The International Agency for Research on Cancer (IARC) evaluation of the carcinogenicity of outdoor air pollution: focus on China

Air pollution and survival in patients with malignant mesothelioma and asbestos-related lung cancer: a follow-up study of 1591 patients in South Korea

BACKGROUND

Despite significant advancements in treatments such as surgery, radiotherapy, and chemotherapy, the survival rate for patients with asbestos-related cancers remains low. Numerous studies have provided evidence suggesting that air pollution induces oxidative stress and inflammation, affecting acute respiratory diseases, lung cancer, and overall mortality. However, because of the high case fatality rate, there is limited knowledge regarding the effects of air pollution exposures on survival following a diagnosis of asbestos-related cancers. This study aimed to determine the effect of air pollution on the survival of patients with malignant mesothelioma and asbestos-related lung cancer.

METHODS

We followed up with 593 patients with malignant mesothelioma and 998 patients with lung cancer identified as asbestos victims between 2009 and 2022. Data on five air pollutants-sulfur dioxide, carbon monoxide, nitrogen dioxide, fine particulate matter with a diameter < 10 μm, and fine particulate matter with a diameter < 2.5 μm-were obtained from nationwide atmospheric monitoring stations. Cox proportional hazard models were used to estimate the association of cumulative air pollutant exposure with patient mortality, while adjusting for potential confounders. Quantile-based g-computation was used to assess the combined effect of the air pollutant mixture on mortality.

RESULTS

The 1-, 3-, and 5-year survival rates for both cancer types decreased with increasing exposure to all air pollutants. The estimated hazard ratios rose significantly with a 1-standard deviation increase in each pollutant exposure level. A quartile increase in the pollutant mixture was associated with a 1.99-fold increase in the risk of malignant mesothelioma-related mortality (95% confidence interval: 1.62, 2.44). For lung cancer, a quartile increase in the pollutant mixture triggered a 1.87-fold increase in the mortality risk (95% confidence interval: 1.53, 2.30).

CONCLUSION

These findings support the hypothesis that air pollution exposure after an asbestos-related cancer diagnosis can negatively affect patient survival.

Accumulation of potentially toxic elements in fourfinger threadfin (Eleutheronema tetradactylum) and black pomfret (Parastromateus niger) from Selangor, Malaysia

The accumulation of potentially toxic elements (PTEs) has raised public awareness due to harmful contamination to both human and marine creatures. This study was designed to determine the concentration of copper (Cu), zinc (Zn), cadmium (Cd), and nickel (Ni) in the intestine, kidney, muscle, gill, and liver tissues of local commercial edible fish, fourfinger threadfin (Eleutheronema tetradactylum), and black pomfret (Parastromateus niger) collected from Morib (M) and Kuala Selangor (KS). Among the studied PTEs, Cu and Zn were essential elements to regulate body metabolism with certain dosages required while Cd and Ni were considered as non-essential elements that posed chronic and carcinogenic risk. The concentration of PTEs in fish tissue samples was analyzed using flame atomic absorption spectrometry (F-AAS). By comparing the concentration of PTEs in fish tissues as a bioindicator, the environmental risk of Morib was more serious than Kuala Selangor because both fish species collected from Morib resulted in a higher PTEs concentration. For an average 62 kg adult with a fish ingestion rate (FIR) of 0.16 kg/person/day in Malaysia, the estimated weekly intake (EWI) of Cd from the consumption of E. tetradactylum (M: 0.0135 mg/kg; KS: 0.0134 mg/kg) and P. niger (M: 0.0140 mg/kg; KS: 0.0132 mg/kg) had exceeded the provisional tolerable weekly intake (Cd: 0.007 mg/kg) established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference dose (ORD) values of Cd (0.001 mg/kg/day) as provided by the United States Environmental Protection Agency (USEPA) regional screening level, thus it posed chronic risks for daily basis consumption. Besides, the value of the carcinogenic risk of Cd (0.7-3 to 0.8-3) and Ni (0.5-3 to 0.6-3) were in between the acceptable range (10-6 to 10-4) of the health index that indicates a relatively low possibility cancer occurrence to the consumers in both Morib and Kuala Selangor. This study recommended FIR to be 0.80 kg/person/day to reduce the possibility of posing chronic and carcinogenic risks while at the same time obtaining the essential nutrients from the fish.

The biological interplay between air pollutants and miRNAs regulation in cancer

Air pollution, especially fine particulate matter (PM2.5, with an aerodynamic diameter of less than 2.5 μm), represents a risk factor for human health. Many studies, regarding cancer onset and progression, correlated with the short and/or long exposition to PM2.5. This is mainly mediated by the ability of PM2.5 to reach the pulmonary alveoli by penetrating into the blood circulation. This review recapitulates the methodologies used to study PM2.5 in cellular models and the downstream effects on the main molecular pathways implicated in cancer. We report a set of data from the literature, that describe the involvement of miRNAs or long noncoding RNAs on the main biological processes involved in oxidative stress, inflammation, autophagy (PI3K), cell proliferation (NFkB, STAT3), and EMT (Notch, AKT, Wnt/β-catenin) pathways. microRNAs, as well as gene expression profile, responds to air pollution environment modulating some key genes involved in epigenetic modification or in key mediators of the biological processes described below. In this review, we provide some scientific evidences about the thigh correlation between miRNAs dysregulation, PM2.5 exposition, and gene pathways involved in cancer progression.

An empirical study of indoor air quality in badminton stadiums in hot summer and cold winter regions of China during spring and fall seasons

The indoor air quality has a direct impact on human health. In order to obtain the current status of indoor air quality in typical sports buildings in hot summer and cold winter climate zones in China, indoor badminton courts in 10 cities in Hubei Province in this climate zone were selected as research objects for field testing of indoor environmental parameters in spring and autumn, and predict air quality parameters for non-testing times. All the tested stadiums are naturally ventilated in non-event conditions, and the average daily indoor CO2 concentration was 526.78 ppm in spring and 527.63 ppm in autumn, and the average daily PM2.5 concentration was 0.035 mg/m3 in spring and 0.024 mg/m3 in autumn, all of which met the requirements of GB/T 18883-2022, the average concentration of CO2 ≤ 1000 ppm and PM2.5 ≤ 0.05 mg/m3. The indoor CO2 concentration and PM2.5 concentration of the tested badminton halls under natural ventilation gradually increased with the accumulation of exercise time, making the indoor air quality of the badminton halls decrease, which would negatively affect the health of the people exercising in this environment.

Temporal analysis of lung injury induced by real-ambient PM2 .5 exposure in mice

Fine particulate matter (PM2.5 ) has been shown to induce lung injury. However, the pathophysiological mechanisms of PM2.5 -induced pulmonary injury after different exposure times are poorly understood. In this study, we exposed male ICR mice to a whole-body PM2.5 inhalation system at daily mean concentration range from 92.00 to 862.00 μg/m3 for 30, 60, and 90 days. We found that following prolonged exposure to PM2.5 , pulmonary injury was increasingly evident with significant histopathological alterations. Notably, the pulmonary inflammatory response and fibrosis caused by PM2.5 after different exposure times were closely associated with histopathological changes. In addition, PM2.5 exposure caused oxidative stress, DNA damage and impairment of DNA repair in a time-dependent manner in the lung. Importantly, exposure to PM2.5 eventually caused apoptosis in the lung through upregulation of cleaved-caspase-3 and downregulation of Bcl-2. Overall, our data demonstrated that PM2.5 led to pulmonary injury in a time-dependent manner via upregulation of proinflammatory and fibrosis-related genes, and activation of the DNA damage response. Our findings provided a novel perspective on the pathophysiology of respiratory diseases caused by airborne pollution.

Occurrence and Distribution of Cancers with Emphasis Upon Oral Cancers in Registered Oncology Institutes of South India - A Retrospective Study

Background

In the past two decades, the growing economy associated with changes in lifestyle-related behavior is partially responsible for the increasing cancer burden in India. To assess the occurrence and distribution of oral cancer based on the analysis of hospital records from registered oncology institutes of South India over a period of three years.

Materials and Methods

A multicenter, retrospective study was conducted at seven major hospitals in South India to assess the incidence and distribution of cancer among patients over a period of three years (2016-2018). Data were collected on a custom-made validated proforma. Analysis was done using R commander software.

