201
|
Malik AO, Jones PG, Chan PS, Peri-Okonny PA, Hejjaji V, Spertus JA. Association of Long-Term Exposure to Particulate Matter and Ozone With Health Status and Mortality in Patients After Myocardial Infarction. Circ Cardiovasc Qual Outcomes 2020; 12:e005598. [PMID: 30950650 DOI: 10.1161/circoutcomes.119.005598] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Long-term exposure to particulate matter <2.5 µm in diameter (PM2.5) and ozone has been associated with the development and progression of cardiovascular disease and, in the case of PM2.5, higher cardiovascular mortality. Whether exposure to PM2.5 and ozone is associated with patients' health status and quality of life is unknown. We used data from 2 prospective myocardial infarction (MI) registries to assess the relationship between long-term PM2.5 and ozone exposure with health status outcomes 1 year after an MI. METHODS AND RESULTS TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction) and PREMIER (Prospective Registry Evaluating Myocardial Infarction: Events and Recovery) enrolled patients presenting with MI at 31 US hospitals between 2003 and 2008. One year later, patients were assessed with the disease-specific Seattle Angina Questionnaire, and 5-year mortality was assessed with the Centers for Disease Control's National Death Index. Individual patients' exposures to PM2.5 and ozone over the year after their MI were estimated from the Environment Protection Agency's Fused Air Quality Surface Using Downscaling tool that integrates monitoring station data and atmospheric models to predict daily air pollution exposure at the census tract level. We assessed the association of exposure to ozone and PM2.5 with 1-year health status and mortality over 5 years using regression models adjusting for age, sex, race, socioeconomic status, date of enrollment, and comorbidities. In completely adjusted models, higher PM2.5 and ozone exposure were independently associated with poorer Seattle Angina Questionnaire summary scores at 1-year (β estimate per +1 SD increase =-0.8 [95% CI, -1.4 to -0.3; P=0.002] for PM2.5 and -0.9 [95% CI, -1.3 to -0.4; P<0.001] for ozone). Moreover, higher PM2.5 exposure, but not ozone, was independently associated with greater mortality risk (hazard ratio =1.13 per +1 SD [95% CI, 1.07-1.20; P<0.001]). CONCLUSIONS In our study, greater exposure to PM2.5 and ozone was associated with poorer 1-year health status following an MI, and PM2.5 was associated with increased risk of 5-year death.
Collapse
Affiliation(s)
- Ali O Malik
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| | - Philip G Jones
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| | - Paul S Chan
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| | - Poghni A Peri-Okonny
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| | - Vittal Hejjaji
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| | - John A Spertus
- Department of Cardiology, University of Missouri-Kansas City. Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO
| |
Collapse
|
202
|
Cohen G, Steinberg DM, Keinan-Boker L, Yuval, Levy I, Chen S, Shafran-Nathan R, Levin N, Shimony T, Witberg G, Bental T, Shohat T, Broday DM, Kornowski R, Gerber Y. Preexisting coronary heart disease and susceptibility to long-term effects of traffic-related air pollution: A matched cohort analysis. Eur J Prev Cardiol 2020; 28:2047487320921987. [PMID: 32389024 DOI: 10.1177/2047487320921987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with coronary heart disease are considered susceptible to traffic-related air pollution exposure. Yet, cohort-based evidence on whether preexisting coronary heart disease modifies the association of traffic-related air pollution with health outcomes is lacking. AIM Using data of four Israeli cohorts, we compared associations of traffic-related air pollution with mortality and cancer between coronary heart disease patients and matched controls from the general population. METHODS Subjects hospitalized with acute coronary syndrome from two patient cohorts (inception years: 1992-1993 and 2006-2014) were age- and sex-matched to coronary heart disease-free participants of two cycles of the Israeli National Health and Nutrition Surveys (inception years: 1999-2001 and 2005-2006). Ambient concentrations of nitrogen oxides at the residential place served as a proxy for traffic-related air pollution exposure across all cohorts, based on a high-resolution national land use regression model (50 m). Data on all-cause mortality (last update: 2018) and cancer incidence (last update: 2016) were retrieved from national registries. Cox-derived stratum-specific hazard ratios with 95% confidence intervals were calculated, adjusted for harmonized covariates across cohorts, including age, sex, ethnicity, neighborhood socioeconomic status, smoking, diabetes, hypertension, prior stroke and prior malignancy (the latter only in the mortality analysis). Effect-modification was examined by testing nitrogen oxides-by-coronary heart disease interaction term in the entire matched cohort. RESULTS The cohort (mean (standard deviation) age 61.5 (14) years; 44% women) included 2393 matched pairs, among them 2040 were cancer-free at baseline. During a median (25th-75th percentiles) follow-up of 13 (10-19) and 11 (7-17) years, 1458 deaths and 536 new cancer cases were identified, respectively. In multivariable-adjusted models, a 10-parts per billion nitrogen oxides increment was positively associated with all-cause mortality among coronary heart disease patients (hazard ratio = 1.13, 95% confidence interval 1.05-1.22), but not among controls (hazard ratio = 1.00, 0.93-1.08) (pinteraction = 0.003). A similar pattern was seen for all-cancer incidence (hazard ratioCHD = 1.19 (1.03-1.37), hazard ratioCHD-Free = 0.93 (0.84-1.04) (pinteraction = 0.01)). Associations were robust to multiple sensitivity analyses. CONCLUSIONS Coronary heart disease patients might be at increased risk for traffic-related air pollution-associated mortality and cancer, irrespective of their age and sex. Patients and clinicians should be more aware of the adverse health effects on coronary heart disease patients of chronic exposure to vehicle emissions.
Collapse
Affiliation(s)
- Gali Cohen
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
- Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Israel
| | - David M Steinberg
- Department of Statistics and Operations Research, Tel Aviv University, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Israel
- School of Public Health, University of Haifa, Israel
| | - Yuval
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Ilan Levy
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Shimon Chen
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Rakefet Shafran-Nathan
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Noam Levin
- Department of Geography, Hebrew University of Jerusalem, Israel
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Israel
| | - Guy Witberg
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
- Department of Cardiology, Rabin Medical Center (Beilinson and Hasharon Hospitals), Israel
| | - Tamir Bental
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
| | - Tamar Shohat
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
| | - David M Broday
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Ran Kornowski
- Remote Sensing Research Centre, School of Earth and Environmental Sciences, The University of Queensland, Australia
- Deptartment of Cardiovascular Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel
- Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Israel
| |
Collapse
|
203
|
Cramer J, Jørgensen JT, Hoffmann B, Loft S, Bräuner EV, Prescott E, Ketzel M, Hertel O, Brandt J, Jensen SS, Backalarz C, Simonsen MK, Andersen ZJ. Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:57003. [PMID: 32438827 PMCID: PMC7263451 DOI: 10.1289/ehp5818] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Air pollution exposure has been linked to coronary heart disease, although evidence on PM2.5 and myocardial infarction (MI) incidence is mixed. OBJECTIVES This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise. METHODS We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses (>44 years of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter <2.5 μg/m3 (PM2.5), PM10, nitrogen dioxide (NO2), and nitrogen oxides (NOx) at the nurses' residences since 1990 (PM10 and PM2.5) or 1970 (NO2 and NOx) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of NO2 and NOx, with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average (Lden). RESULTS Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and 11.5 μg/m3 for PM2.5, PM10, NO2, and NOx, respectively. In Model 1, we observed a positive association between a 3-y running mean of PM2.5 and an overall incident MI with an HR= 1.20 (95% CI: 1.07, 1.35), which attenuated to HR= 1.06 (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of PM2.5, with an HR= 1.69 (95% CI: 1.33, 2.13), which attenuated to HR= 1.35 (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for PM10, with 3-y, Model 2 estimates for overall and fatal incident MI of HR= 1.06 (95% CI: 0.91, 1.23) and HR= 1.35 (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for NO2 or NOx. For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure. CONCLUSIONS We found no association between long-term exposure to PM2.5, PM10, NO2, or NOx and overall MI incidence, but we observed positive associations for PM2.5 and PM10 with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818.
Collapse
Affiliation(s)
- Johannah Cramer
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Steffen Loft
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elvira V Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Eva Prescott
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research, Department of Civil and Environmental Engineering, University of Surrey, Guildford, UK
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Steen S Jensen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Mette K Simonsen
- Diakonissestiftelsen and Parker Institute, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Zorana J Andersen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| |
Collapse
|
204
|
Johnson M, Brook JR, Brook RD, Oiamo TH, Luginaah I, Peters PA, Spence JD. Traffic-Related Air Pollution and Carotid Plaque Burden in a Canadian City With Low-Level Ambient Pollution. J Am Heart Assoc 2020; 9:e013400. [PMID: 32237976 PMCID: PMC7428640 DOI: 10.1161/jaha.119.013400] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The association between fine particulate matter and cardiovascular disease has been convincingly demonstrated. The role of traffic‐related air pollutants is less clear. To better understand the role of traffic‐related air pollutants in cardiovascular disease development, we examined associations between NO2, carotid atherosclerotic plaque, and cardiometabolic disorders associated with cardiovascular disease. Methods and Results Cross‐sectional analyses were conducted among 2227 patients (62.9±13.8 years; 49.5% women) from the Stroke Prevention and Atherosclerosis Research Centre (SPARC) in London, Ontario, Canada. Total carotid plaque area measured by ultrasound, cardiometabolic disorders, and residential locations were provided by SPARC medical records. Long‐term outdoor residential NO2 concentrations were generated by a land use regression model. Associations between NO2, total carotid plaque area, and cardiometabolic disorders were examined using multiple regression models adjusted for age, sex, smoking, and socioeconomic status. Mean NO2 was 5.4±1.6 ppb in London, Ontario. NO2 was associated with a significant increase in plaque (3.4 mm2 total carotid plaque area per 1 ppb NO2), exhibiting a linear dose‐response. NO2 was also positively associated with triglycerides, total cholesterol, and the ratio of low‐ to high‐density lipoprotein cholesterol (P<0.05). Diabetes mellitus mediated the relationship between NO2 and total carotid plaque area (P<0.05). Conclusions Our results demonstrate that even low levels of traffic‐related air pollutants are linked to atherosclerotic plaque burden, an association that may be partially attributable to pollution‐induced diabetes mellitus. Our findings suggest that reducing ambient concentrations in cities with NO2 below current standards would result in additional health benefits. Given the billions of people exposed to traffic emissions, our study supports the global public health significance of reducing air pollution.
Collapse
Affiliation(s)
- Markey Johnson
- Air Health Science Division Health Canada Ottawa Ontario Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health and Department of Chemical Engineering and Applied Chemistry University of Toronto Ontario Canada
| | - Robert D Brook
- Department of Internal Medicine University of Michigan Ann Arbor MI
| | - Tor H Oiamo
- Department of Geography and Environmental Studies Ryerson University Toronto Ontario Canada
| | - Isaac Luginaah
- Department of Geography Western University London Ontario Canada
| | - Paul A Peters
- Department of Health Sciences Carleton University Ottawa Ontario Canada
| | - J David Spence
- Department of Neurology and Clinical Pharmacology Western University London Ontario Canada.,Stroke Prevention and Atherosclerosis Research Centre Robarts Research Institute Western University London Ontario Canada
| |
Collapse
|
205
|
Lipfert FW, Wyzga RE. Environmental predictors of survival in a cohort of U.S. military veterans: A multi-level spatio-temporal analysis stratified by race. ENVIRONMENTAL RESEARCH 2020; 183:108842. [PMID: 31818475 DOI: 10.1016/j.envres.2019.108842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
We analyzed racial differences in all-cause mortality rates associated with air pollution in a cohort of military veterans in which 37% of the 70,000 members identified as African-American (black). In this comprehensive analysis, spatial levels comprised individuals, zip-codes, and counties. Temporal levels comprised the 26-y follow-up period (1976-2001) and 4 subperiods. Proportional hazard regression models were used, controlling for individual age, race (white, black), smoking (current, ever), education, height, body-mass index, and systolic and diastolic blood pressure; zipcode-average socioeconomic indicators; and county-average climate. County-level air quality measures included vehicular traffic density as a surrogate for all traffic-related pollutants including noise. The model accounted for nonlinear mortality relationships with age, body-mass index, blood pressure and zip-code racial composition. Relative to whites, more of the black veterans smoked, had slightly higher blood pressure, and lived in predominately black zip-codes that had more poverty than whites. The black veterans lived in counties that had slightly worse ambient air quality and substantially higher levels of vehicular traffic density. We analyzed all-cause mortality associations with county-level average ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide for 1975-81, and subsequent data on particulates by particle size. We also considered sulfate and elemental carbon particles, benzene, SO2, and NOx based on nationwide modeling for 2002. We had no information on indoor air quality or personal exposures; our risk estimates should thus be regarded as characterizing the counties of residence rather than individual exposures of inhabitants. In addition to age, the strongest predictors of veterans' survival were residence in high-poverty zip-codes, smoking, and diastolic blood pressure, to all of which black veterans were less sensitive than whites. Black veterans had significantly lower mortality risks from aging, smoking, and elevated diastolic blood pressure, but larger risks from excessive body-mass index. They were less at risk from living a high-poverty zip-code than whites. We assumed these risk factors to be stable during follow-up and thus applicable to chronic health effects. After controlling for them, the all-cause mortality risk for black veterans was 10% lower than whites. In an effort to reduce random scatter we computed mean risks associated with overlapping groups of similar pollutants. These means were statistically significant for both black and white veterans for traffic-related, gaseous, and NOx-O3 pollutants, for which the overall mean relative risk was 1.076 (1.057-1.090). Grouped mean risks for particulate pollutants, sulfur compounds, and non-traffic pollutants were not significant for either race. Black veterans carried more of the traffic-related risks than whites because of their greater exposures and risk coefficients. PM2.5 risk estimates were negative for black veterans (0.82 [0.75-0.89]) but positive for whites (1.05 [1.005-1.10]) which is consistent with regional differences in overall mortality. The temporal analyses compared mortality rates by follow-up subperiod for the pollutants measured at enrollment. We expected increasing (cumulative) risks for chronic effects and decreasing risks for delayed acute effects, but found no significant trend for either race. We concluded that the higher exposures and mortality risks associated with vehicular traffic posed environmental injustice for the black veterans.
