the adverse pulmonary effects caused by accidental inhalation exposures to these irritant gases.

Early life exposures of childhood asthma and allergies-an epidemiologic perspective

Children around the world are continuing to develop and suffer from chronic lung diseases such as asthma. Childhood asthma commonly presents with recurrent episodes of cough, shortness of breath, and wheezing, all of which can lead to missed school days and hospitalization admissions. The role of environmental pollutants and aeroallergens has been increasingly recognized in relation to asthma etiology. We showcase the impacts of air pollution and pollen exposures in early life on childhood asthma and allergies through an epidemiologic perspective. We also examine the effects of indoor microbial exposures such as endotoxin and glucan on allergic diseases in schoolchildren as many spend most of their time in a household or classroom setting. Findings of this work can assist in the identification of key environmental factors in critical life periods and improve clinicians' diagnoses of asthma during early childhood.

Spatial shifting of COVID-19 clusters and disease association with environmental parameters in India: A time series analysis

BACKGROUND

The viability and virulence of COVID-19 are complex in nature. Although the relationship between environmental parameters and COVID-19 is well studied across the globe, in India, such studies are limited. This research aims to explore long-term exposure to weather conditions and the role of air pollution on the infection spread and mortality due to COVID-19 in India.

METHOD

District-level COVID-19 data from April 26, 2020 to July 10, 2021 was used for the study. Environmental determinants such as land surface temperature, relative humidity (RH), Sulphur dioxide (SO₂), Nitrogen dioxide (NO₂), Ozone (O₃), and Aerosol Optical Depth (AOD) were considered for analysis. The bivariate spatial association was used to explore the spatial relationship between Case Fatality Rate (CFR) and these environmental factors. Further, the Bayesian multivariate linear regression model was applied to observe the association between environmental factors and the CFR of COVID-19.

RESULTS

Spatial shifting of COVID-19 cases from Western to Southern and then Eastern parts of India were well observed. The infection rate was highly concentrated in most of the Western and Southern regions of India, while the CFR shows more concentration in Northern India along with Maharashtra. Four main spatial clusters of infection were recognized during the study period. The time-series analysis indicates significantly more CFR with higher AOD, O₃, and NO₂ in India.

CONCLUSIONS

COVID-19 is highly associated with environmental parameters and air pollution in India. The study provides evidence to warrant consideration of environmental parameters in health models to mediate potential solutions. Cleaner air is a must to mitigate COVID-19.

Prenatal and Postnatal Exposure to Ambient Air Pollution and Preschool Asthma in Neonatal Jaundice Infants

Purpose

Both air pollutant exposure and neonatal jaundice (NJ) have known effects on childhood asthma, but a higher total serum bilirubin (TSB) level has been associated with lung protection. This study aimed to assess whether prenatal/postnatal exposure to ambient air pollutants is related to the development of asthma in infants with NJ.

Patients and Methods

A nested case–control retrospective study was performed using the data of infants with NJ in the Kaohsiung Medical University Hospital Research Database. Data on average ambient air pollution concentrations within six months, the first year and second year after birth, and in the first, second and third prenatal trimesters were collected. NJ was defined as TSB levels ≥ 2 mg/dl with the diagnosis less than one-month-old. Asthma was defined as a diagnosis with medication use. We constructed conditional logistic regression models to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Results

Exposure to NO and SO₂ at all six time points in the study was significantly associated with an increased risk of preschool asthma in infants with NJ. The overall peak OR (95% CI) of SO₂, PM_2.5, PM₁₀, NO, NO₂, and NO_X were 1.277 (1.129–1.444), 1.057 (1.023–1.092), 1.035 (1.011–1.059), 1.272 (1.111–1.455), 1.168 (1.083–1.259) and 1.104 (1.051–1.161), respectively. Fetuses in the first and second trimester were most vulnerable to ambient air pollutant exposure such as SO₂ PM_2.5, NO, NO₂ and NO_X during the prenatal period. Exposure to all six ambient air pollutants during the first and second years after birth significantly affected preschool asthma in NJ infants.