Results

A total of 156090 various types of cancers were reported to the included institutes over a three-year period, an almost similar gender distribution was observed, males (n = 78806, 42.99% per lakh) compared to their female counterparts (n = 77284, 42.16% per lakh). Among males' lung cancer was the most common type with 17709 cases (9.65% per lakh) and among females, breast cancer was the leading cancer type with 22855 total cases (12.46% per lakh). Over a period of three years, a total of 21084 records of malignancies pertaining to oral cavity were identified accounting for 13.51% of cases. Among oral cancers, tongue was the most common site to be involved accounting for 44.22% (2016-2018) cases followed by buccal mucosa (14.69%), least common site to be involved was lip which accounted for 3.49% of the total oral cancer cases.

Conclusion

Breast cancer was the most common cancer followed by lung cancer. Oral cancers occupied second among males and fifth rank in the order of occurrence among females. Tongue was the most common site followed by buccal mucosa. The least common site affected by oral cancer was the lip.

Air Pollution and Lung Cancer: Contributions of Extracellular Vesicles as Pathogenic Mechanisms and Clinical Utility

PURPOSE OF REVIEW

This review addresses the pressing issue of air pollution's threat to human health, focusing on its connection to non-small cell lung cancer (NSCLC) development. The aim is to explore the role of extracellular vesicles (EVs) as potential pathogenic mechanisms in lung cancer, including NSCLC, induced by air pollutants.

RECENT FINDINGS

Recent research highlights EVs as vital mediators of intercellular communication and key contributors to cancer progression. Notably, this review emphasizes the cargo of EVs released by both cancerous and non-cancerous lung cells, shedding light on their potential role in promoting various aspects of tumor development. The review underscores the importance of comprehending the intricate interplay between air pollution, biological damage mechanisms, and EV-mediated communication during NSCLC development. Major takeaways emphasize the significance of this understanding in addressing air pollution-related lung cancer. Future research avenues are also highlighted, aiming to enhance the applicability of EVs for diagnosis and targeted therapies, ultimately mitigating the inevitable impact of air pollution on NSCLC development and treatment.

Exploring the association of PM2.5 with lung cancer incidence under different climate zones and socioeconomic conditions from 2006 to 2016 in China

Air pollution generated by urbanization and industrialization poses a significant negative impact on public health. Particularly, fine particulate matter (PM2.5) has become one of the leading causes of lung cancer mortality worldwide. The relationship between air pollutants and lung cancer has aroused global widespread concerns. Currently, the spatial agglomeration dynamic of lung cancer incidence (LCI) has been seldom discussed, and the spatial heterogeneity of lung cancer's influential factors has been ignored. Moreover, it is still unclear whether different socioeconomic levels and climate zones exhibit modification effects on the relationship between PM2.5 and LCI. In the present work, spatial autocorrelation was adopted to reveal the spatial aggregation dynamic of LCI, the emerging hot spot analysis was introduced to indicate the hot spot changes of LCI, and the geographically and temporally weighted regression (GTWR) model was used to determine the affecting factors of LCI and their spatial heterogeneity. Then, the modification effects of PM2.5 on the LCI under different socioeconomic levels and climatic zones were explored. Some findings were obtained. The LCI demonstrated a significant spatial autocorrelation, and the hot spots of LCI were mainly concentrated in eastern China. The affecting factors of LCI revealed an obvious spatial heterogeneity. PM2.5 concentration, nighttime light data, 2 m temperature, and 10 m u-component of wind represented significant positive effects on LCI, while education-related POI exhibited significant negative effects on LCI. The LCI in areas with low urbanization rates, low education levels, and extreme climate conditions was more easily affected by PM2.5 than in other areas. The results can provide a scientific basis for the prevention and control of lung cancer and related epidemics.

Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening Committee

INTRODUCTION

The second leading cause of lung cancer is air pollution. Air pollution and smoking are synergistic. Air pollution can worsen lung cancer survival.

METHODS

The Early Detection and Screening Committee of the International Association for the Study of Lung Cancer formed a working group to better understand issues in air pollution and lung cancer. These included identification of air pollutants, their measurement, and proposed mechanisms of carcinogenesis. The burden of disease and the underlying epidemiologic evidence linking air pollution to lung cancer in individuals who never and ever smoked were summarized to quantify the problem, assess risk prediction models, and develop recommended actions.

RESULTS

The number of estimated attributable lung cancer deaths has increased by nearly 30% since 2007 as smoking has decreased and air pollution has increased. In 2013, the International Agency for Research on Cancer classified outdoor air pollution and particulate matter with aerodynamic diameter less than 2.5 microns in outdoor air pollution as carcinogenic to humans (International Agency for Research on Cancer group 1) and as a cause of lung cancer. Lung cancer risk models reviewed do not include air pollution. Estimation of cumulative exposure to air pollution exposure is complex which poses major challenges with accurately collecting long-term exposure to ambient air pollution for incorporation into risk prediction models in clinical practice.

CONCLUSIONS

Worldwide air pollution levels vary widely, and the exposed populations also differ. Advocacy to lower sources of exposure is important. Health care can lower its environmental footprint, becoming more sustainable and resilient. The International Association for the Study of Lung Cancer community can engage broadly on this topic.

The growing impact of air quality on lung-related illness: a narrative review

Background and Objective

Poor air quality can be harmful to human well-being. There are a variety of respiratory disorders associated with toxins present within the atmosphere, such as bronchitis and asthma, which eventually lead to heart or lung complications over time. Fine particles like particulate matter 2.5 (PM2.5) accumulate in the small airways of the lung. These irritants can cause epigenetic modifications in gene regulation, leading to changes responsible for both benign and malignant lung diseases. In this review we will discuss known associations between environmental factors and pulmonary complications, consider preventative measures and offer further areas for future investigation. This review presents a summary of the literature outlining the current work done on air quality and its effects on lung-related illnesses. We discuss regional differences in air quality and consider the causes, such as manufacturing, traffic density, increase in fuel usage and natural events. We further explore disparities based on geography, race, and other social determinants.

Methods

A comprehensive literature review was performed using keywords related to air quality, pollution and lung disease within the PubMed database as well as MEDLINE and Google Scholar.

Key Content and Findings

The Clean Air Act of 1970 marked an essential transition for air quality improvement. The legislation led to decreased emissions and control measures to address atmosphere contamination. Despite these actions, poor atmospheric conditions still persist today and have become an ongoing issue. These poor conditions affect individuals living in metropolitan areas more significantly than suburban or rural areas. Pollution from industrial operations and transportation vehicles have led to increased emission outputs recently. Climate change further aggravates air quality problems by raising pollutant and allergen concentrations. The detrimental consequences of poor air quality include increased incidence of disease processes like asthma, chronic obstructive pulmonary disease (COPD) and lung cancer. To keep up with the well-being of people globally, it is important that actions be taken to battle contamination in the climate so its impact on public health can be limited.

Conclusions

Poor air quality and recent worsening of industrial emissions have had a negative impact on lung-related illnesses. Future mitigation strategies should be taken to reduce pollution and treat diseases earlier in their course. Some of these strategies include more reliance on alternative energy sources, creation of mass transit systems and increased rates of recycling.

Internet of things based visualisation of effect of air pollution on the lungs using HEPA filters air cleaner

The impact of air quality on human health and the environment is very significant, with poor air quality being responsible for numerous deaths and environmental damage worldwide. Whereas a number of studies have been done to monitor the quality of air with help of emerging technologies, little has been done to visualize its effect on health particularly on the lungs. The study explores an approach that combines Internet of Things (IoT) technology with High Efficiency Particulate Air (HEPA) filters air cleaner to monitor and visualize the effects of air pollution on lung health, highlighting the significant damage that poor air quality causes particularly on the lungs graphically. To achieve this, a 3D display of the lungs is modelled using HEPA filters, which changes colour based on the air pollutant concentrations detected by IoT-based sensors. The collected air quality data is then transmitted to Thingspeak, a visualization platform for further analysis. It is observed that the colour of the 3D lung display changed to black over time as air pollutant concentrations increased which in our study is an indicator of unhealthy lung. The study presents an innovative approach to visualize the effects of air pollution on lung health using IoT and HEPA filters air cleaner, which could have significant implications for public health policies aimed at mitigating the harmful effects of air pollution, particularly on lung health.

Changes in the Histology of Lung Cancer in Northern Italy: Impact on Incidence and Mortality

This study assessed the incidence, mortality, and survival of lung cancer subtypes of NSCSLC (non-small-cell lung cancer), SCLC (small-cell lung cancer), and other morphologies. It is an observational epidemiological study using 7197 cases from the Reggio Emilia Cancer Registry recorded between 2001 and 2020 in males and females. The incidence of NSCLC in 5104 males indicates a significant 3% annual increase until 2013 and then a decline of -3.2% that is not statistically significant; until 2014, mortality increased significantly (3.2%), but it then decreased non-significantly (-12.1%), especially squamous cell cancer. In 2093 females, the incidence and mortality trends continued to rise significantly through 2012, and then they began to slightly decline (not statistically significant). The two-year relative survival of NSCLC increased from 32% to 38% in males and from 42% to 56% in females. SCLC in males decreased significantly both in incidence and mortality, while in women, it showed a slight increase (significantly for incidence but not for mortality). This study is important because it analyzes the decrease in lung cancer in males and the increase in females in relation to the different histotypes. Our study's findings confirmed a decline in male incidence and death beginning in 2013. We were unable to determine if the drop in cigarette smoking and the introduction of new drugs such as EGFR in first-line therapy were responsible for the lower incidence.