Collapse
|
206
|
Lv Y, Zhou J, Kraus VB, Li T, Sarnat JA, Wang J, Liu Y, Chen H, Brasher MS, Mao C, Zeng Y, Zheng T, Shi X. Long-term exposure to PM 2.5 and incidence of disability in activities of daily living among oldest old. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 259:113910. [PMID: 32023791 PMCID: PMC7261238 DOI: 10.1016/j.envpol.2020.113910] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 06/10/2023]
Abstract
Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM2.5) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM2.5 exposure with a threshold concentration of 33 μg/m3, and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM2.5 concentrations; compared to 33 μg/m3, the hazard ratio ranged from 1.03 (1.00-1.06) at 40 μg/m3 to 2.25 (1.54-3.29) at 110 μg/m3. The risk magnitude was not significantly changed below this threshold. Each 10 μg/m3 increase in PM2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051-1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m3, and supported that reduction to current World Health Organization interim target-1value (35 μg/m3) and Chinese national ambient air quality standards (35 μg/m3) or lower may be associated with lower risk of disability in ADL.
Collapse
Affiliation(s)
- Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jinhui Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jeremy A Sarnat
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Jiaonan Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yang Liu
- Department of Environmental and Occupational Health, Emory University, Atlanta, GA, 30322, USA
| | - Huashuai Chen
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, 27708, USA
| | - Melanie Sereny Brasher
- Department of Sociology and Anthropology, Department of Human Development and Family Studies, University of Rhode Island, Kingston, RI, 02881, USA
| | - Chen Mao
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, 27708, USA; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, 100871, China
| | - Tongzhang Zheng
- Epidemiology Department, Brown University, Providence, RI, 02912, USA
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
207
|
Kim JB, Prunicki M, Haddad F, Dant C, Sampath V, Patel R, Smith E, Akdis C, Balmes J, Snyder MP, Wu JC, Nadeau KC. Cumulative Lifetime Burden of Cardiovascular Disease From Early Exposure to Air Pollution. J Am Heart Assoc 2020; 9:e014944. [PMID: 32174249 PMCID: PMC7335506 DOI: 10.1161/jaha.119.014944] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The disease burden associated with air pollution continues to grow. The World Health Organization (WHO) estimates ≈7 million people worldwide die yearly from exposure to polluted air, half of which-3.3 million-are attributable to cardiovascular disease (CVD), greater than from major modifiable CVD risks including smoking, hypertension, hyperlipidemia, and diabetes mellitus. This serious and growing health threat is attributed to increasing urbanization of the world's populations with consequent exposure to polluted air. Especially vulnerable are the elderly, patients with pre-existing CVD, and children. The cumulative lifetime burden in children is particularly of concern because their rapidly developing cardiopulmonary systems are more susceptible to damage and they spend more time outdoors and therefore inhale more pollutants. World Health Organization estimates that 93% of the world's children aged <15 years-1.8 billion children-breathe air that puts their health and development at risk. Here, we present growing scientific evidence, including from our own group, that chronic exposure to air pollution early in life is directly linked to development of major CVD risks, including obesity, hypertension, and metabolic disorders. In this review, we surveyed the literature for current knowledge of how pollution exposure early in life adversely impacts cardiovascular phenotypes, and lay the foundation for early intervention and other strategies that can help prevent this damage. We also discuss the need for better guidelines and additional research to validate exposure metrics and interventions that will ultimately help healthcare providers reduce the growing burden of CVD from pollution.
Collapse
Affiliation(s)
- Juyong Brian Kim
- Division of Cardiovascular MedicineDepartment of MedicineStanford UniversityStanfordCA
- Stanford Cardiovascular InstituteStanford UniversityStanfordCA
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| | - Francois Haddad
- Division of Cardiovascular MedicineDepartment of MedicineStanford UniversityStanfordCA
- Stanford Cardiovascular InstituteStanford UniversityStanfordCA
| | - Christopher Dant
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| | - Rushali Patel
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| | - Eric Smith
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| | - Cezmi Akdis
- Swiss Institute for Allergy and Asthma Research (SIAF)University of ZurichDavosSwitzerland
| | - John Balmes
- Department of MedicineUniversity of California San Francisco and Division of Environmental Health SciencesSchool of Public HealthUniversity of California BerkeleyCA
| | - Michael P. Snyder
- Department of Genetics and Center for Genomics and Personalized MedicineStanford UniversityStanfordCA
| | - Joseph C. Wu
- Stanford Cardiovascular InstituteStanford UniversityStanfordCA
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma ResearchStanford UniversityStanfordCA
| |
Collapse
|
208
|
Ward-Caviness CK, Weaver AM, Buranosky M, Pfaff ER, Neas LM, Devlin RB, Schwartz J, Di Q, Cascio WE, Diaz-Sanchez D. Associations Between Long-Term Fine Particulate Matter Exposure and Mortality in Heart Failure Patients. J Am Heart Assoc 2020; 9:e012517. [PMID: 32172639 PMCID: PMC7335509 DOI: 10.1161/jaha.119.012517] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Environmental health risks for individuals with heart failure (HF) have been inadequately studied, as these individuals are not well represented in traditional cohort studies. To address this we studied associations between long-term air pollution exposure and mortality in HF patients. Methods and Results The study population was a hospital-based cohort of individuals diagnosed with HF between July 1, 2004 and December 31, 2016 compiled using electronic health records. Individuals were followed from 1 year after initial diagnosis until death or the end of the observation period (December 31, 2016). We used Cox proportional hazards models to evaluate the association of annual average fine particulate matter (PM2.5) exposure at the time of initial HF diagnosis with all-cause mortality, adjusted for age, race, sex, distance to the nearest air pollution monitor, and socioeconomic status indicators. Among 23 302 HF patients, a 1 μg/m3 increase in annual average PM2.5 was associated with an elevated risk of all-cause mortality (hazard ratio 1.13; 95% CI, 1.10-1.15). As compared with people with exposures below the current national PM2.5 exposure standard (12 μg/m3), those with elevated exposures experienced 0.84 (95% CI, 0.73-0.95) years of life lost over a 5-year period, an observation that persisted even for those residing in areas with PM2.5 concentrations below current standards. Conclusions Residential exposure to elevated concentrations of PM2.5 is a significant mortality risk factor for HF patients. Elevated PM2.5 exposures result in substantial years of life lost even at concentrations below current national standards.
Collapse
Affiliation(s)
- Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - Anne M Weaver
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - Matthew Buranosky
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - Emily R Pfaff
- NC Translational and Clinical Sciences Institute University of North Carolina-Chapel Hill Chapel Hill NC
| | - Lucas M Neas
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - Robert B Devlin
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - Joel Schwartz
- Department of Environmental Health Harvard T. H. Chan School of Public Health Boston MA.,Department of Epidemiology Harvard T. H. Chan School of Public Health Boston MA
| | - Qian Di
- Research Center for Public Health School of Medicine Tsinghua University Beijing China
| | - Wayne E Cascio
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| | - David Diaz-Sanchez
- Center for Public Health and Environmental Assessment US Environmental Protection Agency Chapel Hill NC
| |
Collapse
|
209
|
Zhang J, Liang S, Ning R, Jiang J, Zhang J, Shen H, Chen R, Duan J, Sun Z. PM 2.5-induced inflammation and lipidome alteration associated with the development of atherosclerosis based on a targeted lipidomic analysis. ENVIRONMENT INTERNATIONAL 2020; 136:105444. [PMID: 31935561 DOI: 10.1016/j.envint.2019.105444] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/30/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Epidemiological studies have confirmed that PM2.5 could contribute to the development of atherosclerosis accompanied with lipids dysregulation. However, the lipids biomarkers involved in this progress remain largely unknown. In this study, a targeted lipidomic approach was used to find out the possible lipid biomarkers involved in the development of atherosclerosis after PM2.5 exposure or during a recovery period. Also, we assessed the pro-atherosclerosis effects of PM2.5 and follow-up influence using pulse wave (PW) Doppler ultrasound, oil red O staining and H&E staining. The vascular stiffness was elevated after 2-month PM2.5 exposure and might persist after 1-month recovery. While the lesions mostly concentrated in the aortic arch was significantly increased in 2-month PM2.5 exposure group and remained an increasing trend after 1-month recovery. The expressions of pro-inflammatory cytokines detected by Mouse Inflammation Array were elevated after ApoE-/- mice treated with PM2.5 for 2-month and restored following 1-month recovery. Yet, IL-10 was significantly decreased during 1-month recovery. Additionally, the targeted lipidomic analysis demonstrated that cholesterol ester (CE), phosphatidylcholine (PC), phosphatidylethanolamine (PE), sphingomyelin (SM) were significantly increased while lysophosphatidylethanolamine (LPE), lysophosphatidylcholine (LPC), diacylglycerol (DG), triacylglycerol (TG) were reduced after 2-month PM2.5 exposure, indicating that PM2.5 could disrupt glycerophospholipids, glycerolipids and sphingolipids metabolism. And a persistent impact of PM2.5 on glycerophospholipids and glycerolipids metabolism was found after 1-month recovery. Our study demonstrated that PM2.5-induced inflammation response might promote atherosclerotic lesions probably through lipid dysregulation, and the influence probably persisted after 1-month recovery.
Collapse
Affiliation(s)
- Jingyi Zhang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Shuang Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Ruihong Ning
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Jinjin Jiang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Jie Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, PR China
| | - Heqing Shen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, PR China; Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, PR China
| | - Rui Chen
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| |
Collapse
|
210
|
Baumgartner J, Brauer M, Ezzati M. The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries. BMC Med 2020; 18:39. [PMID: 32089131 PMCID: PMC7038592 DOI: 10.1186/s12916-020-1499-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND As low- and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources. MAIN TEXT Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low- and middle-income countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low- and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable. CONCLUSION Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.
Collapse
Affiliation(s)
- Jill Baumgartner
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1110 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Center for Environment and Health, Imperial College London, London, UK
- WHO Collaborating Centre for NCD Surveillance and Epidemiology, Imperial College London, London, UK
| |
Collapse
|
211
|
Kim SY, Bechle M, Hankey S, Sheppard L, Szpiro AA, Marshall JD. Concentrations of criteria pollutants in the contiguous U.S., 1979 - 2015: Role of prediction model parsimony in integrated empirical geographic regression. PLoS One 2020; 15:e0228535. [PMID: 32069301 PMCID: PMC7028280 DOI: 10.1371/journal.pone.0228535] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 01/17/2020] [Indexed: 12/20/2022] Open
Abstract
National-scale empirical models for air pollution can include hundreds of geographic variables. The impact of model parsimony (i.e., how model performance differs for a large versus small number of covariates) has not been systematically explored. We aim to (1) build annual-average integrated empirical geographic (IEG) regression models for the contiguous U.S. for six criteria pollutants during 1979–2015; (2) explore systematically the impact on model performance of the number of variables selected for inclusion in a model; and (3) provide publicly available model predictions. We compute annual-average concentrations from regulatory monitoring data for PM10, PM2.5, NO2, SO2, CO, and ozone at all monitoring sites for 1979–2015. We also use ~350 geographic characteristics at each location including measures of traffic, land use, land cover, and satellite-based estimates of air pollution. We then develop IEG models, employing universal kriging and summary factors estimated by partial least squares (PLS) of geographic variables. For all pollutants and years, we compare three approaches for choosing variables to include in the PLS model: (1) no variables, (2) a limited number of variables selected from the full set by forward selection, and (3) all variables. We evaluate model performance using 10-fold cross-validation (CV) using conventional and spatially-clustered test data. Models using 3 to 30 variables selected from the full set generally have the best performance across all pollutants and years (median R2 conventional [clustered] CV: 0.66 [0.47]) compared to models with no (0.37 [0]) or all variables (0.64 [0.27]). Concentration estimates for all Census Blocks reveal generally decreasing concentrations over several decades with local heterogeneity. Our findings suggest that national prediction models can be built by empirically selecting only a small number of important variables to provide robust concentration estimates. Model estimates are freely available online.
Collapse
Affiliation(s)
- Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
- * E-mail:
| | - Matthew Bechle
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, United States of America
| | - Steve Hankey
- School of Public and International Affairs, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Julian D. Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, United States of America
| |
Collapse
|
212
|
Cedillo-Pozos A, Ternovoy SK, Roldan-Valadez E. Imaging methods used in the assessment of environmental disease networks: a brief review for clinicians. Insights Imaging 2020; 11:18. [PMID: 32034587 PMCID: PMC7007482 DOI: 10.1186/s13244-019-0814-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/04/2019] [Indexed: 02/08/2023] Open
Abstract
Background Across the globe, diseases secondary to environmental exposures have been described, and it was also found that existing diseases have been modified by exposure to environmental chemicals or an environmental factor that has been found in their pathogenesis. The Institute of Medicine has shared a permanent concern related to the nations environmental health capacity since 1988. Main body Contemporary imaging methods in the last 15 years started reporting alterations in different human systems such as the central nervous system, cardiovascular system and pulmonary system among others; evidence suggests the existence of a human environmental disease network. The primary anatomic regions, affected by environmental diseases, recently assessed with imaging methods include Brain (lead exposure, cerebral stroke, pesticide neurotoxicity), uses MRI, DTI, carotid ultrasonography and MRS; Lungs (smoke inhalation, organophosphates poisoning) are mainly assessed with radiography; Gastrointestinal system (chronic inflammatory bowel disease), recent studies have reported the use of aortic ultrasound; Heart (myocardial infarction), its link to environmental diseased has been proved with carotid ultrasound; and Arteries (artery hypertension), the impairment of aortic mechanical properties has been revealed with the use of aortic and brachial ultrasound. Conclusions Environmental epidemiology has revealed that several organs and systems in the human body are targets of air pollutants. Current imaging methods that can assess the deleterious effects of pollutants includes a whole spectrum: radiography, US, CT and MRI. Future studies will help to reveal additional links among environmental disease networks.
