Air pollution and public health: emerging hazards and improved understanding of risk

Does improving indoor air quality lessen symptoms associated with chemical intolerance?

Aim:

To determine whether environmental house calls that improved indoor air quality (IAQ) is effective in reducing symptoms of chemical intolerance (CI).

Background:

Prevalence of CI is increasing worldwide. Those affected typically report symptoms such as headaches, fatigue, ‘brain fog’, and gastrointestinal problems – common primary care complaints. Substantial evidence suggests that improving IAQ may be helpful in reducing symptoms associated with CI.

Methods:

Primary care clinic patients were invited to participate in a series of structured environmental house calls (EHCs). To qualify, participants were assessed for CI with the Quick Environmental Exposure and Sensitivity Inventory. Those with CI volunteered to allow the EHC team to visit their homes to collect air samples for volatile organic compounds (VOCs). Initial and post-intervention IAQ sampling was analyzed by an independent lab to determine VOC levels (ng/L). The team discussed indoor air exposures, their health effects, and provided guidance for reducing exposures.

Findings:

Homes where recommendations were followed showed the greatest improvements in IAQ. The improvements were based upon decreased airborne VOCs associated with reduced use of cleaning chemicals, personal care products, and fragrances, and reduction in the index patients’ symptoms. Symptom improvement generally was not reported among those whose homes showed no VOC improvement.

Conclusion:

Improvements in both IAQ and patients’ symptoms occur when families implement an action plan developed and shared with them by a trained EHC team. Indoor air problems simply are not part of most doctors’ differential diagnoses, despite relatively high prevalence rates of CI in primary care clinics. Our three-question screening questionnaire – the BREESI – can help physicians identify which patients should complete the QEESI. After identifying patients with CI, the practitioner can help by counseling them regarding their home exposures to VOCs. The future of clinical medicine could include environmental house calls as standard of practice for susceptible patients.

Promoting Sustainable Mobility: To What Extent Is “Health” Considered by Mobility App Studies? A Review and a Conceptual Framework

Promoting cycling and walking in cities improves individual health and wellbeing and, together with public transport, promotes societal sustainability patterns. Recently, smartphone apps informing and motivating sustainable mobility usage have increased. Current research has applied and investigated these apps; however, none have specifically considered mobility-related health components within mobility apps. The aim of this study is to examine the (potential) role of health-related information provided in mobility apps to influence mobility behavior. Following a systematic literature review of empirical studies applying mobility apps, this paper (1) investigates the studies and mobility apps regarding communicated information, strategies, and effects on mobility behavior and (2) explores how, and to what extent, health and its components are addressed. The reviewed studies focus on environmental information, especially CO2-emissions. Health is represented by physical activity or calories burned. The self-exposure to air pollution, noise, heat, traffic injuries or green spaces is rarely addressed. We propose a conceptual framework based on protection motivation theory to include health in mobility apps for sustainable mobility behavior change. Addressing people’s self-protective motivation could empower mobility app users. It might be a possible trigger for behavior change, leading towards healthy and sustainable mobility and thus, have individual and societal benefits.

Mitochondria and traffic-related air pollution linked coronary artery calcification: exploring the missing link

The continuing increase in the exposure to Traffic-related air pollution (TRAP) in the general population is predicted to result in a higher incidence of non-communicable diseases like cardiovascular disease. The chronic exposure of air particulate matter from TRAP upon the vascular system leads to the enhancement of deposition of calcium in the vasculature leading to coronary artery calcification (CAC), triggered by inflammatory reactions and endothelial dysfunction. This calcification forms within the intimal and medial layers of vasculature and the underlying mechanism that connects the trigger from TRAP is not well explored. Several local and systemic factors participate in this active process including inflammatory response, hyperlipidemia, presence of self-programmed death bodies and high calcium-phosphate concentrations. These factors along with the loss of molecules that inhibit calcification and circulating nucleation complexes influence the development of calcification in the vasculature. The loss of defense to prevent osteogenic transition linked to micro organelle dysfunction that includes deteriorated mitochondria, elevated mitochondrial oxidative stress, and defective mitophagy. In this review, we examine the contributory role of mitochondria involved in the mechanism of TRAP linked CAC development. Further we examine whether TRAP is an inducer or trigger for the enhanced progression of CAC.

Quantitative Impact Analysis of Climate Change on Residents' Health Conditions with Improving Eco-Efficiency in China: A Machine Learning Perspective

Climate change affects public health, and improving eco-efficiency means reducing the various pollutants that are the result of economic activities. This study provided empirical evidence of the quantitative impact analysis of climate change on the health conditions of residents across China due to improvements that have been made to eco-efficiency. First, the indicators that were collected present adequate graphical trends and regional differences with a priori evidence about their relationships to each other; second, the present study applied Sensitivity Evaluation with Support Vector Machines (SE-SVM) to Chinese provincial panel data, taking the Visits to Hospitals, Outpatients with Emergency Treatment, and Number of Inpatients as proxy variables for the health conditions of the residents in each area and temperature, humidity, precipitation, and sunshine as the climate change variables, simultaneously incorporating the calculated eco-efficiency with six controlling indicators; third, we compared in-sample forecasting to acquire the optimal model in order to conduct elasticity analysis. The results showed that (1) temperature, humidity, precipitation, and sunshine performed well in forecasting the health conditions of the residents and that climate change was a good forecaster for resident health conditions; (2) from the national perspective, climate change had a positive relationship with Visits to Hospitals and Outpatients with Emergency Treatment but a negative relationship with the Number of Inpatients; (3) An increase in regional eco-efficiency of 1% increase the need for Visits to Hospitals and Outpatients with Emergency Treatment by 0.2242% and 0.2688%, respectively, but decreased the Number of Inpatients by 0.6272%; (4) increasing the regional eco-efficiency did not show any positive effects for any individual region because a variety of local activities, resource endowment, and the level of medical technology available in each region played different roles. The main findings of the present study are helpful for decision makers who are trying to optimize policy formulation and implementation measures in the cross-domains of economic, environmental, and public health.

The role of education and income for cognitive functioning in old age: A cross-country comparison

OBJECTIVES

Previous studies have shown that higher education promotes cognitive health. This effect, however, is embedded in the living conditions of a particular country. Since it is not clear to what extent the country and its specific living standards are necessary preconditions for the observed effect, we investigated whether the impact of education and income on cognitive functioning differs between countries.

METHODS

Analyses were based on harmonized data from the World Health Organization's multi-country Study on global AGEing and adult health, the Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe of over 85,000 individuals aged 50 years and older. Analyses were conducted via multivariate regression analyses and structural equation modeling adjusted for age, gender, marital status, health status, and depression.

RESULTS

The effect of education was twice as large as the effect of income on cognitive functioning and indirectly moderated the effect of income on cognitive functioning. The effect sizes varied strongly between countries. The country's gross domestic product per capita seems to influence cognitive functioning.

CONCLUSIONS

Our findings indicate that education has a dominant effect on cognitive functioning in people aged 50 years and older, which might even offset the adverse implications of living with low income on cognitive health. Therefore, expanding efforts to achieve universal education are essential to mitigate health disparities due to low income and early life disadvantages, including chances for good cognitive functioning over the life-span.

Long-term exposure to black carbon and mortality: A 28-year follow-up of the GAZEL cohort

BACKGROUND

The current evidence on health effects of long-term exposure to outdoor airborne black carbon (BC) exposure remains scarce.

OBJECTIVES

To examine the association between long-term exposure to BC and mortality in a large population-based French cohort, with 28 years of follow-up.

METHODS

Data from the GAZEL cohort were collected between 1989 and 2017. Land use regression model with temporal extrapolation wa used to estimate yearly BC and PM_2.5 exposure at the residential addresses from 1989 until censoring for 19,906 participants. Time-varying Cox models with attained age as time-scale was used to estimate the associations between BC and all-cause and cardiovascular mortality, after adjusting for individual and area-level covariates. To handle confounding by PM_2.5, we used the residual of BC regressed on PM_2.5 as an alternate exposure variable. For all-cause mortality, we also examined effect modification by sex, smoking status, BMI and fruit/vegetable intake.

