Comparison of normal and dusty day impacts on fractional exhaled nitric oxide and lung function in healthy children in Ahvaz, Iran

Dust Storms and Emergency Department Visits in 3 Southwestern States Using NWS Storm Reports

Importance

Dust storms are projected to increase with climate change. The short-term health outcomes associated with dust storms in the US are not well characterized, especially for morbidity outcomes.

Objective

To estimate associations between dust storms and diagnosis-specific emergency department (ED) visits during 2005 to 2018.

Design, Setting, and Participants

In this cross-sectional study using a time-stratified case-crossover design, short-term associations between dust storms and ED visits were estimated at the zip code level using conditional Poisson analysis with adjustment for meteorology and within-month trends. Same-day dust storm events and storm events within a lag period of up to 7 days were considered. State-wide patient-level ED visit records acquired from 3 state health departments (Arizona, California, and Utah) were analyzed. Data were analyzed between April 21 and November 12, 2024.

Exposures

Dust storm events were reported by the US National Weather Service and assigned to each patient zip code that had at least a 5% areal overlap with the National Weather Service forecast zone.

Main Outcomes and Measures

Patient-level ED visits for asthma, chronic obstructive pulmonary disease, culture-negative pneumonia, congestive heart failure (CHF), cerebrovascular disease, ischemic heart disease, and visits due to motor vehicle accidents.

Results

The analysis included 33 500 ED visits among the outcomes of interest (5717 children aged 0-17 years [17.1%] and 11 150 adults aged >65 years [33.3%]; 17 394 male [51.9%] and 16 104 female [48.1%]; 2829 Black [8.4%] and 22 537 White [67.2%]; 9256 Hispanic [27.6%]) and 206 dust-impacted zip codes. The strongest associations between dust storms and ED visits were found for asthma (lag 0-2 relative risk [RR], 1.06; 95% CI, 1.01-1.11; P = .03), culture-negative pneumonia (lag 0-7 RR, 1.06; 95% CI, 1.02-1.10; P = .002), CHF (lag 0-7 RR, 1.06; 95% CI, 1.01-1.10; P = .01), and motor vehicle accidents (lag 0 RR, 1.13; 95% CI, 1.04-1.23; P = .003). Associations of dust storm exposure with ischemic heart disease were mostly protective (eg, lag 0-2 RR, 0.89; 95% CI, 0.84-0.95; P < .001). Associations of dust storm exposure with risk of ED visits for CHF and motor vehicle accidents were robust against adjustment for ambient ozone (eg, CHF: RR, 1.08; 95% CI, 1.03-1.13; P = .003) and nitrogen dioxide (eg, CHF: RR, 1.08; 95% CI, 1.03-1.13; P = .003) air pollution.

Conclusions and Relevance

In this study, dust storms were positively associated with ED visits for asthma, pneumonia, heart failure, and motor vehicle accidents. These findings contribute to our understanding of the association of dust storms with morbidity in the US and potential outcomes under a changing climate.

Air quality and wheeze symptoms in a rural children's cohort near a drying saline lake

BACKGROUND

In California, climate change and competing water demands are intensifying the desiccation of the Salton Sea, a large land-locked "sea" situated near the southeastern rural US-Mexico border region known as the Imperial Valley.

METHODS

To examine the possible effects of living near a saline lake on children's respiratory health, we analyzed the relationship between respiratory health symptoms and ambient PM concentrations among a predominantly Latino/Hispanic cohort of 722 school age children. Guardians completed a survey of their child's wheeze and respiratory health symptoms over the past 12 months, adapted from the International Study of Asthma and Allergies in Childhood (ISAAC). Exposure to dust storm hours (hourly concentrations >150 μg/m3 for PM10) was estimated using a network of regulatory monitors.

RESULTS

Between 2017 and 2019, children were exposed to 98 to 395 dust event hours annually. We observed disparate effects for dust events and wheeze among children living near the Salton Sea. Every additional 100 dust storm hours per year among children living near the Sea (<11 km) was associated with a 9.5 percentage point increase in wheeze (95% CI: 3.5, 15.4), a 4.6 percentage point increase in bronchitic symptoms (95% CI: 0.18, 10.2) and a 6.7 percentage point increase in sleep disturbance due to wheeze (95% CI: 0.96, 12.4). Similarly, increases in PM10 were also associated with greater reported wheeze and bronchitic symptoms among those living near the Sea, compared to children living ≥11 km from the Sea. There was no association of dust storms or PM10 with wheeze or bronchitic symptoms among the children residing farther from the Sea.

CONCLUSION

We observed stronger adverse impacts of PM10 and dust events on respiratory health among those living closer to the drying Salton Sea, compared to children living farther away. In this community of predominantly low-income residents of color, these impacts raise environmental justice concerns about the effects of the drying Salton Sea on public health.

Exposure assessment of metal(loids) in indoor air and biomonitoring in six urban residential areas in Iran

Exposure to metal(loid)s can cause adverse health effects. This study evaluated the concentrations of aluminum, arsenic, cadmium, chromium, mercury, nickel, and lead in particulate matter <10 μm (PM10) and in the urine of 100 participants from urban residential areas in Iran. A total of 100 residential buildings (one adult from each household) in six cities across Iran were recruited for this study. The levels of metal(loid)s in PM10 and the urine of participants were measured using acid digestion followed by inductively coupled plasma mass spectrometry (ICP-MS). The average (±SE) PM10 concentration in the buildings was 51.7 ± 3.46 μg/m3. Aluminum and cadmium had the highest and lowest concentrations among the metal(loid)s, averaging 3.74 ± 1.26 μg/m3 and 0.01 ± 0.001 μg/m3, respectively. In 85 % of the samples, the concentration of metal(loid)s in indoor air exceeded WHO air quality standards. Cadmium and lead had the highest and lowest numbers of indoor air samples exceeding the recommended standards, respectively. A significant correlation was found between the concentration of metal(loid)s in urine samples and indoor PM10 levels, as well as the wealth index of participants. There was also a significant direct relationship between the concentrations of nickel, arsenic, lead, and mercury in urine and the age of participants. Factors such as building location, type of cooling systems, use of printers at home, and natural ventilation influenced the concentration and types of metal(loid)s in the indoor air.