Collapse
Affiliation(s)
- Aime Cedillo-Pozos
- Directorate of Research, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico
| | - Sergey K Ternovoy
- Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,A.L. Myasnikov Research Institute of Clinical Cardiology of National Medical Research Center of Cardiology of the Ministry of Health of Russia, Moscow, Russia
| | - Ernesto Roldan-Valadez
- Directorate of Research, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico. .,Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| |
Collapse
|
213
|
Long-Term Exposure to Fine Particulate Matter and Cardiovascular Disease in China. J Am Coll Cardiol 2020; 75:707-717. [DOI: 10.1016/j.jacc.2019.12.031] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 11/20/2022]
|
214
|
Lubczyńska MJ, Muetzel RL, El Marroun H, Basagaña X, Strak M, Denault W, Jaddoe VW, Hillegers M, Vernooij MW, Hoek G, White T, Brunekreef B, Tiemeier H, Guxens M. Exposure to Air Pollution during Pregnancy and Childhood, and White Matter Microstructure in Preadolescents. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:27005. [PMID: 32074458 PMCID: PMC7064320 DOI: 10.1289/ehp4709] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Air pollution has been related to brain structural alterations, but a relationship with white matter microstructure is unclear. OBJECTIVES We assessed whether pregnancy and childhood exposures to air pollution are related to white matter microstructure in preadolescents. METHODS We used data of 2,954 children from the Generation R Study, a population-based birth cohort from Rotterdam, Netherlands (2002-2006). Concentrations of 17 air pollutants including nitrogen oxides (NOX), particulate matter (PM), and components of PM were estimated at participants' homes during pregnancy and childhood using land-use regression models. Diffusion tensor images were obtained at child's 9-12 years of age, and fractional anisotropy (FA) and mean diffusivity (MD) were computed. We performed linear regressions adjusting for socioeconomic and lifestyle characteristics. Single-pollutant analyses were followed by multipollutant analyses using the Deletion/Substitution/Addition (DSA) algorithm. RESULTS In the single-pollutant analyses, higher concentrations of several air pollutants during pregnancy or childhood were associated with significantly lower FA or higher MD (p<0.05). In multipollutant models of pregnancy exposures selected by DSA, higher concentration of fine particles was associated with significantly lower FA [-0.71 (95% CI: -1.26, -0.16) per 5 μg/m3 fine particles] and higher concentration of elemental silicon with significantly higher MD [0.06 (95% CI: 0.01, 0.11) per 100 ng/m3 silicon]. Multipollutant models of childhood exposures selected by DSA indicated significant associations of NOX with FA [-0.14 (95% CI: -0.23, -0.04) per 20-μg/m3 NOX increase], and of elemental zinc and the oxidative potential of PM with MD [0.03 (95% CI: 0.01, 0.04) per 10-ng/m3 zinc increase and 0.07 (95% CI: 0.00, 0.44) per 1-nmol DTT/min/m3 oxidative potential increase]. Mutually adjusted models of significant exposures during pregnancy and childhood indicated significant associations of silicon during pregnancy, and zinc during childhood, with MD. DISCUSSION Exposure in pregnancy and childhood to air pollutants from tailpipe and non-tailpipe emissions were associated with lower FA and higher MD in white matter of preadolescents. https://doi.org/10.1289/EHP4709.
Collapse
Affiliation(s)
- Małgorzata J. Lubczyńska
- Barcelona Institute for Global Health (ISGlobal)–Campus Mar, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ryan L. Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal)–Campus Mar, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - William Denault
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
- Department of Gobal Public Health and Primary Care, University of Bergen, Bergen, Norway
- Center for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Vincent W.V. Jaddoe
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Meike W. Vernooij
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mònica Guxens
- Barcelona Institute for Global Health (ISGlobal)–Campus Mar, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, Netherlands
| |
Collapse
|
215
|
Pan SC, Huang CC, Chin WS, Chen BY, Chan CC, Guo YL. Association between air pollution exposure and diabetic retinopathy among diabetics. ENVIRONMENTAL RESEARCH 2020; 181:108960. [PMID: 31785778 DOI: 10.1016/j.envres.2019.108960] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/20/2019] [Accepted: 11/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Exposure to air pollution has been linked to adverse effects on vascular diseases. However, the effects of air pollution exposure on diabetic retinopathy (DR), a vascular disease, have not been studied. OBJECTIVE To determine the association of ambient air pollution exposure with DR risk. METHODS Patients newly diagnosed as having diabetes mellitus (DM) during 2003-2012 from Longitudinal Health Insurance Database 2005), a subset of National Health Insurance Research Database, were included as the study cohort. Newly diagnosed DR patients one year or later after DM diagnosis were identified as cases. Kriging was used to interpolate yearly concentrations of air pollutants at township levels and linked with every individual's residence in each year; average concentrations during the follow-up period were then calculated as personal exposure. Conditional logistic regressions with adjustments for age at DM diagnosis and comorbidities were applied. RESULTS Of newly diagnosed DM cases during 2003-2012, 579 were newly diagnosed as having DR over a mean follow-up period of 5.6 years. The Odds ratio (95% confidence interval) of DR occurrence for every 10-μg/m3 increase in particulate matter with ≤2.5 and 2.5-10-μm diameter was 1.29 (1.11-1.50) and 1.37 (1.17-1.61), respectively. CONCLUSION In patients with DM, the higher particulate matter exposure, the higher is the DR risk.
Collapse
Affiliation(s)
- Shih-Chun Pan
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan.
| | - Ching-Chun Huang
- Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.
| | - Wei-Shan Chin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Bing-Yu Chen
- Department of Medical Research and Development, Chang Gung Memorial Hospital, Keelung, Taiwan.
| | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan.
| | - Yue Leon Guo
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan; Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan.
| |
Collapse
|
216
|
Breen M, Chang SY, Breen M, Xu Y, Isakov V, Arunachalam S, Carraway MS, Devlin R. Fine-Scale Modeling of Individual Exposures to Ambient PM 2.5, EC, NO x, CO for the Coronary Artery Disease and Environmental Exposure (CADEE) Study. ATMOSPHERE 2020; 11:1-65. [PMID: 32461808 PMCID: PMC7252567 DOI: 10.3390/atmos11010065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Air pollution epidemiological studies often use outdoor concentrations from central-site monitors as exposure surrogates, which can induce measurement error. The goal of this study was to improve exposure assessments of ambient fine particulate matter (PM2.5), elemental carbon (EC), nitrogen oxides (NOx), and carbon monoxide (CO) for a repeated measurements study with 15 individuals with coronary artery disease in central North Carolina called the Coronary Artery Disease and Environmental Exposure (CADEE) Study. We developed a fine-scale exposure modeling approach to determine five tiers of individual-level exposure metrics for PM2.5, EC, NOx, CO using outdoor concentrations, on-road vehicle emissions, weather, home building characteristics, time-locations, and time-activities. We linked an urban-scale air quality model, residential air exchange rate model, building infiltration model, global positioning system (GPS)-based microenvironment model, and accelerometer-based inhaled ventilation model to determine residential outdoor concentrations (Cout_home, Tier 1), residential indoor concentrations (Cin_home, Tier 2), personal outdoor concentrations (Cout_personal, Tier 3), exposures (E, Tier 4), and inhaled doses (D, Tier 5). We applied the fine-scale exposure model to determine daily 24-h average PM2.5, EC, NOx, CO exposure metrics (Tiers 1-5) for 720 participant-days across the 25 months of CADEE. Daily modeled metrics showed considerable temporal and home-to-home variability of Cout_home and Cin_home (Tiers 1-2) and person-to-person variability of Cout_personal, E, and D (Tiers 3-5). Our study demonstrates the ability to apply an urban-scale air quality model with an individual-level exposure model to determine multiple tiers of exposure metrics for an epidemiological study, in support of improving health risk assessments.
Collapse
Affiliation(s)
- Michael Breen
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Shih Ying Chang
- Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC 27517, USA
| | - Miyuki Breen
- Center for Public Health and Environmental Assessment, ORISE/U.S. Environmental Protection Agency, Chapel Hill, NC 27514, USA
| | - Yadong Xu
- ORAU/U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Vlad Isakov
- Center for Measurements and Modeling, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Sarav Arunachalam
- Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC 27517, USA
| | - Martha Sue Carraway
- Department of Medicine, Pulmonary and Critical Care Medicine, Durham VA Medical Center, Durham, NC 27705 USA
| | - Robert Devlin
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Chapel Hill, NC 27514, USA
| |
Collapse
|
217
|
Wang Z, Peng J, Liu P, Duan Y, Huang S, Wen Y, Liao Y, Li H, Yan S, Cheng J, Yin P. Association between short-term exposure to air pollution and ischemic stroke onset: a time-stratified case-crossover analysis using a distributed lag nonlinear model in Shenzhen, China. Environ Health 2020; 19:1. [PMID: 31898503 PMCID: PMC6941275 DOI: 10.1186/s12940-019-0557-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 12/20/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Stroke, especially ischemic stroke (IS), has been a severe public health problem around the world. However, the association between air pollution and ischemic stroke remains ambiguous. METHODS A total of 63, 997 IS cases aged 18 years or above in Shenzhen were collected from 2008 to 2014. We used the time-stratified case-crossover design combining with distributed lag nonlinear model (DLNM) to estimate the association between air pollution and IS onset. Furthermore, this study explored the variability across gender and age groups. RESULTS The cumulative exposure-response curves were J-shaped for SO2, NO2 and PM10, and V-shaped for O3, and crossed over the relative risk (RR) of one. The 99th, 50th (median) and 1st percentiles of concentration (μg/m3) respectively were 37.86, 10.06, 3.71 for SO2, 116.26, 41.29, 18.51 for NO2, 145.94, 48.29, 16.14 for PM10, and 111.57, 49.82, 16.00 for O3. Extreme high-SO2, high-NO2, high-PM10, high-O3, and low-O3 concentration increased the risk of IS, with the maximum RR values and 95% CIs: 1.50(1.22, 1.84) (99th vs median) at 0-12 lag days, 1.37(1.13, 1.67) (99th vs median) at 0-10 lag days, 1.26(1.04, 1.53) (99th vs median) at 0-12 lag days, 1.25(1.04, 1.49) (99th vs median) at 0-14 lag days, and 1.29(1.03, 1.61) (1st vs median) at 0-14 lag days, respectively. The statistically significant minimal RR value and 95% CI was 0.79(0.66,0.94) at 0-10 lag days for extreme low-PM10. The elderly aged over 65 years were susceptible to extreme pollution conditions. Difference from the vulnerability of males to extreme high-SO2, high-NO2 and low-O3, females were vulnerable to extreme high-PM10 and high-O3. Comparing with the elderly, adults aged 18-64 year were immune to extreme low-NO2 and low-PM10. However, no association between CO and IS onset was found. CONCLUSIONS SO2, NO2, PM10 and O3 exerted non-linear and delayed influence on IS, and such influence varied with gender and age. These findings may have significant public health implications for the prevention of IS.
Collapse
Affiliation(s)
- Zhinghui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Peiyi Liu
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Department of Occupational and Environment Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ying Wen
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yi Liao
- Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| |
Collapse
|
218
|
Song L, Smith GS, Adar SD, Post WS, Guallar E, Navas-Acien A, Kaufman JD, Jones MR. Ambient air pollution as a mediator in the pathway linking race/ethnicity to blood pressure elevation: The multi-ethnic study of atherosclerosis (MESA). ENVIRONMENTAL RESEARCH 2020; 180:108776. [PMID: 31639655 DOI: 10.1016/j.envres.2019.108776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Racial/ethnic disparities in blood pressure and hypertension have been evident in previous studies, as were associations between race/ethnicity with ambient air pollution and those between air pollution with hypertension. The role of air pollution exposure to racial/ethnic differences in hypertension has not been explored. OBJECTIVE To assess the potential mediating effects of ambient air pollution on the association between race/ethnicity and blood pressure levels. METHODS We studied 6,463 White, Black, Hispanic and Chinese adults enrolled across 6 US cities. Systolic (SBP) and diastolic blood pressure (DBP) were measured at Exam 1 (2000-2002) and Exam 2 (2002-2004). Household-level annual average concentrations of fine particulate matter (PM2.5), oxides of nitrogen (NOX), and ozone (O3) for the year 2000 were estimated for participants. RESULTS The difference in SBP levels by race/ethnicity that was related to higher PM2.5 concentrations compared with White men ("indirect associations") was 0.3 (95% CI: 0.1, 0.6) mmHg for Black men, 0.3 (95% CI: 0.1, 0.6) mmHg for Hispanic men and 1.0 (95% CI: 0.2, 1.8) mmHg for Chinese men. Findings were similar although not statistically significant for women. PM2.5 did not mediate racial/ethnic differences in DBP. Indirect associations were significant for O3 for SBP among women and men and for DBP among men. In contrast, racial/ethnic disparities were attenuated due to exposure to NOX. CONCLUSION Racial disparities in blood pressure were reduced after accounting for PM2.5 and ozone while increased after accounting for NOX.
Collapse
Affiliation(s)
- Lanxin Song
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Genee S Smith
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sara D Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wendy S Post
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, School of Public Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| |
Collapse
|
219
|
Chen C, Liu X, Wang X, Qu W, Li W, Dong L. Effect of air pollution on hospitalization for acute exacerbation of chronic obstructive pulmonary disease, stroke, and myocardial infarction. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:3384-3400. [PMID: 31845265 DOI: 10.1007/s11356-019-07236-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/02/2019] [Indexed: 05/03/2023]
Abstract
This study aims to analyze the acute effects of PM2.5, PM10, SO2, NO2, and O3 on hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), stroke, and myocardial infarction (MI) from 2014 to 2017 in Shenyang, China. Hospitalization records for AECOPD (17,655), stroke (276,736) and MI (26,235) and air pollutions concentration data (PM2.5, PM10, SO2, NO2, and O3) were collected. A generalized additive model (GAM) was utilized to determine the impact of air pollutants on the relative risk (RR) of hospitalization for AECOPD, stroke, and MI. Stratified analysis for AECOPD was based on gender and age. It was based on gender, age, hypertension, and diabetes for stroke, and for MI it was based on gender, age, and coronary atherosclerosis. The lag effect for AECOPD in terms of gender analysis occurred at lag3-lag5. The hospitalization risk for stroke with hypertension due to SO2 and NO2 was greater than that of stroke without hypertension. The risk of hospitalization for stroke with hypertension as a comorbidity due to O3 was lower than without hypertension. The risk of hospitalization for MI combined with coronary atherosclerosis due to PM2.5, PM10, or NO2 was higher than that of hospitalizations for MI without coronary atherosclerosis. Air pollution increased the rate of hospitalization for AECOPD. SO2 and O3 appeared protective for stroke patients with coronary atherosclerosis. PM2.5, PM10, and NO2 had no influence on total hospitalization for myocardial infarction.
