Short-term effect of air pollution on asthma patient visits in Shanghai area and assessment of economic costs

The ratio of concentration of organic carbon and elemental carbon bound to particulate matter in ambient air: a global systematic review and meta-analysis

Four hundred and sixty-six references with 625 data reports were included in our study. The high frequency of ratio OC/EC for PM0.1 was observed in 3.92-5.93; PM1 in 1.08-3.08; PM2.5, 2.08-4.08; PM10 in 2.70-4.70 and TSP in 2.66-4.66. The rank order of areas based on the pooled concentration of OC bound to PM2.5 was traffic (17.893 µg/m3) > industrial (10.58 µg/m3) > urban (7.696 µg/m3) > rural (4.08 µg/m3). The rank order of areas based on the pooled (mean) concentration of EC in PM2.5 was traffic (17.893 µg/m3) > industrial (2.65 µg/m3) > Urban (1.48 µg/m3) > rural (1.06 µg/m3). The pooled concentrations of OC and EC bound to PM2.5 in traffic areas were higher than in other areas. Therefore, it is recommended that monitoring and effectively reducing concentration plans are carried out, especially in traffic areas.

Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China

Background

This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution.

Methods

We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach.

Results

The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively.

Conclusion

This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.

Associations of Ambient NO2 with Daily Hospitalization, Hospitalization Expenditure and Length of Hospital Stay of Cause-Specific Respiratory Diseases - Shanxi, China, 2017-2019

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?

Numerous epidemiological studies have documented the association between ambient nitrogen dioxide (NO₂) and mortality and morbidity of respiratory diseases, however, research on the effect of NO₂ on the length of hospital stay (LOS) and hospitalization expenditure is limited.

WHAT IS ADDED BY THIS REPORT?

This study collected the respiratory hospitalization, hospital expenditure, and LOS for respiratory diseases from 2017-2019 in Shanxi, China, and comprehensively evaluated the association between ambient NO₂ exposure and respiratory hospitalization, expenditure, and LOS.

WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?

This study provides evidence on the association between ambient NO₂ and respiratory burden, suggesting that continuously reducing the NO₂ concentrations could prevent respiratory disease-associated hospital admissions and decrease the relative burden in Shanxi Province and other similar regions.

Short-term effects and economic burden assessment of ambient air pollution on hospitalizations for schizophrenia

The evidence on the health and economic impacts of air pollution with schizophrenia is scarce, especially in developing countries. In this study, we aimed to systemically examine the short-term effects of PM_2.5 (particulate matter ≤ 2.5 μm in diameter), PM₁₀ (≤ 10 μm in diameter), NO₂ (nitrogen dioxide), SO₂ (sulfur dioxide), CO (carbon monoxide), and O₃ (ozone) on hospital admissions for schizophrenia in a Chinese coastal city (Qingdao) and to further assess the corresponding attributable risk and economic burden. A generalized additive model (GAM) was applied to model the impact of air pollution on schizophrenia, and the corresponding economic burden including the direct costs (medical expenses) and indirect costs (productivity loss). Stratified analyses were also performed by age, gender, and season (warm or cold). Our results showed that for a 10 μg/m³ increase in the concentrations of PM_2.5, PM₁₀, SO₂, and CO at lag5, the corresponding relative risks (RRs) were 1.0160 (95% CI: 1.0038-1.0282), 1.0097 (1.0018-1.0177), 1.0738 (1.0222-1.01280), and 1.0013 (1.0001-1.0026), respectively. However, no significant effect of NO₂ or O₃ on schizophrenia admissions was found. The stratified analysis indicated that females and younger individuals (< 45 years old) appeared to be more vulnerable, but no significant difference was found between seasons. Furthermore, 12.41% of schizophrenia hospitalizations were attributable to exposure to air pollution exceeding the World Health Organization (WHO) air quality standard, with a total economic burden of 89.67 million RMB during the study period. At the individual level, excessive air pollution exposure resulted in an economic burden of 8232.08 RMB per hospitalization. Our study found that short-term exposure to air pollutants increased the risk of hospital admissions for schizophrenia and resulted in a substantial economic burden. Considerable health benefits can be achieved by further reducing air pollution.

Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study

Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m3 was 1.013 (1.002–1.024) for PM10; 1.014 (1.000–1.028) for PM2.5; 1.054 (1.031–1.078) for NO2; and 1.044 for SO2 (95%CI: 0.986–1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%–8.14%) for PM10; 3.74% (0.29%–7.11%) for PM2.5; 16.4% (10.0%–21.8%) for NO2; and 2.50% (−0.75%–5.36%) for SO2. In conclusion, PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years.

Population Health Effects of Air Pollution: Fresh Evidence From China Health and Retirement Longitudinal Survey

The effects of air pollution on population health are currently a hot topic. However, few studies have examined the physical and mental health effects of air pollution jointly in China. Using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, this study explores how air pollution affects the physical and mental health of middle-aged and elderly residents. The empirical results highlight that air pollution can negatively affect both physical and mental health. In terms of physical health, those exposed to chronic shock are likely to suffer more adverse effects from air pollution than those exposed to acute shock. In terms of mental health, those exposed to depression suffer greater adverse effects than those exposed to episodic memory and mental cognition. Besides, heterogeneity analysis also shows that air pollution affects the mental and physical health of males more than females. Furthermore, the increase in air pollution is expected to result in huge hospitalization costs. Therefore, the Chinese government should formulate differentiated public health policies to reduce the effects of air pollution on the health of middle-aged and elderly residents.

Impacts of firewood burning for cooking on respiratory health and healthcare utilisation: Empirical evidence from Sri Lankan micro-data

Despite escalating income levels of Sri Lankan households, 70.3% of them still depend on firewood for cooking. This might lead to bad respiratory health and thereby, increased healthcare utilisation. With this backdrop, this paper examines how firewood burning for cooking influences respiratory health and healthcare utilisation of Sri Lankans. The study proposes a theoretical model to explain effects of firewood burning on respiratory health and healthcare utilisation and empirically tests it using nation-wide micro-data of 79,170 individuals belonging to 21,748 households. The data are drawn from the most recent wave of Sri Lankan household income and expenditure survey. After addressing potential endogeneity by applying instrumental variable regression models, the study finds that firewood burning increases households' probability of asthma prevalence by 10.9 percentage points (P < 0.001), out-patient care utilisation by 33.1 percentage points (P < 0.001), and in-patient care utilisation by 17.5 percentage points (P < 0.001), on average. Our individual level analysis demonstrates that females are more vulnerable to bad respiratory health induced by firewood burning (β = 0.055, P < 0.001) compared to males (β = 0.008, P > 0.1). The results imply policies on promoting improved-cooking stoves, separated-kitchen designs, and switching more towards cleaner energy sources, including LP gas and solar power.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses

BACKGROUND

There has been a notable increase in knowledge production on air pollution and human health.

OBJECTIVE

To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs).

METHODS

The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020.

RESULTS

Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 μm (PM_2.5) and 10 μm (PM₁₀) or less) and nitrogen dioxide (NO₂) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM_2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases.

DISCUSSION

The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Quantifying the Potential Contribution of Urban Forest to PM2.5 Removal in the City of Shanghai, China

Climate change and air pollution pose multiple health threats to humans through complex and interacting pathways, whereas urban vegetation can improve air quality by influencing pollutant deposition and dispersion. This study estimated the amount of PM2.5 removal by the urban forest in the city of Shanghai by using remote sensing data of vegetation and a model approach. We also identified its potential contribution of urban forest presence in relation to human population and particulate matter concentration. Results show that the urban forest in Shanghai reached 46,161 ha in 2017, and could capture 874 t of PM2.5 with an average of 18.94 kg/ha. There are significant spatial heterogeneities in the role of different forest communities and administrative districts in removing PM2.5. Although PM2.5 removal was relatively harmonized with the human population distribution in terms of space, approximately 57.41% of the urban forest presented low coupling between removal capacity and PM2.5 concentration. Therefore, we propose to plant more trees with high removal capacity of PM2.5 in the western areas of Shanghai, and increase vertical planting in bridge pillars and building walls to compensate the insufficient amount of urban forest in the center area.