Suspended particulate matter promotes epithelial-to-mesenchymal transition in alveolar epithelial cells via TGF-β1-mediated ROS/IL-8/SMAD3 axis

Epidemiological evidence presents that dust storms are related to respiratory diseases, such as pulmonary fibrosis (PF). However, the precise underlying mechanisms of SPM-elicited adverse effects still need to be investigated. Epithelial-mesenchymal transition (EMT) process is a characteristic of PF. We discussed whether suspended particulate matter (SPM) is involved in EMT induction via transforming growth factor-β1 (TGF-β1). In this study, a detailed elemental analysis (55 elements), particle size, and morphology were determined. To investigate the toxicity of SPM, an MTT test was performed to detect cell viability. Next, A549 cells were exposed to selected concentrations of SPM (20 and 40 µg/mL) for single and repeated exposures. The DCFH-DA assay showed that exposure to SPM could produce reactive oxygen species (ROS). The ELISA assay demonstrated increased levels of interleukin-8 (IL-8) and TGF-β1 in the supernatant. Western blot was used to detect the expression of proteins associated with EMT and the SMAD3-dependent pathway. Results of western blot demonstrated that E-cadherin was reduced, whereas p-SMAD3, vimentin, and α-smooth muscle actin were elevated. Our findings indicated that SPM triggered EMT by induction of oxidative stress, inflammation, and the TGF-β1/SMAD3 pathway activation.

Air pollution in major Polish cities in the period 2005-2021: Intensity, effects and attempts to reduce it

Air quality in Poland is among the lowest in Europe due to high emissions of harmful substances. This causes the development of diseases and leads to a high number of premature deaths. Particularly high pollution occurs in parts of urban areas. The most serious problem is unregulated emissions from buildings and vehicles. That is why it is so important to take action to improve air quality at the local level. The study assessed changes in the concentrations of NO2, O3, PM10, PM2.5 and benzo(a)pyrene in 11 major Polish cities between 2005 and 2021. In 2021 average levels were: NO2 - 25 μg/m3, O3 - 45 μg/m3, PM10 - 26 μg/m3, PM2.5 -17 μg/m3, benzo(a)pyrene - 2.1 ng/m3. The highest exceedances of WHO standards over the studied period were for PM2.5, followed by NO2 and PM10. The annual average levels fell by 17% for NO2 and by 18% for PM10 between 2005 and 2021, and by 34% for PM2.5 and 27% for benzo(a)pyrene between 2010 and 2021. The most polluted cities are Kraków, Katowice and Łódź. The highest concentrations of pollutants typically occurred in 2006 and 2011, the lowest in 2020. Strategic documents and programmes that formulate objectives for reducing emissions and improving air quality were evaluated. Policy documents enable numerous measures to improve air quality. Plans are not always effectively implemented due to a lack of formal tools and financial resources.

Personal PM2.5 Elemental Components, Decline of Lung Function, and the Role of DNA Methylation on Inflammation-Related Genes in Older Adults: Results and Implications of the BAPE Study

Epidemiological evidence of the effects of PM_2.5 elements on lung function and DNA methylation is limited. We conducted a longitudinal panel study of 76 healthy older adults aged 60-69 years in Jinan, China, from September 2018 to January 2019. We periodically measured individual 72 h PM_2.5 and element concentrations, lung function, and DNA methylation levels of eight inflammation-related genes. We used linear mixed-effect models to investigate the effects of exposure to personal PM_2.5 elements on the lung function and DNA methylation. Mediation analysis was used to investigate the underlying effect mechanism. Negative changes in the ratio of forced expiratory volume in 1 s to forced vital capacity, ranging from -1.23% [95% confidence interval (CI): -2.11%, -0.35%] to -0.77% (95% CI: -1.49%, -0.04%), were significantly associated with interquartile range (IQR) increases in personal PM_2.5 at different lag periods (7-12, 13-24, 25-48, 0-24, 0-48, and 0-72 h). Arsenic (As), nickel, rubidium (Rb), selenium, and vanadium were significantly associated with at least three lung function parameters, and IQR increases in these elements led to 0.12-5.66% reductions in these parameters. PM_2.5 elements were significantly associated with DNA methylation levels. DNA methylation mediated 7.28-13.02% of the As- and Rb-related reduced lung function. The findings indicate that exposure to elements in personal PM_2.5 contributes to reduced lung function through DNA methylation.

Estimation of the effects PM2.5, NO2, O3 pollutants on the health of Shahrekord residents based on AirQ+ software during (2012-2018)

Research objectives

Intertwined with modern life, air pollution is not a new phenomenon. Air pollution imposes a significant number of deaths and disease complications on society, and therefore it is very important to determine the extent of its effects on health in any society. This study sought to evaluate the concentration and short-term and long-term excess mortality attributed to PM2.5, NO₂ and O3 observed in Shahrekord.