Collapse
Affiliation(s)
- Cai Chen
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China
| | - Xuejian Liu
- The First General Internal Medicine, Shengjing Hospital, China Medical University, No.16 Puhe Road, Shenbei New District, Shenyang City, 110000, Liaoning Province, China
| | - Xianfeng Wang
- PFLMET Experimental Center, Shandong University, Jinan, People's Republic of China
| | - Wenxiu Qu
- The First General Internal Medicine, Shengjing Hospital, China Medical University, No.16 Puhe Road, Shenbei New District, Shenyang City, 110000, Liaoning Province, China.
| | - Wei Li
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China.
| | - Leilei Dong
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China
| |
Collapse
|
220
|
Abstract
Air pollution is a major, preventable and manageable threat to people's health, well-being and the fulfillment of sustainable development. Air pollution is estimated to contribute to at least 5 million premature deaths each year across the world. No one remains unaffected by dirty air, but the adverse impacts of air pollution fall most heavily upon vulnerable populations, such as children, women, and people living in poverty - groups to whom States have special obligations under international human rights law. The National Academies of Sciences and Medicine of South Africa, Brazil, Germany and the United States of America are calling upon government leaders, business and citizens to take urgent action on reducing air pollution throughout the world - to the benefit of human health and well-being, to the benefit of the environment and as a condition towards sustainable development. Air pollution is a cross-cutting aspect of many UN Sustainable Development Goals.
Collapse
|
221
|
Liberda EN, Zuk AM, Tsuji LJS. Complex contaminant mixtures and their associations with intima-media thickness. BMC Cardiovasc Disord 2019; 19:289. [PMID: 31830904 PMCID: PMC6909558 DOI: 10.1186/s12872-019-1246-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/06/2019] [Indexed: 01/04/2023] Open
Abstract
Background The burden of cardiovascular disease (CVD) morbidity and mortality is higher among Indigenous persons, who also experience greater health disparities when compared to non-Indigenous Canadians, particularly in remote regions of Canada. Assessment of carotid intima-media thickness (cIMT), a noninvasive screening tool and can be used as biomarker to assess increased CVD risk. Few studies have examined environmental contaminant body burden and its association with cIMT. Methods Data from the Environment-and-Health Study in the Eeyou Istchee territory of northern Québec, Canada was used to assess complex body burden mixtures of POPs, metals and metalloids among (n = 535) Indigenous people between 15 and 87 years of age with cIMT. First, Principal Component Analysis (PCA) was used to reduce the complexity of the contaminant data. Second, based on the underlying PCA profiles from the biological data, we examined each of the prominent principal component (PC) axes on cIMT using multivariable linear regression models. Lastly, based on these PC axes, cIMT was also regressed on summed (Σ) organic compound concentrations, polychlorinated biphenyl, perfluorinated compounds, respectively, ∑10 OCs, ∑13 PCBs, ∑3PFCs, and nickel. Results Most organochlorines and PFCs loaded primarily on PC-1 (53% variation). Nickel, selenium, and cadmium were found to load on PC-5. Carotid-IMT was significantly associated with PC-1 β = 0.004 (95 % CI 0.001, 0.007), and PC-5 β = 0.013 (95 % CI 0.002, 0.023). However, the association appears to be greater for PC-5, accounting for 3% of the variation, and mostly represented by nickel. Results show that that both nickel, and ∑3PFCs were similarly associated with cIMT β = 0.001 (95 % CI 0.0003, 0.003), and β = 0.001 (95 % CI 0.0004, 0.002), respectively. But ∑10OCs was significantly associated with a slightly greater β = 0.004 (95 % CI 0.001, 0.007) cIMT change, though with less precision. Lastly, ∑13PCBs also increased β = 0.002 (95 % CI 0.0004, 0.003) cIMT after fully adjusting for covariates. Conclusion Our results suggest that environmental contaminants are associated with cIMT. This is important for the Cree from the Eeyou Istchee territory who may experience higher body burdens of contaminants than non-Indigenous Canadians.
Collapse
Affiliation(s)
- Eric N Liberda
- School of Occupational and Public Health, Ryerson University, Toronto, 350 Victoria St, Toronto, Ontario, M5B 2K3, Canada.
| | - Aleksandra M Zuk
- Health Studies, and the Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, M1C 1A4, Ontario, Canada
| | - Leonard J S Tsuji
- Health Studies, and the Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, M1C 1A4, Ontario, Canada
| |
Collapse
|
222
|
Abstract
Background:
Exposure to air pollution increases cardiovascular morbidity and mortality. Preventing chronic cardiovascular diseases caused by air pollution relies on detecting the early effects of pollutants on the risk of cardiovascular disease development, which is limited by the lack of sensitive biomarkers. We have previously identified promising biomarkers in experimental animals but comparable evidence in humans is lacking.
Methods:
Air pollution is substantially worse in Beijing than in Los Angeles. We collected urine and blood samples from 26 nonsmoking, healthy adult residents of Los Angeles (mean age, 23.8 years; 14 women) before, during, and after spending 10 weeks in Beijing during the summers of 2014 and 2015. We assessed a panel of circulating biomarkers indicative of lipid peroxidation and inflammation. Personal exposure to polycyclic aromatic hydrocarbons (PAHs), a group of combustion-originated air pollutants, was assessed by urinary PAH metabolite levels.
Results:
Urinary concentrations of 4 PAH metabolites were 176% (95% CI, 103% to 276%) to 800% (95% CI, 509% to 1780%) greater in Beijing than in Los Angeles. Concentrations of 6 lipid peroxidation biomarkers were also increased in Beijing, among which 5-, 12-, and 15-hydroxyeicosatetraenoic acid and 9- and 13-hydroxyoctadecadienoic acid levels reached statistical significance (false discovery rate <5%), but not 8-isoprostane (20.8%; 95% CI, −5.0% to 53.6%). The antioxidative activities of paraoxonase (−9.8%; 95% CI, −14.0% to −5.3%) and arylesterase (−14.5%; 95% CI, −22.3% to −5.8%) were lower and proinflammatory C-reactive protein (101%; 95% CI, 3.3% to 291%) and fibrinogen (48.3%; 95% CI, 4.9% to 110%) concentrations were higher in Beijing. Changes in all these biomarkers were reversed, at least partially, after study participants returned to Los Angeles. Changes in most outcomes were associated with urinary PAH metabolites (
P
<0.05).
Conclusions:
Traveling from a less-polluted to a more-polluted city induces systemic pro-oxidative and proinflammatory effects. Changes in the levels of 5-, 12-, and 15-hydroxyeicosatetraenoic acid and 9- and 13-hydroxyoctadecadienoic acid as well as paraoxonase and arylesterase activities in the blood, in association with exposures to PAH metabolites, might have important implications in preventive medicine as indicators of increased cardiovascular risk caused by air pollution exposure.
Collapse
|
223
|
Rappazzo KM, Joodi G, Hoffman SR, Pursell IW, Mounsey JP, Cascio WE, Simpson RJ. A case-crossover analysis of the relationship of air pollution with out-of-hospital sudden unexpected death in Wake County, North Carolina (2013-2015). THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 694:133744. [PMID: 31756798 PMCID: PMC6876709 DOI: 10.1016/j.scitotenv.2019.133744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/10/2019] [Accepted: 08/01/2019] [Indexed: 05/30/2023]
Abstract
Out-of-hospital sudden unexpected deaths are non-accidental deaths that occur without obvious underlying causes and may account for 10% of natural deaths before age 65. Short-term exposure to ambient air pollution is associated with all-cause (non-accidental) and cause-specific (e.g., cardiovascular) mortality, and with immediate exposures often yielding the highest magnitude risk estimates. Few studies have focused on short-term exposure to air pollution and sudden unexpected deaths. Using the University of North Carolina Sudden Unexpected Death in North Carolina population, we examine associations between short-term criteria air pollutant exposures with sudden unexpected deaths using a time-stratified case-crossover design, with data on criteria air pollutants from the Environmental Protection Agency's Air Quality System. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression with air pollutant exposures scaled to roughly inter-quartile ranges; models were adjusted for average temperature and relative humidity on event day and preceding 3 days. Potential for confounding by co-pollutants were examined in two pollutant models. ORs for PM2.5 at lag day 1 were elevated (adjusted OR for 5 μg/m3 increase: 1.17 (0.98, 1.40)), and were robust to co-pollutant adjustment. Elevated odds were observed for SO2 at lag day 0, and reduced odds for O3 at lag day 0; however, these associations were somewhat attenuated toward the null (SO2) or were not robust (O3) to co-pollutant adjustment. This analysis in a racially and socioeconomically diverse cohort, with a more inclusive definition of sudden unexpected death than is typically employed offers evidence that PM2.5 may be a clinically relevant trigger of sudden unexpected deaths in susceptible individuals.
Collapse
Affiliation(s)
- Kristen M Rappazzo
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Research Triangle Park, 27711, NC, USA.
| | - Golsa Joodi
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, 27514, NC, USA
| | - Sarah R Hoffman
- Oak Ridge Associated Universities, contractor to U.S. Environmental Protection Agency, Research Triangle Park, 27711, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27514, NC, USA
| | - Irion W Pursell
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, 27514, NC, USA
| | - J Paul Mounsey
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, 27514, NC, USA
| | - Wayne E Cascio
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Research Triangle Park, 27711, NC, USA
| | - Ross J Simpson
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, 27514, NC, USA
| |
Collapse
|
224
|
Shang L, Huang L, Yang W, Qi C, Yang L, Xin J, Wang S, Li D, Wang B, Zeng L, Chung MC. Maternal exposure to PM 2.5 may increase the risk of congenital hypothyroidism in the offspring: a national database based study in China. BMC Public Health 2019; 19:1412. [PMID: 31739791 PMCID: PMC6862828 DOI: 10.1186/s12889-019-7790-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/16/2019] [Indexed: 12/05/2022] Open
Abstract
Background Maternal exposure to air pollution is related to fetal dysplasia. However, the association between maternal exposure to air pollution and the risk of congenital hypothyroidism (CH) in the offspring is largely unknown. Methods We conducted a national database based study in China to explore the association between these two parameters. The incidence of CH was collected from October 1, 2014 to October 1, 2015 from the Chinese Maternal and Child Health Surveillance Network. Considering that total period of pregnancy and consequently the total period of particle exposure is approximately 10 months, average exposure levels of PM2.5, PM10 and Air Quality Index (AQI) were collected from January 1, 2014 to January 1, 2015. Generalized additive model was used to evaluate the association between air pollution and the incidence of CH, and constructing receiver operating characteristic (ROC) curve was used to calculate the cut-off value. Results The overall incidence of CH was 4.31 per 10,000 screened newborns in China from October 1, 2014 to October 1, 2015. For every increase of 1 μg/m3 in the PM2.5 exposure during gestation could increase the risk of CH (adjusted OR = 1.016 per 1 μg/m3 change, 95% CI, 1.001–1.031). But no significant associations were found with regard to PM10 (adjusted OR = 1.009, 95% CI, 0.996–1.018) or AQI (adjusted OR = 1.012, 95% CI,0.998–1.026) and the risk of CH in the offspring. The cut-off value of prenatal PM2.5 exposure for predicting the risk of CH in the offspring was 61.165 μg/m3. Conclusions The present study suggested that maternal exposure to PM2.5 may exhibit a positive association with increased risk of CH in the offspring. We also proposed a cut-off value of PM2.5 exposure that might determine reduction in the risk of CH in the offspring in highly polluted areas.
Collapse
Affiliation(s)
- Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Liyan Huang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China. .,Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston, USA.
| | - Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Juan Xin
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shanshan Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Danyang Li
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,Department of Women's and Children's Health, Karolinska Institute, Solna, Stockholm, Sweden
| | - Baozhu Wang
- Northwest Women's and Children's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Lingxia Zeng
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Mei Chun Chung
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road. Xi'an, Shaanxi Province, 710061, Xian, People's Republic of China.,Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston, USA
| |
Collapse
|
225
|
Acceleratory effects of ambient fine particulate matter on the development and progression of atherosclerosis in apolipoprotein E knockout mice by down-regulating CD4+CD25+Foxp3+ regulatory T cells. Toxicol Lett 2019; 316:27-34. [DOI: 10.1016/j.toxlet.2019.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/30/2019] [Accepted: 09/07/2019] [Indexed: 01/04/2023]
|
226
|
Combes A, Franchineau G. Fine particle environmental pollution and cardiovascular diseases. Metabolism 2019; 100S:153944. [PMID: 31610849 DOI: 10.1016/j.metabol.2019.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/06/2019] [Indexed: 01/24/2023]
Abstract
Air pollution affects 90% of the world's population and has caused 9 million deaths in 2015, becoming the most important cause of premature deaths in the world. Exposure to fine particulate matter, a major component of urban air pollution, has been associated with an increase in cardiovascular risk and associated mortality. Impact of fine particles on the cardiovascular system includes inflammation, activation of prothrombotic pathways, oxidative stress, vascular dysfunction and remodeling, and neurological dysfunction. Genetic and epigenetic factors might also increase the susceptibility to air pollution. Consequently, epidemiologic studies have identified correlations between air particulate matter concentrations and acute coronary events, ischemic cardiomyopathy, acute heart failure, and stroke. Interestingly, these effects are present even for fine particulate matter concentrations below current US and EU regulatory standards, and seems to be more harmful in the most fragile population such as low-income or elderly subjects, or patients with previous cardiovascular disease. This review aims to summarize recent data on the pathophysiology and epidemiology of cardiovascular disease after particulate matter exposure. It will also discuss potential strategies to reduce the impact of air pollution on current and future populations' health.