Bark, soil and lichens are effective indicators of dust from limestone industries in Thailand

Cement production, quarrying and stone crushing are major emission sources of alkaline dust that can affect human health and vegetation. The main objectives of this study were to evaluate the potential of using bark pH, soil pH and lichen community for indicating alkaline dust pollution. Twelve polluted sites were in a limestone industrial area. Bark pH and the lichen community were observed on Alstonia scholaris trees, and soil pH was obtained from topsoil samples. The bark pH at all polluted sites was significantly higher (5.5 to 7.3) than that at the unpolluted site (4.3). Among the polluted sites, the highest bark pH value was observed at the nearest site to the center of the industrial area, while the lowest value was discovered at the farthest site. Bark pH showed a strongly negative correlation with the distance from the center. Soil pH at the unpolluted site (6.3) was also significantly lower than that at the polluted sites (7.6 to 8.1), except at the farthest site (6.5). The soil pH also tended to increase closer to the center. Seven lichen species were observed on the trunks of investigated trees in all polluted sites and were observed only at sites more than 4.7 km away from the center, where bark pH ranged from 5.5 to 6.3. The extent of dust impact on vegetation seemed to be within 6-7 km from the center. The results of this study confirm the potential of the bark pH of A. scholaris, soil pH and lichen community as long-term indicators of alkaline dust pollution.

Association of outdoor air pollution, lifestyle, genetic factors with the risk of lung cancer: A prospective cohort study

OBJECTIVES

The effect of air pollution exposure on incident lung cancer remains uncertain, and the modifying role of lifestyle and genetic susceptibility in association between air pollution and lung cancer is ambiguous.

METHODS

A total of 367,623 participants from UK biobank cohort were enrolled in the analysis. The concentrations of particle matter (PM_2.5, PM₁₀), nitrogen dioxide (NO₂), and nitrogen oxides (NO_x), were evaluated by land-use regression model. Cox proportional hazard model was applied to assess the associations between air pollution and incident lung cancer. A lifestyle risk score and a polygenic risk score were established to investigate whether lifestyle and heritable risk could modify the effect of air pollution on lung cancer risk.

RESULTS

Per interquartile range (IQR) increment in annual concentrations of PM_2.5 (HR = 1.22, 95% CI, 1.15∼1.30), NO₂ (HR = 1.19, 95% CI, 1.10∼1.27), and NO_x (HR = 1.14, 95% CI, 1.09∼1.20) were associated with increased risk of lung cancer. We observed an additive interaction between air pollution including PM_2.5 and NO_x and lifestyle or genetic risk. Individuals with high air pollution exposure, poor lifestyle and high genetic risk had the highest risk of incident lung cancer.

CONCLUSION

Long-term exposures to air pollution is associated with increased risk of lung cancer, and this effect was modified by lifestyle or genetic risk. Integrated interventions for environmental pollution by government and adherence to healthy lifestyle by individuals are advocated for lung cancer prevention.

Organic extracts in PM2.5 are the major triggers to induce ferroptosis in SH-SY5Y cells

As a major air pollutant, PM2.5 can induce apoptosis of nerve cells, causing impairment of the learning and memory capabilities of humans and animals. Ferroptosis is a newly discovered way of programmed cell death. It is unclear whether the neurotoxicity induced by PM2.5 is related to the ferroptosis of nerve cells. In this study, we observed the changes in ferroptosis hallmarks of SH-SY5Y cells after exposure to various doses (40, 80, and 160 μg/mL PM2.5) for 24 h, exposure to 40 μg/mL PM2.5 for various times (24, 48, and 72 h), as well as exposure to various components (Po, organic extracts; Pw, water-soluble extracts; Pc, carbon core component). The results showed that PM2.5 reduced the cell viability, the content of GSH, and the activity of GSH-PX and SOD in SH-SY5Y cells with exposure dose and duration increasing. On the other hand, PM2.5 increased the content of iron, MDA, and the level of lipid ROS in SH-SY5Y cells with exposure dose and duration increasing. Additionally, PM2.5 reduced the expression levels of HO-1, NRF2, SLC7A11, and GPX4. The ferroptosis inhibitors Fer-1 and DFO significantly increase the cells viabilities and significantly reversed the changes of other above ferroptosis hallmarks. We also observed the different effects on ferroptosis hallmarks in the SH-SY5Y cells exposed to PM2.5 (160 μg/mL) and its various components (organic extracts, water-soluble extracts, and carbon core) for 24 h. We found that only the organic extracts shared similar results with PM2.5 (160 μg/mL). This study demonstrated that PM2.5 induced ferroptosis of SH-SY5Y cells, and organic extracts might be the primary component that caused ferroptosis.

Assessment of the exposure to PM2.5 in different Lebanese microenvironments at different temporal scales

The weak potential of using the sole outdoor concentrations to represent personal exposure to PM_2.5 is confirmed by the literature; therefore, it is important to account for a person's movements over time when estimating the short-term personal air pollution exposure within different microenvironments (MEs). This study is an example of applying an assessment method of the exposure to PM_2.5 in different microenvironments at different temporal scales. A low-cost particle counter (the Dylos 1700) was used; its performance was validated in comparison with equivalent instruments such the SidePak AM520 Personal Aerosol Monitor (R² = 0.89). This validation also provided a function to convert measured particle number concentrations (PNCs) into calculated particle mass concentrations. The 150 profiles that was collected on a minute-by-minute basis regarding PM_2.5 concentration from December 2018 to May 2021 highlight the influence of individual activities and contextual factors on the air quality, so that Lebanon's annual PM_2.5 mean (24.2 µg⁄m³) is 142% higher than the World Health Organization (WHO) annual mean guideline (10 µg⁄m³). Winter is the most polluted period due to the increased application of space heating devices. Additionally, the occurrence of dusty winds during the spring period leads to the elevated levels of dispersed PM_2.5. Simultaneously, the rural zones are more polluted than urban ones due to the usage of more traditional heating equipment, in addition to the usage of chemical products like pesticides and fertilizers in agricultural activities in such areas. Furthermore, the (outdoor-indoor-transport) MEs indicate that the transport and indoor MEs have similar levels of suspended fine particulates, while outdoor MEs are less polluted. Studies based on the personal exposure to PM_2.5 were generally applied on specific and limited places such as schools, workplaces, or residences. The study aims to shed light on the modern method in an attempt to estimate the personal exposure to PM_2.5 and to inspire similar studies to achieve the maximum efficiency.

Heavy Metal Pollution and Risk Assessment of Surface Dust in the Arid NW China

High concentrations of heavy metals (HMs) in urban surface dust (USD) can be extremely hazardous to urban ecology and human health. Oasis cities are located at the edge of deserts and are more exposed to salt/sandstorms, and they face a significantly higher accumulation of USD than wet or semi-humid areas. However, systematic studies on the pollution and risk assessment of HMs in USD in oasis cities have rarely been conducted. This study systematically analyzed the enrichment status, spatial distribution, pollution levels, health risks, and sources of HMs in USD in a typical oasis city (Changji city). The results showed that the average concentrations of Pb, Ni, As, Cd, Hg, and Cu in the USD of Changji city were 46.83, 26.35, 9.92, 0.21, 0.047, and 59.33 mg/kg, respectively, and the results of the pollution index evaluation showed moderate Pb, Hg, and Cu pollution, mild Cd pollution, and no Ni or As pollution. The spatial distribution of HM concentrations in the USD was substantially heterogeneous. High values of Pb, Hg, and Cu concentrations were mainly observed in areas with relatively intensive transportation and commercial activities, and high values of Cd and Ni were observed in industrial areas. The health risk assessment showed that HMs do not pose non-carcinogenic risks to humans at their current level, but they pose a carcinogenic risk to children, with As contributing the largest carcinogenic and non-carcinogenic risks. The source identification of HMs showed that the main pollution of HMs were traffic sources for Pb and Cu, industrial sources for Ni and Cd, natural sources for As, and coal-fired sources for Hg. According to the results of the quantitative analysis with the positive matrix factorization, the contribution of pollution sources followed this order: industrial sources (31.08%) > traffic sources (26.80%) > coal-fired sources (23.31%) > natural sources (18.81%).