Procedure

Hourly concentrations of PM2.5, O₃, and NO₂ measured at different stations of the Shahrekord Monitoring Network were obtained from the Shahrekord Department of Environment (DOE). Then, for different air quality monitoring stations, the average 24-hour PM2.5 concentration, the one-hour average NO₂ concentration and the maximum 8-hour daily O₃ concentration were calculated using Excel 2010. When the maximum 8-hour daily ozone level exceeds 35, it drops below 35 to calculate the SOMO35 index for modeling.

Results

The death rates of IHD, COPD, lung cancer and ALRI and stroke related to PM2.5 were 176, 7, 0, 10, 105, respectively. The effect of ozone on respiratory mortality was zero. During the study period in Shahrekord, no respiratory mortality was determined due to ozone and acute lower respiratory tract infection (ALRI). this study is first ever study on health effects of air pollution in shahrekord city.

Conclusion

A significant number of deaths due to air pollutants in Shahrekord have been reported. It can be concluded that by designing and implementing strategies and measures to control air pollution, both health effects and economic losses are prevented.

Effect of long-term exposure to PM2.5 on years of life lost in a populated Middle Eastern city

From a public health point of view, years of life lost (YLL) is a more important index than the number of deaths to evaluate the effect of risk factors. The objective of the present study was to estimate the burden of disease including years of life lost (YLL) and expected life remaining (ELR) attributed to long-term exposure to PM_2.5 in Ahvaz, one of the most polluted cities of the world, during March 2014 through March 2017. AirQ +  software was used for the estimation of YLL and ELR due to all natural causes of death. Hourly concentrations of PM_2.5 were acquired from the Department of Environment (DoE) of Ahvaz. Several steps were performed to validate the raw air quality data. Only the monitors were included that had minimum data completeness of 75%. Two age groups were selected for this study, including 0-64 and 65 < years. The life table approach was used to estimate YLL and ELR. Annual averages of PM_2.5 were 5.2-8 times higher than the air quality guideline (10 μg/m³) set by WHO for long-term exposure to PM_2.5. In total, PM_2.5 has caused 234,041 years of life lost due to mortality. About 84% of YLLs were attributed to people older than 65 years old. The YLLs of men were higher than those for women. The YLLs in the third year were greater than the first two years. PM_2.5 has caused the average age of total population, people aged 0-64 years old, and people > 65 years old decreased by 2.5, 3, and 1.6 years, respectively. These studies indicated that people in a city that the air quality is highly affected by dust storms, industrial emissions, and urban air pollution are significantly at risk. Air pollution control strategies and actions should be designed and executed to improve the quality of ambient air.

Vulnerability mapping and risk analysis of sand and dust storms in Ahvaz, IRAN

In this work, a sand and dust storm vulnerability mapping (SDS-VM) approach is developed to model the vulnerability of urban blocks to SDS using GIS spatial analysis and a range of geographical data. The SDS-VM was carried out in Ahvaz, IRAN, representing one of the most dust-polluted cities in West Asia. Here, vulnerability is defined as a function of three components: exposure, sensitivity, and adaptive capacity of the people in the city blocks to sand and dust storms. These components were formulated into measurable indicators (i.e. GIS layers) including: PM_2.5, wind speed, distance from dust emission sources, demographic statistics (age, gender, family size, education level), number of building floors, building age, land surface temperature (LST), land use, percentage of literate population, distance from health services, distance from city facilities (city center, shopping centers), distance from infrastructure (public transportation, main roads and highways), distance from parks and green spaces, and green area per capita. The components and the indicators were weighted using analytical hierarchy process (AHP). Different levels of risks for the components and the indicators were defined using ordered weighted averaging (OWA). Urban SDS vulnerability maps at different risk levels were generated through spatial multi-criteria data analysis procedure. Vulnerability maps, with different risk levels, were validated against field-collected data of 781 patients hospitalized for dust-related diseases (i.e. respiratory, cardiovascular, and skin). Results showed that (i) SDS vulnerability map, obtained from the developed methodology, gives an overall accuracy of 79%; (ii); regions 1 and 5 of Ahvaz are recognized with the highest and lowest vulnerabilities to SDS, respectively; and (iii) ORness equal to 0 (very low risk) is the optimum SDS-VM risk level for decision-making to mitigate the harmful impacts of SDS in the deposition areas of Ahvaz city.

Influence of the meteorological conditions and some pollutants on PM10 concentrations in Lamphun, Thailand

Particulate matter (PM) has been occurring regularly during the dry season in the upper north of Thailand including Lamphun Province that might be influenced by various factors including climatologic and other pollutants. This paper aims to investigate the climatologic and gaseous factors influencing the occurrence of PM₁₀ concentration using Pollution Control Department (PCD) data. The secondary data of 2009 to 2017 obtained from the PCD was used for analysis. We used descriptive statistics, Pearson's correlation coefficient, multiple regression and graphic presentation using R program (R packages of 'open air' and 'ncdf4') and Microsoft Excel Spreadsheet®. In addition, the periodic measurement of PM_2.5 and PM₁₀ were investigated to determine the ratio of PM_2.5/PM₁₀. The results indicated that haze episodes (daily PM₁₀ concentration always over the PCD standard) normally occur during the dry season from February to April. The maximum concentration was always found in March. The PM₁₀ concentration was negatively associated with relative humidity and temperature while the PM₁₀ concentration showed a strongly positive association with CO and NO₂ concentration with correlation values of 0.70 and 0.57, respectively. Furthermore, we found CO and PM₁₀ concentration was associated with ozone concentration. This finding will benefit local communities and the public health sector to provide a warning system for preparation and response plans to react to PM₁₀ episodes in their responsible areas.