Short-term ambient nitrogen dioxide exposure is associated with increased risk of spontaneous abortion: A hospital-based study

There are increasing concerns with regard to spontaneous abortion (SAB), the loss of pregnancy without external intervention before 20 weeks of gestation, among reproductive-aged women. To date, limited evidence is available concerning the association between SAB and air pollutants, especially in developing countries. Daily baseline outpatient data for SAB from January 1, 2014, to December 31, 2018 (1826 days) were obtained in Chongqing, a metropolis of southwest China. The over-dispersed Poisson generalized additive model with control of meteorological conditions and day of week was used to estimate the short-term effects of ambient air pollution on the daily number of SAB outpatients. A total of 42,334 SAB outpatient visits for SAB were recorded. No statistically significant association was observed between SAB and CO, PM2.5, PM10, O3, and SO2. The positive association only appeared for NO2: positive associations between SAB and NO2 were observed in both single-day models (lag 0, lag 1, lag 3, and lag 4) and cumulative exposure models (lag 01, lag 03, and lag 05) and the most significant effects were observed at lag 05 (3.289%; 95% CI: 1.568%, 5.011%). Moreover, the women with higher ages (30-39 and > 39) were more sensitive than those with lower ages (18-29), and the effect estimates were more evident in cool seasons. Collectively, our results suggested that short-term NO2 exposure was associated with higher risk of SAB, especially in elder women and cool seasons, which may contribute to further understand the role of air pollution on SAB and other adverse obstetric outcomes.

Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010

BACKGROUND

Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers.

OBJECTIVE

The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO₂), a common traffic-related air pollutant in urban areas, in the United States at the state level.

METHODS

We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO₂ using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO₂-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO₂ in the United States.

RESULTS

The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO₂ in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20-$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62-$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06-$144,269.18).

CONCLUSION

This study estimates the annual costs of childhood asthma incident cases attributable to NO₂ and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP's impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population's exposure.

Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis

BACKGROUND

Air pollution is a major environmental hazard to human health and a leading cause of morbidity for asthma worldwide.

OBJECTIVES

To assess the current evidence on short-term effects (from several hours to 7 days) of exposure to ozone (O₃), nitrogen dioxide (NO₂), and sulphur dioxide (SO₂) on asthma exacerbations, defined as emergency room visits (ERVs) and hospital admissions (HAs).

METHODS

We searched PubMed/MEDLINE, EMBASE and other electronic databases to retrieve studies that investigated the risk of asthma-related ERVs and HAs associated with short-term exposure to O₃, NO₂, or SO₂. We evaluated the risks of bias (RoB) for individual studies and the certainty of evidence for each pollutant in the overall analysis. A subgroup analysis was performed, stratified by sex, age, and type of asthma exacerbation. We conducted sensitivity analysis by excluding the studies with high RoB and based on the E-value. Publication bias was examined with the Egger's test and with funnel plots.

RESULTS

Our literature search retrieved 9,059 articles, and finally 67 studies were included, from which 48 studies included the data on children, 21 on adults, 14 on the elderly, and 31 on the general population. Forty-three studies included data on asthma ERVs, and 25 on asthma HAs. The pooled relative risk (RR) per 10 µg/m³ increase of ambient concentrations was 1.008 (95%CI: 1.005, 1.011) for maximum 8-hour daily or average 24-hour O₃, 1.014 (95%CI: 1.008, 1.020) for average 24-hour NO₂, 1.010 (95%CI: 1.001, 1.020) for 24-hour SO₂, 1.017 (95%CI: 0.973, 1.063) for maximum 1-hour daily O₃, 0.999 (95%CI: 0.966, 1.033) for 1-hour NO₂, and 1.003 (95%CI: 0.992, 1.014) for 1-hour SO₂. Heterogeneity was observed in all pollutants except for 8-hour or 24-hour O₃ and 24-hour NO₂. In general, we found no significant differences between subgroups that can explain this heterogeneity. Sensitivity analysis based on the RoB showed certain differences in NO₂ and SO₂ when considering the outcome or confounding domains, but the analysis using the E-value showed that no unmeasured confounders were expected. There was no major evidence of publication bias. Based on the adaptation of the Grading of Recommendations Assessment, Development and Evaluation, the certainty of evidence was high for 8-hour or 24-hour O₃ and 24-hour NO₂, moderate for 24-hour SO₂, 1-hour O₃, and 1-hour SO₂, and low for 1-hour NO₂.