RESULTS

The median of 20-year moving average of BC exposure was 2.02 10^-5/m in study population. We found significant associations between BC exposure and all-cause mortality (n = 2357) using both 20-year moving average of BC and residual of BC, with corresponding hazard ratios (HR) of 1.14 (95 %CI: 1.07-1.22) and 1.17 (95 %CI: 1.10-1.24) for an inter-quartile range (IQR) increase (0.86 10^-5/m for BC and 0.57 10^-5/m for residual of BC). We found a similar association between BC and cardiovascular mortality (n = 277) with a HR of 1.15 (95 %CI: 0.95-1.38). The dose-response relationship between BC and all-cause mortality was monotonic but nonlinear with a steeper slope at high BC levels. In addition, the effect of BC was higher among never-smokers and among those having fruit/vegetables less than twice a week.

CONCLUSIONS

There was a positive association between long-term exposure to BC and increased mortality risk, reinforcing the emerging evidence that BC is a harmful component of PM_2.5.

Resident perspectives of environmental health risk exposures after Hurricane Harvey

This study examines what visitors to urban parks in Houston, TX, know about environmental health risks resulting from Hurricane Harvey, a category 4 storm that made landfall in August 2017 and dropped over 60 in. of rain in 8 days making it the most significant rainfall event in US history. Interviews were conducted with adult Houstonians using purposive sampling. In total, 27 interviews were conducted with 36 different participants. Interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively using a phronetic iterative approach. This study found that park visitors lack sufficient knowledge about environmental health risks, yet they have strong desires to learn more about such risks. In particular, participants have clear opinions on what the content of the messages (i.e., concise, manageable, not fear-inducing) should be and how they would like to receive the information (i.e., conveniently accessible, from trusted local sources). Implications for health campaign interventions utilizing uncertainty theories are discussed.

Assessing Health Impacts of Winter Smog in Lahore for Exposed Occupational Groups

The goal of this research was to investigate the health effects of winter pollution on various occupations in Lahore and its neighboring peri-urban areas. A questionnaire survey, key informants, and focused group discussions were employed to collect data, which included demographic, socioeconomic, and health-related information. Descriptive statistics and the multivariate logistic regression model (MLRM) were used to examine the effects of pollution on exposed occupational groups who experienced symptoms such as coughing, shortness of breath, and eye discomfort. According to data from interviews, MLRM revealed that individuals working in various occupations with outdoor and indoor environments are equally affected by winter smog, but being middle-aged (odds ratio OR = 5.73), having a history of a respiratory ailment (OR = 4.06), and location (OR = 2.26) all play important roles in determining health. However, less educated people, elders, and people who already live in polluted areas are more likely to develop respiratory health symptoms. During the smog incident, it was determined that diverse health and socioeconomic factors exacerbate an individual’s negative health impact more than others.

Are There Heterogeneous Impacts of Air Pollution on Mental Health?

Many studies reveal that air pollution is related to mental health. However, the level of impact and the regulatory mechanism of air pollution on different types of mental health are unknown. This paper examines the heterogeneous impact and mediating mechanisms of air pollution on mental health based on data of 51 countries from 2010 to 2017 by using panel Tobit random effect model, mediating effect model, and bootstrap test. The findings show that, firstly, there is heterogeneous impact of air pollution on different types of mental health. Specifically, air pollution has a significant positive impact on depression; and the impacts on happiness and anxiety are closely related to income level. Secondly, the heterogeneous impact of air pollution on mental health is contingent on income levels. Thirdly, the heterogeneous impacts under different income levels are exacerbated by different levels of education and population density. Lastly, the mediating effect of physical health on different types of mental health is also heterogeneous. To be specific, the effects of air pollution on depression and anxiety are partly mediated by physical health; whereas the effect on happiness is not. These findings contribute to the understanding of air pollution on public health, and have significant implication for social and public health policy makers.

Ecotoxicity testing of airborne particulate matter-comparison of sample preparation techniques for the Vibrio fischeri assay

The bioassay based on the bioluminescence inhibition of the marine bacterium Vibrio fischeri has been the most widely used test for the assessment of airborne particulate matter ecotoxicity. Most studies available use an extract of the solid sample, either made with water or organic solvents. As an alternative, a whole-aerosol test is also available where test bacteria are in actual contact with contaminated particles. In our study, different extraction procedures were compared to this direct contact test based on the V. fischeri assay and analytical measurements. The lowest PAH content and the highest EC₅₀ were determined in water extract, while the highest PAH amount and lowest EC₅₀ were measured in dichloromethane, hexane, and dimethyl-sulphoxide extracts. EC₅₀ of the direct contact test was comparable to that of the methanol extract. Our results suggest that the sensitivity of the direct contact test equals to that of extraction procedures using organic solvents, moreover, it is mimicking an environmentally realistic exposure route.

Evaluating the energy, health efficiency, and productivity in OECD

In the past, energy and environmental research focused on the performance of individual efficiencies. In order to make up for the research deficiencies, this research uses SBM (slack-based measures) dynamic network DEA (DN-SBM) to assess energy, health efficiency, and DN-TFP productivity changes from 2011 to 2015. This research uses forest area as the carryover that can objectively measure the performance of OECD energy, health, and total efficiency, and calls for the importance of forest protection and planting. The empirical results show that Estonia, Finland, Hungary, Iceland, Mexico, New Zealand, Portugal, Slovenia, Sweden, and Turkey have the best overall efficiency performance, while Ireland (0.4469), Israel (0.4179), and the Netherlands (0.3697) are the three worst. In total, 29 economies show progress in terms of productivity. Moreover, Chile (0.9706), Mexico (0.9995), Slovak Republic (0.9942), Turkey (0.9815), and the UK (0.9886) exhibit a slight decline. The overall efficiency value of 20 countries is greater than the average, and their productivity is showing an upward trend. Only the UK (0.5081, 0.9886) has an overall efficiency value that is less than the overall average with productivity that is showing a drop. About research method, this study utilizes dynamic intertemporal data to evaluate the changes in the overall efficiency and productivity of OECD members with DN-SBM and DN-TFP indices in order to offer more objective research results for various economies that are useful for formulating policies related to energy, national health, and forest conservation.

Effects of air pollutant emission on the prevalence of respiratory and circulatory system diseases in Linyi, China

As a typical industrial city, Linyi has suffered severe atmospheric pollution in recent years. Meanwhile, a high incidence of respiratory and circulatory diseases has been observed in Linyi. The relationship between air pollutants and the prevalence of respiratory and circulatory system diseases in Linyi is still unclear, and therefore, there is an urgent need to assess the human health risks associated with air pollutants. In this study, the number of outpatient visits and spatial distribution of respiratory and circulatory diseases were first investigated. To clarify the correlation between diseases and air pollutant emissions, the residential intake fraction (IF) of air pollutants was calculated. The results showed that circulatory and respiratory diseases accounted for 62.32% of the total causes of death in 2015. The incidence of respiratory diseases was high in the winter, and outpatient visits were observed for more males (60.9%) than females (39.1%). The spatial distribution suggested that outpatient visits for respiratory and circulatory diseases were concentrated in the main urban area of Linyi, including the Hedong District, Lanshan District, and Luozhuang District, and especially at the junction of these three areas. After calculating the IF combined with the characteristics of pollution sources, meteorological conditions, and population data, a high IF value was concentrated in urban and suburban areas, which was consistent with the high incidence of diseases. Moreover, high R values and a significant correlation (R > 0.6, p < 0.05) between outpatient visits and residential IF of air pollutants imply similar spatial distributions of outpatient visits and IF value of residents. The spatial similarity of air pollution and outpatient visits suggested that future air pollution control policies should better reflect the health risks of spatial hotspots. This study can provide a potentially important reference for environmental management and air pollution-related health interventions.

Physicochemical and microbiological characteristics of urban aerosols in Krakow (Poland) and their potential health impact

Eight aerosol samples were collected in Krakow using a low-volume sampler in February and March 2019 during variable meteorological conditions and times of the day, to study their single particles' properties (size, morphology and chemical composition analyzed using a scanning electron microscope fitted with an energy-dispersive spectrometer) and microbiological characteristics. The content of particles of different chemical compositions larger than 2.5 μm was low. Considering the number of the particles, submicron particles strongly dominated with a high content of ultrafine particles (nanoparticles). Tar ball-type particles were relatively common in the studied samples, while soot was the dominant component. Soot was present as small agglomerates composed of few particles, but also as bigger agglomerates. Metal-containing particles of various chemical characteristics were abundant, with transition metals commonly occurring in these particles. The physicochemical characteristics of aerosols indicate that despite a relatively low mass concentration, their adverse health impact could be very strong because of the high content of nanoparticles, the abundance of soot and other fuel combustion-related particles, and the high incidence of transition metal-rich particles. Microbiological analysis was based on cultures on both solid and liquid agar. The MALDI-TOF method was used for species identification-for bacteria and fungi. Twelve different species of bacteria were isolated from the collected samples of aerosols. The most frequently isolated species was Gram-positive sporulating Bacillus licheniformis. The isolated mold fungi were of the genus Aspergillus.