Iranian population exposures to heavy metals, PAHs, and pesticides and their intake routes: a study protocol of a national population health survey

Cancer is the second leading cause of death in the world and the third leading cause of death in Iran. It has been proven that numerous cancer cases are caused by exposure to environmental pollutants. There is a public health concern regarding an increase in exposure to carcinogens across Iran through different sources (air, food, and water) and a lack of research to address this issue. This study aims to gather data on exposure to heavy metals, polycyclic aromatic hydrocarbons (PAHs), and pesticides and their intake routes during the implementation of a national population health survey. This is a cross-sectional study of environmental pollutants in Iran, with a stratified multi-stage random sampling method, which led to 660 nationally representative samples in 132 clusters in three sequential parts. The first will be questionnaires to obtain demographics, assets, food records, air quality, and food frequency. The second will be physical measurements, including anthropometric and body composition. The third will be lab assessments that measure 26 types of environmental pollutants (7 heavy metals, 16 PAHs, and 3 pesticides) in urine, inhaled air, and consumed food and water of the population under study using ICP-MS and GS-MS devices. The results of this study will inform policymakers and the general population regarding the level of threat and will provide evidence for the development of interventional and observatory plans on the reduction of exposures to these pollutants. It could also be used to develop local standards to control contaminants through the three exposure routes. This study protocol will obtain data needed for policymakers to set surveillance systems for these pollutants at the national and provincial level to address the public concerns regarding the contamination of food, air, and water.

Investigation of fungal contamination in indoor air and on surfaces of traditional public baths in a historical city

It has been proven that exposure to bioaerosols is associated with several health effects, such as pulmonary diseases and allergies. The present cross-sectional study was aimed to investigate fungal contamination in indoor air and on the surfaces of four traditional baths in Shiraz, Iran, one of the most historical cities in the world. Samples were taken from indoor air, using a microbial air sampler, as well as the surfaces of the shower, hallway, and dressing rooms of studied baths for 3 months. Totally 180 samples, including 45 air and 135 surfaces samples, were collected from studied baths. The concentrations of fungi collected from the air of studied baths were ranged from 22.6 to 34.6 CFU/m³. Besides, the levels of fungi collected from the surface samples of studied baths were ranged from 21.2 to 60 CFU/m². The highest and lowest fungi species detected both in air and surfaces samples of the studied baths were Penicillium spp. and Mucor spp. respectively. Although the levels of fungi in the studied baths were lower than the levels recommended by the World Health Organization, some environmental health measures such as washing and disinfecting surfaces and tools after each working shift and periodic inspections are recommended ensuring the safety of costumers who are visiting such places.

Temporal fluctuations of PM2.5 and PM10, population exposure, and their health impacts in Dezful city, Iran

Morbidity and mortality impacts of particulate matter (PM) are globally important health critical parameters. In this ecological-descriptive study, the health impact of PM10 and PM2.5 associated with there temporal variations in Dezful city were assessed from 2013 to 2015. AirQ+ software handles the PM air pollutants by addressing impact evaluation and life table evaluation. We used a new method to analysis fine particles feature by using regular daily observations of PM10. In this method, relationship between PM2.5 and PM10 mass concentrations were analyzed and calculated. The annual average concentrations of PM10 were 147.1, 114.3 and 158.8 μg/m3, and the annual average concentration of PM2.5 were 57.8, 50.7 and 58.2 μg/m3 in 2013, 2014 and 2015, respectively. PM10 also had obvious diurnal variations with highest hourly concentrations in 13:00 and 22:00 but the lowest concentrations often occurred in 05:00 and 16:00. Unexpectedly, in weekends the concentration of PM pollutants appeared to have increased from 18:00 to midnight. The daily based analysis showed that there are 147 dusty days in the study period during which the most severe dusty day occurred in 2014. Over the study period, mean levels of PM10 and PM2.5 in both conditions were higher in 2015 compare to 2013 and 2014, which probably is due to higher frequency of dust storms in 2015. Hence, during 2015 and 2013 they're were higher morbidity and mortality compare to 2014 due to exposure to higher polluted air with PMs in all cases except lung cancer (LC).

Ambient air pollution, lung function and COPD: cross-sectional analysis from the WHO Study of AGEing and adult health wave 1

BACKGROUND

Long-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult populations is inconsistent.

OBJECTIVE

To address this knowledge gap, we investigated the associations between particulate matter (PM), nitrogen dioxide (NO2) exposure and lung function, as well as COPD prevalence, in older Chinese adults.

METHODS

We used data from the WHO Study on global AGEing and adult health (SAGE) China Wave 1, which includes 111 693 participants from 64 townships in China. A cross-sectional analysis explored the association between satellite-based air pollution exposure estimates (PM with an aerodynamic diameter of ≤10 µm [PM10], ≤2.5 µm [PM2.5] and NO2) and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (defined as post-bronchodilator FEV1/FVC <70%). Data on lung function changes were further stratified by COPD status.

