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Zhang J, Lim YH, So R, Mortensen LH, Napolitano GM, Cole-Hunter T, Tuffier S, Bergmann M, Maric M, Taghavi Shahri SM, Brandt J, Ketzel M, Loft S, Andersen ZJ. Long-Term Exposure to Air Pollution and Risk of Acute Lower Respiratory Infections in the Danish Nurse Cohort. Ann Am Thorac Soc 2024. [PMID: 38513223 DOI: 10.1513/annalsats.202401-074oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/21/2024] [Indexed: 03/23/2024] Open
Abstract
RATIONALE Air pollution is a major risk factor for chronic cardiorespiratory diseases, affecting both the immune and respiratory systems' functionality, while the epidemiological evidence on respiratory infections remains sparse. OBJECTIVE We aimed to assess the association of long-term exposure to ambient air pollution with risk of developing new and recurrent ALRIs that characterized by persistently severe symptoms necessitating hospital contact, and identify the potential susceptible populations by socio-economic status (SES), smoking, physical activity status, overweight, and co-morbidity with chronic lung disease. METHODS We followed 23,912 female nurses from the Danish Nurse Cohort (> 44 years) from baseline (1993 or 1999) until 2018 for the incident and recurrent ALRIs defined by hospital contact (in-, outpatient, and emergency room) data from the National Patient Register. Residential annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) were modelled using Danish DEHM/UBM/AirGIS system. We used marginal Cox models with time-varying exposures to assess the association of 3-year running-mean air pollution with incident and recurrent ALRIs and examine effect modification by age, socio-economic status (SES), smoking, physical activity, body mass index, and comorbidity with asthma or chronic obstructive pulmonary disease (COPD). RESULTS During a 21.3 years mean follow-up, 4,746 ALRIs were observed, of which 2,553 were incident. We observed strong positive associations of all three pollutants with incident ALRIs, with hazard ratios and 95% confidence intervals of 1.19 (1.08-1.31) per 2.5 µg/m3 for PM2.5, 1.17 (1.11-1.24) per 8.0 µg/m3 for NO2, and 1.09 (1.05-1.12) per 0.3 µg/m3 for BC, and slightly stronger associations with recurrent ALRIs. Associations were strongest in COPD patients and nurses with low physical activity. CONCLUSION Long-term exposure to air pollution at low levels was associated with risk of new and recurrent ALRIs, with COPD patients and physically inactive subjects most vulnerable. Primary Source of Funding: This study was supported by the Novo Nordisk Foundation Challenge Programme (NNF17OC0027812).
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Affiliation(s)
- Jiawei Zhang
- University of Copenhagen Section of Environmental Health, 86986, Department of Public Health, Kobenhavn, Denmark
| | - Youn-Hee Lim
- University of Copenhagen, Section of Environmental Health, Department of Public Health, Copenhagen, Denmark
| | - Rina So
- University of Copenhagen, Section of Environmental Health, Department of Public Health, Copenhagen, Denmark
| | - Laust H Mortensen
- University of Copenhagen, Section of Epidemiology, Department of Public Health, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
| | - George Maria Napolitano
- University of Copenhagen Section of Environmental Health, 86986, Department of Public Health, Kobenhavn, Denmark
| | - Thomas Cole-Hunter
- University of Copenhagen, Section of Environmental Health, Department of Public Health, Copenhagen, Denmark
- University of Sydney, Centre for Air pollution, energy and health Research (CAR), Sydney, Denmark
| | - Stéphane Tuffier
- University of Copenhagen Section of Environmental Health, 86986, Kobenhavn, Denmark
| | | | - Matija Maric
- University of Copenhagen Section of Environmental Health, 86986, Kobenhavn, Denmark
| | | | - Jørgen Brandt
- Department of Environmental Science, Roskilde, Djibouti
| | - Matthias Ketzel
- Aarhus University, 1006, Department of Environmental Science, Roskilde, Denmark
- University of Surrey, 3660, Global Centre for Clean Air Research, Guildford, Surrey, United Kingdom of Great Britain and Northern Ireland
| | - Steffen Loft
- University of Copenhagen, Public Health, Copenhagen K, Denmark
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Lim YH, Bilsteen JF, Mortensen LH, Lanzky LRM, Zhang J, Tuffier S, Brandt J, Ketzel M, Flensborg-Madsen T, Wimmelmann CL, Okholm GT, Hegelund ER, Napolitano GM, Andersen ZJ, Loft S. Lifetime exposure to air pollution and academic achievement: A nationwide cohort study in Denmark. Environ Int 2024; 185:108500. [PMID: 38430583 DOI: 10.1016/j.envint.2024.108500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 03/04/2024]
Abstract
Recent research suggests a link between air pollution and cognitive development in children, and studies on air pollution and academic achievement are emerging. We conducted a nationwide cohort study in Denmark to explore the associations between lifetime exposure to air pollution and academic performance in 9th grade. The study encompassed 785,312 children born in Denmark between 1989 and 2005, all of whom completed 9th-grade exit examinations. Using linear mixed models with a random intercept for each school, we assessed the relationship between 16 years of exposure to PM2.5, PM10, and gaseous pollutants and Grade Point Averages (GPA) in exit examinations, covering subjects such as Danish literature, Danish writing, English, mathematics, and natural sciences. The study revealed that a 5 µg/m3 increase in PM2.5 and PM10 was associated with a decrease of 0.99 (95 % Confidence Intervals: -1.05, -0.92) and 0.46 (-0.50, -0.41) in GPA, respectively. Notably, these negative associations were more pronounced in mathematics and natural sciences compared to language-related subjects. Additionally, girls and children with non-Danish mothers were found to be particularly susceptible to the adverse effects of air pollution exposure. These results underscore the potential long-term consequences of air pollution on academic achievement, emphasizing the significance of interventions that foster healthier environments for children's cognitive development.