Indoor PM2.5, VOCs and asthma outcomes: A systematic review in adults and their home environments

INTRODUCTION

As the amount of time people spend indoors increases globally, exposure to indoor air pollutants has become an important public health concern. Asthma is a complex disease caused and/or exacerbated by increased exposure to diverse chemical, physical and biological exposures from multiple indoor and outdoor sources. This review aims to investigate the relationship between increased indoor PM and VOC concentrations (i.e. objectively measured) and the risk of adult asthma in higher-income countries.

METHODS

Eleven databases were systematically searched on the February 1, 2019 and again on the February 2, 2020. Articles were limited to those published since 1990. Reference lists were independently screened by three reviewers and authors were contacted to identify relevant articles. Backwards and forward citation chasing was used to identify further studies. Data were extracted from included studies meeting our eligibility criteria by three reviewers and assessed for quality using the Newcastle-Ottawa scale designed for case-control and cohort studies.

RESULTS

Twelve studies were included in a narrative synthesis. We found insufficient evidence to determine the effect of PM2.5 on asthma in the indoor home environment. However, there was strong evidence to suggest that VOCs, especially aromatic compounds, and aliphatic compounds, were associated with increased asthma symptoms.

DISCUSSION & CONCLUSION

Although no single exposure appears to be responsible for the development of asthma or its associated symptoms, the use of everyday products may be associated with increased asthma symptoms. To prevent poor health outcomes among the general population, health professionals and industry must make a concerted effort to better inform the general population of the importance of appropriate use of and storage of chemicals within the home as well as better health messaging on product labelling.

Atrial proarrhythmic effect of lead as one of the PM10 metal components of air pollution. An in-silico study

Particulate matter (PM) is considered the most severe environmental pollution problem due to its serious effects on human health associated with an increased risk of cardiovascular morbidity and mortality. In this work, a physicochemical characterization of PM10 from the city of Medellin was developed. The results evince that lead (Pb) is one of the most abundant elements since it is present in all analyzed samples. Therefore, Pb was chosen to perform an in-silico study to assess its effects on atrial arrhythmias generation. For this purpose, we developed a model representing the Pb2+ blocking effect on the L-type calcium channel. This formulation was incorporated in a human atrial cell mathematical model and in 2D and 3D models of human atria. The simulations showed a proarrhythmic effect at high Pb2+ concentrations, through shortening of action potential duration inducing the generation of reentrant activity and atrial flutter. The results contribute to the knowledge about the cardiac physiopathological processes, triggered by lead as one of the main PM10 metal components of air pollution, that yields the generation of arrhythmias.

Air Pollution as a Determinant of Undernutrition Prevalence among Under-Five Children in India: An Exploratory Study

AIM

The association of air pollution with prevalence of undernutrition indices (namely, anaemia, stunting, wasting and underweight) among under-five children in India was investigated.

METHODS

Estimates of population weighted annual average gridded PM2.5 concentrations and proportion of households using solid cooking fuel (HSCF usage percent) during 2017 in India, reflecting the magnitude of ambient and household air pollution respectively, were extracted in a state-wise manner from India State Level Disease Burden Initiative (ISLDBI) reports. Their relationships with the corresponding prevalence of anaemia, underweight, wasting and stunting in under-five children were analysed.

RESULTS

The state-level PM2.5 concentrations (mean: 65.5 µg/m3; median: 49.2 µg/m3; range: 17.3-209.0 µg/m3) correlated significantly (P < 0.01) with anaemia (r = 0.65), stunting (r = 0.58) and underweight (r = 0.50) prevalence; while HSCF usage (mean: 49.3%; median: 46.0%; range: 1.9-81.5%) correlated significantly (P < 0.01) with stunting (r = 0.69) and underweight (r = 0.58) prevalence. When examined across median cut-offs and after adjusting for socio-demographic index, the association of anaemia prevalence with PM2.5 concentrations persisted. This association was maintained even after controlling for the coverage of anaemia-specific interventions (namely, iron supplements and deworming medications). The mean difference in PM2.5 concentrations between the high and low PM2.5 states was 58.6 µg/m3, which accounted for 11.8% higher anaemia prevalence in the former as compared to the latter.

CONCLUSION

The burden of childhood undernutrition, particularly anaemia, in India may be linked to PM2.5 levels. To mitigate this burden, it may be necessary to complement the ongoing nutritional interventions with air pollution control measures.

Effectiveness of road dust suppressants: insights from particulate matter-related health damage

Although dust suppressants are widely applied to control road dust pollution, a consensus on their effectiveness has not been reached. To evaluate the effectiveness of dust suppressants (a calcium-magnesium complex) from health risks and health damage, spraying and sampling activities were conducted at four sites in Beijing. Using inhalation risk model and health damage assessment, health risks of PM_x for three sensitive occupational groups were calculated and converted to life and economic loss. Results revealed that dust suppressants can indeed mitigate PM pollution and its accompanying health risks and health damage in road dust, but at a limited efficiency. By spraying dust suppressants, the total PM-related life loss reduced by 1.60E-02 years and 2.50E-04 years in urban and suburban areas on average, and the total willingness to pay (WTP) values decreased by 120 and 50 US$ for PM_2.5 and PM₁₀, indicating a more considerable environmental gain if dust suppressants were sprayed in additional regions when necessary. Overall, our study demonstrated that the effectiveness of dust suppressants cannot be pictured only by the variations of pollutant concentrations, and indicators with practice and economic value should be more useful for traffic-related pollution management.

Tracking Airborne Pollution with Environmental Magnetism in A Medium-Sized African City

As in other parts of the world, air pollution over West and Central Africa has major health and meteorological impacts. Air quality assessment and its possible sanitary impact have become essential even in medium-sized towns, therefore amplifying the need for easy-to-implement monitoring methods with low environmental impact. We present here the potential of magnetic methods to monitor air quality at street level in the medium-sized city of Maroua (northern Cameroon) affected by dust-laden desert winds. More than five hundred (544) samples of bark and leaves taken from Neem trees in Maroua were analyzed. Magnetic susceptibility, saturation remanence, and S-ratio were found to determine the concentration and nature of magnetic particles. They are dominated by magnetite-like particle signals as a part of particulate emissions due to urban activities, including both traffic, composed of a substantial proportion of motorcycles, and wood burning for food preparation. We show that both bark and leaves from Neem trees are adequate passive bio-recorders. The use of both enables different times and heights to be sampled, allowing for the high-resolution monitoring, in terms of spatialization, of various urban environments. Particle emissions require assessment and screening that could be carried out rapidly and efficiently by magnetic methods on bio-recorders, even in cities impacted by dust-laden wind.

[Environmental surveillance of the steel industry by the people: the experiences of Piquiá de Baixo (MA) and Santa Cruz (RJ)]

Environmental surveillance by the people fosters the protagonism of individuals in a situation of environmental vulnerability to generate and evaluate data regarding the pollution to which they are exposed. The scope of this work was to analyze such experiences in two areas impacted by the steel industry: Santa Cruz/RJ and Piquiá de Baixo/MA. At these sites, community environmental monitoring (CEM) activities were conducted to measure 2.5 micrometer particulate matter (PM2.5) levels in the atmosphere, between November/2016 and July/2017. Such activities were conducted using a low-cost and easy-to-operate air quality monitor. Monthly averages of PM2.5 levels in Piquiá and Santa Cruz were high, depending on the period assessed, since they surpassed the annual average recommended by the World Health Organization (WHO) of 10 µg/m3, and, on several occasions, the recommended daily average of 25 µg/m3. The main idea of this monitoring proposal was to establish a process capable of presenting a counterpoint to official information on local atmospheric pollution scenarios, with the involvement of affected communities. The pollution data produced enable these communities to participate in public debates and decision-making processes in a more informed way.