RESULTS

Higher exposure to each pollutant was associated with lower lung function. An IQR (26.1 µg/m3) increase in PM2.5 was associated with lower FEV1 (-71.88 mL, 95% CI -92.13 to -51.64) and FEV1/FVC (-2.81 mL, 95% CI -3.37 to -2.25). For NO2, an IQR increment of 26.8 µg/m3 was associated with decreases in FEV1 (-60.12 mL, 95% CI -84.00 to -36.23) and FVC (-32.33 mL, 95% CI -56.35 to -8.32). A 31.2 µg/m3 IQR increase in PM10 was linked to reduced FEV1 (-8.86 mL, 95% CI -5.40 to 23.11) and FEV1/FVC (-1.85 mL, 95% CI -2.24 to -1.46). These associations were stronger for participants with COPD. Also, COPD prevalence was linked to higher levels of PM2.5 (POR 1.35, 95% CI 1.26 to 1.43), PM10 (POR 1.24, 95% CI 1.18 to 1.29) and NO2 (POR 1.04, 95% CI 0.98 to 1.11).

CONCLUSION

Ambient air pollution was associated with lower lung function, especially in individuals with COPD, and increased COPD prevalence in older Chinese adults.

Real-time monitoring of toxic components from fine dust air pollutant samples by utilizing spark-induced plasma spectroscopy

A growing modern-day concern is fine dust air pollution that contains heavy metals and ammonium ions (NH₄⁺) from industrial and agricultural waste sources, respectively. In the current study, the development of an innovative and effective technique for real-time, quantitative monitoring of toxic fine dust components using plasma emission spectroscopy is presented as a complement to emergency preparedness plans aimed at reducing dust pollution. A novel spark-induced plasma spectroscopic (SIPS) device that can control the frequency and magnitude of plasma was developed for the toxic pollutants in this work. SIPS utilizes an electrical discharge from a high voltage at a low current to produce plasma when the applied voltage is higher than the ambient voltage surrounding the electrodes. The detection limit of this setup was enhanced by a factor of 4.3 over laser-induced plasma spectroscopy (LIPS). This compact sensing device was used in combination with a new quantitative analytical method to measure the concentration of heavy metals and ammonia molecules in fine dust air pollution. By integrating the time-resolved plasma emission signals that were based on the plasma continuum decay time of each element, quantitative measurements of the minute changes in composition of 0.1 μg/m³ were conducted. The findings of this study could inspire future research on the use of SIPS for monitoring airborne fine dust pollutants with better sensitivity in real-time via a new quantitative analytical method.

Associations Between Dust Storms and Intensive Care Unit Admissions in the United States, 2000-2015

Anthropogenic climate change is influencing the incidence of dust storms and associated human exposure to coarse particulate matter (PM2.5-10) in the United States. Studies have found adverse health consequences related to dust exposure. These consequences include respiratory disease exacerbations and premature mortality, resulting in increased health care utilization. However, the impact of dust storms on critical care demand has not been studied in the United States. We seek to quantify the relationship between dust storms and surges in critical care demand by investigating the association between dust storms and intensive care unit (ICU) admissions at nearby hospitals from 2000 to 2015. ICU data were acquired from Premier, Inc. and encompass 15-20% of all ICU admissions in the United States. Dust storm, meteorology, and air pollutant data were downloaded from the U.S. National Weather Service, the U.S. National Climatic Data Center, and the U.S. Environmental Protection Agency websites, respectively. Associations between ICU admission and dust storms, controlling for temperature, dew point temperature, ambient PM2.5 and ozone, as well as seasonally varying confounders, were estimated using a distributed lag conditional Poisson model with overdispersion. We found a 4.8% (95% CI: 0.4, 9.4; p = 0.033) increase in total ICU admissions on the day of the dust storm (Lag 0) and a 9.2% (95% CI: 1.8, 17.0; p = 0.013) and 7.5% (95% CI: 0.3, 15.2; p = 0.040) increase in respiratory admissions at Lags 0 and 5. North American dust storms are associated with increases in same day and lagged demand for critical care services at nearby hospitals.

The association between ambient NO2 and PM2.5 with the respiratory health of school children residing in informal settlements: A prospective cohort study

BACKGROUND

No previous epidemiological study has investigated the combined association of long-term ambient nitrogen dioxide (NO₂) and particulate matter of diameter size-2.5 (PM_2.5) exposure with asthma outcomes among schoolchildren in Africa.

OBJECTIVES

This study investigated the independent and co-pollutant association of long-term exposures to ambient air pollutants on asthma-associated outcomes in a cohort of schoolchildren in the Western Cape Province of South Africa.

METHODS

A total of 590 grade-4 schoolchildren residing in four informal settlements were studied. Spirometry and fractional exhaled nitric-oxide (FeNO) measurements were conducted, including a standardized questionnaire administered to caregivers at baseline and 12-months follow-up. Annual NO₂ and PM_2.5 levels were estimated for each child's home using land-use regression modelling. Single- and two-pollutant models were constructed to assess the independent and co-pollutant association of both air pollutants (NO₂ and PM_2.5) on new cases of asthma-associated outcomes adjusting-for host characteristics, indoor exposures and study area.

RESULTS

The annual average concentration of PM_2.5 and NO₂ were 10.01μg/m³ and 16.62μg/m³ respectively, across the four study areas, and were below the local Standards of 20μg/m³ and 40μg/m³, for both pollutants, respectively. In the two-pollutant-adjusted models, an interquartile range (IQR) increase of 14.2μg/m³ in NO₂ was associated with an increased risk of new onset of ocular-nasal symptoms (adjusted odds ratio-aOR: 1.63, 95% CI: 1.01-2.60), wheezing (aOR: 3.57, 95% CI: 1.18-10.92), more than two or more asthma symptom score (aOR: 1.71, 95% CI: 1.02-2.86), and airway inflammation defined as FeNO > 35 ppb (aOR: 3.10, 95% CI: 1.10-8.71), independent of PM_2.5 exposures.