CONCLUSION

Short-term exposure to daily O₃, NO₂, and SO₂ was associated with an increased risk of asthma exacerbation in terms of asthma-associated ERVs and HAs.

Coarse particles (PM2.5-10) and cause-specific hospitalizations in southwestern China: Association, attributable risk and economic costs

The short-term morbidity effects of the coarse particle (diameter in 2.5-10 μm, PM_2.5-10), as well as the corresponding morbidity burden and economic costs, remain understudied, especially in developing countries. This study aimed to examine the associations of PM_2.5-10 with cause-specific hospitalizations in a multi-city setting in southwestern China and assess the attributable risk and economic costs. City-specific associations were firstly estimated using generalized additive models with quasi-poisson distribution to handle over-dispersion, and then combined to obtain the regional average association. City-specific and pooled concentration-response (C-R) associations of PM_2.5-10 with cause-specific hospitalizations were also modeled. Subgroup analyses were performed by age, sex, season and region. The health and economic burden of hospitalizations for multiple outcomes due to PM_2.5-10 were further evaluated. A total of 4,407,601 non-accidental hospitalizations were collected from 678 hospitals. The estimates of percentage change in hospitalizations per 10 μg/m³ increase in PM_2.5-10 at lag01 was 0.68% (95%CI: 0.33%-1.03%) for non-accidental causes, 0.86% (95% CI: 0.36%-1.37%) for circulatory diseases, 1.52% (95% CI: 1.00%-2.05%) for respiratory diseases, 1.08% (95% CI: 0.47%-1.69%) for endocrine diseases, 0.66% (95% CI: 0.12%-1.21%) for nervous system diseases, and 0.84% (95% CI: 0.42%-1.25%) for genitourinary diseases, respectively. The C-R associations of PM_2.5-10 with cause-specific hospitalizations suggested some evidence of nonlinearity, except for endocrine diseases. Meanwhile, the adverse effects were modified by age and season. Overall, about 0.70% (95% CI: 0.35%-1.06%) of non-accidental hospitalizations and 0.78% (95% CI: 0.38%-1.17%) of total hospitalization expenses could be attributed to PM_2.5-10. The largest morbidity burden and economic costs were observed in respiratory diseases. Our findings indicate that PM_2.5-10 exposure may increase the risk of hospitalizations for multiple outcomes, and account for considerable morbidity and economic burden.

Short-term effect of particular matter and sulfur dioxide exposure on asthma and/or chronic obstructive pulmonary disease hospital admissions in Center of Anatolia

We investigated the associations between the daily variations of coarse particulate matter (PM₁₀) and/or sulfur dioxide (SO₂) and hospital admissions for asthma and/or chronic obstructive pulmonary disease (COPD) diseases in Kirsehir, Center of Anatolia of Turkey. We analyzed the poison generalized linear model (GLM) to analyze the association between ambient air pollutants such as PM₁₀ and SO₂ and asthma and/or COPD admissions. We investigated single-lag days and multi-lag days for the risk increase in asthma, COPD, asthma, and/or COPD hospital admissions PM₁₀, SO₂, and PM₁₀ with SO₂ per 10 μg/m³. In single-lag day model a 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.027 (95% CI:1.022-1.033) and 1.069 (95% CI:1.062, 1.077) for asthma. A 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.029 (95% CI:1.022-1.035) and 1.065 (95% CI:1.056, 1.075) for COPD. A 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.028 (95% CI:1.024-1.032) and 1.068 (95% CI:1.062, 1.074) for asthma and/or COPD. It was found that some lag structures were related with PM₁₀ and SO₂. Significant lags were detected in some lag structures from the previous first day until the previous eighth day (lag 1 to lag 7) in the asthma, COPD, and asthma and/or COPD hospital admissions in the model created with PM₁₀ with SO₂ both in the single-lag day model and in the multi-lag day model. Our study that used GLM in time series analysis showed that PM₁₀ and/or SO₂ short-term exposure in single-lag day and multi-lag day models was related with increased asthma, COPD, and asthma and/or COPD hospital admissions in the city between 2016 and 2019 until the previous-eighth day.