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Affiliation(s)
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Josephine Funck Bilsteen
- Ministry of Children and Education, National Agency for Education and Quality, Copenhagen, Denmark
| | | | | | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stéphane Tuffier
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Roskilde, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Faculty of Technical Sciences, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, United Kingdom
| | - Trine Flensborg-Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | | | - George Maria Napolitano
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Bergmann ML, Andersen ZJ, Massling A, Kindler PA, Loft S, Amini H, Cole-Hunter T, Guo Y, Maric M, Nordstrøm C, Taghavi M, Tuffier S, So R, Zhang J, Lim YH. Short-term exposure to ultrafine particles and mortality and hospital admissions due to respiratory and cardiovascular diseases in Copenhagen, Denmark. Environ Pollut 2023; 336:122396. [PMID: 37595732 DOI: 10.1016/j.envpol.2023.122396] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
Ultrafine particles (UFP; particulate matter <0.1 μm in diameter) may be more harmful to human health than larger particles, but epidemiological evidence on their health effects is still limited. In this study, we examined the association between short-term exposure to UFP and mortality and hospital admissions in Copenhagen, Denmark. Daily concentrations of UFP (measured as particle number concentration in a size range 11-700 nm) and meteorological variables were monitored at an urban background station in central Copenhagen during 2002-2018. Daily counts of deaths from all non-accidental causes, as well as deaths and hospital admissions from cardiovascular and respiratory diseases were obtained from Danish registers. Mortality and hospital admissions associated with an interquartile range (IQR) increase in UFP exposure on a concurrent day and up to six preceding days prior to the death or admission were examined in a case-crossover study design. Odds ratios (OR) with 95% confidence intervals (CI) per one IQR increase in UFP were estimated after adjusting for temperature and relative humidity. We observed 140,079 deaths in total, 236,003 respiratory and 342,074 cardiovascular hospital admissions between 2002 and 2018. Hospital admissions due to respiratory and cardiovascular diseases were significantly positively associated with one IQR increase in UFP (OR: 1.04 [95% CI: 1.01, 1.07], lag 0-4, and 1.02 [1.00, 1.04], lag 0-1, respectively). Among the specific causes, the strongest associations were found for chronic obstructive pulmonary disease (COPD) mortality and asthma hospital admissions and two-day means (lag 0-1) of UFP (OR: 1.13 [1.01, 1.26] and 1.08 [1.00, 1.16], respectively, per one IQR increase in UFP). Based on 17 years of UFP monitoring data, we present novel findings showing that short-term exposure to UFP can trigger respiratory and cardiovascular diseases mortality and morbidity in Copenhagen, Denmark. The strongest associations with UFP were observed with COPD mortality and asthma hospital admissions.
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Affiliation(s)
- Marie L Bergmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Massling
- Department of Environmental Science, IClimate, Aarhus University, Denmark
| | | | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Department of Environmental Medicine and Public Health, and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Matija Maric
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Claus Nordstrøm
- Department of Environmental Science, IClimate, Aarhus University, Denmark
| | - Mahmood Taghavi
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stéphane Tuffier
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Tuffier S, Upegui E, Raghoumandan C, Viel JF. Retrospective assessment of pregnancy exposure to particulate matter from desert dust on a Caribbean island: could satellite-based aerosol optical thickness be used as an alternative to ground PM 10 concentration? Environ Sci Pollut Res Int 2021; 28:17675-17683. [PMID: 33403634 DOI: 10.1007/s11356-020-12204-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
Desert dust transported from the Saharan-Sahel region to the Caribbean Sea is responsible for peak exposures of particulate matter (PM). This study explored the potential added value of satellite aerosol optical thickness (AOT) measurements, compared to the PM concentration at ground level, to retrospectively assess exposure during pregnancy. MAIAC MODIS AOT retrievals in blue band (AOT470) were extracted for the French Guadeloupe archipelago. AOT470 values and PM10 concentrations were averaged over pregnancy for 906 women (2005-2008). Regression modeling was used to examine the AOT470-PM10 relationship during pregnancy and test the association between dust exposure estimates and preterm birth. Moderate agreement was shown between mean AOT470 retrievals and PM10 ground-based measurements during pregnancy (R2 = 0.289). The magnitude of the association between desert dust exposure and preterm birth tended to be lower using the satellite method compared to the monitor method. The latter remains an acceptable trade-off between epidemiological relevance and exposure misclassification, in areas with few monitoring stations and complex topographical/meteorological conditions, such as tropical islands.