Paleopathology of the Ychsma: Evidence of respiratory disease during the Late Intermediate Period (AD 1000-1476) at the Central Coastal site of Pachacamac, Peru

OBJECTIVE

To investigate evidence for maxillary sinusitis and pulmonary inflammation in archaeological skeletons dating to the Late Intermediate Period (AD 1000-1476) at the site of Pachacamac, Peru.

MATERIALS

Thirty-nine individuals (male, female, and unknown sex; 16+ years age-at-death) were analyzed for inflammatory periosteal reaction (IPR) on the visceral (inner) surfaces of the ribs, and 16 individuals were analyzed for evidence of maxillary sinusitis.

METHODS

All individuals were macroscopically examined for bony changes in the maxillary sinuses and new bone formation on the ribs according to pre-established criteria.

RESULTS

Some 33.3% (13/39) of individuals had IPR on the ribs and 93.8% (15/16) had bony changes in the maxillary sinuses.

CONCLUSIONS

Respiratory disease was likely prevalent in people buried at Pachacamac during the Late Intermediate Period. A number of factors may have increased the risk of developing respiratory disease, including exposure to poor air quality and increased crowding and social mixing, resulting from pilgrimage to this important ritual center.

SIGNIFICANCE

This paper represents one of the first systematic analyses of evidence for respiratory disease in Peruvian and South American human skeletal remains, demonstrating the suitability of the region for further study.

LIMITATIONS

A limited sample was available for analysis. Additionally, the site's skeletal preservation was excellent, meaning the sample available for assessment of maxillary sinusitis was smaller, being limited to individuals with post-mortem breakage.

FURTHER RESEARCH

The results of this study should stimulate further much needed systematic investigation of evidence for respiratory disease in other Peruvian and South American populations.

Changes in arachidonic acid (AA)- and linoleic acid (LA)-derived hydroxy metabolites and their interplay with inflammatory biomarkers in response to drastic changes in air pollution exposure

BACKGROUND

Untargeted metabolomics analyses have indicated that fatty acids and their hydroxy derivatives may be important metabolites in the mechanism through which air pollution potentiates diseases. This study aimed to use targeted analysis to investigate how metabolites in arachidonic acid (AA) and linoleic acid (LA) pathways respond to short-term changes in air pollution exposure. We further explored how they might interact with markers of antioxidant enzymes and systemic inflammation.

METHODS

This study included a subset of participants (n = 53) from the Beijing Olympics Air Pollution (BoaP) study in which blood samples were collected before, during, and after the Beijing Olympics. Hydroxy fatty acids were measured by liquid chromatography/mass spectrometry (LC/MS). Native total fatty acids were measured as fatty acid methyl esters (FAMEs) using gas chromatography. A set of chemokines were measured by ELISA-based chemiluminescent assay and antioxidant enzyme activities were analyzed by kinetic enzyme assays. Changes in levels of metabolites over the three time points were examined using linear mixed-effects models, adjusting for age, sex, body mass index (BMI), and smoking status. Pearson correlation and repeated measures correlation coefficients were calculated to explore the relationships of metabolites with levels of serum chemokines and antioxidant enzymes.

RESULTS

12-hydroxyeicosatetraenoic acid (12-HETE) decreased by 50.5% (95% CI: -66.5, -34.5; p < 0.0001) when air pollution dropped during the Olympics and increased by 119.4% (95% CI: 36.4, 202.3; p < 0.0001) when air pollution returned to high levels after the Olympics. In contrast, 13-hydroxyoctadecadienoic acid (13-HODE) elevated significantly (p = 0.023) during the Olympics and decreased nonsignificantly after the games (p = 0.104). Interleukin 8 (IL-8) correlated with 12-HETE (r = 0.399, BH-adjusted p = 0.004) and 13-HODE (r = 0.342, BH-adjusted p = 0.014) over the three points; it presented a positive and moderate correlation with 12-HETE during the Olympics (r = 0.583, BH-adjusted p = 0.002) and with 13-HODE before the Olympics (r = 0.543, BH-adjusted p = 0.008).

CONCLUSION

AA- and LA-derived hydroxy metabolites are associated with air pollution and might interact with systemic inflammation in response to air pollution exposure.

Hierarchical Bayesian estimation of covariate effects on airway and alveolar nitric oxide

Exhaled breath biomarkers are an important emerging field. The fractional concentration of exhaled nitric oxide (FeNO) is a marker of airway inflammation with clinical and epidemiological applications (e.g., air pollution health effects studies). Systems of differential equations describe FeNO—measured non-invasively at the mouth—as a function of exhalation flow rate and parameters representing airway and alveolar sources of NO in the airway. Traditionally, NO parameters have been estimated separately for each study participant (Stage I) and then related to covariates (Stage II). Statistical properties of these two-step approaches have not been investigated. In simulation studies, we evaluated finite sample properties of existing two-step methods as well as a novel Unified Hierarchical Bayesian (U-HB) model. The U-HB is a one-step estimation method developed with the goal of properly propagating uncertainty as well as increasing power and reducing type I error for estimating associations of covariates with NO parameters. We demonstrated the U-HB method in an analysis of data from the southern California Children’s Health Study relating traffic-related air pollution exposure to airway and alveolar airway inflammation.

Quantifying the short-term effects of air pollution on health in the presence of exposure measurement error: a simulation study of multi-pollutant model results

BACKGROUND

Most epidemiological studies estimate associations without considering exposure measurement error. While some studies have estimated the impact of error in single-exposure models we aimed to quantify the effect of measurement error in multi-exposure models, specifically in time-series analysis of PM_2.5, NO₂, and mortality using simulations, under various plausible scenarios for exposure errors. Measurement error in multi-exposure models can lead to effect transfer where the effect estimate is overestimated for the pollutant estimated with more error to the one estimated with less error. This complicates interpretation of the independent effects of different pollutants and thus the relative importance of reducing their concentrations in air pollution policy.

METHODS

Measurement error was defined as the difference between ambient concentrations and personal exposure from outdoor sources. Simulation inputs for error magnitude and variability were informed by the literature. Error-free exposures with their consequent health outcome and error-prone exposures of various error types (classical/Berkson) were generated. Bias was quantified as the relative difference in effect estimates of the error-free and error-prone exposures.

RESULTS

Mortality effect estimates were generally underestimated with greater bias observed when low ratios of the true exposure variance over the error variance were assumed (27.4% underestimation for NO₂). Higher ratios resulted in smaller, but still substantial bias (up to 19% for both pollutants). Effect transfer was observed indicating that less precise measurements for one pollutant (NO₂) yield more bias, while the co-pollutant (PM_2.5) associations were found closer to the true. Interestingly, the sum of single-pollutant model effect estimates was found closer to the summed true associations than those from multi-pollutant models, due to cancelling out of confounding and measurement error bias.

CONCLUSIONS

Our simulation study indicated an underestimation of true independent health effects of multiple exposures due to measurement error. Using error parameter information in future epidemiological studies should provide more accurate concentration-response functions.

Fear in a Handful of Dust: The Epidemiological, Environmental, and Economic Drivers of Death by PM2.5 Pollution

This study evaluates numerous epidemiological, environmental, and economic factors affecting morbidity and mortality from PM2.5 exposure in the 27 member states of the European Union. This form of air pollution inflicts considerable social and economic damage in addition to loss of life and well-being. This study creates and deploys a comprehensive data pipeline. The first step consists of conventional linear models and supervised machine learning alternatives. Those regression methods do more than predict health outcomes in the EU-27 and relate those predictions to independent variables. Linear regression and its machine learning equivalents also inform unsupervised machine learning methods such as clustering and manifold learning. Lower-dimension manifolds of this dataset's feature space reveal the relationship among EU-27 countries and their success (or failure) in managing PM2.5 morbidity and mortality. Principal component analysis informs further interpretation of variables along economic and health-based lines. A nonlinear environmental Kuznets curve may describe the fuller relationship between economic activity and premature death from PM2.5 exposure. The European Union should bridge the historical, cultural, and economic gaps that impair these countries' collective response to PM2.5 pollution.

Relationship between Air Pollution and Hospital Admissions for Chronic Obstructive Pulmonary Disease in Changchun, China: A Season-Stratified Case-Cross Study

Background

This study aimed to explore the relationship between air pollution and hospital admissions for COPD in Changchun, a northeast city of China, in different seasons.