Conclusion

In different time windows, prenatal and postnatal exposure to SO₂, PM_2.5, PM₁₀, NO, NO₂, and NO_X were associated with preschool asthma in NJ infants. The relatively high impact of NO and SO₂ exposure in infants with NJ requires further studies and prevention measures.

Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China

Background: Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time.

Methods: We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM_2.5), particulate matter ≤ 10 μm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season.

Results: In the single-pollutant models, higher levels of PM_2.5, SO₂, and NO₂ were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO₂ at lag06 (RR = 1.25, 95%CI: 1.06-1.48), followed by SO₂ at lag05 (RR = 1.17, 95%CI: 1.05–1.31). The robustness of effects of SO₂ and NO₂ were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO₂. The effects of SO₂ were stronger in the cold season, while the effects of NO₂ were stronger in the warm season. No significant sex-specific differences were observed.

Conclusions: These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.

Air pollution and hospitalization of patients with idiopathic pulmonary fibrosis in Beijing: a time-series study

Background

A small number of studies suggested that air pollution was associated with idiopathic pulmonary fibrosis (IPF) exacerbation, incidence and mortality. However, no studies to date were conducted in regions where air pollution is substantial. We aimed to investigate whether there are associations between acute increases in air pollution and hospitalization of patients with a confirmed primary diagnosis of IPF in Beijing.

Methods

Daily count of IPF hospitalizations (International Classification of Disease-10th Revision, J84.1) was obtained from an administrative database for 2013–2017 while daily city-wide average concentrations of PM₁₀, PM_2.5, NO₂, Ozone, SO₂ were obtained from 35 municipal monitoring stations for the same period. The association between daily IPF hospitalization and average concentration of each pollutant was analyzed with a generalized additive model estimating Poisson distribution.

Results

Daily 24-h mean PM_2.5 concentration during 2013–2017 was 76.7 μg/m³. The relative risk (RR) of IPF hospitalization per interquartile range (IQR) higher (72 μg/m³) in PM_2.5 was 1.049 (95% CI 1.024–1.074) and 1.031 (95% CI 1.007–1.056) for lag0 and moving averages 0–1 days respectively. No significant associations were observed for other lags. Statistically significant positive associations were also observed at lag0 with SO₂, Ozone and NO₂ (in men only). Positive associations were seen at moving averages 0–30 days for PM₁₀ (RR per 86 μg/m³: 1.021, 95% CI 0.994–1.049), NO₂ (RR per 30 μg/m³: 1.029, 95% CI 0.999–1.060), and SO₂ (RR per 15 μg/m³: 1.060 (95% CI 1.025–1.097), but not with PM_2.5 or Ozone.

Conclusions

Despite improvement in air quality since the implementation of clean air policy in 2013, acute exposure to higher levels of air pollution is significantly associated with IPF hospitalization in Beijing. Air quality policy should be continuously enforced to protect vulnerable IPF populations as well as the general public.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12931-022-01998-8.

Association Between the Ambient Fine Particulate Pollution and the Daily Internal Medicine Outpatient Visits in Zhoushan, China: A Time-Series Study

Background: There has been a recent worsening of air pollution in China, which poses a huge threat to public health by inducing and promoting circulatory and respiratory diseases. This study aimed to explore the association between the concentration of air pollution and daily internal medicine outpatient visits registered for the treatment of circulatory and respiratory symptoms in Zhoushan, China using a time-series method.

Methods: We validated and acquired the daily internal medicine outpatient visits records between January 1, 2014, and December 31, 2019, from the Zhoushan Center for Disease Control and Prevention in Zhejiang, China. Further, we collected the daily average records of the ambient air pollutants from the Zhoushan Environmental Monitoring Centre within the same duration. A generalized additive model with the natural splines was constructed to explore the association between the ambient air pollutants and daily internal medicine outpatient visits. Further, we conducted a lag analysis by using the distributed lag non-linear model to estimate the time-delayed effects of the air pollutants on the daily internal medicine outpatient visits.