Traffic-related Air Pollution and Lung Cancer Incidence: The California Multiethnic Cohort Study

Rationale: Although the contribution of air pollution to lung cancer risk is well characterized, few studies have been conducted in racially, ethnically, and socioeconomically diverse populations. Objectives: To examine the association between traffic-related air pollution and risk of lung cancer in a racially, ethnically, and socioeconomically diverse cohort. Methods: Among 97,288 California participants of the Multiethnic Cohort Study, we used Cox proportional hazards regression to examine associations between time-varying traffic-related air pollutants (gaseous and particulate matter pollutants and regional benzene) and lung cancer risk (n = 2,796 cases; average follow-up = 17 yr), adjusting for demographics, lifetime smoking, occupation, neighborhood socioeconomic status (nSES), and lifestyle factors. Subgroup analyses were conducted for race, ethnicity, nSES, and other factors. Measurements and Main Results: Among all participants, lung cancer risk was positively associated with nitrogen oxide (hazard ratio [HR], 1.15 per 50 ppb; 95% confidence interval [CI], 0.99-1.33), nitrogen dioxide (HR, 1.12 per 20 ppb; 95% CI, 0.95-1.32), fine particulate matter with aerodynamic diameter <2.5 μm (HR, 1.20 per 10 μg/m3; 95% CI, 1.01-1.43), carbon monoxide (HR, 1.29 per 1,000 ppb; 95% CI, 0.99-1.67), and regional benzene (HR, 1.17 per 1 ppb; 95% CI, 1.02-1.34) exposures. These patterns of associations were driven by associations among African American and Latino American groups. There was no formal evidence for heterogeneity of effects by nSES (P heterogeneity > 0.21), although participants residing in low-SES neighborhoods had increased lung cancer risk associated with nitrogen oxides, and no association was observed among those in high-SES neighborhoods. Conclusions: These findings in a large multiethnic population reflect an association between lung cancer and the mixture of traffic-related air pollution and not a particular individual pollutant. They are consistent with the adverse effects of air pollution that have been described in less racially, ethnically, and socioeconomically diverse populations. Our results also suggest an increased risk of lung cancer among those residing in low-SES neighborhoods.

Association between Air Pollution and Squamous Cell Lung Cancer in South-Eastern Poland

Air pollution is closely associated with the development of respiratory illness. The aim of the present study was to assess the relationship between long-term exposure to PM2.5, PM10, NO₂, and SO₂ pollution and the incidence of lung cancer in the squamous subtype in south-eastern Poland from the years 2004 to 2014. We collected data of 4237 patients with squamous cell lung cancer and the level of selected pollutants. To investigate the relationship between the level of concentrations of pollutants and the place of residence of patients with lung cancer in the squamous subtype, proprietary pollution maps were applied to the places of residence of patients. To analyze the data, the risk ratio was used as well as a number of statistical methods, i.e., the pollution model, inverse distance weighted interpolation, PCA, and ordered response model. Cancer in women and in men seems to depend in particular on the simultaneous inhalation of NO₂ and PM10 (variable NO₂PM10) and of NO₂ and SO₂ (variable NO₂ SO₂), respectively. Nitrogen dioxide exercises a synergistic leading effect, which once composed with the other elements it becomes more persistent in explaining higher odds in the appearance of cancers and could constitute the main cause of squamous cancer.

Particulate matter 2.5 promotes inflammation and cellular dysfunction via reactive oxygen species/p38 MAPK pathway in primary rat corneal epithelial cells

PURPOSE

Numerous studies have linked particulate matter 2.5 (PM_2.5) to ocular surface diseases, but few studies have been conducted on the biological effect of PM_2.5 on the cornea. The objective of the present study was to evaluate the harmful effect of PM2.5 on primary rat corneal epithelial cells (RCECs) in vitro and identify the toxic mechanism involved.

MATERIALS AND METHODS

Primary cultured RCECs were characterized by pan-cytokeratin (CK) staining. In PM2.5-exposed RCECs, cell viability, microarray gene expression, inflammatory cytokine levels, mitochondrial damage, DNA double-strand break and signaling pathway were investigated.

RESULTS

Exposure to PM_2.5 induced cytotoxicity and morphological changes in RCECs. In addition, PM_2.5 markedly up-regulated pro-inflammatory mediators but down-regulated the wound healing-related transforming growth factor-β. Furthermore, PM_2.5 promoted mitochondrial reactive oxygen species (ROS) production and mediated cellular damage to mitochondria and DNA, whereas these cellular alterations induced by PM_2.5 were markedly suppressed by a potential ROS scavenger. Noteworthy, removal of ROS selectively down-regulated the phosphorylation of p38 mitogen-activated protein kinase (MAPK) and the activation of the nuclear factor-κB (NF-κB) p65 in PM_2.5-stimulated cells. Additionally, SB203580, a p38 MAPK inhibitor, markedly suppressed these PM_2.5-mediated cellular dysfunctions.

CONCLUSIONS

Taken together, our findings show that PM_2.5 can promote the ROS/p38 MAPK/NF-κB signaling pathway and lead to mitochondrial damage and DNA double-strand break, which is ultimately caused inflammation and cytotoxicity in RCECs. These findings indicate that the ROS/p38 MAPK/NF-κB signaling pathway is one mechanism involved in PM_2.5-induced ocular surface disorders.

Air Quality and Cancer Prevalence Trends across the Sub-Saharan African Regions during 2005-2020

Poor air quality and environmental pollution remain some of the main etiological factors leading to cancers and cancer-related deaths worldwide. As a result of human activities, deleterious airborne chemicals can be dispersed not only in the environment but also released in occupational environments and industrial areas. Air pollutants and cancer links are now established through various oxidative stress-related mechanisms and related DNA damages. Generally, ambient and indoor air pollutants have been understudied in sub-Saharan Africa (SSA) compared to other regions in the world. Our study not only highlights the deleterious effects of air pollutants in these developing countries, but it has strived to examine the trends and correlations between cancers and some air pollutants-carbon dioxide, other greenhouse gases, PM_2.5, and human development index-in some SSA countries, where recent cancer burdens were reported as high. Our results showed strikingly higher yearly trends of cancers and above-mentioned air pollutant levels in some sub-Saharan countries during 2005-2020. Relative risks (RR) of these air pollutants-related cancer case rates were, however, below, or slightly above 1.0, or not statistically significant possibly due to other responsible and confounding factors which were not considered in our analyses due to data unavailability. We recommend new approaches to monitoring, minimizing, and creating awareness of the trends of hazardous air pollutants in sub-Saharan Africa, which will help ameliorate cancer prevalence and support the reduction in air pollution levels within regulatory limits, thereby relieving the cumulative burdens of cancers. Utilization of the findings from the study will support large-scale public health and health policy efforts on cancer management through environmental stewardship in SSA countries having the poorest outcome and the shortest survival rates from cancers.

Radiology for Thoracic Conditions in Low- and Middle-Income Countries

With a disproportionately high burden of global morbidity and mortality caused by chronic respiratory diseases (CRDs) in low and middle-income countries (LMICs), access to radiological services is of critical importance for screening, diagnosis, and treatment guidance.

Effects of indoor air pollution on tribal community in rural India and health risk assessment due to domestic biomass burning: a realistic approach using the lung deposition model

Indoor air pollution from the combustion of biomass fuel and associated health risks is a critical issue in developing countries. Concentrations of PM2.5 and PM10 are measured in Birbhum, West Bengal, during 2017-2018. PM2.5-bound elemental concentrations of twelve metals are determined in rural kitchens. The results showed higher toxicological risks in BMF (1.15) than the LPG users (0.14). The risk of non-carcinogenic exposure related with dermal contact and ingestion was observed in the acceptable limits (HQ < 1) for all age groups, and the risk associated with inhalation exposure from Cr, Ni, As, and Mn exceeded the acceptable limit. Results also suggest that carcinogenic risks from ingestion and dermal contact are within the acceptable limit (1 × 10-4-1 × 10-6) except Cr and As which were found to exceed the range. The deposition flux (Dφ) for multiple metals in the head airway region, tracheobronchial region, and alveolar regions was found to be higher in teenagers as compared to other groups, whereas the value was lower in infants. Further, it was notified from the Dφ that the metals could pass through the head airways and harm the tracheobronchial tree and alveolar region, increasing the risk of human health.