Collapse
Affiliation(s)
- Alain Combes
- Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, F-75013 Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, F-75013 Paris, France.
| | - Guillaume Franchineau
- Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, F-75013 Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| |
Collapse
|
227
|
Ljungman PLS, Andersson N, Stockfelt L, Andersson EM, Nilsson Sommar J, Eneroth K, Gidhagen L, Johansson C, Lager A, Leander K, Molnar P, Pedersen NL, Rizzuto D, Rosengren A, Segersson D, Wennberg P, Barregard L, Forsberg B, Sallsten G, Bellander T, Pershagen G. Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:107012. [PMID: 31663781 PMCID: PMC6867232 DOI: 10.1289/ehp4757] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 09/24/2019] [Accepted: 10/01/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Long-term exposure to particulate matter (PM) in ambient air has been associated with cardiovascular mortality, but few studies have considered incident disease in relation to PM from different sources. OBJECTIVES We aimed to study associations between long-term exposure to different types of PM and sources, and incident ischemic heart disease (IHD) and stroke in three Swedish cities. METHODS Based on detailed emission databases, monitoring data, and high-resolution dispersion models, we calculated source contributions to PM with aerodynamic diameter ≤10μm (PM10), PM with aerodynamic diameter ≤2.5μm (PM2.5), and black carbon (BC) from road wear, traffic exhaust, residential heating, and other sources in Gothenburg, Stockholm, and Umeå. Registry data for participants from four cohorts were used to obtain incidence of IHD and stroke for first hospitalization or death. We constructed time windows of exposure for same-year, 1- to 5-y, and 6- to 10-y averages preceding incidence from annual averages at residential addresses. Risk estimates were based on random effects meta-analyses of cohort-specific Cox proportional hazard models. RESULTS We observed 5,166 and 3,119 incident IHD and stroke cases, respectively, in 114,758 participants. Overall, few consistent associations were observed between the different air pollution measures and IHD or stroke incidence. However, same-year levels of ambient locally emitted BC (range: 0.01-4.6 μg/m3) were associated with a 4.0% higher risk of incident stroke per interquartile range (IQR), 0.30 μg/m3 [95% confidence interval (CI): 0.04, 7.8]. This association was primarily related to BC from traffic exhaust. PM10 (range: 4.4-52 μg/m3) and PM2.5 (range: 2.9-22 μg/m3) were not associated with stroke. Associations with incident IHD were observed only for PM2.5 exposure from residential heating. DISCUSSION Few consistent associations were observed between different particulate components and IHD or stroke. However, long-term residential exposure to locally emitted BC from traffic exhaust was associated with stroke incidence. The comparatively low exposure levels may have contributed to the paucity of associations. https://doi.org/10.1289/EHP4757.
Collapse
Affiliation(s)
- Petter L. S. Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Leo Stockfelt
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva M. Andersson
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Nilsson Sommar
- Unit of Occupational and Environmental Medicine, Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kristina Eneroth
- SLB-analys, Environment and Health Administration, Stockholm, Sweden
| | - Lars Gidhagen
- Swedish Meteorological and Hydrological Institute, Norrköping, Sweden
| | - Christer Johansson
- SLB-analys, Environment and Health Administration, Stockholm, Sweden
- Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden
| | - Anton Lager
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Peter Molnar
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, Norrköping, Sweden
| | - Patrik Wennberg
- Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bertil Forsberg
- Unit of Occupational and Environmental Medicine, Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
228
|
Nabizadeh R, Yousefian F, Moghadam VK, Hadei M. Characteristics of cohort studies of long-term exposure to PM 2.5: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:30755-30771. [PMID: 31494855 DOI: 10.1007/s11356-019-06382-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
This study systematically reviewed all the cohort studies investigating the relationship between long-term exposure to PM2.5 and any health outcome until February 2018. We searched ISI Web of Knowledge, Pubmed, and Scopus databases for peer-reviewed journal research articles published in English. We only extracted the results of the single-pollutant main analysis of each study, excluding the effect modifications and sensitivity analyses. Out of the initial 9523 articles, 203 articles were ultimately included for analysis. Based on the different characteristics of studies such as study design, outcome, exposure assessment method, and statistical model, we calculated the number and relative frequency of analyses with statistically significant and insignificant results. Most of the studies were prospective (84.8%), assessed both genders (66.5%), and focused on a specific age range (86.8%). Most of the articles (78.1%) had used modeling techniques for exposure assessment of cohorts' participants. Among the total of 317 health outcomes, the most investigated outcomes include mortality due to cardiovascular disease (6.19%), all causes (5.48%), lung cancer (4.00%), ischemic heart disease (3.50%), and non-accidental causes (3.50%). The percentage of analyses with statistically significant results were higher among studies that used prospective design, mortality as the outcome, fixed stations as exposure assessment method, hazard ratio as risk measure, and no covariate adjustment. We can somehow conclude that the choice of right characteristics for cohort studies can make a difference in their results.
Collapse
Affiliation(s)
- Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Yousefian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Kazemi Moghadam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mostafa Hadei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
229
|
Cohen G, Steinberg DM, Levy I, Chen S, Kark JD, Levin N, Witberg G, Bental T, Broday DM, Kornowski R, Gerber Y. Cancer and mortality in relation to traffic-related air pollution among coronary patients: Using an ensemble of exposure estimates to identify high-risk individuals. ENVIRONMENTAL RESEARCH 2019; 176:108560. [PMID: 31295664 DOI: 10.1016/j.envres.2019.108560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/26/2019] [Accepted: 06/27/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Moderate correlations were previously observed between individual estimates of traffic-related air pollution (TRAP) produced by different exposure modeling approaches. This induces exposure misclassification for a substantial fraction of subjects. AIM We used an ensemble of well-established modeling approaches to increase certainty of exposure classification and reevaluated the association with cancers previously linked to TRAP (lung, breast and prostate), other cancers, and all-cause mortality in a cohort of coronary patients. METHODS Patients undergoing percutaneous coronary interventions in a major Israeli medical center from 2004 to 2014 (n = 10,627) were followed for cancer (through 2015) and mortality (through 2017) via national registries. Residential exposure to nitrogen oxides (NOx) -a proxy for TRAP- was estimated by optimized dispersion model (ODM) and land use regression (LUR) (rPearson = 0.50). Mutually exclusive groups of subjects classified as exposed by none of the methods (high-certainty low-exposed), ODM alone, LUR alone, or both methods (high-certainty high-exposed) were created. Associations were examined using Cox regression models. RESULTS During follow-up, 741 incident cancer cases were diagnosed and 3051 deaths occurred. Using a ≥25 ppb cutoff, compared with high-certainty low exposed, the multivariable-adjusted hazard ratios (95% confidence intervals) for lung, breast and prostate cancer were 1.56 (1.13-2.15) in high-certainty exposed, 1.27 (0.86-1.86) in LUR-exposed alone, and 1.13 (0.77-1.65) in ODM-exposed alone. The association of the former category was strengthened using more extreme NOx cutoffs. A similar pattern, albeit less strong, was observed for mortality, whereas no association was shown for cancers not previously linked to TRAP. CONCLUSIONS Use of an ensemble of TRAP exposure estimates may improve classification, resulting in a stronger association with outcomes.
Collapse
Affiliation(s)
- Gali Cohen
- Dept. of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David M Steinberg
- Dept. of Statistics and Operations Research, School of Mathematical Sciences, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Levy
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Shimon Chen
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Jeremy D Kark
- Epidemiology Unit, Braun School of Public Health and Community Medicine, Hebrew University and Hadassah Medical Organization, Jerusalem, Israel
| | - Noam Levin
- Dept. of Geography, Hebrew University of Jerusalem, Israel
| | - Guy Witberg
- Dept. of Cardiology, Rabin Medical Center, Petach-Tikva, Israel; Dept. of Cardiovascular Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamir Bental
- Dept. of Cardiology, Rabin Medical Center, Petach-Tikva, Israel
| | - David M Broday
- Technion Center of Excellence in Exposure Science and Environmental Health, Technion Israel Institute of Technology, Israel
| | - Ran Kornowski
- Dept. of Cardiology, Rabin Medical Center, Petach-Tikva, Israel; Dept. of Cardiovascular Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yariv Gerber
- Dept. of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
230
|
Commuter Exposure to Black Carbon, Fine Particulate Matter and Particle Number Concentration in Ferry and at the Pier in Istanbul. ATMOSPHERE 2019. [DOI: 10.3390/atmos10080439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This paper presents measurements and analyses of the concentrations of black carbon (BC), particle number concentration (PNC), and PM2.5 (≤2.5 μm) while commuting by ferries in Istanbul. In this context, exposures to the mentioned pollutants were estimated for car ferry, fast ferry, and at the piers, and for two travel routes, for a total of 89 trips. BC, PNC, and PM2.5 measurements were simultaneously performed in a ferry and at the piers, and the correlation between pollutant concentrations, meteorological parameters, and environmental factors were analyzed. The mean concentrations for all pollutants in car ferry were lower than the average concentrations in fast ferry. The concentration ratios of fast ferry to car ferry for BC, PNC, and PM2.5 were 6.4, 1.2, and 1.3, respectively. High variability in the concentrations was observed at the piers and in ferry during berthing. The highest mean concentrations (±standard deviation) of BC (14.3 ± 10.1 µg m−3) and PNC (42,005 ± 30,899 pt cm−3) were measured at Yalova pier. The highest mean concentration (±standard deviation) of PM2.5 (26.1 ± 11.5) was measured at Bostancı pier. It was observed that the main external sources of BC, PNC, and PM2.5 at the piers were road transport, residential heating, and shipping activity. There were no significant correlations between BC, PNC, and PM2.5 in fast ferry, while BC was positively correlated with PNC (r = 0.61, p < 0.01) and PM2.5 (r = 0.76, p < 0.01) in car ferry. At the piers, significant relations between pollutants and meteorological variables were observed. It was noticed that there was no significant difference between summer and winter in ferry and at the pier concentrations of BC, PNC, and PM2.5 except for Yenikapı pier and Bakırköy pier. The highest total exposure to PNC and PM2.5 was in car ferry mode, while the highest total exposure to BC was in fast ferry mode.
Collapse
|
231
|
Qiu J, Dong M, Zhou F, Li P, Kong L, Tan J. Associations between ambient air pollution and pregnancy rate in women who underwent in vitro fertilization in Shenyang, China. Reprod Toxicol 2019; 89:130-135. [PMID: 31306769 DOI: 10.1016/j.reprotox.2019.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/17/2019] [Accepted: 07/08/2019] [Indexed: 01/02/2023]
Abstract
To assess the associations between air pollution and the pregnancy rate of IVF, we performed a retrospective cohort study on 1455 women who underwent the first fresh IVF cycle at a fertility center from January 2014 to April 2018 and lived in Shenyang during treatment. Binary logistic regression models were used to evaluate the effect of an interquartile range increase in each pollutant on the intrauterine pregnancy rate. Both average chronic and daily acute exposure to air pollution were considered. Increased O3 (adjusted OR = 0.87, 95% CI: 0.81, 0.98) during the period from gonadotropins starting to oocyte retrieval was associated with decreased probability of intrauterine pregnancy, especially the day before oocyte retrieval (adjusted OR = 0.86, 95% CI: 0.78, 0.95). Our results suggest that exposure to O3 before oocyte retrieval has an adverse effect on intrauterine pregnancy. Future studies should be performed in order to confirm our findings.
Collapse
Affiliation(s)
- Jiahui Qiu
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Meng Dong
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Feifei Zhou
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Pingping Li
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Lin Kong
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Jichun Tan
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China.
| |
Collapse
|
232
|
Miao X, Li W, Niu B, Li J, Sun J, Qin M, Zhou Z. Mitochondrial dysfunction in endothelial cells induced by airborne fine particulate matter (<2.5 μm). J Appl Toxicol 2019; 39:1424-1432. [DOI: 10.1002/jat.3828] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/05/2019] [Accepted: 05/05/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Xiaoyan Miao
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Wenke Li
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Bingyu Niu
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Jiangshuai Li
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Jingjie Sun
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Mengnan Qin
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| | - Zhixiang Zhou
- College of Life Science and BioengineeringBeijing University of Technology Beijing China
| |
Collapse
|
233
|
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S. Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur J Vasc Endovasc Surg 2019; 58:S1-S109.e33. [PMID: 31182334 PMCID: PMC8369495 DOI: 10.1016/j.ejvs.2019.05.006] [Citation(s) in RCA: 678] [Impact Index Per Article: 135.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
GUIDELINE SUMMARY Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.