Results: A total of 2,190,258 daily internal medicine outpatient visits with a mean of 202.4 visits per day were recorded. The non-linear relationships were found among particulate matter_2.5 (PM_2.5), sulfur dioxide (SO₂), and the daily internal medicine outpatient visits. Overall, PM_2.5 was positively correlated with the daily internal medicine outpatient visits. Both ozone (O₃) and SO₂ had significant delayed effects on the daily internal medical outpatient numbers; however, PM_2.5 only showed a short-term risk.

Conclusion: Short-term exposure to PM_2.5 was associated with an increase in the daily internal medicine outpatient visits for circulatory and respiratory diseases/symptoms in Zhoushan, China. SO₂ and O₃ were shown to induce significant effects after a concentration-dependent time lag.

Early childhood traffic-related air pollution and risk of allergic rhinitis at 2-4 years of age modification by family stress and male gender: a case-control study in Shenyang, China

Background

Few studies have explored the modifications by family stress and male gender in the relationship between early exposure to traffic-related air pollution (TRAP) and allergic rhinitis (AR) risk in preschool children.

Methods

We conducted a case-control study of 388 children aged 2–4 years in Shenyang, China. These children AR were diagnosed by clinicians. By using measured concentrations from monitoring stations, we estimated the exposures of particulate matter less than 10 μm in diameter (PM₁₀), nitrogen dioxide (NO₂), ozone (O₃), carbon monoxide (CO), and sulfur dioxide (SO₂) in preschool children aged 2–4 years. After adjusted potential confounding factors, we used logistic regression model to evaluate the odds ratio (OR) and 95% confidence interval (CI) for childhood AR with exposure to different air pollutants according to the increasing of the interquartile range (IQR) in the exposure level.

Results

The prevalence of AR in children aged 2–4 years (6.4%) was related to early TRAP exposure. With an IQR (20 μg/m³) increase in PM₁₀ levels, an adjusted OR was significantly elevated by 1.70 (95% CI, 1.19 to 2.66). Also, with an IQR (18 μg/m³) increase in NO₂, an elevated adjusted OR was 1.85 (95% CI, 1.52 to 3.18). Among children with family stress and boys, PM₁₀ and NO₂ were positively related to AR symptoms. No significant association was found among children without family stress and girls.

Conclusions

Family stress and male gender may increase the risk of AR in preschool children with early exposure to PM₁₀ and NO₂.

Inhalation Injury: Unmet Clinical Needs and Future Research

Pulmonary and systemic insults from inhalation injury can complicate the care of burn patients and contribute to significant morbidity and mortality. However, recent progress in diagnosis and treatment of inhalation injury has not kept pace with the care of cutaneous thermal injury. There are many challenges unique to inhalation injury that have slowed advancement, including deficiencies in our understanding of its pathophysiology, the relative difficulty and subjectivity of bronchoscopic diagnosis, the lack of diagnostic biomarkers, the necessarily urgent manner in which decisions are made about intubation, and the lack of universal recommendations for the application of mucolytics, anticoagulants, bronchodilators, modified ventilator strategies, and other measures. This review represents a summary of critical shortcomings in our understanding and management of inhalation injury identified by the American Burn Association's working group on Cutaneous Thermal Injury and Inhalation Injury in 2018. It addresses our current understanding of the diagnosis, pathophysiology, and treatment of inhalation injury and highlights topics in need of additional research, including 1) airway repair mechanisms; 2) the airway microbiome in health and after injury; and 3) candidate biomarkers of inhalation injury.