A novel particulate matter sampling and cell exposure strategy based on agar membrane for cytotoxicity study

Laboratories use different strategies to sample and extract atmospheric particulate matter (PM), some of which can be very complicated. Due to the absence of a standard protocol, it is difficult to compare the results of PM toxicity assessment across different laboratories. Here, we proposed a novel PM sampling and cell exposure strategy based on agar membrane. The agar membrane, prepared by a simple freeze-drying method, has a relatively flat surface and porous interior. We demonstrated that the agar membrane was a reliable substitute material for PM sampling. Then the PM on the agar membranes was directly extracted with the culture medium by vortex method, and the PM on the polytetrafluoroethylene (PTFE) filters was extracted with water by the traditional ultrasonic method for comparison. The extraction efficiency was evaluated and in vitro cytotoxicity assays were carried out to investigate the toxic effects of PM extracted with two strategies on macrophage cells. The results showed that the PM extracted from agar membranes induced higher cytotoxicity and more differentially expressed proteins. Overall, the novel PM sampling-cell exposure strategy based on the agar membrane is easy to operate, biocompatible and comparable, and has low disturbance, could be an alternative sampling and extraction method for PM toxicity assessment.

Outpatient Department Visits and Mortality with Various Causes Attributable to Ambient Air Pollution in the Eastern Economic Corridor of Thailand

The Eastern Economic Corridor in Thailand is undergoing development, but industrial activities are causing serious air pollution. This study aimed to examine the effects of particulate matter (PM₁₀), fine particulate matter (PM_2.5), SO₂, NO₂, O₃, and CO on outpatient department (OPD) visits and mortality with various causes in the Eastern Economic Corridor, Thailand between 2013 and 2019 using a case-crossover design and conditional Poisson model. The corresponding burden of disease due to air pollution exposure was calculated. A 1 µg/m³ increase in the PM₁₀ was associated with significant increases in OPD visits for circulatory diseases (0.22, 95% CI 0.01, 0.34), respiratory diseases (0.21, 95% CI 0.13, 0.28), and skin and subcutaneous tissue diseases (0.18, 95% CI 0.10, 0.26). By contrast, a 1 µg/m³ increase in the PM₁₀ was associated with significant increases in mortality from skin and subcutaneous tissue diseases (0.79, 95% CI 0.04, 1.56). A 1 µg/m³ increase in PM_2.5 was associated with significant increases in mortality from circulatory diseases (0.75, 95% CI 0.20, 1.34), respiratory diseases (0.82, 95% CI 0.02, 1.63), and skin and subcutaneous tissue diseases (2.91, 95% CI 0.99, 4.86). The highest OPD burden was for circulatory diseases. Respiratory effects were attributed to PM₁₀ exceeding the national ambient air quality standards (NAAQS) of Thailand (120 μg/m³). The highest morbidity burden was for skin and subcutaneous tissue diseases attributed to PM_2.5 concentrations that exceeded the NAAQs (50 μg/m³). PM pollution in the EEC could strongly contribute to OPD visits and morbidity from various diseases. Preventing PM₁₀ concentrations from being higher than 60 µg/m³ could decrease OPD visits by more than 33,265 and 29,813 for circulatory and respiratory diseases, respectively. Our study suggests that such pollution increases the risks of OPD visits and mortality in various causes in the Thai EEC. Reducing the ambient air pollution concentration of NAAQSs in Thailand could reduce the health effect on the Thai population.

Air Quality, Pollution and Sustainability Trends in South Asia: A Population-Based Study

Introduction: Worsening air quality and pollution lead to numerous environmental health and sustainability issues in the South Asia region. This study analyzes India, Nepal, Bangladesh, Pakistan, Sri Lanka, and Nepal for air quality data trends and sustainability indicators. Methodology: By using a population-based study design, six South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly available repositories for region dynamics and key variables. Results: Between 1990 and 2020, air quality data indicated the highest rise in CO₂ emissions in India (578.5 to 2441.8 million tons) (MT), Bangladesh, Nepal, and Pakistan. Greenhouse gas emissions, from 1990 to 2018, nearly tripled in India (1990.4 to 3346.6 MT of CO₂-equivalents), Nepal (20.6 to 54.6 MT of CO₂-equivalents), and Pakistan, and doubled in Bangladesh. Methane emissions rose the highest in Pakistan (70.4 to 151 MT of CO₂-equivalents), followed by Nepal (17 to 31 MT of CO₂-equivalents) and India (524.8 to 669.3 MT of CO₂-equivalents). Nitrous oxide nearly doubled in Bangladesh (16.5 to 29.3 MT of CO₂-equivalents), India (141.6 to 256.9 MT of CO₂-equivalents), Nepal (17 to 31 MT of CO₂-equivalents), and more than doubled in Pakistan (27 to 61 MT of CO₂-equivalents). On noting particulate matter 2,5 annual exposure, India saw the highest rise from 81.3 µg/m³ (in 1990) to 90.9 µg/m³ (2017), whereas trends were steady in Pakistan (60.34 to 58.3 µg/m³). The highest rise was noted in Nepal (87.6 to 99.7 µg/m³) until 2017. During the coronavirus disease 19 pandemic, the pre-and post-pandemic changes between 2018 and 2021 indicated the highest PM_2.5 concentration in Bangladesh (76.9 µg/m³), followed by Pakistan (66.8 µg/m³), India (58.1 µg/m³), Nepal (46 µg/m³) and Sri Lanka (17.4 µg/m³). Overall, South Asian countries contribute to the worst air quality and sustainability trends regions worldwide. Conclusions: Air pollution is prevalent across a majority of South Asia countries. Owing to unsustainable industrial practices, pollution trends have risen to hazardous levels. Economic, environmental, and human health impacts have manifested and require urgent, concerted efforts by governing bodies in the region.

Air pollution and health impacts during the COVID-19 lockdowns in Grenoble, France

It is undeniable that exposure to outdoor air pollution impacts the health of populations and therefore constitutes a public health problem. Any actions or events causing variations in air quality have repercussions on populations' health. Faced with the worldwide COVID-19 health crisis that began at the end of 2019, the governments of several countries were forced, in the beginning of 2020, to put in place very strict containment measures that could have led to changes in air quality. While many works in the literature have studied the issue of changes in the levels of air pollutants during the confinements in different countries, very few have focused on the impact of these changes on health risks. In this work, we compare the 2020 period, which includes two lockdowns (March 16 - May 10 and a partial shutdown Oct. 30 - Dec. 15) to a reference period 2015-2019 to determine how these government-mandated lockdowns affected concentrations of NO₂, O₃, PM_2.5, and PM₁₀, and how that affected human health factors, including low birth weight, lung cancer, mortality, asthma, non-accidental mortality, respiratory, and cardiovascular illnesses. To this end, we structured 2020 into four periods, alternating phases of freedom and lockdowns characterized by a stringency index. For each period, we calculated (1) the differences in pollutant levels between 2020 and a reference period (2015-2019) at both background and traffic stations; and (2) the resulting variations in the epidemiological based relative risks of health outcomes. As a result, we found that relative changes in pollutant levels during the 2020 restriction period were as follows: NO₂ (-32%), PM_2.5 (-22%), PM₁₀ (-15%), and O₃ (+10.6%). The pollutants associated with the highest health risk reductions in 2020 were PM_2.5 and NO_2, while PM₁₀ and O₃ changes had almost no effect on health outcomes. Reductions in short-term risks were related to reductions in PM_2.5 (-3.2% in child emergency room visits for asthma during the second lockdown) and NO₂ (-1.5% in hospitalizations for respiratory causes). Long-term risk reductions related to PM_2.5 were low birth weight (-8%), mortality (-3.3%), and lung cancer (-2%), and to NO₂ for mortality (-0.96%). Overall, our findings indicate that the confinement period in 2020 resulted in a substantial improvement in air quality in the Grenoble area.

Impacts of Built Environment on Risk of Women's Lung Cancer: A Case Study of China

Built environment factors such as air pollution are associated with the risk of respiratory disease, but few studies have carried out profound investigation. We aimed to evaluate the association between the built environment and Chinese women’s lung cancer incidence data from the China Cancer Registry Annual Report 2017, which covered 345,711,600 people and 449 qualified cancer registries in mainland China. The air quality indicator (PM2.5) and other built environment data are obtained from the China Statistical Yearbook and other official approved materials. An exploratory regression tool is applied by using Chinese women’s lung cancer incidence data (Segi population) as the dependent variable, PM2.5 index and other built environment factors as the independent variables. An apparent clustering region with a high incidence of women’s lung cancer was discovered, including regions surrounding Bohai bay and the three Chinese northeastern provinces, Heilongjiang, Liaoning and Inner Mongolia. Besides air quality, built environment factors were found to have a weak but clear impact on lung cancer incidence. Land-use intensity and the greening coverage ratio were positive, and the urbanization rate and population density were negatively correlated with lung cancer incidence. The role of green spaces in Chinese women’s lung cancer incidence has not been proven.