Collapse
Affiliation(s)
- Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA, USA.
| | - Andrew W Bradbury
- Department of Vascular Surgery, University of Birmingham, Birmingham, United Kingdom
| | - Philippe Kolh
- Department of Biomedical and Preclinical Sciences, University Hospital of Liège, Wallonia, Belgium
| | - John V White
- Department of Surgery, Advocate Lutheran General Hospital, Niles, IL, USA
| | - Florian Dick
- Department of Vascular Surgery, Kantonsspital St. Gallen, St. Gallen, and University of Berne, Berne, Switzerland
| | - Robert Fitridge
- Department of Vascular and Endovascular Surgery, The University of Adelaide Medical School, Adelaide, South Australia, Australia
| | - Joseph L Mills
- Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA
| | - Jean-Baptiste Ricco
- Department of Clinical Research, University Hospitalof Poitiers, Poitiers, France
| | | | - M Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN, USA
| | - Victor Aboyans
- Department of Cardiology, Dupuytren, University Hospital, France
| | - Murat Aksoy
- Department of Vascular Surgery American, Hospital, Turkey
| | | | | | | | - Jill Belch
- Ninewells Hospital University of Dundee, UK
| | - Michel Bergoeing
- Escuela de Medicina Pontificia Universidad, Catolica de Chile, Chile
| | - Martin Bjorck
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Sweden
| | | | | | - Joseph Dawson
- Royal Adelaide Hospital & University of Adelaide, Australia
| | - Eike S Debus
- University Heart Center Hamburg, University Hospital Hamburg-Eppendorf, Germany
| | - Andrew Dueck
- Schulich Heart Centre, Sunnybrook Health, Sciences Centre, University of Toronto, Canada
| | - Susan Duval
- Cardiovascular Division, University of, Minnesota Medical School, USA
| | | | - Roberto Ferraresi
- Interventional Cardiovascular Unit, Cardiology Department, Istituto Clinico, Città Studi, Milan, Italy
| | | | - Mauro Gargiulo
- Diagnostica e Sperimentale, University of Bologna, Italy
| | | | | | | | - Wei Guo
- 301 General Hospital of PLA, Beijing, China
| | | | | | - Prasad Jetty
- Division of Vascular and Endovascular Surgery, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | | | | | - Wei Liang
- Renji Hospital, School of Medicine, Shanghai Jiaotong University, China
| | - Robert Lookstein
- Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai
| | | | | | | | | | | | | | - Juan E Paolini
- Sanatorio Dr Julio Mendez, University of Buenos Aires, Argentina
| | - Manesh Patel
- Division of Cardiology, Duke University Health System, USA
| | | | | | | | - Lee Rogers
- Amputation Prevention Centers of America, USA
| | | | - Peter Schneider
- Kaiser Foundation Hospital Honolulu and Hawaii Permanente Medical Group, USA
| | - Spence Taylor
- Greenville Health Center/USC School of Medicine Greenville, USA
| | | | - Martin Veller
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Jinsong Wang
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shenming Wang
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
234
|
Hennig F, Moebus S, Reinsch N, Budde T, Erbel R, Jöckel KH, Lehmann N, Hoffmann B, Kälsch H. Investigation of air pollution and noise on progression of thoracic aortic calcification: results of the Heinz Nixdorf Recall Study. Eur J Prev Cardiol 2019; 27:965-974. [PMID: 31189380 PMCID: PMC7272124 DOI: 10.1177/2047487319854818] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims Air pollution and noise are potential risk factors for subclinical
atherosclerosis. Longitudinal analyses, especially on the interplay of these
environmental factors, are scarce and inconsistent. Hence we investigated
long-term traffic-related exposure to air pollution and noise with the
development and progression of thoracic aortic calcification, a marker of
subclinical atherosclerosis. Methods We used baseline (2000–2003) and follow-up (2006–2008) data from the German
Heinz Nixdorf Recall cohort study, including 4814 middle-aged adults.
Residence-based air pollution (PM2.5 (aerodynamic
diameter ≤ 2.5 µm), PM10, nitrogen dioxide and particle number),
and noise was assessed with dispersion models. Thoracic aortic calcification
was quantified from non-contrast enhanced electron beam computed tomography.
The presence and extent of thoracic aortic calcification progression were
analysed with multiple logistic and linear regression models, respectively,
adjusting for age, sex, lifestyle variables, socioeconomic status and
respective co-exposure. Results We observed no association in the full study sample
(n = 3155, mean age 59.1 (±7.6) years, 52.8% women). While
an interquartile range in particle number and night-time noise yielded odds
ratios of 1.20 (1.03, 1.40) and 1.21 (1.00, 1.46) for binary thoracic aortic
calcification progression, and 0.02 (–0.01, 0.05) and 0.04 (0.00, 0.07)
higher growth rates of thoracic aortic calcification in participants with
baseline thoracic aortic calcification less than 10, negative findings were
observed in those with baseline thoracic aortic calcification of 10 or
greater. Results were similar for other pollutants and daytime noise. Conclusion Our study shows no overall associations. Subgroup analyses suggest
independent associations of traffic-related air pollution and noise with the
development and progression of subclinical atherosclerosis in participants
with no or minor thoracic aortic calcification at baseline, in contrast to
negative findings in those with advanced calcification.
Collapse
Affiliation(s)
- Frauke Hennig
- Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine University Düsseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany
| | - Nico Reinsch
- Alfried Krupp Hospital Essen, Department of Cardiology, Germany.,Medical Department, University Witten/Herdecke, Germany
| | - Thomas Budde
- Alfried Krupp Hospital Essen, Department of Cardiology, Germany
| | - Raimund Erbel
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany
| | - Nils Lehmann
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine University Düsseldorf, Germany
| | - Hagen Kälsch
- Alfried Krupp Hospital Essen, Department of Cardiology, Germany.,Medical Department, University Witten/Herdecke, Germany
| | | |
Collapse
|
235
|
Xiao T, Ling M, Xu H, Luo F, Xue J, Chen C, Bai J, Zhang Q, Wang Y, Bian Q, Liu Q. NF-κB-regulation of miR-155, via SOCS1/STAT3, is involved in the PM 2.5-accelerated cell cycle and proliferation of human bronchial epithelial cells. Toxicol Appl Pharmacol 2019; 377:114616. [PMID: 31185220 DOI: 10.1016/j.taap.2019.114616] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/02/2019] [Accepted: 06/05/2019] [Indexed: 12/16/2022]
Abstract
Air pollution, especially fine particulate matter (PM2.5, particles <2.5 μm in size), induces adverse health effects on the respiratory system. Uncontrolled proliferation of bronchial epithelial cells, resulting from deregulated cell cycle progression, contributes to pulmonary homeostatic imbalance. Although dysregulation of miRNAs is involved in a variety of pathophysiologic processes, the role of miRNAs in lung injury caused by PM2.5 is unclear. In the present study, we found that different concentrations of PM2.5 caused a biphasic effect on proliferation of human bronchial epithelial (HBE) cells. PM2.5 induced an aberrant cell cycle and proliferation of HBE cells, and up-regulated miR-155 levels with a concentration-dependent manner. High miR-155 expression, mediated by NF-κB activation, produced an accelerated G1/S phase and cell proliferation though the STAT3 pathway, which targeted SOCS1. These findings indicate that NF-κB-mediated miR-155 induces an altered cell cycle through epigenetic modulation of the SOCS1/STAT3 signaling pathway and provide a mechanism for the biphasic effect of different concentrations of PM2.5 in inducing respiratory injury.
Collapse
Affiliation(s)
- Tian Xiao
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China
| | - Min Ling
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Hui Xu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China
| | - Fei Luo
- Faculty of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, PR China
| | - Junchao Xue
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China
| | - Chao Chen
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China
| | - Jun Bai
- School of Public Health, Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Qingbi Zhang
- School of Public Health, Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Yan Wang
- Faculty of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, PR China
| | - Qian Bian
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China.
| | - Qizhan Liu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, PR China.
| |
Collapse
|
236
|
Huang Y, Bao M, Xiao J, Qiu Z, Wu K. Effects of PM 2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112017. [PMID: 31174256 PMCID: PMC6604325 DOI: 10.3390/ijerph16112017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 02/06/2023]
Abstract
Exposure to fine particulate matter 2.5 (PM2.5) is associated with adverse health effects, varying by its components. The health-related effects of PM2.5 exposure from ore mining may be different from those of environment pollution. The aim of this study was to investigate the effects of different concentrations of PM2.5 exposure on the cardio-pulmonary function of manganese mining workers. A total of 280 dust-exposed workers who were involved in different types of work in an open-pit manganese mine were randomly selected. According to the different concentrations of PM2.5 in the working environment, the workers were divided into an exposed group and a control group. The electrocardiogram, blood pressure, and multiple lung function parameters of the two groups were measured and analyzed. The PM2.5 exposed group had significantly lower values in the pulmonary function indexes of forced expiratory volume in one second (FEV1.0), maximum mid expiratory flow (MMEF), peak expiratory flow rate (PEFR), percentage of peak expiratory flow out of the overall expiratory flow volume (PEFR%), forced expiratory flow at 25% and 75% of forced vital capacity (FEF 25, FEF75), forced expiratory flow when 25%, 50%, and 75% of forced vital capacity has been exhaled (FEF25%,FEF50%, FEF75%), and FEV1.0/FVC% (the percentage of the predicted value of forced vital capacity) than the control group (all p < 0.05). Both groups had mild or moderate lung injury, most of which was restrictive ventilatory disorder, and there was significant difference in the prevalence rate of restrictive respiratory dysfunction between the two groups (41.4% vs. 23.6%, p = 0.016). Electrocardiogram (ECG) abnormalities, especially sinus bradycardia, were shown in both groups, but there was no statistical difference of the prevalence rate between the two groups (p > 0.05). Also, no significant difference of the prevalence rate of hypertension was observed between the PM2.5 exposure and control groups (p > 0.05). PM2.5 exposure was associated with pulmonary function damage of the workers in the open-pit manganese mine, and the major injury was restrictive ventilatory disorder. The early effect of PM2.5 exposure on the cardiovascular system was uncertain at current exposure levels and exposure time.
Collapse
Affiliation(s)
- Yuanni Huang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Mian Bao
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Jiefeng Xiao
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Zhaolong Qiu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
| |
Collapse
|
237
|
Aaron CP, Hoffman EA, Kawut SM, Austin JHM, Budoff M, Michos ED, Hinckley Stukovsky K, Sack C, Szpiro AA, Watson KD, Kaufman JD, Barr RG. Ambient air pollution and pulmonary vascular volume on computed tomography: the MESA Air Pollution and Lung cohort studies. Eur Respir J 2019; 53:13993003.02116-2018. [PMID: 31167881 DOI: 10.1183/13993003.02116-2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/14/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Air pollution alters small pulmonary vessels in animal models. We hypothesised that long-term ambient air pollution exposure would be associated with differences in pulmonary vascular volumes in a population-based study. METHODS The Multi-Ethnic Study of Atherosclerosis recruited adults in six US cities. Personalised long-term exposures to ambient black carbon, nitrogen dioxide (NO2), oxides of nitrogen (NO x ), particulate matter with a 50% cut-off aerodynamic diameter of <2.5 μm (PM2.5) and ozone were estimated using spatiotemporal models. In 2010-2012, total pulmonary vascular volume was measured as the volume of detectable pulmonary arteries and veins, including vessel walls and luminal blood volume, on noncontrast chest computed tomography (TPVVCT). Peripheral TPVVCT was limited to the peripheral 2 cm to isolate smaller vessels. Linear regression adjusted for demographics, anthropometrics, smoking, second-hand smoke, renal function and scanner manufacturer. RESULTS The mean±sd age of the 3023 participants was 69.3±9.3 years; 46% were never-smokers. Mean exposures were 0.80 μg·m-3 black carbon, 14.6 ppb NO2 and 11.0 μg·m-3 ambient PM2.5. Mean±sd peripheral TPVVCT was 79.2±18.2 cm3 and TPVVCT was 129.3±35.1 cm3. Greater black carbon exposure was associated with a larger peripheral TPVVCT, including after adjustment for city (mean difference 0.41 (95% CI 0.03-0.79) cm3 per interquartile range; p=0.036). Associations for peripheral TPVVCT with NO2 were similar but nonsignificant after city adjustment, while those for PM2.5 were of similar magnitude but nonsignificant after full adjustment. There were no associations for NO x or ozone, or between any pollutant and TPVVCT. CONCLUSIONS Long-term black carbon exposure was associated with a larger peripheral TPVVCT, suggesting diesel exhaust may contribute to remodelling of small pulmonary vessels in the general population.
Collapse
Affiliation(s)
- Carrie P Aaron
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Eric A Hoffman
- Dept of Radiology, University of Iowa, Iowa City, IA, USA
| | - Steven M Kawut
- Depts of Medicine and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John H M Austin
- Dept of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Matthew Budoff
- Dept of Medicine, University of California, Los Angeles, CA, USA
| | - Erin D Michos
- Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Coralynn Sack
- Dept of Medicine, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Dept of Biostatistics, University of Washington, Seattle, WA, USA
| | - Karol D Watson
- Dept of Medicine, University of California, Los Angeles, CA, USA
| | - Joel D Kaufman
- Dept of Medicine, University of Washington, Seattle, WA, USA.,Dept of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.,Dept of Epidemiology, University of Washington, Seattle, WA, USA
| | - R Graham Barr
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
238
|
Wang M, Hou ZH, Xu H, Liu Y, Budoff MJ, Szpiro AA, Kaufman JD, Vedal S, Lu B. Association of Estimated Long-term Exposure to Air Pollution and Traffic Proximity With a Marker for Coronary Atherosclerosis in a Nationwide Study in China. JAMA Netw Open 2019; 2:e196553. [PMID: 31251382 PMCID: PMC6604100 DOI: 10.1001/jamanetworkopen.2019.6553] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Epidemiologic evidence of the mechanisms of the association between long-term exposure to air pollution and coronary heart disease (CHD) is limited and relies heavily on studies performed in Europe and the United States, where air pollution levels are relatively low. In particular, the association between air pollution and CHD in patients with underlying risks for CHD is understudied. OBJECTIVE To determine whether air pollution and proximity to traffic are associated with the coronary artery calcium (CAC) score, a key atherosclerotic marker. DESIGN, SETTING, AND PARTICIPANTS In this prospective, population-based cross-sectional study in a large-scale setting in China, 8867 consecutive patients aged 25 to 92 years with suspected CHD were recruited between November 17, 2015, and September 13, 2017. Participants were excluded if they had previous myocardial infarction, stenting, or coronary artery bypass grafting or incomplete risk factors and exposure data. Each participant underwent assessment of CAC and CHD risk factors at baseline. Data were analyzed from December 2017 to November 2018. EXPOSURES Annual means of fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) were estimated at the participants' residences using a validated geostatistical prediction model. Exposure to a nearby roadway was also estimated. MAIN OUTCOMES AND MEASURES Computed tomography measurement of CAC score. RESULTS The mean (SD) age of the 8867 participants was 56.9 (10.4) years; 4378 (53.6%) were men. Annual mean (SD) PM2.5, NO2, and O3 measurements were 70.1 (20.0), 41.4 (14.7), and 93.9 (10.5) μg/m3, respectively. The mean (SD) CAC score was 91.4 (322.2) Agatston units. Exposure to PM2.5 and NO2, adjusting for CHD risk factors and multiple pollutants, were independently associated with increases in CAC scores of 27.2% (95% CI, 10.8% to 46.1%) per 30 μg/m3 PM2.5 and 24.5% (95% CI, 3.6% to 49.7%) per 20 μg/m3 NO2. For PM2.5, odds of both detectable CAC (Agatston score >0; odds ratio, 1.28; 95% CI, 1.13 to 1.45) and severe CAC (Agatston score >400; odds ratio, 1.59; 95% CI, 1.20 to 2.12) were increased. Associations of CAC with PM2.5 and NO2 were greater among male participants (PM2.5: 42.2%; 95% CI, 24.3% to 62.7%; NO2: 45.7%; 95% CI, 25.3% to 69.5%) and elderly participants (PM2.5: 50.1%; 95% CI, 28.8% to 75.0%; NO2: 55.5%; 95% CI, 31.8% to 83.6%) and those with diabetes (PM2.5: 62.2%; 95% CI, 30.9% to 101.0%; NO2: 31.2%; 95% CI, 13.9% to 51.0%). Independent association with CAC score was 9.0% (95% CI, -1.4% to 20.4%) for O3 per 15 μg/m3 and 2.4% (95% CI, -0.6% to 5.4%) for distance near roadway per 50% decrease. CONCLUSIONS AND RELEVANCE In this large Chinese study, long-term exposures to PM2.5 and NO2 were independently associated with severity of CAC. This finding may provide support for the pathophysiological role of coronary atherosclerosis through which air pollution exposure may be associated with CHD.