CONCLUSION

This study provided evidence that ambient NO₂ levels below local standards and international guidelines, independent of PM_2.5 exposure, increases new cases of asthma-associated outcomes after 12-months.

The response of dust emission sources to climate change: Current and future simulation for southwest of Iran

This study recognizes present dust emission sources (DESs) and their future projections in the southwest of Iran (2050 and 2070) through simulations performed by distribution models. The sites observation, raster dataset of climate layers and statistical models in the MaxEnt software were used to predict the current and future dust coverage and distribution, and their response to climate change using representative concentration pathways (RCPs) scenarios of +2.6, +4.5, +6.0, and +8.5 W m^-2 projections. Statistical machine learning analysis show that 40.8% of the study area covering 25,810 km² are susceptible to emit dust at the present time, and its projections will increase up to 28,839, 26,002, 26,071 and 26,124 km² for RCP scenarios of +2.6, +4.5, +6.0, and +8.5 W m^-2, respectively, by the year 2070. Temperature and precipitation assessments show that the most effective parameters determine future changes in DES coverage and distribution. The area under the curve (AUC) for DESs was 0.919, and results of Jackknife analyses show high sensitivity of dust sources to climate variables. The results illustrate that the present DESs are mainly driven by a combination of temperature, precipitation and land-use management, and the effects of nature are comparable to the anthropogenic activities, as humans continue to shape the DESs through energy, water and land use. The predicted increase of DESs may substantially worsen dust storms in the future, thereby affecting the functioning of ecosystems as well as human health. The outcomes of this study may support biocrust restoration technologies as a suitable option in sustainable management of arid lands and dust emission sources.

Relationship between Particulate Matter (PM10) and Airway Inflammation Measured with Exhaled Nitric Oxide Test in Seoul, Korea

Purpose

Particulate matter (PM) is increasing every year in Asia. It is not fully understood how the airway is affected when inhaling PM. We investigated the correlation between particulate matter with a diameter of less than 10 μm (PM₁₀) and fractional exhaled nitric oxide (FeNO) to determine whether PM causes airway inflammation. Material and Methods. We analyzed patients who visited our outpatient clinic and tested FeNO from January 2016 to December 2017 at the Korea University Guro Hospital. PM₁₀ data were provided by the government of the Republic of South Korea, and measuring station of PM₁₀ is located 800 meters from the hospital. We analyzed the correlation between PM₁₀ and FeNO by a Pearson correlation analysis and by a multivariate linear regression analysis. To identify the most correlated times, we analyzed the correlation between the FeNO and PM₁₀ daily average from the day of visit to 4 days before visit.

Results

FeNO positively correlated with PM₁₀ at two days before hospital visit in the Pearson correlation (Pearson correlation coefficient = 0.057; P-value = 0.023) and in the multivariate linear regression analysis (B = 0.051, P-value = 0.026). If the PM₁₀ increased by 100 μg/m³, the FeNO result was expected to rise to 8.3 ppb in healthy people without respiratory disease.

Conclusion

The positive correlation was found in both healthy people and asthmatic patients. Therefore, PM₁₀ can increase airway inflammation.

Relationship between environmental Fungi and changes in lung function indices of new referral allergic patients in Ahvaz city under normal and dust conditions

BACKGROUND

Aim of this study was to determine whether any specific fungal spores could be responsible for changes observed in lung function indices.

MATERIALS AND METHODS

1042 new allergic patients were selected from July 2017 to May 2018 in Ahvaz City, Iran. Fungal samples were collected in normal and dusty condition within 5 and 2 min, respectively. Sampling was repeated once every 6 days and also in the dusty days.

RESULTS

Average numbers of fungi colony were 639.86 and 836.44 CFU m^-3 under normal and dusty conditions, respectively. Most common fungi in Ahwaz City air were Cladosporium sp., Penicillium sp., Aspergillus Niger, Aspergillus Flavus and Alternaria sp.. Highest fungal mean concentrations, 392 and 480 CFU m^-3, were related to Cladosporium sp. under normal and dust conditions, respectively. Average total numbers of colony fungal were 614, 483, 1082, 424 CFU m^-3 and 856, 701, 1418, 418 CFU m^-3 during the spring, summer, autumn, and winter under normal and dusty conditions, respectively. Patients were evaluated by measured lung function parameters of FEV₁ (L), FEV₁ (%pred), FVC (L), FVC (%pred), and FEV₁/FVC ratio with mean values of 1.85, 58.32, 2.63, 68.18, and 69.43, respectively.

CONCLUSION

Increases in mean total spores of fungi in spring were accompanied by decreases in FEV₁/FVC ratio. Enhanced spores of Cladosporium sp. in spring led to reduced FEV₁/FVC ratio. Increase the spores of Curvularia sp. in summer decreased by FEF_25-75%. The augmented spores of Drechslera sp. in summer were associated with declined FEV₁ and FEV₁/FVC ratio. Enhanced fungal spores of Rhizopus sp. in spring resulted in lowered FEV₁, FEV₁/FVC ratio, and FEF_25-75%.