Effects of sulfur dioxide, ozone, and ambient air pollution on lung histopathology, oxidative-stress biomarkers, and apoptosis-related gene expressions in rats

PURPOSE OF THE STUDY

Ambient air pollution (AAP) has become an important health problem globally. Besides, several pieces of evidence indicate that air pollutants such as sulfur dioxide (SO₂) and ozone (O₃) are major contributors to a wide range of non-communicable diseases. The present study investigated the effects of AAP, sulfur dioxide, and ozone on oxidative stress, histopathology, and some apoptosis-related genes expressions of lung tissue in a rat model.

MATERIALS AND METHODS

Thirty-two Wistar rats were randomly divided into the control, AAP, sulfur dioxide (10 ppm), and ozone (0.6 ppm) groups. After five consecutive weeks' exposure to the selected pollutants (3 h/day), lung tissues were harvested and immediately fixed with formalin. The samples were routinely processed, sectioned, stained with hematoxylin and eosin (H&E), and finally assessed for presence of pathological changes. Expression changes of BAX, p-53, EGFR, caspase-3, caspase-8 and caspase-9 were assayed using the RT-qPCR method. One hundred milligrams of lung tissues were extracted and the supernatants were used for assaying malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidase (GP_X), and catalase activities.

RESULTS

GPx activity was increased in the ozone (P = 0.05) and AAP (P < 0.001) groups and also MDA level in sulfur dioxide group (P = 0.008). Pathological lesions were mild, moderate, and severe in the sulfur dioxide, ozone, and AAP groups, respectively, as compared to control group (P ˂ 0.05). Exposure to AAP and sulfur dioxide enhanced BAX (P = 0.002) and caspase-8 (P < 0.001) mRNA expression, respectively. Caspases-3 and -8 mRNA expressions were elevated in ozone group (P < 0.001).

CONCLUSIONS

The results indicated induction of oxidative stress. Our results suggest the apoptosis stimuli effect of AAP and also the extrinsic apoptotic pathway trigger effect of sulfur dioxide and ozone in the lung tissue in the concentrations used in the present study. The histopathological and the genes expression changes may be a result of the induced oxidative stress in the lung tissues.

Vitamin D and Cancer: An Historical Overview of the Epidemiology and Mechanisms

This is a narrative review of the evidence supporting vitamin D’s anticancer actions. The first section reviews the findings from ecological studies of cancer with respect to indices of solar radiation, which found a reduced risk of incidence and mortality for approximately 23 types of cancer. Meta-analyses of observational studies reported the inverse correlations of serum 25-hydroxyvitamin D [25(OH)D] with the incidence of 12 types of cancer. Case-control studies with a 25(OH)D concentration measured near the time of cancer diagnosis are stronger than nested case-control and cohort studies as long follow-up times reduce the correlations due to changes in 25(OH)D with time. There is no evidence that undiagnosed cancer reduces 25(OH)D concentrations unless the cancer is at a very advanced stage. Meta-analyses of cancer incidence with respect to dietary intake have had limited success due to the low amount of vitamin D in most diets. An analysis of 25(OH)D-cancer incidence rates suggests that achieving 80 ng/mL vs. 10 ng/mL would reduce cancer incidence rates by 70 ± 10%. Clinical trials have provided limited support for the UVB-vitamin D-cancer hypothesis due to poor design and execution. In recent decades, many experimental studies in cultured cells and animal models have described a wide range of anticancer effects of vitamin D compounds. This paper will review studies showing the inhibition of tumor cell proliferation, dedifferentiation, and invasion together with the sensitization to proapoptotic agents. Moreover, 1,25-(OH)₂D₃ and other vitamin D receptor agonists modulate the biology of several types of stromal cells such as fibroblasts, endothelial and immune cells in a way that interferes the apparition of metastases. In sum, the available mechanistic data support the global protective action of vitamin D against several important types of cancer.

Nucleotide Excision Repair Pathway Activity Is Inhibited by Airborne Particulate Matter (PM10) through XPA Deregulation in Lung Epithelial Cells

Airborne particulate matter with a diameter size of ≤10 µm (PM₁₀) is a carcinogen that contains polycyclic aromatic hydrocarbons (PAH), which form PAH–DNA adducts. However, the way in which these adducts are managed by DNA repair pathways in cells exposed to PM₁₀ has been partially described. We evaluated the effect of PM₁₀ on nucleotide excision repair (NER) activity and on the levels of different proteins of this pathway that eliminate bulky DNA adducts. Our results showed that human lung epithelial cells (A549) exposed to 10 µg/cm² of PM₁₀ exhibited PAH–DNA adducts as well as an increase in RAD23 and XPD protein levels (first responders in NER). In addition, PM₁₀ increased the levels of H4K20me2, a recruitment signal for XPA. However, we observed a decrease in total and phosphorylated XPA (Ser196) and an increase in phosphatase WIP1, aside from the absence of XPA–RPA complex, which participates in DNA-damage removal. Additionally, an NER activity assay demonstrated inhibition of the NER functionality in cells exposed to PM₁₀, indicating that XPA alterations led to deficiencies in DNA repair. These results demonstrate that PM₁₀ exposure induces an accumulation of DNA damage that is associated with NER inhibition, highlighting the role of PM₁₀ as an important contributor to lung cancer.

Proteomic characteristics of PM2.5-induced differentially expressed proteins in k-ras-silenced HBE cells

The human bronchial epithelial cells (HBE) and K-ras-silenced HBE cells were treated with fine particulate matter (PM_2.5) samples from Taiyuan for 24 h. To screen the proteomic characteristics of PM_2.5-induced differentially expressed proteins (DEPs), the Q Exactive mass spectrometer was used. Gene ontology (GO) analysis, Kyoto encyclopedia of genes and genomes (KEGG) analysis, functional prediction, protein-protein interaction (PPI) network analysis, and visualization of differential protein interactions were performed. 251 DEPs in K-ras silenced cells and 535 DEPs in normal HBE cells were identified, respectively. KEGG analysis showed that the differentially expressed proteins of PM_2.5-treated cells were related to the biosynthesis of ribosomes, antibiotics, and amino acids. On the other hand, K-ras silenced cells were related to metabolic pathways, RNA transport, and DNA replication. Through the construction of a PPI network, the top 10 hub proteins were screened from the two cell groups, among which MRPL13, RPS20, and EIF1AX were of great significance. Our results indicated that the K-ras gene plays an important role in PM_2.5-induced DEPs, and the findings provide a scientific basis for the further study of PM_2.5 toxic mechanisms and biomarkers.

Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females

BACKGROUND

Although lung cancer incidence rates according to smoking status, sex, and detailed race/ethnicity have not been available, it is estimated that more than half of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females with lung cancer have never smoked.

METHODS

We calculated age-adjusted incidence rates for lung cancer according to smoking status and detailed race/ethnicity among females, focusing on AANHPI ethnic groups, and assessed relative incidence across racial/ethnic groups. We used a large-scale dataset that integrates data from electronic health records from 2 large health-care systems-Sutter Health in Northern California and Kaiser Permanente Hawai'i-linked to state cancer registries for incident lung cancer diagnoses between 2000 and 2013. The study population included 1 222 694 females (n = 244 147 AANHPI), 3297 of which were diagnosed with lung cancer (n = 535 AANHPI).

RESULTS

Incidence of lung cancer among never-smoking AANHPI as an aggregate group was 17.1 per 100 000 (95% confidence interval [CI] = 14.9 to 19.4) but varied widely across ethnic groups. Never-smoking Chinese American females had the highest rate (22.8 per 100 000, 95% CI = 17.3 to 29.1). Except for Japanese American females, incidence among every never-smoking AANHPI female ethnic group was higher than that of never-smoking non-Hispanic White females, from 66% greater among Native Hawaiian females (incidence rate ratio = 1.66, 95% CI = 1.03 to 2.56) to more than 100% greater among Chinese American females (incidence rate ratio = 2.26, 95% CI = 1.67 to 3.02).

CONCLUSIONS

Our study revealed high rates of lung cancer among most never-smoking AANHPI female ethnic groups. Our approach illustrates the use of innovative data integration to dispel the myth that AANHPI females are at overall reduced risk of lung cancer and demonstrates the need to disaggregate this highly diverse population.