Ambient air pollution and its influence on human health and welfare: an overview

Human health is closely related to his environment. The influence of exposure to air pollutants on human health and well-being has been an interesting subject and gained much volume of research over the last 50 years. In general, polluted air is considered one of the major factors leading to many diseases such as cardiovascular and respiratory disease and lung cancer for the people. Besides, air pollution adversely affects the animals and deteriorates the plant environment. The overarching objective of this review is to explore the previous researches regarding the causes and sources of air pollution, how to control it and its detrimental effects on human health. The definition of air pollution and its sources were introduced extensively. Major air pollutants and their noxious effects were detailed. Detrimental impacts of air pollution on human health and well-being were also presented.

Economic losses and willingness to pay for haze: the data analysis based on 1123 residential families in Jiangsu province, China

Haze pollution is a key obstacle for environmental management faced by China and many other developing countries. The survey on residential families' economic losses and willingness to pay (WTP) are regarded as an essential reference for the implementation of environmental policies for haze treatment. For Jiangsu province of China, the authors of this paper first conducted three qualitative interviews with respectively meteorologists, meteorological administrators, and residents, a questionnaire was then elaborately designed, and subsequent surveys of 1123 families were administered in Jiangsu province. Further, the authors investigated measurements of direct economic losses by using the contingent valuation method (CVM) and explored influential factors of WTP by utilizing the binary logistic regression. From this survey, the estimated total economic loss incurred by haze disasters and total treatment cost for haze-related diseases were respectively 22.38 billion (in RMB) and 8.4 billion for Jiangsu province. 55.9% of residential families were willing to pay 11.6 billion RMB annually (51.97% of total loss) for haze treatment, leaving a shortage of 11.05 billion RMB, which the government is responsible to pay. These findings provide empirical information reflecting the opinions of communities and residential families, useful for the governments and industrial sectors to design environmental policies to meet the requirements of the public and control environmental pollution in an effective way to achieve sustainable development.

Acute Effects of Exposure to Ambient Air Pollutants on Preterm Birth in Xiamen City (2015-2018), China

Backgrounds: Urban energy consumption is one of the important causes of air pollution. The epidemiological risk assessment guided by air pollution is of great significance to the promotion of urban environmental protection. Objectives: The work researched the acute impact of exposure to air pollution on preterm birth (PTB) in Xiamen city from 2015 to 2018. Furthermore, the economic losses were assessed as well. Methods: Association of air pollution and PTB with economic losses were assessed using the generalized additive model. Results: A total of 1991 PTB visits, who are inhabitant in Xiamen, have been investigated. An interquartile range (IQR) (10 μg/m³) increase of PM₁₀, NO₂, and SO₂ in the current day corresponded to the increase of 0.64% [95% CI: -1.22, 2.54%], 0.52% [95% CI: -5.21, 6.61%], and 2.33% [95% CI: -6.41, 11.58%] in daily PTB visits. Especially, PTB visits were significantly related with PM₁₀ and NO₂ in Lag 1 and NO₂ and SO₂ in Lag 2. Furthermore, for multipollutants, an IQR increase in PM_2.5, O₃, and CO, after adjustment with SO₂, was related with 5.04% [95% CI: -5.90, 17.24], 2.49% [95% CI: -6.07, 11.81], and 7.10% [95% CI: -2.79, 18.00] increase of PTB morbidity, respectively. The estimates of the number of excess PTBs attributed to typical pollutants PM₁₀ and SO₂ were ∼2400 and 1200 people, respectively, every year. The highest excess PTBs was estimated to occur as a result of PM₁₀ and SO₂ effects. Conclusions: Although Xiamen has a relatively low level of air pollution, short-term exposure to NO₂, SO₂, and PM₁₀ was linked to the increase of PTB visits.