The Challenge by Multiple Environmental and Biological Factors Induce Inflammation in Aging: Their Role in the Promotion of Chronic Disease

The aging process is driven by multiple mechanisms that lead to changes in energy production, oxidative stress, homeostatic dysregulation and eventually to loss of functionality and increased disease susceptibility. Most aged individuals develop chronic low-grade inflammation, which is an important risk factor for morbidity, physical and cognitive impairment, frailty, and death. At any age, chronic inflammatory diseases are major causes of morbimortality, affecting up to 5-8% of the population of industrialized countries. Several environmental factors can play an important role for modifying the inflammatory state. Genetics accounts for only a small fraction of chronic-inflammatory diseases, whereas environmental factors appear to participate, either with a causative or a promotional role in 50% to 75% of patients. Several of those changes depend on epigenetic changes that will further modify the individual response to additional stimuli. The interaction between inflammation and the environment offers important insights on aging and health. These conditions, often depending on the individual's sex, appear to lead to decreased longevity and physical and cognitive decline. In addition to biological factors, the environment is also involved in the generation of psychological and social context leading to stress. Poor psychological environments and other sources of stress also result in increased inflammation. However, the mechanisms underlying the role of environmental and psychosocial factors and nutrition on the regulation of inflammation, and how the response elicited for those factors interact among them, are poorly understood. Whereas certain deleterious environmental factors result in the generation of oxidative stress driven by an increased production of reactive oxygen and nitrogen species, endoplasmic reticulum stress, and inflammation, other factors, including nutrition (polyunsaturated fatty acids) and behavioral factors (exercise) confer protection against inflammation, oxidative and endoplasmic reticulum stress, and thus ameliorate their deleterious effect. Here, we discuss processes and mechanisms of inflammation associated with environmental factors and behavior, their links to sex and gender, and their overall impact on aging.

Environmental and Endogenous Acids Can Trigger Allergic-Type Airway Reactions

Inflammatory allergic and nonallergic respiratory disorders are spreading worldwide and often coexist. The root cause is not clear. This review demonstrates that, from a biochemical point of view, it is ascribable to protons (H+) released into cells by exogenous and endogenous acids. The hypothesis of acids as the common cause stems from two considerations: (a) it has long been known that exogenous acids present in air pollutants can induce the irritation of epithelial surfaces, particularly the airways, inflammation, and bronchospasm; (b) according to recent articles, endogenous acids, generated in cells by phospholipases, play a key role in the biochemical mechanisms of initiation and progression of allergic-type reactions. Therefore, the intracellular acidification and consequent Ca2+ increase, induced by protons generated by either acid pollutants or endogenous phospholipases, may constitute the basic mechanism of the multimorbidity of these disorders, and environmental acidity may contribute to their spread.

Construction of polluted aerosol in accumulation that affects the incidence of lung cancer

Background

This model demonstrated the correlation between lung cancer incidences and the parts of ambient air pollution according to the National Aeronautics and Space Administration (NASA)'s high resolution technology satellites.

Methods

Chemical type of aerosols was investigated by the Aerosol Diagnostics Model such as black carbon, mineral dust, organic carbon, sea-salt and SO4. The model investigated associations between the six year accumulation of each aerosol and lung cancer incidence by Bayesian hierarchical spatio-temporal model. Which also represented integrated geophysical parameters.

Results

In analyses of accumulated chemical aerosol component from 2010 – 2016, the incidence rate ratio (IRR) of patients in 2017 were estimated. We observed a significant increasing risk for organic carbon exposure (IRR 1.021, 95%CI 1.020–1.022), SO₄, (IRR 1.026, 95% CI 1.025–1.028) and dust, (IRR 1.061, 95% CI 1.058–1.064). There was also suggestion of an increased risk with, every 1 ug/m³ increase in organic carbon compound is associated with 21% increased risk of lung cancer, whereas a 26% excess risk of cancer per 1 ug/m³ increase in mean SO₄ and 61% increased risk of lung cancer for dust levels. The other variables were the negative IRR which did not increase the risk of the exposed group.

