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Kazi DS, Katznelson E, Liu CL, Al-Roub NM, Chaudhary RS, Young DE, McNichol M, Mickley LJ, Kramer DB, Cascio WE, Bernstein AS, Rice MB. Climate Change and Cardiovascular Health: A Systematic Review. JAMA Cardiol 2024:2820068. [PMID: 38865135 DOI: 10.1001/jamacardio.2024.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Importance Climate change may increase the risk of adverse cardiovascular outcomes by causing direct physiologic changes, psychological distress, and disruption of health-related infrastructure. Yet, the association between numerous climate change-related environmental stressors and the incidence of adverse cardiovascular events has not been systematically reviewed. Objective To review the current evidence on the association between climate change-related environmental stressors and adverse cardiovascular outcomes. Evidence Review PubMed, Embase, Web of Science, and Cochrane Library were searched to identify peer-reviewed publications from January 1, 1970, through November 15, 2023, that evaluated associations between environmental exposures and cardiovascular mortality, acute cardiovascular events, and related health care utilization. Studies that examined only nonwildfire-sourced particulate air pollution were excluded. Two investigators independently screened 20 798 articles and selected 2564 for full-text review. Study quality was assessed using the Navigation Guide framework. Findings were qualitatively synthesized as substantial differences in study design precluded quantitative meta-analysis. Findings Of 492 observational studies that met inclusion criteria, 182 examined extreme temperature, 210 ground-level ozone, 45 wildfire smoke, and 63 extreme weather events, such as hurricanes, dust storms, and droughts. These studies presented findings from 30 high-income countries, 17 middle-income countries, and 1 low-income country. The strength of evidence was rated as sufficient for extreme temperature; ground-level ozone; tropical storms, hurricanes, and cyclones; and dust storms. Evidence was limited for wildfire smoke and inadequate for drought and mudslides. Exposure to extreme temperature was associated with increased cardiovascular mortality and morbidity, but the magnitude varied with temperature and duration of exposure. Ground-level ozone amplified the risk associated with higher temperatures and vice versa. Extreme weather events, such as hurricanes, were associated with increased cardiovascular risk that persisted for many months after the initial event. Some studies noted a small increase in cardiovascular mortality, out-of-hospital cardiac arrests, and hospitalizations for ischemic heart disease after exposure to wildfire smoke, while others found no association. Older adults, racial and ethnic minoritized populations, and lower-wealth communities were disproportionately affected. Conclusions and Relevance Several environmental stressors that are predicted to increase in frequency and intensity with climate change are associated with increased cardiovascular risk, but data on outcomes in low-income countries are lacking. Urgent action is needed to mitigate climate change-associated cardiovascular risk, particularly in vulnerable populations.
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Affiliation(s)
- Dhruv S Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ethan Katznelson
- Department of Cardiology, Weill Cornell Medical Center, New York, New York
| | - Chia-Liang Liu
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nora M Al-Roub
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Richard S Chaudhary
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Diane E Young
- Knowledge Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Megan McNichol
- Knowledge Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Loretta J Mickley
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Daniel B Kramer
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Wayne E Cascio
- US Environmental Protection Agency, Durham, North Carolina
| | - Aaron S Bernstein
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Center for Climate, Health, and Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Mary B Rice