MOF-based fibrous membranes adsorb PM efficiently and capture toxic gases selectively

Air pollution is harmful to the functioning of the lungs, heart, and brain even at low concentrations of particle matter (PM) and toxic gases. Purification methods and materials have made tremendous progress to improve the purity of air to adhere to national quality standards. Metal-organic frameworks (MOFs) have an excellent gas adsorption capacity due to their high specific surface area and porous structure, but the intrinsic fragility of MOF crystals limits their application. In this study, we selected appropriate organic ligands to prepare MOF-surface-grown fibrous membranes using an electrospinning technique, which have an excellent ability to adsorb PM and capture toxic gases selectively. The efficiency of the MOF-surface-grown fibrous membranes to remove PM reached 99.99%, even for fine PM. More importantly, under low partial pressure and complex gas composition conditions, the fibrous membrane was able to selectively adsorb SO2. The concentration of SO2 dropped from 7300 ppb to 40 ppb. Interestingly, the MOF-surface-grown fibrous membrane had a higher purification capacity toward O3 than toward SO2. The concentration of O3 rapidly dropped from 3000 ppb to 7 ppb, which was far below national air quality standards (81 ppb). The MOF-surface-grown fibrous membrane was able to adsorb toxic atmospheric gases selectively, while not being influenced by the presence of other gases, such as CO2 and O2. MOF-based fibrous membranes prepared using a simple and inexpensive electrospinning technique have wide potential for practical use in the field of environmental protection and air purification.

The effect and burden modification of heating on adult asthma hospitalizations in Shijiazhuang: a time-series analysis

Background

Previous studies have found associations between asthma morbidity and air pollution especially in young population, (PLoS One 12:e0180522, 2017; Can J Public Health 103:4-8, 2012; Environ Health Perspect 118:449-57, 2010; Am J Respir Crit Care Med 182:307-16, 2010; J Allergy Clin Immunol 104:717-22, 2008; J Allergy Clin Immunol 104:717-22, 1999; Environ Res 111:1137-47, 2011) but most of them were conducted in areas with relatively low air pollutant level. Moreover, very few studies have investigated the effect and burden modification of heating season during which the ambient air pollution level is significantly different from that during non-heating season in north China.

Objectives

This study aimed to evaluate the effect and burden modification of heating on short-term associations between adult asthma hospitalizations and ambient air pollution in the north China city of Shijiazhuang.

Methods

Generalized additive models combined with penalized distributed lag nonlinear models were used to model associations between daily asthma hospitalizations and ambient air pollutants from 1 January 2013 to 16 December 2016 in Shijiazhuang city, adjusting for long-term and seasonality trend, day of week, statutory holiday, daily mean air pressure and temperature. Attributable risks were calculated to evaluate the burden of asthma hospitalizations due to air pollutants exposure. The effect of pollutants on hospitalization and the attributable measures were estimated in heating and non-heating season separately and the comparisons between the two seasons were conducted.

Results

All pollutants demonstrated positive and significant impacts on asthma hospitalizations both in heating season and non-heating season, except for O₃ in heating season where a negative association was observed. However, the differences of the pollutant-specific effects between the two seasons were not significant. SO₂ and NO₂ exposure were associated with the heaviest burden among all pollutants in heating season; meanwhile, PM₁₀ and PM_2.5 were associated with the heaviest burden in heating season.

Conclusions

In conclusion, we found evidence of the effect of ambient air pollutants on asthma hospitalizations in Shijiazhuang. The central heating period could modify the effects in terms of attributable risks. The disease burden modification of heating should be taken into consideration when planning intervention measures to reduce the risk of asthma hospitalization.