The disappearing Salton Sea: A critical reflection on the emerging environmental threat of disappearing saline lakes and potential impacts on children's health

Changing weather patterns, droughts and competing water demands are dramatically altering the landscape and creating conditions conducive to the production of wind-blown dust and dust storms. In California, such factors are leading to the rapid shrinking of the Salton Sea, a 345 mile² land-locked "sea" situated near the southeastern rural border region known as the Imperial Valley. The region is anticipated to experience a dramatic increase in wind-blown dust and existing studies suggest a significant impact on the health and quality of life for nearby residents of this predominantly low-income, Mexican-American community. The discussion calls attention to the public health dimensions of the Salton Sea crisis. We know little about the possible long-term health effects of exposure to mobilized lakebed sediments or the numerous toxic contaminants that may become respirable on entrained particles. We draw on existing epidemiological literature of other known sources of wind-blown dust, such as desert dust storms, and related health effects to begin to understand the potential public health impact of wind-blown dust exposure. The increased production of wind-blown dust and environmental exposures to such non-combustion related sources of particulate matter are a growing health threat, due in part to drought coupled with increasing pressures on limited water resources. Recent population-based studies have linked dust storms with cardiovascular mortality, asthma hospitalization and decrease in pulmonary function in both adults and children. A growing number of studies provide evidence of the acute health effects of wind-blown dust exposures among children, which with repeated insults have the potential to influence respiratory health over time. The shrinking of the Salton Sea illustrates a public health and environmental justice crisis that requires action and attention to protect the health and well-being of local communities.

Chemical and organic characteristics of PM2.5 particles and their in-vitro cytotoxic effects on lung cells: The Middle East dust storms in Ahvaz, Iran

There are very few reports about the effect of PM_2.5 particles carried by the Middle East dust storms on lung cells. This study aimed to investigate the chemical properties and in-vitro cytotoxic effects of PM_2.5 extracts. Water-soluble fraction and organic solvent-extractable components of the samples collected from the city of Ahvaz, Khuzestan Province, Iran, during the normal and dust storm days of the winter of 2016 were analyzed and then applied on the human lung epithelial cell line (A549). The chemical properties and the cytotoxicity were analyzed by ICP-OES and Lactase Dehydrogenase (LDH) assay, respectively. The results of the independent t-test showed significantly higher mean cytotoxicity in the samples of normal days than that of dust storm days. It could be due to the fact that the cells were exposed to the same amount of water-soluble extract, whether it be from a normal day or a dust storm day, and since the normal air of Ahvaz is severely affected by traffic and industrial pollutants, its normal day samples showed stronger cytotoxic effect. The results of the Kruskal-Wallis test showed that cytotoxic effect increased with the particulate concentration. The highest cytotoxicity levels observed at 62, 125, and 250 μg/mL concentrations after 24-h incubation were 17% (belonging to a dust storm day), 37% (belonging to a normal day), and 47% (belonging to a dust storm day), respectively Since PAH compounds were measured in the particulate phase, their amount was naturally correlated with the quantity of particulates. However, it was observed that the samples of normal days contained the species with stronger human carcinogens ΣPAHs = 0.82 ng/m³.The results of one-way ANOVA showed a significant difference between the incubation times regarding the resulted cytotoxicity levels. In general, as the incubation duration increased, so did the cytotoxicity level. Although normal day particulates had a greater cytotoxic effect on A549 cell line, dust storm days are associated with higher levels of health risk; simply because during dust storms, people inhale much larger amounts of particulates.

Children environmental exposure to particulate matter and polycyclic aromatic hydrocarbons and biomonitoring in school environments: A review on indoor and outdoor exposure levels, major sources and health impacts

Children, an important vulnerable group, spend most of their time at schools (up to 10 h per day, mostly indoors) and the respective air quality may significantly impact on children health. Thus, this work reviews the published studies on children biomonitoring and environmental exposure to particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) at school microenvironments (indoors and outdoors), major sources and potential health risks. A total of 28, 35, and 31% of the studies reported levels that exceeded the international outdoor ambient air guidelines for PM₁₀, PM_2.5, and benzo(a)pyrene, respectively. Indoor and outdoor concentrations of PM₁₀ at European schools, the most characterized continent, ranged between 7.5 and 229 μg/m³ and 21-166 μg/m³, respectively; levels of PM_2.5 varied between 4 and 100 μg/m³ indoors and 6.1-115 μg/m³ outdoors. Despite scarce information in some geographical regions (America, Oceania and Africa), the collected data clearly show that Asian children are exposed to the highest concentrations of PM and PAHs at school environments, which were associated with increased carcinogenic risks and with the highest values of urinary total monohydroxyl PAH metabolites (PAH biomarkers of exposure). Additionally, children attending schools in polluted urban and industrial areas are exposed to higher levels of PM and PAHs with increased concentrations of urinary PAH metabolites in comparison with children from rural areas. Strong evidences demonstrated associations between environmental exposure to PM and PAHs with several health outcomes, including increased risk of asthma, pulmonary infections, skin diseases, and allergies. Nevertheless, there is a scientific gap on studies that include the characterization of PM fine fraction and the levels of PAHs in the total air (particulate and gas phases) of indoor and outdoor air of school environments and the associated risks for the health of children. There is a clear need to improve indoor air quality in schools and to establish international guidelines for exposure limits in these environments.