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Pulmonary, Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Ma Y, Zang E, Liu Y, Wei J, Lu Y, Krumholz HM, Bell ML, Chen K. Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.01.31.23285059. [PMID: 36778437 PMCID: PMC9915814 DOI: 10.1101/2023.01.31.23285059] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Despite the substantial evidence on the health effects of short-term exposure to ambient fine particles (PM 2.5 ), including increasing studies focusing on those from wildland fire smoke, the impacts of long-term wildland fire smoke PM 2.5 exposure remain unclear. We investigated the association between long-term exposure to wildland fire smoke PM 2.5 and non-accidental mortality and mortality from a wide range of specific causes in all 3,108 counties in the contiguous U.S., 2007-2020. Controlling for non-smoke PM 2.5 , air temperature, and unmeasured spatial and temporal confounders, we found a non-linear association between 12-month moving average concentration of smoke PM 2.5 and monthly non-accidental mortality rate. Relative to a month with the long-term smoke PM 2.5 exposure below 0.1 μg/m 3 , non-accidental mortality increased by 0.16-0.63 and 2.11 deaths per 100,000 people per month when the 12-month moving average of PM 2.5 concentration was of 0.1-5 and 5+ μg/m 3 , respectively. Cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality were all found to be associated with long-term wildland fire smoke PM 2.5 exposure. Smoke PM 2.5 contributed to approximately 11,415 non-accidental deaths/year (95% CI: 6,754, 16,075) in the contiguous U.S. Higher smoke PM 2.5 -related increases in mortality rates were found for people aged 65 above. Positive interaction effects with extreme heat (monthly number of days with daily mean air temperature higher than the county's 90 th percentile warm season air temperature) were also observed. Our study identified the detrimental effects of long-term exposure to wildland fire smoke PM 2.5 on a wide range of mortality outcomes, underscoring the need for public health actions and communications that span the health risks of both short- and long-term exposure. Significance Statement The area burned by wildland fire has greatly increased in the U.S. in recent decades. Short-term exposure to smoke pollutants emitted by wildland fires, particularly PM 2.5 , is associated with numerous adverse health effects. However, the impacts of long-term exposure to wildland fire smoke PM 2.5 on health and specifically mortality remain unclear. Utilizing wildland fire smoke PM 2.5 and mortality data in the contiguous U.S. during 2007-2020, we found positive associations between long-term smoke PM 2.5 exposure and increased non-accidental, cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality rates. Each year, in addition to the well-recognized mortality burden from non-smoke PM 2.5 , smoke PM 2.5 contributed to an estimated over 10 thousand non-accidental deaths in the U.S. This study demonstrates the detrimental effects of wildland fire smoke PM 2.5 on a wide range of health outcomes, and calls for more effective public health actions and communications that span the health risks of both short- and long-term exposure.
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Achebak H, Rey G, Chen ZY, Lloyd SJ, Quijal-Zamorano M, Méndez-Turrubiates RF, Ballester J. Heat Exposure and Cause-Specific Hospital Admissions in Spain: A Nationwide Cross-Sectional Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57009. [PMID: 38775486 PMCID: PMC11110655 DOI: 10.1289/ehp13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 03/20/2024] [Accepted: 04/02/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND More frequent and intense exposure to extreme heat conditions poses a serious threat to public health. However, evidence on the association between heat and specific diagnoses of morbidity is still limited. We aimed to comprehensively assess the short-term association between cause-specific hospital admissions and high temperature, including the added effect of temperature variability and heat waves and the effect modification by humidity and air pollution. METHODS We used data on cause-specific hospital admissions, weather (i.e., temperature and relative humidity), and air pollution [i.e., fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), fine particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 ), NO 2 , and ozone (O 3 )] for 48 provinces in mainland Spain and the Balearic Islands between 1 January 2006 and 31 December 2019. The statistical analysis was performed for the summer season (June-September) and consisted of two steps. We first applied quasi-Poisson generalized linear regression models in combination with distributed lag nonlinear models (DLNM) to estimate province-specific temperature-morbidity associations, which were then pooled