Primary Pollutants and Air Quality Analysis for Urban Air in China: Evidence from Shanghai

In recent years, China's urban air pollution has caused widespread concern in the academic world. As one of China's economic and financial centers and one of the most densely populated cities, Shanghai ranks among the top in China in terms of per capita energy consumption per unit area. Based on the Shanghai Energy Statistical Yearbook and Shanghai Air Pollution Statistics, we have systematically analyzed Shanghai’s atmospheric pollutants from three aspects: Primary pollutants, pollutants changing trends, and fine particulate matter. The comprehensive pollution index analysis method, the grey correlation analysis method, and the Euclid approach degree method are used to evaluate and analyze the air quality in Shanghai. The results have shown that Shanghai's primary pollutants are PM2.5 and O3, and the most serious air pollution happens during the first half of the year, particularly in the winter. This is because it is the peak period of industrial energy use, and residential heating will also lead to an increase in energy consumption. Furthermore, by studying the particulate pollutants of PM2.5 and PM10, we clearly disclosed the linear correlation between PM2.5 and PM10 concentrations in Shanghai which varies seasonally.

Application of Fuzzy Optimization Model Based on Entropy Weight Method in Atmospheric Quality Evaluation: A Case Study of Zhejiang Province, China

A fuzzy optimization model based on the entropy weight method for investigating air pollution problems in various cities of Zhejiang Province, China has been proposed in this paper. Meanwhile, the air quality comprehensive evaluation system has been constructed based on the six major pollutants (SO2, NO2, CO, PM10, PM2.5 and O3) involved in China’s current air quality national standards. After analyzing the monthly data of six pollutants in 11 cities of Zhejiang Province from January 2015 to April 2018 by the above method, the authors found that, although the air quality of cities in Zhejiang Province did not reach the long-term serious pollution of Beijing, Tianjin, and Hebei, the air quality changes in the northern cities of Zhejiang were worse than those in southern Zhejiang. For example, the air quality of Shaoxing in northern Zhejiang has dropped by 14.85% in the last study period when compared with that of the beginning period, and Hangzhou, the provincial capital of Zhejiang, has also seen a decrease of 6.69% in air quality. The air quality of Lishui, Zhoushan and Wenzhou in southern Zhejiang has improved by 8.04%, 4.67% and 4.22% respectively. Apart from the geographical influence, the industrial structure of these cities is also an important cause for worse air quality. From the local areas in southern Zhejiang, cities have developed targeted air pollution control measures according to their own characteristics, including adjusting the industrial structure, changing the current energy consumption structure that heavily relies on coal, and improving laws and regulations on air pollution control, etc. In the four cities in central Zhejiang, the air quality at the end of the period (April 2018) has decreased from the beginning of the period (January 2015), given that there were no fundamental changes in their industrial structure and energy pattern.

Re-Du-Ning inhalation solution exerts suppressive effect on the secretion of inflammatory mediators via inhibiting IKKα/β/IκBα/NF-κB, MAPKs/AP-1, and TBK1/IRF3 signaling pathways in lipopolysaccharide stimulated RAW 264.7 macrophages

Background: Re-Du-Ning inhalation solution (RIS) is a novel preparation derived from the Re-Du-Ning injection, which has been clinically used to treat respiratory diseases such as pneumonia for more than twenty years in China. However, scant reports have been issued on its anti-inflammatory mechanisms. Aim: we investigated the suppressive effect of RIS on inflammatory mediators and explored the underlying mechanism of action. Methods: RIS freeze dried powder was characterized by HPLC analysis. Lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophage was selected as the cell model. The cell viability was determined by using the MTT assay. Moreover, the production of nitric oxide (NO) was measured by the Griess reaction. The protein secretions from inflammatory mediators were determined by the enzyme-linked immunosorbent assay (ELISA). The protein levels and enzyme activities were examined by Western blotting. The nuclear translocation of nuclear factor-kappa B (NF-κB), AP-1, and IRF3 was further explored by immunofluorescence assay. Results: the viability of the RAW 264.7 cells was not significantly changed after 24 h incubation with RIS concentration up to 400 μg mL-1. The RIS remarkably reduced the production of NO and prostaglandin E2 (PGE2), and downregulated the expression of iNOS and COX-2. The concentrations of cytokines (IL-1β, IL-6, and TNF-α) and chemokines (MCP-1, CCL-5, and MIP-1α) in the culture medium were significantly decreased by the RIS treatment. Furthermore, the phosphorylation of IκB-α, IKKα/β, TBK1, ERK, p38, JNK, NF-κB, AP-1, and IRF3 was downregulated by the RIS treatment. The nuclear translocation of NF-κB, AP-1, and IRF3 was also inhibited after the RIS treatment. Conclusion: the suppressive effect of RIS is associated with the regulated NF-κB, AP-1, and IRF3 and their upstream proteins. This study provides a pharmacological basis for the application of RIS in the treatment of inflammatory disorders.