Conclusion

With our results, this process can determine that organic carbon, SO₄ and dust was significantly associated with the elevated risk of lung cancer.

Annual SO2 exposure, asthma, atopy, and lung function in Puerto Rican children

BACKGROUND

Long-term effects of sulfur dioxide (SO₂ ) exposure on children, a vulnerable population, are largely unknown. Further, how long-term SO₂ affects Puerto Rican children living in the island of Puerto Rico, a group with high asthma prevalence, is unclear. We evaluated the effects of annual average 1-hour daily maximum SO₂ average on asthma, atopy, total immunoglobulin E (IgE), and lung function in Puerto Rican children.

METHODS

A cohort of 678 children (351 with asthma, 327 without asthma) was recruited in Puerto Rico from 2009 to 2010. Annual average 1-hour daily maximum SO₂ exposure was interpolated utilizing publicly available monitoring data. Multivariable logistic and linear regression was used for the analysis of asthma, atopy (defined as an IgE ≥0.35 IU/mL to at least one of five common aero-allergens), total IgE, and lung function measures (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], and FEV1/FVC ratio).

RESULTS

Annual SO₂ exposure (per 1 ppb) was significantly associated with asthma (odds ratio [OR] = 1.42; 95% confidence interval [CI] = 1.05-1.91) and atopy (OR = 1.35; 95% CI = 1.02-1.78). Such exposure was also significantly associated with lower FEV1/FVC in all children (β = -1.42; 95% CI = -2.78 to -0.08) and in children with asthma (β = -2.39; 95% CI= -4.31 to -0.46). Annual SO₂ exposure was not significantly associated with total IgE, FEV1, or FVC.

CONCLUSIONS

Among Puerto Rican children in Puerto Rico, long-term SO₂ exposure is linked to asthma and atopy. In these children, long-term SO₂ exposure is also associated with reduced FEV1/FVC, particularly in those with asthma.

Establishing a method of HPLC involving precolumn derivatization by 2,2'-dithiobis (5-nitropyridine) to determine the sulfites in shrimps in comparison with ion chromatography

Although sulfites are widely used in shrimp processing, the contents of residual sulfite need to be strictly controlled due to their potential toxicity. In this paper, a novel method was developed for determination of the free and total sulfites in shrimps. Major procedures of the method includes separation of free and total sulfites with ultrasound-assisted extraction and pH adjustment for 20 min, then a precolumn derivatization was conducted by 2,2'-Dithiobis (5-nitropyridine) and verified by LC-MS, and finally HPLC coupled with an ultraviolet (UV) detector was carried out. Results indicated that the UV absorption wavelength shifted from 213 (sulfites) to 320 nm (new disulfide compounds), significantly reducing the interference of natural occurring compounds and solvents in the matrix. The standard curves exhibited a good linear range of 3.2-51.2 mg/L (R 2 = 0.9996). The limit of detection (LOD) and limit of quantification (LOQ) were 0.3 and 1.0 mg/L, respectively. The contents of free and total sulfite in frozen shrimps were 26.58 ± 0.48 and 31.44 ± 0.83 mg/kg calculated by SO2, respectively. These were similar (p > 0.05) to the data obtained by the method of ion chromatography. In conclusion, the new developed method has been proved to be a reliable and economic method for effective determination of free and total sulfites in the shrimps, and the method could be expanded in determination of the sulfites in other food products.