Collapse
Affiliation(s)
- Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
- RENEW Institute, University at Buffalo, Buffalo, New York
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
| | - Zhi-Hui Hou
- Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Hao Xu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Matthew J. Budoff
- Department of Medicine, Division of Cardiology, Harbor UCLA Medical Center, Torrance, California
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle
| | - Bin Lu
- Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
239
|
Chen JJ, Ma WM, Yuan JL, Cui LQ. PM2.5 exposure aggravates left heart failure induced pulmonary hypertension. Acta Cardiol 2019; 74:238-244. [PMID: 30348056 DOI: 10.1080/00015385.2018.1488568] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Aim: Particulate matter 2.5 (PM2.5) exposure is high risk to cardiovascular diseases. We investigated the influence of PM2.5 exposure on pulmonary arterial hypertension (PAH) murine model induced by left ventricular (LV) failure. Methods: Thirty 10 weeks old C57BL/6 mice were randomised to four groups: sham group, sham + PM2.5 group, TAC group, and TAC + PM2.5 group. Eight weeks post TAC surgery, right ventricular (RV) and lung remodelling (Sirius Red staining and WGA Staining), heart and lung function (EF and RVSBP), and fibrotic genes (TGF-ti mRNA expression and collagen III protein level in lung tissue were measured. Results: Exposure to PM2.5 augments TAC induced PAH as evidenced by decreased EF value and increased RVSBP, RV cardiomyocytes size, RV and lung fibrosis, and upregulated expression of collagen III and TGF-a in comparison to TAC group in lung tissues. Even the LV EF value was deceased from 79.3 ± 3.4% to 63.4 ± 2.1% when sham group exposed to PM2.5, PM2.5 exposure had no effect on RVSBP, RV cardiomyocytes' size, RV weight/tibia length, RV and lung fibrosis, and expression of collagen III and TGF-a in sham surgery mice. Conclusions: Exposure to PM2.5 aggravates deterioration of LV failure induced PAH.
Collapse
Affiliation(s)
| | - Wen-Ming Ma
- Department of Clinical Pharmacy, Weifang People's Hospital, Weifang, China
| | - Jing-Liang Yuan
- Department of Cardiology, Shouguang People's Hospital, Shouguang, China
| | - Lian-Qun Cui
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| |
Collapse
|
240
|
Kirrane EF, Luben TJ, Benson A, Owens EO, Sacks JD, Dutton SJ, Madden M, Nichols JL. A systematic review of cardiovascular responses associated with ambient black carbon and fine particulate matter. ENVIRONMENT INTERNATIONAL 2019; 127:305-316. [PMID: 30953813 PMCID: PMC8517909 DOI: 10.1016/j.envint.2019.02.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 02/07/2019] [Accepted: 02/10/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Exposure to fine particulate matter (PM2.5), an ambient air pollutant with mass-based standards promulgated under the Clean Air Act, and black carbon (BC), a common component of PM2.5, are both associated with cardiovascular health effects. OBJECTIVES To elucidate whether BC is associated with distinct, or stronger, cardiovascular responses compared to PM2.5, we conducted a systematic review. We evaluated the associations of short- and long-term BC, or the related component elemental carbon (EC), with cardiovascular endpoints including heart rate variability, heart rhythm, blood pressure and vascular function, ST segment depression, repolarization abnormalities, atherosclerosis and heart function, in the context of what is already known about PM2.5. DATA SOURCES We conducted a stepwise systematic literature search of the PubMed, Web of Science and TOXLINE databases and applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines for reporting our results. STUDY ELIGIBILITY CRITERIA Studies reporting effect estimates for the association of quantitative measurements of ambient BC (or EC) and PM2.5, with relevant cardiovascular endpoints (i.e. meeting inclusion criteria) were included in the review. Included studies were evaluated for risk of bias in study design and results. STUDY APPRAISAL AND SYNTHESIS METHODS Risk of bias evaluations assessed aspects of internal validity of study findings based on study design, conduct, and reporting to identify potential issues related to confounding or other biases. Study results are presented to facilitate comparison of the consistency of associations with PM2.5 and BC within and across studies. RESULTS Our results demonstrate similar associations for BC (or EC) and PM2.5 with the cardiovascular endpoints examined. Across studies, associations for BC and PM2.5 varied in their magnitude and precision, and confidence intervals were generally overlapping within studies. Where differences in the magnitude of the association between BC or EC and PM2.5 within a study could be discerned, no consistent pattern across the studies examined was apparent. LIMITATIONS We were unable to assess the independence of the effect of BC, relative the effect of PM2.5, on the cardiovascular system, nor was information available to understand the impact of differential exposure misclassification. CONCLUSIONS Overall, the evidence indicates that both BC (or EC) and PM2.5 are associated with cardiovascular effects but the available evidence is not sufficient to distinguish the effect of BC (or EC) from that of PM2.5 mass.
Collapse
Affiliation(s)
- E F Kirrane
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA.
| | - T J Luben
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - A Benson
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - E O Owens
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA; National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Cincinnati, OH, USA
| | - J D Sacks
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - S J Dutton
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - M Madden
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA; Economics Department, Duke University, Durham, NC, USA
| | - J L Nichols
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| |
Collapse
|
241
|
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg 2019; 69:3S-125S.e40. [PMID: 31159978 PMCID: PMC8365864 DOI: 10.1016/j.jvs.2019.02.016] [Citation(s) in RCA: 654] [Impact Index Per Article: 130.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.
Collapse
Affiliation(s)
- Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California, San Francisco, Calif.
| | - Andrew W Bradbury
- Department of Vascular Surgery, University of Birmingham, Birmingham, United Kingdom
| | - Philippe Kolh
- Department of Biomedical and Preclinical Sciences, University Hospital of Liège, Wallonia, Belgium
| | - John V White
- Department of Surgery, Advocate Lutheran General Hospital, Niles, Ill
| | - Florian Dick
- Department of Vascular Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Robert Fitridge
- Department of Vascular and Endovascular Surgery, The University of Adelaide Medical School, Adelaide, South Australia
| | - Joseph L Mills
- Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, Tex
| | - Jean-Baptiste Ricco
- Department of Clinical Research, University Hospitalof Poitiers, Poitiers, France
| | | | - M Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minn
| |
Collapse
|
242
|
Ye R, Cui L, Peng X, Yu K, Cheng F, Zhu Y, Jia C. Effect and threshold of PM 2.5 on population mortality in a highly polluted area: a study on applicability of standards. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:18876-18885. [PMID: 31065985 DOI: 10.1007/s11356-019-04999-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
For assessing the effect and threshold of PM2.5 on mortality in highly polluted areas and further studying the standard applicability, daily data on meteorological factors, air pollutants, and mortality were obtained in Jinan, China, from 2011 to 2017. A generalized additive model (GAM) and a distributed lag non-linear model (DLNM) were employed to assess the nonlinearity and the hysteresis of associations. We further explored the breakpoints to evaluate the existence of the threshold. The correlation between mortality and PM2.5 was nonlinear. The impact of average PM2.5 on non-accidental mortality (RR = 1.11; 95% CI = 1.06, 1.16), cardiovascular disease (CVD) mortality (RR = 1.17; 95% CI = 1.10, 1.24), and respiratory disease (RD) mortality (RR = 1.17; 95% CI = 1.10, 1.24) reached the highest in the current day (lag 0). The excess risks of PM2.5 at secondary standard level to non-accidental, CVD, and RD mortality are 8.79% (95% CI = 3.84, 13.98), 14.41% (95% CI = 7.79, 21.43), 15.35% (95% CI = 1.76, 30.74), respectively. The saturation points exist in highly polluted areas. Above the saturation points of 247 μg/m3 for non-accidental mortality, 245 μg/m3 for CVD mortality, and 250 μg/m3 for RD mortality, the model of all three relationships presented a harvesting effect. This study underscores the necessity of the ongoing efforts of reducing particulate air pollution and the adjustment of the standards in seriously polluted areas to adapt to regional conditions. At the same time, for highly polluted areas, it is advocated to strengthen personal protection to decrease the saturation point and control the concentration of pollutants as much as possible, which will substantially save more cost that benefits the public.
Collapse
Affiliation(s)
- Runze Ye
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Liangliang Cui
- Department of Environmental Health, Jinan Municipal Center for Disease Control and Prevention, No. 2 Weiliu Road, Jinan, 250012, People's Republic of China
| | - Xiumiao Peng
- Department of Environmental Health, Jinan Municipal Center for Disease Control and Prevention, No. 2 Weiliu Road, Jinan, 250012, People's Republic of China
| | - Kunkun Yu
- Department of Environmental Health, Jinan Municipal Center for Disease Control and Prevention, No. 2 Weiliu Road, Jinan, 250012, People's Republic of China
| | - Fang Cheng
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Yakun Zhu
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Chongqi Jia
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China.
| |
Collapse
|
243
|
Duan C, Talbott EO, Broadwin R, Brooks M, Matthews K, Barinas-Mitchell E. Residential Exposure to PM 2.5 and Ozone and Progression of Subclinical Atherosclerosis Among Women Transitioning Through Menopause: The Study of Women's Health Across the Nation. J Womens Health (Larchmt) 2019; 28:802-811. [PMID: 30730252 PMCID: PMC6590715 DOI: 10.1089/jwh.2018.7182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: This article aims to examine the association between long-term ambient air pollution and progression of subclinical atherosclerosis with 2-year follow-up among midlife women from the Study of Women's Health Across the Nation (SWAN). Materials and Methods: Carotid duplex ultrasonography was performed in participants from a SWAN ancillary study carried out at the Pittsburgh and Chicago sites. Mean and maximum carotid intima-media thickness (CIMT) and plaque burden were assessed throughout the common, bulb, and internal carotid artery. The yearly mean exposure to PM2.5 (particulate matter) and ozone was generated based on monitors within 20 km of the participants' home. The effect of air pollutants during follow-up on progression of CIMT was estimated using linear mixed-effects models, and the effect on progression of plaque presence and plaque index, a measure of extent of plaque, was evaluated using logistic regression. Results: This study included 417 (257 White and 160 Black) women with a mean age of 51 years at baseline. A 1 μg/m3 higher yearly mean exposure to PM2.5 during follow-up was associated with a 4.28 (95% confidence interval [CI]: 0.02-8.54) μm/year increase in maximum CIMT, after adjusting for socioeconomic and traditional cardiovascular disease (CVD) risk factors. Exposure to PM2.5 contributed to a 30% (95% CI: 3%-65%) higher odds of plaque index progression adjusting for socioeconomic factors only. Conclusions: PM2.5 independently contributed to progression of subclinical atherosclerosis, among women transitioning through menopause, a time of increasing CVD risk. Yet no significant associations between ozone and subclinical atherosclerosis were observed.
Collapse
Affiliation(s)
- Chunzhe Duan
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Evelyn O. Talbott
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Rachel Broadwin
- California Office of Environmental Health Hazard Assessment, Oakland, California
| | - Maria Brooks
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Karen Matthews
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| |
Collapse
|
244
|
Liu J, Liang S, Du Z, Zhang J, Sun B, Zhao T, Yang X, Shi Y, Duan J, Sun Z. PM 2.5 aggravates the lipid accumulation, mitochondrial damage and apoptosis in macrophage foam cells. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 249:482-490. [PMID: 30928520 DOI: 10.1016/j.envpol.2019.03.045] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 06/09/2023]
Abstract
Epidemiological evidence showed that the particulate matter exposure is associated with atherosclerotic plaque progression, which may be related to foam cell formation, but the mechanism is still unknown. The study was aimed to investigate the toxic effects and possible mechanism of PM2.5 on the formation of macrophage foam cells induced by oxidized low density lipoprotein (ox-LDL). Results showed that PM2.5 induced cytotoxicity by decreasing the cell viability and increasing the LDH level in macrophage foam cells. PM2.5 aggravated the lipid accumulation in ox-LDL-stimulated macrophage RAW264.7 within markedly increasing level of intracellular lipid by Oil red O staining. The level of ROS increased obivously after co-exposure to PM2.5 and ox-LDL than single exposure group. In addition, serious mitochondrial damage such as the mitochondrial swelling, cristae rupturing and disappearance were observed in macrophage foam cells. The loss of the mitochondrial membrane potential (MMP) further exacerbated the mitochondrial damage in PM2.5-induced macrophage foam cells. The apoptotic rate increased more severely via up-regulated protein level of Bax, Cyt C, Caspase-9, Caspase-3, and down-regulated that of Bcl-2, indicating that PM2.5 activated the mitochondrial-mediated apoptosis pathway. In summary, our results demonstrated that PM2.5 aggravated the lipid accumulation, mitochondrial damage and apoptosis in macrophage foam cells, suggesting that PM2.5 was a risk factor of atherosclerosis progression.