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Affiliation(s)
- Stéphane Tuffier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, University of Rennes 1, F-35000, Rennes, France
| | - Erika Upegui
- Faculty of Engineering, Universidad Distrital Francisco José de Caldas, CP, 110001, Bogota, Colombia
| | | | - Jean François Viel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, University of Rennes 1, F-35000, Rennes, France.
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Tracol C, Vannier S, Hurel C, Tuffier S, Eugene F, Le Reste PJ. Predictors of malignant middle cerebral artery infarction after mechanical thrombectomy. Rev Neurol (Paris) 2020; 176:619-625. [PMID: 32624178 DOI: 10.1016/j.neurol.2020.01.352] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/05/2020] [Accepted: 01/10/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Several predictors have been described to early diagnose malignant middle cerebral artery infarction (MMI) and select patient for hemicraniectomy. Nevertheless, few studies have assessed them among patients with acute ischemic stroke undergoing mechanical endovascular thrombectomy (MET). The overall objective in this study was to evaluate these predictors in patients undergoing MET in the purpose to guide the medical care in the acute phase. METHODS We selected patients from a prospective local database which reference all patients eligible for treatment with Alteplase thrombolysis and/or mechanical endovascular thrombectomy in acute stroke. We investigated demographic, clinical, and radiological data. Multivariate regression analysis was used to identify clinical and imaging predictors of MMI. RESULTS In 32 months, 66 patients were included. Eighteen (27.3%) developed MMI. Malignant evolution was associated with: severity of neurological deficit and level of consciousness at admission, infarct size in DWI sequence and involvement of other vascular territories. Study groups didn't differ in terms of successful reperfusion. Two variables were identified as independent predictors of MMI: DWI infarct volume (p<0.001) and time to thrombectomy (p=0.018). A decision tree based on these two factors was able to predict malignant evolution with high specificity (100%) and sensibility (73%). CONCLUSION Our study proposes a practical decision tree including DWI lesion volume and delay before thrombectomy to early and accurately predict MMI in a subgroup of patients with MCA infarction undergoing MET regardless to the status of reperfusion.
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Affiliation(s)
- C Tracol
- Neurology, university hospital, 37, quai de la Prevalaye, 35000 Rennes, France.
| | - S Vannier
- Neurology, university hospital, Rennes, France
| | - C Hurel
- Department of epidemiology, university hospital, Rennes, France
| | - S Tuffier
- Department of epidemiology, university hospital, Rennes, France
| | - F Eugene
- Radiology, university hospital, Rennes, France
| | - P J Le Reste
- Neurosurgery, university hospital, Rennes, France
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Catillon F, Tuffier S, Guilcher A, Tollenaere Q, Métairie A, Miossec A, Mauger C, Laneelle D, Mahé G. Proficiency of Medical Students at Obtaining Pressure Measurement Readings Using Automated Ankle and Toe Measuring Devices for Diagnosis of Lower Extremity Peripheral Artery Disease. Ann Vasc Surg 2020; 65:183-189. [DOI: 10.1016/j.avsg.2019.10.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 12/24/2022]
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Alix L, Bajeux E, Hubert J, Cador B, Josselin JM, Tuffier S, Gicquel V, Somme D, Jego P, Bacle A, Hue B. Medication reconciliation in hospital patients over the age of 65: How long does it take and how much does it cost? A time-motion study in an internal medicine ward. Eur J Intern Med 2020; 73:100-102. [PMID: 31859024 DOI: 10.1016/j.ejim.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/04/2019] [Accepted: 12/07/2019] [Indexed: 11/21/2022]
Affiliation(s)
- L Alix
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - E Bajeux
- Service d'Epidémiologie et de Santé Publique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - J Hubert
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - B Cador
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - J M Josselin
- Faculté de Sciences Economiques de Rennes 1 - 7 place Hoche - 35000 Rennes, France.
| | - S Tuffier
- Service d'Epidémiologie et de Santé Publique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - V Gicquel
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - D Somme
- Service de Gériatrie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - P Jego
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - A Bacle
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - B Hue
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
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Tuffier S, Jarno P, Petureau A, Lemoine R, Carson S. Analyse rétrospective des causes et des pertes financières des séjours longs au centre hospitalo-universitaire (CHU) de Rennes, France. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.01.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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