Interrelationship of Indoor Particulate Matter and Respiratory Dust Depositions of Women in the Residence of Dhanbad City, India

Women spend relatively more time in indoor environments in developing countries. Exposure to various indoor air pollutants leads them to higher health risks according to household air quality in which they reside. Particulate matter (PM) exposure with their exposure duration inside the household plays a significant role in women's respiratory problems. This study measured size-segregated particulate matter concentrations in 63 residences at different locations. Respiratory dust depositions (RDDs) for 118 women in their different respiratory regions like head airway (HD), tracheobronchial (TB), and alveolar (AL) regions for the three PM size fractions (PM₁₀, PM_2.5, and PM₁) were investigated. For different positions like light exercise and the sitting condition, RDDs values found for AL region were 0.091 μgmin^-1 (SD: 0.067, 0.012-0.408) and 0.028 μgmin^-1 (SD: 0.021, 0.003-0.126) for PM₁₀, 0.325 μgmin^-1 (SD: 0.254, 0.053-1.521) and 0.183 μgmin^-1 (SD: 0.143, 0.031-0.857) for PM_2.5, 0.257 μgmin^-1 (SD: 0.197, 0.043-1.04) and 0.057 μgmin^-1 (SD: 0.044, 0.009-0.233) respectively for PM₁ to females. RDDs values in the AL region significantly increase as PM₁₀ (11%), PM_2.5 (68%), and PM₁ (21%), confirming that for women, the AL region is the most prominent affected zone by fine particles (PM_2.5).

Luteolin Reduces Aqueous Extract PM2.5-induced Metastatic Activity in H460 Lung Cancer Cells

Fine particulate matter (PM2.5) is the critical cause of lung cancer and can further promote tumor cell migration and invasion. This study investigated the effects of luteolin, an antiangiogenic flavonoid agent, on blocking aqueous extract PM2.5-prompted cancer progression. We observed that luteolin reduced cell migration and the expression of pro-metastatic factors pro-matrix metalloproteinase (MMP)-2 and intercellular adhesion molecule (ICAM)-1 in PM2.5-exposed H460 lung cancer cells. Luteolin treatment also reduced the transduction of PM2.5-induced epidermal growth factor receptor (EGFR)-phosphatidylinositol 3-kinase (PI3K)-protein kinase B (AKT) cascade signaling. Furthermore, the reduction of MMP-2 expression and ICAM-1 production by luteolin in PM2.5-stimulated H460 cells is EGFR-PI3K-AKT pathway dependent. These results suggest that luteolin exhibits antitumor progression by inhibiting EGFR-PI3K-AKT pathway.

Transcription profiles in BEAS-2B cells exposed to organic extracts from particulate emissions produced by a port-fuel injection vehicle, fueled with conventional fossil gasoline and gasoline-ethanol blend

Emissions from road traffic are among the major contributors to air pollution worldwide and represent a serious environmental health risk. Although traffic-related pollution has been most commonly associated with diesel engines, increasing evidence suggests that gasoline engines also produce a considerable amount of potentially hazardous particulate matter (PM). The primary objective of this study was to compare the intrinsic toxic properties of the organic components of PM, generated by a conventional gasoline engine fueled with neat gasoline (E0), or gasoline-ethanol blend (15 % ethanol, v/v, E15). Our results showed that while E15 has produced, compared to gasoline and per kg of fuel, comparable particle mass (μg PM/kg fuel) and slightly more particles by number, the organic extract from the particulate matter produced by E15 contained a larger amount of harmful polycyclic aromatic hydrocarbons (PAHs), as determined by the chemical analysis. To examine the toxicity, we monitored genome-wide gene expression changes in human lung BEAS-2B cells, exposed for 4 h and 24 h to a subtoxic dose of each PM extract. After 4 h exposure, numerous dysregulated genes and processes such as oxidative stress, lipid and steroid metabolism, PPARα signaling and immune response, were found to be common for both extract treatments. On the other hand, 24 h exposure resulted in more distinctive gene expression patterns. Although we identified several common modulated processes indicating the metabolism of PAHs and activation of aryl hydrocarbon receptor (AhR), E15 specifically dysregulated a variety of other genes and pathways related to cancer promotion and progression. Overall, our findings suggest that the ethanol addition to gasoline changed the intrinsic properties of PM emissions and increased the PAH content in PM organic extract, thus contributing to a more extensive toxic response particularly after 24 h exposure in BEAS-2B cells.

Dynamic Linkages Among Energy Consumption, Environment and Health Sustainability: Evidence from the Different Income Level Countries

Environment pollution was closely related to human health. The energy consumption is one of the important sources of environmental pollution in the development of economy. This paper used undesirable two-stage meta-frontier DDF (distance difference function) data envelopment analysis model to explore the impact of environment pollutants from energy consumption on the mortality of children and the aged, survival rate of 65 years old and health expenditure efficiency in 27 high income countries, 21 upper middle income countries, and 16 lower middle income countries from 2010 to 2014. High income countries had higher efficiency of energy and health than middle income countries in general. But whether in high income or middle income countries, the efficiency of non-renewable energy is higher than renewable energy. There was much room for both high income countries and middle income countries to improve renewable energy efficiency. Besides, middle income countries need to improve the efficiency of non-renewable energy and reduce pollutant emissions per unit of GDP. In terms of health efficiency, upper middle income countries performed worse than lower income countries. This phenomenon might indicate there was a U-shaped relationship between health efficiency and income level. Upper income countries should pay more attention to the environmental and health problems and cross the U-shaped turning point. The contribution of this article was to consider the heterogeneous performance of energy efficiency, environmental efficiency, and health efficiency under the influence of income level differences, and found that there might be a U-shaped relationship between health efficiency and income level.

Airborne particulate matter induces oxidative damage, DNA adduct formation and alterations in DNA repair pathways

Air pollution, which includes particulate matter (PM), is classified in group 1 as a carcinogen to humans by the International Agency for Research in Cancer. Specifically, PM exposure has been associated with lung cancer in patients living in highly polluted cities. The precise mechanism by which PM is linked to cancer has not been completely described, and the genotoxicity induced by PM exposure plays a relevant role in cell damage. In this review, we aimed to analyze the types of DNA damage and alterations in DNA repair pathways induced by PM exposure, from both epidemiological and toxicological studies, to comprehend the contribution of PM exposure to carcinogenesis. Scientific evidence supports that PM exposure mainly causes oxidative stress by reactive oxygen species (ROS) and the formation of DNA adducts, specifically by polycyclic aromatic hydrocarbons (PAH). PM exposure also induces double-strand breaks (DSBs) and deregulates the expression of some proteins in DNA repair pathways, precisely, base and nucleotide excision repairs and homologous repair. Furthermore, specific polymorphisms of DNA repair genes could lead to an adverse response in subjects exposed to PM. Nevertheless, information about the effects of PM on DNA repair pathways is still limited, and it has not been possible to conclude which pathways are the most affected by exposure to PM or if DNA damage is repaired properly. Therefore, deepening the study of genotoxic damage and alterations of DNA repair pathways is needed for a more precise understanding of the carcinogenic mechanism of PM.

Air pollution-induced epigenetic changes: disease development and a possible link with hypersensitivity pneumonitis

Air pollution is a serious threat to our health and has become one of the major causes of many diseases including cardiovascular disease, respiratory disease, and cancer. The association between air pollution and various diseases has long been a topic of research interest. However, it remains unclear how air pollution actually impacts health by modulating several important cellular functions. Recently, some evidence has emerged about air pollution-induced epigenetic changes, which are linked with the etiology of various human diseases. Among several epigenetic modifications, DNA methylation represents the most prominent epigenetic alteration underlying the air pollution-induced pathogenic mechanism. Several other types of epigenetic changes, such as histone modifications, miRNA, and non-coding RNA expression, have also been found to have been linked with air pollution. Hypersensitivity pneumonitis (HP), one of the most prevalent forms of interstitial lung diseases (ILDs), is triggered by the inhalation of certain organic and inorganic substances. HP is characterized by inflammation in the tissues around the lungs' airways and may lead to irreversible lung scarring over time. This review, in addition to other diseases, attempts to understand whether certain pollutants influence HP development through such epigenetic modifications.

Autophagy induced by H. pylori VacA regulated the survival mechanism of the SGC7901 human gastric cancer cell line

Background

Vacuolating cytotoxin (VacA) is an important virulence factor of Helicobacter pylori (H. pylori). It was previously believed that VacA can trigger the cascade of apoptosis on mitochondria to lead to cell apoptosis. Recently, it was found that VacA can induce autophagy. However, the molecular mechanism by which VacA induces autophagy is largely unknown.

Objective

We aimed to explore the molecular mechanism of autophagy induced by H. pylori in gastric cancer cells and the effect of autophagy on the survival of gastric cancer cells.