Methods

The data on a total of 1,733 hospitalized patients living in Changchun with acute exacerbation of COPD from September 2013 to April 2018 were collected from a comprehensive 3A hospital of Changchun. Daily average concentrations of PM2.5, PM10, SO₂, NO₂, CO, and O₃ were collected from the Department of Ecology and Environment of Jilin Province. The conditional logistic regression model was adopted to analyze the effect of air pollutant concentration on the number of hospitalized patients with COPD in different seasons.

Results

The maximum OR value for most air pollutants emitted in spring was on lag day 4, in summer and autumn on lag day 3, and in winter on lag day 2. In spring, SO₂ and NO₂ were entered into the regression equation, and the OR (95%CI) was 0.992 (0.986-0.998) and 1.009 (1.002-1.017); in autumn, PM2.5, PM10, and SO₂ were entered into the regression equation, and the OR (95%CI) was 1.005 (1.000-1.011), 0.995 (0.991-1.000), and 1.006 (1.001-1.011), respectively; and in winter, PM2.5 and PM10 were entered into the regression equation, and the OR (95%CI) was 1.008 (1.002-1.015) and 0.994 (0.988-0.999), respectively.

Conclusion

The relationship between air pollution and hospital admission for COPD in Northeast China varies with different seasons. In spring, NO₂ is likely to be the major risk factor for hospital admissions for COPD; in autumn, PM2.5 and SO₂ are the major risk factors; and in winter, PM2.5 is the major risk factor.

Reducing the Influence of Environmental Factors on Performance of a Diffusion-Based Personal Exposure Kit

Sensor technology has enabled the development of portable low-cost monitoring kits that might supplement many applications in conventional monitoring stations. Despite the sensitivity of electrochemical gas sensors to environmental change, they are increasingly important in monitoring polluted microenvironments. The performance of a compact diffusion-based Personal Exposure Kit (PEK) was assessed for real-time gaseous pollutant measurement (CO, O₃, and NO₂) under typical environmental conditions encountered in the subtropical city of Hong Kong. A dynamic baseline tracking method and a range of calibration protocols to address system performance were explored under practical scenarios to assess the performance of the PEK in reducing the impact of rapid changes in the ambient environment in personal exposure assessment applications. The results show that the accuracy and stability of the ppb level gas measurement is enhanced even in heterogeneous environments, thus avoiding the need for data post-processing with mathematical algorithms, such as multi-linear regression. This establishes the potential for use in personal exposure monitoring, which has been difficult in the past, and for reporting more accurate and reliable data in real-time to support personal exposure assessment and portable air quality monitoring applications.

Toxicity of Water- and Organic-Soluble Wood Tar Fractions from Biomass Burning in Lung Epithelial Cells

Widespread smoke from wildfires and biomass burning contributes to air pollution and the deterioration of air quality and human health. A common and major emission of biomass burning, often found in collected smoke particles, is spherical wood tar particles, also known as "tar balls". However, the toxicity of wood tar particles and the mechanisms that govern their health impacts and the impact of their complicated chemical matrix are not fully elucidated. To address these questions, we generated wood tar material from wood pyrolysis and isolated two main subfractions: water-soluble and organic-soluble fractions. The chemical characteristics as well as the cytotoxicity, oxidative damage, and DNA damage mechanisms were investigated after exposure of A549 and BEAS-2B lung epithelial cells to wood tar. Our results suggest that both wood tar subfractions reduce cell viability in exposed lung cells; however, these fractions have different modes of action that are related to their physicochemical properties. Exposure to the water-soluble wood tar fraction increased total reactive oxygen species production in the cells, decreased mitochondrial membrane potential (MMP), and induced oxidative damage and cell death, probably through apoptosis. Exposure to the organic-soluble fraction increased superoxide anion production, with a sharp decrease in MMP. DNA damage is a significant process that may explain the course of toxicity of the organic-soluble fraction. For both subfractions, exposure caused cell cycle alterations in the G2/M phase that were induced by upregulation of p21 and p16. Collectively, both subfractions of wood tar are toxic. The water-soluble fraction contains chemicals (such as phenolic compounds) that induce a strong oxidative stress response and penetrate living cells more easily. The organic-soluble fraction contained more polycyclic aromatic hydrocarbons (PAHs) and oxygenated PAHs and induced genotoxic processes, such as DNA damage.

Sepsis-related hospital admissions and ambient air pollution: a time series analysis in 6 Chinese cities

Background

Some prevalent but rarely studied causes of hospital admissions, such as sepsis is still unknown whether affected by air pollution.

Methods

We used time-series regression within generalized additive models to estimate the effect of air pollutant level on the sepsis-related hospital admissions, for the years 2017–18, using data from six cities in Sichuan, China. Potential effect modifications by age and sex were also explored. The effects of air pollutant on hospital stays for sepsis were also quantified.

Results

Positive associations between short-term exposure to NO₂ and O₃ and risk of sepsis-related hospital admissions and stays were found. Each 10 μg/m³ increase in short-term NO₂ at lag 03 and O₃ at lag 4 was associated with an increase of 2.76% (95% CI: 0.67, 4.84%) and 0.64% (95% CI: 0.14, 1.14%) hospital admissions, respectively. An increase of 0.72% (95% CI: 0.05, 1.40%) hospital stay was associated with 10 μg/m³ increase in O₃ concentration at lag 4. Besides, the adverse effect of exposure to NO₂ was more significant in males and population aged less than 14 years; while more significant in females and population aged 14 ~ 65 and over 65 years for exposure to O₃. These associations remained stable after the adjustment of other air pollutants.8.

Conclusion

Exposure to ambient NO₂ and O₃ may cause substantial sepsis hospitalizations, and hospital stays in Sichuan, China. These associations were different in subgroup by age and sex.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11220-x.

Traffic Density-Related Black Carbon Distribution: Impact of Wind in a Basin Town

Black carbon is one of the riskiest particle matter pollutants that is harmful to human health. Although it has been increasingly investigated, factors that depend on black carbon distribution and concentration are still insufficiently researched. Variables, such as traffic density, wind speeds, and ground levels can lead to substantial variations of black carbon concentrations and potential exposure, which is even riskier for people living in less-airy sites. Therefore, this paper “fills the gaps” by studying black carbon distribution variations, concentrations, and oscillations, with special emphasis on traffic density and road segments, at multiple locations, in a small city located in a basin, with frequent temperature inversions and infrequent low wind speeds. As wind speed has a significant impact on black carbon concentration trends, it is critical to present how low wind speeds influence black carbon dispersion in a basin city, and how black carbon is dependent on traffic density. Our results revealed that when the wind reached speeds of 1 ms⁻¹, black carbon concentrations actually increased. In lengthy wind periods, when wind speeds reached 2 or 3 ms⁻¹, black carbon concentrations decreased during rush hour and in the time of severe winter biomass burning. By observing the results, it could be concluded that black carbon persists longer in higher altitudes than near ground level. Black carbon concentration oscillations were also seen as more pronounced on main roads with higher traffic density. The more the traffic decreases and becomes steady, the more black carbon concentrations oscillate.

The Dynamic Impact of the COVID-19 Pandemic on Air Quality: The Beijing Lessons

Air pollution is one of the major environmental problems that endanger human health. The COVID-19 pandemic provided an excellent opportunity to investigate the possible methods to improve Beijing's air quality meanwhile considering Beijing's economic impact. We used the TVP-VAR model to analyze the dynamic relationship among the pandemic, economy and air quality based on the daily data from 1 January to 30 August 2020. The result shows that the COVID-19 pandemic indeed had a positive effect on air governance which was good for human health, while doing business as usual would gradually weaken this effect. It shows that the Chinese authority's production restriction effectively deals with air pollution in a short period of time since the pandemic is just like a quasi-experiment that suddenly suspended all the companies. However, as the limitation stops, the improvement decreases. It is not sustainable. In addition, a partial quarantine also has a positive impact on air quality, which means a partial limitation was also helpful in improving air quality and also played an important role in protecting people's health. Second, the control measures really hurt Beijing's economy. However, the partial quarantine had fewer adverse effects on the economy than the lockdown. It is supposed to be a reference for air governance and pandemic control. Third, the more the lag periods were, the smaller their impact. Thus, restrictions on production can only be used in emergencies, such as some international meetings, while it is hard to improve the air quality and create a healthy and comfortable living environment only by limitation in the long-term.