Impact of upstream oil extraction and environmental public health: A review of the evidence

Upstream oil extraction, which includes exploration and operation to bring crude oil to the surface, frequently occurs near human populations. There are approximately 40,000 oil fields globally and 6 million people that live or work nearby. Oil extraction can impact local soil, water, and air, which in turn can influence community health. As oil resources are increasingly being extracted near human populations, we highlight the current scope of scientific knowledge regarding potential community health impacts with the aim to help identify scientific gaps and inform policy discussions surrounding oil drilling operations. In this review, we assess the wide range of both direct and indirect impacts that oil drilling operations can have on human health, with specific emphasis on understanding the body of scientific literature to assess potential environmental and health risks to residents living near active onshore oil extraction sites. From an initial literature search capturing 2236 studies, we identified 22 human studies, including 5 occupational studies, 5 animal studies, 6 experimental studies and 31 oil drilling-related exposure studies relevant to the scope of this review. The current evidence suggests potential health impacts due to exposure to upstream oil extraction, such as cancer, liver damage, immunodeficiency, and neurological symptoms. Adverse impacts to soil, air, and water quality in oil drilling regions were also identified. Improved characterization of exposures by community health studies and further study of the chemical mixtures associated with oil extraction will be critical to determining the full range of health risks to communities living near oil extraction.

The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study

This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM_2.5), particulate matter ≤10 μm (PM₁₀), ozone (O₃), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂), were positively associated with childhood asthma hospitalization, while O₃ was negatively associated with childhood asthma hospitalization. SO₂ was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.

A case of severe acute exacerbation of Yokkaichi asthma treated with a vibrating mesh nebulizer

Yokkaichi asthma was one of the most common environmental pollution diseases in Japan in the 1960s and 1970s. The problem of air pollution in Yokkaichi was solved in the 1970s. However, mortality and life expectancy were still affected by the late effects of air pollution in patients with Yokkaichi asthma even in the 2000s. In this case report, we described the experience of successful treatment of a patient with severe asthmatic status due to Yokkaichi asthma. A 40s-year-old man, who was officially certified as a patient with Yokkaichi asthma from his infancy, was admitted to hospital due to acute exacerbation of asthma. Mechanical ventilation, intravenous administration of aminophylline and dexamethasone, enteral administration of montelukast, and a transdermal patch of tulobuterol were started. However, because of the lack of improvement in clinical status, inhalation of procaterol using vibrating mesh nebulizer systems was started. Inhalation of procaterol was used three times a day. After using the vibrating mesh nebulizer, respiratory system compliance and hypercapnia rapidly improved. Bilateral expiratory wheezing was diminished. Weaning from mechanical ventilation was initiated, and on the eighth day of mechanical ventilation, the patient was extubated. Although intractable respiratory failure with decreased respiratory system compliance resulting from the late effects of air pollution and a long-time asthmatic inflammatory condition was observed, the use of a vibrating mesh nebulizer for the inhaled administration of procaterol was useful to relieve severe bronchospasm due to Yokkaichi asthma.

The Potential Role of 8-Oxoguanine DNA Glycosylase-Driven DNA Base Excision Repair in Exercise-Induced Asthma

Asthma is characterized by reversible airway narrowing, shortness of breath, wheezing, coughing, and other symptoms driven by chronic inflammatory processes, commonly triggered by allergens. In 90% of asthmatics, most of these symptoms can also be triggered by intense physical activities and severely exacerbated by environmental factors. This condition is known as exercise-induced asthma (EIA). Current theories explaining EIA pathogenesis involve osmotic and/or thermal alterations in the airways caused by changes in respiratory airflow during exercise. These changes, along with existing airway inflammatory conditions, are associated with increased cellular levels of reactive oxygen species (ROS) affecting important biomolecules including DNA, although the underlying molecular mechanisms have not been completely elucidated. One of the most abundant oxidative DNA lesions is 8-oxoguanine (8-oxoG), which is repaired by 8-oxoguanine DNA glycosylase 1 (OGG1) during the base excision repair (BER) pathway. Whole-genome expression analyses suggest a cellular response to OGG1-BER, involving genes that may have a role in the pathophysiology of EIA leading to mast cell degranulation, airway hyperresponsiveness, and bronchoconstriction. Accordingly, this review discusses a potential new hypothesis in which OGG1-BER-induced gene expression is associated with EIA symptoms.