Health damage assessment of particulate matter pollution in Jing-Jin-Ji region of China

Jing-Jin-Ji is the largest and most dynamic economic region in northern China, and its air pollution has attracted much public attention. Scientific evaluation of health losses caused by air pollution can provide decision-making basis for formulation and improvement of pollution reduction policies in the Jing-Jin-Ji region. This paper estimated the adverse effects of particulate matter pollution on health in the Jing-Jin-Ji region in 2016 by using logarithmic linear exposure-response function, and monetized the health effects by adjusting human capital method and disease cost method. The results show non-ignorable health hazards and economic impacts caused by atmospheric particulate pollution. The economic losses relevant to health hazards by PM2.5 in the Jing-Jin-Ji region are 122.40 billion yuan, and those relevant to PM10 are 118.34 billion yuan, accounting for 1.62% and 1.56% of the region's GDP, respectively. Similar evaluations previously conducted in other countries yielded figures within the same order of magnitude. Considering the difference in economic losses per unit among disease types, the economic losses caused by air pollution in the Jing-Jin-Ji region mainly come from premature deaths. Infants and elderly people are the main victims of particulate matter. Affected by population, pollutant concentration, industrial structure, and other factors, the economic losses of particulate matter pollution in Beijing, Tianjin, Shijiazhuang, Tangshan, and Baoding are large. In order to reduce health hazards and economic impacts caused by particulate matter pollution, this paper put forward to guide the urban population diversion, reduce the outgoing frequency of susceptible groups such as infants and the elderly in haze weather, adopt high-efficiency particulate matter air purifier indoors, and develop public transportation to reduce motor vehicle exhaust emissions. In Tianjin and Hebei, promoting cleaner production in industries such as steel and cement and reducing coal use in the power industry are also suggested.

The impact of outdoor air pollutants on outpatient visits for respiratory diseases during 2012-2016 in Jinan, China

Background

Few studies have investigated the associations between outdoor air pollution and outpatient visits for respiratory diseases (RDs) in general population.

Methods

We collected daily outpatient data of primary RDs from five hospitals in Jinan during January 2012 and December 2016, as well as daily measurements of air pollutants from the Jinan Environmental Monitoring Center and daily meteorological variables from the China Meteorological Data Sharing Service System. A generalized additive model (GAM) with quasi-Poisson regression was constructed to estimate the associations between daily average concentrations of outdoor air pollutants (PM_2.5,PM₁₀, SO₂, NO₂, CO and O₃) and daily outpatient visits of RDs after adjusting for long-time trends, seasonality, the “day of the week” effect, and weather conditions. Subgroup analysis stratified by gender, age group and the type of RDs was conducted.

Results

A total of 1,373,658 outpatient visits for RDs were identified. Increases of 10 μg/m³ in PM_2.5, PM₁₀, NO₂, CO and O₃ were associated with0.168% (95% CI, 0.072–0.265%), 0.149% (95% CI, 0.082–0.215%), 0.527% (95% CI, 0.211–0.843%), 0.013% (95% CI, 0.003–0.023%), and 0.189% (95% CI, 0.032–0.347%) increases in daily outpatient visits for RDs, respectively. PM_2.5 and PM₁₀ showed instant and continuous effects, while NO₂, CO and O₃ showed delayed effects on outpatient visits for RDs. In stratification analysis, PM_2.5 and PM₁₀ were associated with acute RDs only.

Conclusions

Exposure to outdoor air pollutants including PM_2.5, PM₁₀, NO₂, CO and O₃ associated with increased risk of outpatient visits for RDs.

Electronic supplementary material

The online version of this article (10.1186/s12931-018-0958-x) contains supplementary material, which is available to authorized users.