Public perception of air pollution sources across Europe

Air pollution is one of the primary concerns of our society for its effect on human health and the environment. Among the policy measures that can be put in place to limit air pollutant emissions, end-of-pipe technologies and/or regulatory instruments may be implemented through legislative acts. Also, equally important are behavioural measures, requiring citizens' active involvement. The success of any measure to limit pollutant emissions requires the acceptance by the citizens that, in turn, implies a correct perception of the main pollutant emission drivers. We present here the comparison between the public perception of air pollution sources and the real-world situation through a survey carried out in seven European countries and involving 16 101 respondents. Our study shows a dramatic underestimation of the contribution of the agri-food sector to air pollution. This result is common to all respondents in the seven countries examined and only to a small extent depends on gender, age and socio-economic status of the respondents.

Characterising and communicating the potential hazard posed by potentially toxic elements in indoor dusts from schools across Lagos, Nigeria

Ambient and indoor air pollution results in an estimated 7 million premature deaths globally each year, representing a major contemporary public health challenge, but one poorly quantified from a toxicological and source perspective. Indoor exposure represents possibly the greatest potential overall exposure, yet our indoor environments are still poorly understood, modelled and characterized. In rapidly growing cities, such as Lagos, Nigeria, environmental monitoring can play an important role in establishing baseline data, monitoring urban pollution trends and in environmental education. Classroom dust samples were collected from 40 locations from across the twenty local government areas (LGAs) of Lagos, in June 2019. The aim of the study was to assess the potential hazard posed by PTE in indoor dusts and to develop a suitable risk communication strategy to inform and educate the public, promoting environmental health literacy. Concentrations of total PTE in indoor dusts were assessed using Energy Dispersive X-Ray Fluorescence (ED-XRF) spectrometry. Oral bioaccessibility determinations using the unified BARGE method, and analysis by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) were also performed on the dust samples to determine the fraction available for absorption in the gastrointestinal tract. Results showed that the indoor dust samples were largely uncontaminated, with only few exceptions (2 samples). Enrichment factor pollution trend for the total PTE concentrations was in the order of Pb > Zn > U > Cr > Cu > Ba > Mn > V > As > Cd > Ni > Al. Source apportionment studies using factor analysis suggests concentrations of Al, As, Fe, Mn, Ni, and U may be influenced largely by lithogenic factors, while Cd, Cu and Pb originated principally from anthropogenic sources. Chromium, V and Zn appear to originate from mixed sources of both lithogenic and anthropogenic origin. Our oral bioaccessibility determinations indicate that the assumption of 100% bioavailability based on pseudototal or total concentrations would overestimate the hazard potential of PTE in these indoor dusts. Zinc was the most bioaccessible PTE (mean of 88%), with Mn (57%), Pb (48%), Ba (48%), Al (41%), As (37%), Cu (36%), Ni (28%), Cr (10%) and Fe (7%) the least bioaccessible. Human health risk assessment, for both children and adults using the bioaccessible fraction, showed values to be within acceptable risk levels.

Environmental and health impacts of contaminants of emerging concerns: Recent treatment challenges and approaches

In the past few decades, new contaminants of emerging concern (CECs) in the air, water, and soil have gained significant attention due to their adverse impact on human health and the environment. The sources of CECs have been identified in different forms from domestic and industrial activities such as personal care products and pharmaceuticals. It has been established that aqueous medium plays a major role in the dissemination of various contaminants, like drinking water, reservoirs, lakes, rivers and waste with water medium. There remains inadequate technology for the treatment of CECs in the wastewater systems. Though different techniques have advanced for the treatment of CECs, they still pose a severe threat to human health and disturb the ecological balance. In this review, the characteristics, recent technologies, risk assessment and management of CECs have been discussed. The primary aim is to highlight the new innovative and cost-effective technologies for the remediations of CECs in all forms. Biochar is readily and economically available in abundance and an economical adsorbent with 100% adsorptive removal for H₂PO₄^-. The bibliometric analysis also performed to understand the emerging research trends on the treatment techniques, which can help in developing a guiding pathway to modern research in academia and industry.

Heart Failure and PAHs, OHPAHs, and Trace Elements Levels in Human Serum: Results from a Preliminary Pilot Study in Greek Population and the Possible Impact of Air Pollution

Cardiovascular diseases (CVDs) have been associated with environmental pollutants. The scope of this study is to assess any potential relation of polycyclic aromatic hydrocarbons (PAHs), their hydroxylated derivatives, and trace elements with heart failure via their direct determination in human serum of Greek citizens residing in different areas. Therefore, we analyzed 131 samples including cases (heart failure patients) and controls (healthy donors), and the respective demographic data were collected. Significantly higher concentrations (p < 0.05) were observed in cases' serum regarding most of the examined PAHs and their derivatives with phenanthrene, fluorene, and fluoranthene being the most abundant (median of >50 μg L-1). Among the examined trace elements, As, Cd, Cu, Hg, Ni, and Pb were measured at statistically higher concentrations (p < 0.05) in cases' samples, with only Cr being significantly higher in controls. The potential impact of environmental factors such as smoking and area of residence has been evaluated. Specific PAHs and trace elements could be possibly related with heart failure development. Atmospheric degradation and smoking habit appeared to have a significant impact on the analytes' serum concentrations. PCA-logistic regression analysis could possibly reveal common mechanisms among the analytes enhancing the hypothesis that they may pose a significant risk for CVD development.

An impact of air pollution on moderate to severe relapses among multiple sclerosis patients

BACKGROUND

Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system with both a genetic and environmental component.

OBJECTIVE

In the current study, we examined an association between incidence of MS moderate to severe relapses and exposure to air pollutants and meteorological exposures.

METHODS

We enrolled MS patients in Southern Israel during 2000-2017. Exposure assessment relied on satellite-based model of exposure to particulate matter of size <2.5 and 10 microns (PM_2.5, PM₁₀) and temperature at a spatial resolution of 1 km (Kloog et al., 2015). The information on exposure to nitrogen dioxide (NO₂), sulfur dioxide (SO₂) and ozone (O₃) levels was completed from the database of the monitoring stations. We analyzed the data using a semi-ecological approach. The monthly incidence of MS-related relapses requiring hospitalization as a function of environmental factors was analyzed by time-series technique, adjusting to sex, age and smoking. We also used a case-crossover approach to compare environmental exposure of a patient on the day of the relapse with the exposure on the relapse-free days. All estimates were adjusted to the heat index and were divided by IQR.

RESULTS

There were 287 MS patients in the study, with an average age of 52.8 ± 16.7 years, 37% of them (107) being under 40. Mostly female (66.2%), and 13.6% of the patients smoking (47% non-smoking and 39.4% unknown). PM_2.5 was independently associated with MS relapses within the non-smoking population [Relative Risk (RR)=1.28, 95%CI:1.01-1.62]. O₃ was found adversely associated with MS relapses among patients younger than 40 [RR=1.58, 95%CI 1.03-4.43]. Based on the case-crossover approach, relapses were associated with elevated levels of PM₁₀ and NO₂ in all subjects [Odds Ratio (OR)=1.05, 95%CI:1.00-1.11; OR=1.85, 95%CI: 1.28-2.68, respectively]. An adverse association with PM_2.5 was observed in non-smokers [OR 1.12, 95%CI 1.00-1.25].

CONCLUSIONS

The findings show that MS relapses are adversely associated with an ambient exposure to PM and NO₂.

Increased respiratory morbidity associated with exposure to a mature volcanic plume from a large Icelandic fissure eruption

The 2014-15 Holuhraun eruption in Iceland was the largest fissure eruption in over 200 years, emitting prodigious amounts of gas and particulate matter into the troposphere. Reykjavík, the capital area of Iceland (250 km from eruption site) was exposed to air pollution events from advection of (i) a relatively young and chemically primitive volcanic plume with a high sulphur dioxide gas (SO2) to sulphate PM (SO42-) ratio, and (ii) an older and chemically mature volcanic plume with a low SO2/SO42- ratio. Whereas the advection and air pollution caused by the primitive plume were successfully forecast and forewarned in public advisories, the mature plume was not. Here, we show that exposure to the mature plume is associated with an increase in register-measured health care utilisation for respiratory disease by 23% (95% CI 19.7-27.4%) and for asthma medication dispensing by 19.3% (95% CI 9.6-29.1%). Absence of public advisories is associated with increases in visits to primary care medical doctors and to the hospital emergency department. We recommend that operational response to volcanic air pollution considers both primitive and mature types of plumes.