Collapse
Affiliation(s)
- Jiangyan Liu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Shuang Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Zhou Du
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Jingyi Zhang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Baiyang Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Tong Zhao
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Xiaozhe Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Yanfeng Shi
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| |
Collapse
|
245
|
Avila-Palencia I, Laeremans M, Hoffmann B, Anaya-Boig E, Carrasco-Turigas G, Cole-Hunter T, de Nazelle A, Dons E, Götschi T, Int Panis L, Orjuela JP, Standaert A, Nieuwenhuijsen MJ. Effects of physical activity and air pollution on blood pressure. ENVIRONMENTAL RESEARCH 2019; 173:387-396. [PMID: 30954912 DOI: 10.1016/j.envres.2019.03.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 06/09/2023]
Abstract
AIM To assess the main and interaction effects of black carbon and physical activity on arterial blood pressure in a healthy adult population from three European cities using objective personal measurements over short-term (hours and days) and long-term exposure. METHODS A panel study of 122 healthy adults was performed in three European cities (Antwerp, Barcelona, and London). In 3 seasons between March 2015 and March 2016, each participant wore sensors for one week to objectively measure their exposure to black carbon and monitor their physical activity continuously. Blood pressure was assessed three times during the week: at the beginning (day 0), in the middle (day 4), and at the end (day 7). Associations of black carbon and physical activity with blood pressure and their interactions were investigated with linear regression models and multiplicative interaction terms, adjusting for all the potential confounders. RESULTS In multiple exposure models, we did not see any effects of black carbon on blood pressure but did see effects on systolic blood pressure of moderate-to-vigorous physical activity effect that were statistically significant from 1 h to 8 h after exposure and for long-term exposure. For a 1METhour increase of moderate-to-vigorous physical activity, the difference in the expected mean systolic blood pressure varied from -1.46 mmHg (95%CI -2.11, -0.80) for 1 h mean exposure, to -0.29 mmHg (95%CI -0.55, -0.03) for 8 h mean exposure, and -0.05 mmHg (95%CI -0.09, -0.00) for long-term exposure. There were little to no interaction effects. CONCLUSIONS Results from this study provide evidence that short-term and long-term exposure to moderate-to-vigorous physical activity is associated with a decrease in systolic blood pressure levels. We did not find evidence for a consistent main effect of black carbon on blood pressure, nor any interaction between black carbon and physical activity levels.
Collapse
Affiliation(s)
- Ione Avila-Palencia
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Michelle Laeremans
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Germany
| | | | - Glòria Carrasco-Turigas
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tom Cole-Hunter
- Centre for Air Pollution, Energy and Health Research (CAR), Sydney, Australia; International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, School of Chemistry, Physics and Mechanical Engineering, Faculty of Science and Engineering, Queensland University of Technology (QUT), Brisbane, Australia
| | | | - Evi Dons
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | - Thomas Götschi
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
| | - Luc Int Panis
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | | | - Arnout Standaert
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Mark J Nieuwenhuijsen
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| |
Collapse
|
246
|
Yang X, Zhao T, Feng L, Shi Y, Jiang J, Liang S, Sun B, Xu Q, Duan J, Sun Z. PM 2.5-induced ADRB2 hypermethylation contributed to cardiac dysfunction through cardiomyocytes apoptosis via PI3K/Akt pathway. ENVIRONMENT INTERNATIONAL 2019; 127:601-614. [PMID: 30986742 DOI: 10.1016/j.envint.2019.03.057] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Long-term exposure to fine particulate matter (PM2.5) can causally contribute to progression of atherosclerosis, risk of ischemic heart disease and death, but the underlying mechanism is little known. Since DNA methylation impacts the process of heart disease, it might be useful in exploring potential mechanistic pathways linking PM2.5 exposure and heart disease. OBJECTIVES Here, we investigated the PM2.5-induced ADRB2 hypermethylation and the involving epigenetic mechanism of PM2.5-induced cardiomyocytes apoptosis and cardiac dysfunction. METHODS AND RESULTS In vitro, PM2.5 markedly augmented cardiotoxicity including oxidative damage and apoptosis in cardiomyocytes AC16 as well as epigenetic alteration. DNA methylation profiling revealed a significant gene-ADRB2 was involved in the cardiac relative GO and KEGG pathways. Methylation chip and Bisulfite Sequencing PCR (BSP) both identified the hypermethylation status of ADRB2 which encodes β2-Adrenergic receptor (β2AR). Mechanistic study showed ADRB2 hypermethylation-induced down-regulation of β2AR inhibited PI3K/Akt and then activated Bcl-2/BAX and p53 pathway in AC16. The transgenic cell lines showed over-expression of ADRB2 weakened the PM2.5-induced cardiomyocytes apoptosis in opposite way, but was augmented by PI3K inhibitor (LY294002). In vivo, echocardiography showed the heart contractile function was decreased after SD rats intratracheal instillation of PM2.5 for 30 days. The myocardial interstitial edema, myocardial gap expansion and myofibril disorder in PM2.5 treated group were observed in rats heart tissue. What's more, basal expression of β2AR and VEGFR2 decreased in heart tissue as the dosage of PM2.5 increasing, meanwhile PM2.5 markedly attenuated PI3K/Akt pathway followed by augmented Bcl-2/BAX and p53 pathway, thus caused a greater number of TUNEL positive cardiomyocytes resulted in cardiac dysfunction in vivo. CONCLUSIONS PM2.5 exposure could cause the myocardial ADRB2 hypermethylation and activate the β2AR/PI3K/Akt pathway, resulted in PM2.5-induced cardiomyocytes apoptosis and cardiac dysfunction. Our study suggested that the ADRB2 demethylation or ADRB2/β2AR activation may serve as a potential pathway to prevent cardiac dysfunction induced by PM2.5 exposure.
Collapse
Affiliation(s)
- Xiaozhe Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Tong Zhao
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Lin Feng
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Yanfeng Shi
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Jinjin Jiang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Shuang Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Baiyang Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Qing Xu
- Core Facilities for Electrophysiology, Core Facilities Center, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| |
Collapse
|
247
|
Wang M, Sampson PD, Sheppard LE, Stein JH, Vedal S, Kaufman JD. Long-Term Exposure to Ambient Ozone and Progression of Subclinical Arterial Disease: The Multi-Ethnic Study of Atherosclerosis and Air Pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:57001. [PMID: 31063398 PMCID: PMC6791411 DOI: 10.1289/ehp3325] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Long-term ozone ([Formula: see text]) exposure is associated with cardiovascular mortality, but little is known about the associations between [Formula: see text] and subclinical arterial disease. OBJECTIVES We studied the longitudinal association of exposure to [Formula: see text] and progression of key subclinical arterial markers in adults: intima-media thickness of common carotid artery ([Formula: see text]), carotid plaque (CP) burden, and coronary artery calcification (CAC). METHODS CAC was measured one to four times at baseline and at follow-up exams (1999–2012) by computed tomography (CT) in 6,619 healthy adults, recruited at age 45-84 y without cardiovascular disease (CVD), over a mean of 6.5 y (standard deviation: 3.5 y). [Formula: see text] and CP burden were quantified in 3,392 participants using carotid artery ultrasound imaging acquired over a mean of 9 y (1.7 y). Over 91% and 89% participants had at least one follow-up [Formula: see text] and CAC measurement, respectively. Residence-specific [Formula: see text] concentrations were estimated by a validated spatiotemporal model spanning from 1999 to 2012. This model relied on comprehensive monitoring data and geographical variables to predict individualized long-term average concentrations since baseline. Linear mixed models and logistic regression model were used to evaluate relationships of long-term average exposure to [Formula: see text] with longitudinal change in [Formula: see text], CAC, and CP formation, respectively. RESULTS Mean progression rates of [Formula: see text] and CAC were [Formula: see text] and [Formula: see text]. CP formation was identified in 55% of the subjects. A [Formula: see text] increase in long-term average [Formula: see text] exposure was associated with a [Formula: see text] [95% confidence interval (CI): 1.4, 9.7] greater increase in [Formula: see text] over 10 y. A [Formula: see text] increase in [Formula: see text] was also associated with new CP formation [odds ratio (OR): 1.2 (95% CI: 1.1, 1.4)] but not CAC progression [[Formula: see text] (95% CI: [Formula: see text], 2)]. Associations were robust in the analysis with extended covariate adjustment, including copollutants, i.e., nitrogen oxides ([Formula: see text]) and particulate matter with diameter [Formula: see text] ([Formula: see text]). CONCLUSION Over almost a decade of follow-up, outdoor [Formula: see text] concentrations were associated with increased rate of carotid wall thickness progression and risk of new plaque formation, suggesting arterial injury in this cohort. https://doi.org/10.1289/EHP3325.
Collapse
Affiliation(s)
- Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
- RENEW Institute, University at Buffalo, Buffalo, New York, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, Washington, USA
| | - Lianne E. Sheppard
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - James H. Stein
- University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, Wisconsin, USA
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| |
Collapse
|
248
|
Yap J, Ng Y, Yeo KK, Sahlén A, Lam CSP, Lee V, Ma S. Particulate air pollution on cardiovascular mortality in the tropics: impact on the elderly. Environ Health 2019; 18:34. [PMID: 30999903 PMCID: PMC6471752 DOI: 10.1186/s12940-019-0476-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/04/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Air pollution has a significant health impact. Most data originate from temperate regions. We aim to study the health impact of air pollution, particularly among the elderly, in a tropical region. METHODS A daily time-series analysis was performed to estimate excess risk (ER) of various air pollutants on daily death counts amongst the general population in Singapore from 2001 to 2013. Air pollutants included particulate matters smaller than 10 μm, and 2.5 μm (PM10, PM2.5), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and sulphur dioxide (SO2). The studied outcomes were non-accidental and cardiovascular mortality. Single-day lag and distributed lag models were studied and adjusted for confounders. RESULTS In single-day lag models, a 10 μg/m3 increase in particulate matter was associated with significant increases in non-accidental (PM10 ER: 0.627%; 95% confidence interval (CI): 0.260-0.995% and PM2.5 ER: 0.660%; 95% CI: 0.204-1.118%) and cardiovascular mortality (PM10 ER: 0.897; 95% CI: 0.283-1.516 and PM2.5 ER: 0.883%; 95% CI: 0.121-1.621%). This was significant in the elderly ≥ 65 years but not in those < 65 years and were seen in the acute phase of lag 0-5 days. Effects by other pollutants were minimal. For cardiovascular mortality, the effects turned protective at a cumulative lag of 30 days in the elderly and could due to "harvesting". CONCLUSIONS These first contemporary population-based data from an equatorial country with tropical climate show that exposure to particulate air pollution was significantly associated with non-accidental mortality and cardiovascular mortality, especially in the elderly.
Collapse
Affiliation(s)
- Jonathan Yap
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609 Singapore
| | - Yixiang Ng
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609 Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Anders Sahlén
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609 Singapore
- Karolinska Institutet, Stockholm, Sweden
| | - Carolyn Su Ping Lam
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609 Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Vernon Lee
- Public Health Group, Ministry of Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Stefan Ma
- Public Health Group, Ministry of Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| |
Collapse
|
249
|
Ping P, Watson K, Han J, Bui A. Individualized Knowledge Graph: A Viable Informatics Path to Precision Medicine. Circ Res 2019; 120:1078-1080. [PMID: 28360346 DOI: 10.1161/circresaha.116.310024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Peipei Ping
- From the NIH BD2K Center of Excellence for Biomedical Computing at UCLA, Los Angeles, CA (P.P., K.W., A.B.); and NIH BD2K KnowEng Center of Excellence for Biomedical Computing at UIUC, Urbana, IL (J.H.).
| | - Karol Watson
- From the NIH BD2K Center of Excellence for Biomedical Computing at UCLA, Los Angeles, CA (P.P., K.W., A.B.); and NIH BD2K KnowEng Center of Excellence for Biomedical Computing at UIUC, Urbana, IL (J.H.)
| | - Jiawei Han
- From the NIH BD2K Center of Excellence for Biomedical Computing at UCLA, Los Angeles, CA (P.P., K.W., A.B.); and NIH BD2K KnowEng Center of Excellence for Biomedical Computing at UIUC, Urbana, IL (J.H.)
| | - Alex Bui
- From the NIH BD2K Center of Excellence for Biomedical Computing at UCLA, Los Angeles, CA (P.P., K.W., A.B.); and NIH BD2K KnowEng Center of Excellence for Biomedical Computing at UIUC, Urbana, IL (J.H.)
| |
Collapse
|
250
|
Abstract
The conference "Climate change, air pollution and health" was held at the Pontifical Academy of Sciences. The data presented highlighted that air pollution is a major, under-recognized and modifiable risk factor for stroke and heart disease. Air pollution causes 7.6% of all deaths making it the fifth cause of death globally, and this figure is expected to increase by 50% by 2050. Particulate matter causes endothelial dysfunction and induces thrombosis by altering reactive oxygen species, nitric oxide, insulin resistance, and lipid levels. Thirty-three articles published since 2002 were reviewed to assess the relation between air pollution and stroke with age, geographical location, particulate and gaseous matter type, duration of exposure, previous stroke, and comorbidities. It remains to be defined if air pollution has pathophysiological effects that preferentially predispose individuals to ischemic or hemorrhagic stroke. There is ample evidence showing an association between acute and chronic exposure to PM2.5 or gaseous pollutants with stroke. This potentially avoidable scenario and its dramatic consequences are heavily under-recognized by health professionals and the wider public. Preventive measures in people at high vascular risk are warranted. Procrastination in implementing efforts to stop the current worldwide course of worsening air pollution is the seed of a potential global health catastrophe.
Collapse
Affiliation(s)
- Conrado J Estol
- Stroke Unit, Sanatorio Guemes, Francisco Acuña de Figueroa 1240, C1180, CABA, Argentina
| |
Collapse
|