through multilevel univariate/multivariate random-effect meta-analysis. RESULTS High temperature had a generalized impact on cause-specific hospitalizations, while the added effect of temperature variability [i.e., diurnal temperature range (DTR)] and heat waves was limited to a reduced number of diagnoses. The strongest impact of heat was observed for metabolic disorders and obesity [relative risk (RR) = 1.978; 95% empirical confidence interval (eCI): 1.772, 2.208], followed by renal failure (1.777; 95% eCI: 1.629, 1.939), urinary tract infection (1.746; 95% eCI: 1.578, 1.933), sepsis (1.543; 95% eCI: 1.387, 1.718), urolithiasis (1.490; 95% eCI: 1.338, 1.658), and poisoning by drugs and nonmedicinal substances (1.470; 95% eCI: 1.298, 1.665). We also found differences by sex (depending on the diagnosis of hospitalization) and age (very young children and the elderly were more at risk). Humidity played a role in the association of heat with hospitalizations from acute bronchitis and bronchiolitis and diseases of the muscular system and connective tissue, which were higher in dry days. Moreover, heat-related effects were exacerbated on high pollution days for metabolic disorders and obesity (PM 2.5 ) and diabetes (PM 10 , O 3 ). DISCUSSION Short-term exposure to heat was found to be associated with new diagnoses (e.g., metabolic diseases and obesity, blood diseases, acute bronchitis and bronchiolitis, muscular and connective tissue diseases, poisoning by drugs and nonmedicinal substances, complications of surgical and medical care, and symptoms, signs, and ill-defined conditions) and previously identified diagnoses of hospital admissions. The characterization of the vulnerability to heat can help improve clinical and public health practices to reduce the health risks posed by a warming planet. https://doi.org/10.1289/EHP13254.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, Paris, France
- ISGlobal, Barcelona, Spain
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Chu L, Chen K, Yang Z, Crowley S, Dubrow R. A unified framework for assessing interaction effects among environmental exposures in epidemiologic studies: A case study on temperature, air pollution, and kidney-related conditions in New York state. ENVIRONMENTAL RESEARCH 2024; 248:118324. [PMID: 38301759 DOI: 10.1016/j.envres.2024.118324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/05/2023] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND There are various methods to assess interaction effects. However, current methods have limitations, and quantification of interaction effects is rarely performed. This study aimed to develop a unified quantitative framework for assessing interaction effects. METHODS We proposed a novel framework using log-linear models with a product term(s) across the exposures that generates parametric bi-variate association and interaction effect surfaces and allows flexible functional forms for exposures in the interaction term(s). In a case study, we assessed the interaction effects between temperature and air pollution (i.e., PM2.5, NO2, and O3) on risk for kidney-related conditions in New York State (2007-2016) using a case-crossover design with conditional logistic models. Our measures of exposure were the moving averages at lag 0-5 days for air pollution (linear) and daytime mean outdoor wet-bulb globe temperature (WBGT; using a natural cubic spline). RESULTS We derived closed-form expressions for the magnitude of multiplicative interaction effects (the joint relative risk divided by the product of the two conditional relative risks) and their uncertainties. In the case study, we found a Bonferroni-corrected significant multiplicative interaction effect (IE) between outdoor WBGT at the 99th percentile (median as the reference) and (1) PM2.5 (per 5 μg/m3 increase, IE = 1.052; 95 % confidence interval [CI]: 1.019, 1.087) for acute kidney failure and (2) O3 (per 5 ppb increase; IE = 1.022; 95 % CI: 1.008, 1.036) for urolithiasis (the latter being inconclusive based on the sensitivity analysis). CONCLUSIONS Our framework allows different functional forms of exposure variables in the interaction term, quantifies the magnitudes of entire-exposure-range (in addition to discrete exposure level) multiplicative interaction effects and their uncertainties in a categorical or continuous (linear or non-linear) manner, and harmonizes the two-way evaluation of effect modification. The case study underscores co-consideration of heat and air pollution when estimating health burden and designing heat/pollution alert systems.