Maternal exposure to air pollution and umbilical asprosin concentration, a novel insulin-resistant marker

Air pollution exposure during pregnancy has been associated with abnormal glucose hemostasis in the fetus, which may result in the programming of type 2 diabetes mellitus (T2DM) development in future life. Therefore, we investigated the association of maternal exposure to particulate matters (PMs) and traffic indicators with umbilical asprosin concentration, a novel insulin-resistant inducing adipokine, in newborns. Accordingly, 759 mother-newborn pairs from Sabzevar, Iran (2018-2019) participated in our study. Maternal exposure to PM₁, PM_2.5 and PM₁₀ concentrations was estimated using spatial-temporal models developed for the study area. The associations of exposure to traffic indicators (total street length in 100, 300 and 500 m buffers around home and proximity of mothers to nearest major roads) and air pollution with umbilical asprosin concentration were estimated using linear regression models, adjusted for potential confounders. The median (interquartile range (IQR)) of umbilical asprosin concentration was 30.4 (19.1) ng/mL. In fully adjusted models, each one IQR increase in PM₁₀ and PM_2.5 were associated with 26.43 ng/mL (95% CI: 10.97, 41.88) and 31.76 ng/mL (95% CI: 15.66, 47.86) increase in umbilical asprosin concentration, respectively. A similarity result was observed for total street length in 100 m buffer. An increase in proximity to major roads was associated with a decrease of -21.48 ng/mL (95% CI: 33.29, -9.67) in umbilical asprosin concentration. Our results suggested that maternal exposure to air pollution during pregnancy could increase the umbilical asprosin concentration. These novel findings may improve our understanding of the mechanisms whereby air pollutants impaired glucose hemostasis during the fetal period.

Chronic exposure to PM2.5 aggravates SLE manifestations in lupus-prone mice

Background

Air pollution causes negative impacts on health. Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations and multifactorial etiology. Recent studies suggest that air pollution can trigger SLE and induce disease activity. However, this association has not been deeply investigated. Thus, the aim of this study was to evaluate whether exposure to fine particulate matter (PM2.5) exacerbates SLE manifestations, focusing on renal complications, in a lupus-prone animal model. Female NZBWF1 mice were exposed daily to 600 μg/m³ of inhaled concentrated ambient particles (CAP) or filtered air (FA). Survival rate, body weight, weight of organs (kidney, spleen, thymus, liver and heart), blood cell count, proteinuria, kidney stereology, renal histopathology, gene expression and oxidative stress were analyzed.

Results

Female NZBW mice exposed to CAP showed decreased survival, increased circulating neutrophils, early onset of proteinuria and increased kidney weight with renal cortex enlargement when compared to NZBW mice exposed to FA.

Conclusions

This work shows that air pollution aggravates some SLE manifestations in lupus-prone mice. These results reinforce the need of reducing air pollutant levels in order to promote a better quality of life for individuals diagnosed with SLE.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12989-021-00407-0.

Establishing a sorting protocol for healthcare databases

BACKGROUND

Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon.

DESIGN AND METHODS

Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition.

RESULTS

A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically.

CONCLUSIONS

The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records.

Ambient air pollution and emergency department visits among children and adults in Casablanca, Morocco

This study presents the relationships between ambient air pollutants and morbidity and emergency department visits among children and adults performed in Great Casablanca, the most populated and economic region in Morocco. This research was analyzed using conditional Poisson model for the period 2011-2013. In the period of study, the daily average concentrations of SO2, NO2, O3 and PM10 in Casablanca were 209.4 µg/m3, 61 µg/m3, 113.2 µg/m3 and 75.1 µg/m3, respectively. In children less than 5 years old, risk of asthma could be increased until 12% per 10 µg/m3 increase in NO2, PM10, SO2 and O3. In children over 5 years and adults, an increase of 10 µg/m3 air pollutant can cause an increase until 3% and 4% in respiratory consultations and acute respiratory infection, respectively. Similarly, impact on emergency department visits due to respiratory and cardiac illness was established. Our results suggest a not negligible impact on morbidity of outdoor air pollution by NO2, SO2, O3, and PM10.

Ambient air quality and the risk for Chronic Obstructive Pulmonary Disease among Metro Manila Development Authority traffic enforcers in Metro Manila: An exploratory study

Background

Air pollution and poor ambient air quality are significantly related to multiple health risks. One associated disease is chronic obstructive pulmonary disease (COPD), a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally. A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution. In the Philippines, the MMDA has the widest coverage in traffic management. The study determined the risk of COPD among Metro Manila Development Authority (MMDA) traffic enforcers in relation to ambient air quality level, as well as identified other factors that increase the risk of developing COPD.

Methods

Fifty-two MMDA traffic enforcers deployed in PM_2.5 air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling. The International Primary Airways Guidelines (IPAG) questionnaire was utilized to measure risk of COPD. Respiratory health and working history were obtained through questionnaires. Department of environment and natural resources provided PM_2.5 ambient air quality data which aided in the construction of the Exposure-Month Index. Ordinal logistic regression was used to examine the association of PM_2.5 together with the relevant factors and the risk of COPD.

Results

We found statistically significant associations between PM_2.5 and COPD among high risk category [odds risk (OR): 1.24, 95% confidence interval (CI): 1.07-1.44]. Age (Moderate, OR: 1.16, 95% CI: 0.98-1.38 and High, OR: 10.06, 95% CI: 4.02-25.17) and chest pain (Moderate, OR: 68.65, 95% CI: 1.71-2.75 × 10³) were potential risk factors, whereas body mass index (BMI) (OR: 0.05, 95% CI: 0.01-0.53) exhibited protective effect.

Conclusions

Exposure to PM_2.5 was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers. Age and chest pain were potential risk factors to risk of COPD, whereas BMI exhibited a potential protective effect. Results of this study can be used for clinical management of high-risk populations, such that of MMDA traffic enforcers.

Addressing the global Challenge of NCDs using a Risk Factor approach: voices from around the world

Noncommunicable diseases (NCDs) are growing at an alarming rate around the world, drawing attention in multiple United Nations high‐level meetings, the Sustainable Development Goals, regional alliances for NCDs, and in scientific research agendas. In 2018, the World NCD Federation selected the University of Michigan from seven universities around the world to host the 2nd World NCD Congress in 2020. For the scientific program, we defined an intersecting matrix of “risk factors” and “disease‐oriented” lenses for examining NCDs to highlight the multiple risk factors that contribute to major NCDs. Through deliberation with two committees representing over 50 individuals and 11 countries, eight risk factors were selected for the scientific program: social determinants of health and demographics, climate and environment, stress, sleep, substance use, nutrition, and physical activity, and genetics. These eight risk factors served as submission categories for a call for abstracts as well as topics for the planned plenary sessions. In April 2020, we pivoted our approach when meeting in person for a conference was no longer feasible. Building upon the risk factor model, we shifted the invited talks to invited articles for publication as a special collection for FASEB BioAdvances. We are delighted to launch this collection with 13 invited articles by 32 experts from ten countries. Significant transferable lessons about key risk factors and prevention of NCDs from this collection could be leveraged in various geographic areas and in settings with varying levels of resources, as they cover a diverse range of topics from community‐level interventions to indigenous leadership structures to national policies to intergovernmental programs.

Crowdsourcing without Data Bias: Building a Quality Assurance System for Air Pollution Symptom Mapping

Crowdsourcing is one of the spatial data sources, but due to its unstructured form, the quality of noisy crowd judgments is a challenge. In this study, we address the problem of detecting and removing crowdsourced data bias as a prerequisite for better-quality open-data output. This study aims to find the most robust data quality assurance system (QAs). To achieve this goal, we design logic-based QAs variants and test them on the air quality crowdsourcing database. By extending the paradigm of urban air pollution monitoring from particulate matter concentration levels to air-quality-related health symptom load, the study also builds a new perspective for citizen science (CS) air quality monitoring. The method includes the geospatial web (GeoWeb) platform as well as a QAs based on conditional statements. A four-month crowdsourcing campaign resulted in 1823 outdoor reports, with a rejection rate of up to 28%, depending on the applied. The focus of this study was not on digital sensors’ validation but on eliminating logically inconsistent surveys and technologically incorrect objects. As the QAs effectiveness may depend on the location and society structure, that opens up new cross-border opportunities for replication of the research in other geographical conditions.