Preparedness components of health systems in the Eastern Mediterranean Region for effective responses to dust and sand storms: a systematic review

Background: Dust and Sand Storm (DSS), according to estimates by global reports, will increase dramatically in the Eastern Mediterranean Region (EMR). Numerous health problems caused by DSS will be severely affected regions and vulnerable groups. This study aimed to identify the components of the preparedness of health systems for the DSS phenomenon in EMR. Methods: In this systematic review, the peer-reviewed papers in four electronic databases, including Medline through PubMed, Scopus, ISI Web of Science and the Cochrane library, as well as available grey literature, were searched and selected. The research process was carried out by including papers whose results were related to the potential health effects caused by desert dusts in EMR. Was used the combination of three groups of keywords: the exposure factor, health effects as outcomes, and the countries located in EMR. The focus was on the PRISMA checklist, with no time limitations until December 2017. Finally, through 520 related citations, 30 articles were included. Descriptive and thematic content analyses were evaluated. Results: The preparedness components were divided into three and ten main categories and subcategories, respectively. The three categories covered the areas of DSS hazard identification, planning and policy-making, and risk assessment. Conclusions: Recognition of the health system preparedness factors for DSS in EMR will help policy-makers and managers perform appropriate measures when dealing with this hazard. More studies should be conducted to understand these factors in other parts of the world. Registration: PROSPERO registration number CRD42018093325.

On the chemical nature of precipitation in a populated Middle Eastern Region (Ahvaz, Iran) with diverse sources

This study reports on the chemical composition of rainwater collected at three ground sites with varying degrees of pollution in Ahvaz, Iran, between January 2014 and February 2015. A total of 24 rainwater samples were analyzed for pH and concentrations of trace elements (Fe, Al, Pb, and Cd) and major ions (Na⁺, NH₄⁺, Ca²⁺, Mg²⁺, HCO₃^-, NO₃^-, Cl^- and SO₄^2-). Principle Component Analysis (PCA) was used to identify sources of the measured species. The equivalent concentration of the components followed the order of Ca²⁺ > SO₄^2- > HCO₃^- > NH₄⁺ > Cl^- > Na⁺ > NO₃^- > Mg²⁺. The average pH of the rainwater samples was 6, and only three events exhibited acidic conditions below a pH of 5.6. The lowest and the highest average pH values were observed in the high traffic area (5.96) and industrial area (6.54), respectively. The highest and lowest Ca²⁺ levels were observed in the industrial and high traffic areas, respectively. Na⁺, Mg²⁺, and SO₄^2- exhibited their highest and lowest concentrations in the industrial and high traffic areas, respectively. 70.36% of the total variance was due to anthropogenic species (Ca²⁺, SO₄^2-, Mg²⁺, NO₃^-, Cl^-), soil particles (Cl^-, Na⁺, and HCO₃^-), and biomass burning (NH₄⁺, pH). The results of this study show that local anthropogenic sources and Middle Eastern Dust (MED) storms affect the rainwater chemistry strongly, which the latter stems from the Arabian Peninsula, Kuwait, Iraq, and some parts of Iran.

Short-term effects of particle size fractions on lung function of late adolescents

Although ambient air pollution has been linked to reduced lung function in healthy students, longitudinal studies that compare the response of asthmatic and healthy adolescents are lacking. To evaluate lung function responses to short-term ambient air particulate matter (PM₁₀, PM_2.5, and PM₁) levels, we conducted a study on high school students aged 15-18 years. The aim of this study was to assess effects of acute exposure to ambient air particulate matter (PM) on lung function in healthy and asthmatic late adolescents. We examined associations of lung function indices and ambient PM levels in 23 asthmatic and 23 healthy students. Paired-samples T test was used to evaluate the association of exposure to airborne PM concentrations with lung function test results (FVC, FEV₁, FEV₁/FVC, and FEF_25-75). We observed negative impact of exposure to an increased concentration of ambient air PM₁₀, PM_2.5, and PM₁ on lung function parameters of asthmatic and healthy late adolescents. These findings are consistent with other similar short-term studies which have confirmed the adverse effect of PM air pollution. These associations were stronger in asthmatic subjects compared with those in healthy ones. There are significant adverse effects of ambient air PM on pulmonary function of adolescents, especially asthmatics.

Acute changes in a respiratory inflammation marker in guards following Beijing air pollution controls

The adverse respiratory health effects of PM_2.5 have been studied. However, the epidemiological evidence for the association of specific PM_2.5 sources with health outcomes is still limited. This study investigated the association between PM_2.5 components and sources with a biomarker of acute respiratory inflammation (FeNO) in guards. Personal exposure was estimated by microenvironment samplers and FeNO measurements were carried out before, during and after the Victory Day Military Parade in Beijing. Four sources were determined by factor analysis, including urban pollution, dust, alloy steel abrasion and toxic metals. A mixed-effect model was used to estimate the associations of FeNO with PM_2.5 sources and chemical constituents, controlling for age, BMI, smoke activity, physical activity, waist circumference, temperature and relative humidity. In summary, large concentration decreases in PM_2.5 concentration and PM_2.5 chemical constituents were observed in both roadside and indoor environments during the air control periods, immediately followed by statistically significant decreases in FeNO of roadside guards and patrol guards. Besides, statistically significant increases in FeNO were found to be associated with interquartile range (IQR) increases in some pollutants, with an increase of 1.45ppb (95% CI: 0.69, 2.20), 0.65ppb (95% CI: 0.13, 1.17), 1.48ppb (95% CI: 0.60, 2.35), 0.82ppb (95% CI: 0.44, 1.20), 0.77ppb (95% CI: 0.42, 1.11) in FeNO for mass, sulfate, BC, Ca²⁺ and Sm, respectively. In addition, compared to alloy steel abrasion and toxic metals, urban pollution and dust factors were more associated with acute airway inflammation for highly-exposed populations.

Acute effects of air pollution on spontaneous abortion, premature delivery, and stillbirth in Ahvaz, Iran: a time-series study

Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO2, PM10, SO2, O3, and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value < 0.05). Contact with polluted air during pregnancy may increase adverse pregnancy outcomes and stillbirth. Pregnant women should avoid polluted air.