Methods

The autophagy of human gastric cancer cell line SGC7901 was detected by Western blot and RT-PCR in the treatment of VacA protein of H. pylori. The relationship between autophagy and reactive oxygen species (ROS) in the proliferation of gastric cancer cells were studied by gene expression silences (siRNA) and CM-H2DCFDA (DCF) staining.

Results

The results showed that VacA protein secreted by H. pylori in the supernatant stimulated autophagy in SGC7901 cells. After VacA protein treatment, the mRNA expressions of BECN1, ATG7 and PIK3C3, were up-regulated. ATG7 silencing by siRNA inhibited VacA-induced autophagy. Furthermore, our data demonstrated that VacA protein increased ROS levels. Addition of the antioxidant N-acetyl-l-cysteine (NAC) suppressed the levels of ROS, leading to inhibition of autophagy.

Conclusions

H. pylori VacA is a key toxin that induces autophagy by increased ROS levels. And our findings demonstrated that VacA significantly inhibited proliferation in SGC7901 cells.

Proteomic characteristics of PM2.5 -induced differentially expressed proteins in human renal tubular epithelial cells

Human renal epithelial (HK-2) cells were treated with PM_2.5 (50 μg/mL) from Shenzhen and Taiyuan, proteomics and bioinformatics were used to screen the differentially expressed proteins (DEPs). A total of 577 DEPs were screened after HK-2 cells exposed to Shenzhen PM_2.5, of which 426 were up-regulated and 151 were down-regulated. A total of 1250 DEPs were screened in HK-2 cells after exposure to Taiyuan PM_2.5, of which 488 were up-regulated and 185 were down-regulated. The top 10 proteins with the highest number of nodes were screened using the interaction network map of DEPs. HK-2 cells exposed to Shenzhen PM_2.5 contained CYR61, CTGF, and THBS1 proteins, while HK-2 cells exposed to Taiyuan PM_2.5 contained ALB, FN1, and CYR61 proteins. Additionally, PM_2.5 components were detected, PM_2.5 samples from Shenzhen and Taiyuan induced obvious changes in DEPs expression, the difference in DEPs between the two cities was probably associated with the different PM_2.5 components.

Ambient air pollution and ovarian cancer survival in California

OBJECTIVE

To examine whether exposure to ambient ozone, particulate matter with diameter less than 2.5 μm (PM_2.5), nitrogen dioxide (NO₂), and distance to major roadways (DTR) impact ovarian cancer-specific survival, while considering differences by stage, race/ethnicity, and socioeconomic status.

METHODS

Women diagnosed with epithelial ovarian cancer from 1996 to 2014 were identified through the California Cancer Registry and followed through 2016. Women's geocoded addresses were linked to pollutant exposure data and averaged over the follow-up period. Pollutants were considered independently and in multi-pollutant models. Cox proportional hazards models assessed hazards of disease-specific death due to environmental exposures, controlling for important covariates, with additional models stratified by stage at diagnosis, race/ethnicity and socioeconomic status.

RESULTS

PM_2.5 and NO₂, but not ozone or DTR, were significantly associated with survival in univariate models. In a multi-pollutant model for PM_2.5, ozone, and DTR, an interquartile range increase in PM_2.5 (Hazard Ratio [HR], 1.45; 95% Confidence Interval [CI], 1.41-1.49) was associated with worse prognosis. Similarly, in the multi-pollutant model with NO₂, ozone, and DTR, women with higher NO₂ exposures (HR for 20.0-30.0 ppb, 1.30; 95% CI, 1.25-1.36 and HR for >30.0 ppb, 2.48; 95% CI, 2.32-2.66) had greater mortality compared to the lowest exposed (<20.0 ppb). Stratified results show the effects of the pollutants differed by race/ethnicity and were magnified among women diagnosed in early stages.

CONCLUSIONS

Our analyses suggest that greater exposure to NO₂ and PM_2.5 may adversely impact ovarian cancer-specific survival, independent of sociodemographic and treatment factors. These findings warrant further study.

A comprehensive meta-analysis and a case-control study give insights into genetic susceptibility of lung cancer and subgroups

Reports of genetic association of polymorphisms with lung cancer in the Indian subcontinent are often conflicting. To summarise and replicate published evidence for association with lung cancer and its subgroups. We performed a meta-analysis of candidate associations on lung cancer, its histological subtypes and smoking status in the Indian subcontinent following PRISMA guidelines. Multiple testing corrections were done by the Benjamini-Hochberg method through assessment of significance at a false discovery rate of 10%. We genotyped and investigated rs1048943/CYP1A1 in a case-control sample from eastern India, followed by its global meta-analysis using a similar protocol. Meta-analysis of 18 variants of 11 genes reported in 39 studies (7630 cases and 8169 controls) showed significant association of rs1048943/CYP1A1 [2.07(1.49-2.87)] and rs4646903/CYP1A1 [1.48(1.93-1.95)] with overall lung cancer risk at 10% FDR, while nominal association (p < 0.05) was observed for del1/GSTT1, del2/GSTM1, rs1695/GSTP1 and rs17037102/ DKK2. Subtype analysis showed a significant association of del1/GSTT1 with adenocarcinoma, rs4646903/CYP1A1 with squamous carcinoma, and rs1048943/CYP1A1 with both. Association of rs4646903/CYP1A1 in smokers and effect modification by meta-regression analysis was observed. Genotyping of rs1048943/CYP1A1 that presented significant heterogeneity (p < 0.1) revealed an association with adenocarcinoma among eastern Indian smokers, while a global meta-analysis in 10458 cases and 10871 controls showed association with lung cancer and its subgroups. This study identified the susceptibility loci for lung cancer and its covariate-subgroups.

Airborne particulate matter upregulates expression of early and late adhesion molecules and their receptors in a lung adenocarcinoma cell line

BACKGROUND

Epidemiological evidence associates chronic exposure to particulate matter (PM) with respiratory damage and lung cancer. Inhaled PM may induce systemic effects including inflammation and metastasis. This study evaluated whether PM induces expression of adhesion molecules in lung cancer cells promoting interaction with monocytes.

METHODS

The expression of early and late adhesion molecules and their receptors was evaluated in A549 (human lung adenocarcinoma) cells using a wide range of concentrations of PM_2.5 and PM₁₀. Then we evaluated cellular adhesion between A549 cells and U937 (human monocytes) cells after PM exposure.

RESULTS

We found higher expression of both early and late adhesion molecules and their ligands in lung adenocarcinoma cells exposed to PM_2.5 and PM₁₀ particles present in the air pollution at Mexico City from 0.03 μg/cm² with a statistically significant difference (p ≤ 0.05). PM₁₀ had stronger effect than PM_2.5. Both PM also stimulated cellular adhesion between tumor cells and monocytes.

CONCLUSIONS

This study reveals a comprehensive expression profile of adhesion molecules and their ligands upregulated by PM_2.5 and PM₁₀ in A549 cells. Additionally these particles induced cellular adhesion of lung cancer cells to monocytes. This highlights possible implications of PM in two cancer hallmarks i.e. inflammation and metastasis, underlying the high cancer mortality associated with air pollution.

lncRNA SOX2-OT ceRNA network enhances the malignancy of long-term PM2.5-exposed human bronchial epithelia

Exposure to fine particulate matter (PM_2.5) in outdoor air is carcinogenic and associated with the development of lung cancer; however, the underlying mechanism remains unclear. In the present study, the profiles of lncRNA, microRNA and mRNA expression profiles in human bronchial epithelia (HBE) following exposure to PM_2.5, diesel exhaust particles (DEPs), or aluminum oxide nanoparticles (Al₂O₃ NPs) were explored by microarray to reveal the lncRNA-microRNA-mRNA network participating in the malignant transformation of HBE cells following long-term PM_2.5 exposure. The results showed that lncRNA SOX2 overlapping transcript (SOX2-OT) was significantly induced in HBE cells exposed to PM_2.5, DEPs, or Al₂O₃ NPs, acting as a sponge to microRNA-345-5p, which subsequently increased the expression levels of epidermal growth factor receptor (EGFR). EGFR is a therapeutic target in non-small cell lung cancer. Here, we found that SOX2-OT is an upstream trigger of EGFR in HBE cells during long-term PM_2.5 exposure. Importantly, SOX2-OT knockdown effectively reduced the colony formation and migration capacities of HBE cells, compared to the wild type control. Collectively, SOX2-OT/microRNA-345-5p/EGFR is a ceRNA mechanism underlying the malignant transformation of bronchial epithelia exposed to PM_2.5, which improves our understanding of the association between ambient PM_2.5 exposure and the development of lung cancer.