How to improve infectious disease prediction by integrating environmental data: an application of a novel ensemble analysis strategy to predict HFMD

This study proposed a novel ensemble analysis strategy to improve hand, foot and mouth disease (HFMD) prediction by integrating environmental data. The approach began by establishing a vector autoregressive model (VAR). Then, a dynamic Bayesian networks (DBN) model was used for variable selection of environmental factors. Finally, a VAR model with constraints (CVAR) was established for predicting the incidence of HFMD in Chengdu city from 2011 to 2017. DBN showed that temperature was related to HFMD at lags 1 and 2. Humidity, wind speed, sunshine, PM₁₀, SO₂ and NO₂ were related to HFMD at lag 2. Compared with the autoregressive integrated moving average model with external variables (ARIMAX), the CVAR model had a higher coefficient of determination (R², average difference: + 2.11%; t = 6.2051, P = 0.0003 < 0.05), a lower root mean-squared error (−24.88%; t = −5.2898, P = 0.0007 < 0.05) and a lower mean absolute percentage error (−16.69%; t = −4.3647, P = 0.0024 < 0.05). The accuracy of predicting the time-series shape was 88.16% for the CVAR model and 86.41% for ARIMAX. The CVAR model performed better in terms of variable selection, model interpretation and prediction. Therefore, it could be used by health authorities to identify potential HFMD outbreaks and develop disease control measures.

Circulating lead modifies hexavalent chromium-induced genetic damage in a chromate-exposed population: An epidemiological study

Chromium (Cr) can coexist with other heavy metals in the blood of chronically chromate-exposed individuals. However, few studies have explored the health impacts of other hazardous metals after exposure to hexavalent chromium [Cr(VI)]. This study aimed to assess the modification effects of blood lead (Pb) on the genetic damage induced by Cr(VI). During 2010-2019, 1000 blood samples were collected from 455 workers exposed to chromate and 545 workers not exposed to chromate from the same factory with similar labor intensity. The levels of Cr and Pb were measured in whole blood samples. Micronucleus frequency (MNF) and urinary 8-hydroxydeoxyguanosine (8-OHdG) were measured to reflect different types of genetic damage. Multivariate linear regression analyses were performed to evaluate the associations between hazardous metals and the modification effects of Pb on genetic damage. The geometric mean levels of Cr and Pb in the exposure group were significantly higher than those in the control group [Cr: 6.42 (6.08- 6.79) vs. 1.29 (1.22- 1.36) μg/L; Pb: 38.82 (37.22- 40.50) vs. 34.47 (33.15- 35.85) μg/L]. The geometric means of urinary 8-OHdG and MNF in exposure group were 4.00 (3.64- 4.40) μg/g and 5.40 (4.89- 5.97) ‰, respectively, significantly higher than the 3.20 (2.94- 3.48) μg/g and 4.57 (4.15- 5.03) ‰, respectively, in control group. log₂Cr was independently and positively associated with urinary 8-OHdG (β_-adjusted = 0.143, 95% CI: 0.082- 0.204) and MNF (β_-adjusted = 0.303, 95%CI: 0.020- 0.587). With the change in circulating Pb levels, the types of genetic damage induced by Cr(VI) were different. At low levels of circulating Pb (<30.80 μg/L), chromate mainly caused changes in 8-OHdG, while at high circulating Pb levels (≥44.88 μg/L), chromate induced alterations in MNF. The findings suggested that chromate exposure could cause multiple types of genetic damage, and circulating Pb might modify the association between circulating Cr and the form of genetic damage.

Structures and reactivity of peroxy radicals and dimeric products revealed by online tandem mass spectrometry

Organic peroxy radicals (RO₂) play a pivotal role in the degradation of hydrocarbons. The autoxidation of atmospheric RO₂ radicals produces highly oxygenated organic molecules (HOMs), including low-volatility ROOR dimers formed by bimolecular RO₂ + RO₂ reactions. HOMs can initiate and greatly contribute to the formation and growth of atmospheric particles. As a result, HOMs have far-reaching health and climate implications. Nevertheless, the structures and formation mechanism of RO₂ radicals and HOMs remain elusive. Here, we present the in-situ characterization of RO₂ and dimer structure in the gas-phase, using online tandem mass spectrometry analyses. In this study, we constrain the structures and formation pathway of several HOM-RO₂ radicals and dimers produced from monoterpene ozonolysis, a prominent atmospheric oxidation process. In addition to providing insights into atmospheric HOM chemistry, this study debuts online tandem MS analyses as a unique approach for the chemical characterization of reactive compounds, e.g., organic radicals.

Organic peroxy radicals play a pivotal role in producing highly oxygenated organic molecules but the formation mechanisms remain elusive. Here, the authors show in-situ characterization of peroxy radicals and dimer structures in the gas-phase, using online tandem mass spectrometry analyses.

COVID-19 lockdowns reduce the Black carbon and polycyclic aromatic hydrocarbons of the Asian atmosphere: source apportionment and health hazard evaluation

ABSTRACT

The entire world is affected by Coronavirus disease (COVID-19), which is spreading worldwide in a short time. India is one of the countries which is affected most, therefore, the Government of India has implemented several lockdowns in the entire country from April 25, 2020. We studied air pollutants (i.e., PM_2.5, Black Carbon (BC), and Polycyclic Aromatic Hydrocarbons (PAHs) level, and observed significantly sudden reduced. In India, most of the anthropogenic activities completely stopped. Therefore, we studied the levels of BC, PAHs and PM_2.5 concentrations, their sources apportion, and health risk assessment during normal days, lockdown (from lockdown 1.0 to lockdown 4.0) and unlock down 1.0 situation at Sakchi, Jamshedpur city. It was observed that lockdowns and unlock down situations BC, PAHs and PM_2.5 concentrations were significantly lower than regular days. We applied the advanced air mass back trajectory (AMBT) model to locate airborne particulate matter dispersal from different directions to strengthen the new result. The diagnostic ratio analyses of BC shows that wood burning contribution was too high during the lockdown situations. However, during normal days, the PAHs source profile was dedicated toward biomass, coal burning, and vehicle emission as primary sources of PAHs. During the lockdown period, emission from biomass and coal burning was a significant contributor to PAHs. The summaries of health risk assessment of BC quantified an equal number of passively smoked cigarettes (PSC) for an individual situation was studied. This study focuses on the overall climate impact of pandemic situations.

Emission reduction of black carbon and polycyclic aromatic hydrocarbons during COVID-19 pandemic lockdown

The global pandemic COVID-19 necessitated various responses throughout the world, including social distancing, use of mask, and complete lockdown. While these measures helped prevent the community spread of the virus, the resulting environmental benefits of lockdown remained mostly unnoticed. While many studies documented improvements in air quality index, very few have explored the reduction in black carbon (BC) aerosols and polycyclic aromatic hydrocarbons (PAHs) concentrations due to lockdown. In this study, we evaluated the changes in concentrations of BC, PAHs, and PM_2.5 before and during the lockdown period. Our results show that lockdown resulted in a significant reduction in concentrations of these pollutants. The average mass concentration of BC, PAHs, and PM_2.5 before the lockdown was 11.71 ± 3.33 μgm^-3, 108.71 ± 27.77 ngm^-3, and 147.65 ± 41.77 μgm^-3, respectively. During the lockdown period, the concentration of BC, PAHs, and PM_2.5 was 2.46 ± 0.95 μgm^-3, 23.19 ± 11.21 ngm^-3, and 50.31 ± 11.95 μgm^-3, respectively. The diagnostic ratio analysis for source apportionment showed changes in the emission sources before and during the lockdown. The primary sources of PAHs emissions before the lockdown were biomass, coal combustion, and vehicular traffic, while during the lockdown, PAHs emissions were primarily from the combustion of biomass and coal. Similarly, before the lockdown, the BC mass concentrations came from fossil-fuel and wood-burning, while during the lockdown period, most of the BC mass concentration came from wood-burning. Human health risk assessment demonstrated a significant reduction in risk due to inhalation of PAHs and BC-contaminated air.