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Affiliation(s)
- Lingzhi Chu
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| | - Zhuoran Yang
- Department of Statistics and Data Science, Yale University, 24 Hillhouse Avenue, New Haven, CT, 06511-6814, USA
| | - Susan Crowley
- Department of Medicine (Nephrology), Yale University School of Medicine, New Haven, CT, 06520, USA; Veterans Administration Health Care System of Connecticut, West Haven, CT, 06516, USA
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
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Di W, Yu J, Zong D, Ge Y, Zhang Y, Chen X, He X. Effects of ambient temperature, relative humidity and absolute humidity on risk of nasopharyngeal carcinoma in China. Int J Cancer 2024. [PMID: 38598851 DOI: 10.1002/ijc.34933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 04/12/2024]
Abstract
Nasopharyngeal carcinoma (NPC) has a unique geographic distribution. It is unknown whether meteorological factors are related to the incidence of NPC. To investigate the effect of ambient temperature, relative humidity (RH), and absolute humidity (AH) on the incidence of NPC, we collected the incidence rate of NPC in 2016 and meteorological data from 2006 to 2016 from 484 cities and counties across 31 provinces in China. Generalized additive models with quasi-Poisson regression and generalized linear models with natural cubic splines were employed respectively to elucidate the nonlinear relationships and specify the partial linear relationships. Subgroup and interactive analysis were also conducted. Temperature (R2 = 0.68, p < .001), RH (R2 = 0.47, p < .001), and AH (R2 = 0.70, p < .001) exhibited nonlinear correlations with NPC incidence rate. The risk of NPC incidence increased by 20.3% (95% confidence intervals [CI]: [18.9%, 21.7%]) per 1°C increase in temperature, by 6.3% (95% CI: [5.3%, 7.2%]) per 1% increase in RH, and by 32.2% (95% CI: [30.7%, 33.7%]) per 1 g/m3 increase in AH, between their the 25th and the 99th percentiles. In addition, the combination of low temperature and low RH was also related to increased risk (relative risk: 1.60, 95% CI: [1.18, 2.17]). Males and eastern or rural populations tended to be more vulnerable. In summary, this study suggests that ambient temperature, RH, and particularly AH are associated with the risk of NPC incidence.
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Affiliation(s)
- Wenyi Di
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Jiamin Yu
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Dan Zong
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Yizhi Ge
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Yujie Zhang
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Xin Chen
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Xia He
- Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
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Du H, Yan M, Liu X, Zhong Y, Ban J, Lu K, Li T. Exposure to Concurrent Heatwaves and Ozone Pollution and Associations with Mortality Risk: A Nationwide Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47012. [PMID: 38662525 PMCID: PMC11045006 DOI: 10.1289/ehp13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/01/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Concurrent extreme events are projected to occur more frequently under a changing climate. Understanding the mortality risk and burden of the concurrent heatwaves and ozone (O 3 ) pollution may support the formulation of adaptation strategies and early warning systems for concurrent events in the context of climate change. OBJECTIVES We aimed to estimate the mortality risk and excess deaths of concurrent heatwaves and O 3 pollution across 250 counties in China. METHODS We collected daily mortality, meteorological, and air pollution data for the summer (1 June to 30 September) during 2013-2018. We defined heatwaves and high O 3 pollution days, then we divided the identified days into three categories: a) days with only heatwaves (heatwave-only event), b) days with only high O 3 pollution (high O 3 pollution-only event), and c) days with concurrent heatwaves and high O 3 pollution (concurrent event). A generalized linear model with a quasi-Poisson regression was used to estimate the risk of mortality associated with extreme events for each county. Then we conducted a random-effects meta-analysis to pool the county-specific estimates to derive the overall effect estimates. We used mixed-effects meta-regression to identify the drivers of the heterogeneity. Finally, we estimated the excess death attributable to extreme events (heatwave-only, high O 3 pollution-only, and concurrent events) from 2013 to 2020. RESULTS A higher all-cause mortality risk was associated with exposure to the concurrent heatwaves and high O 3 pollution than exposure to a heatwave-only or a high O 3 pollution-only event. The effects of a concurrent event on circulatory and respiratory mortality were higher than all-cause and nonaccidental mortality. Sex and age significantly impacted the association of concurrent events and heatwave-only events with all-cause mortality. We estimated that annual average excess deaths attributed to the concurrent events were 6,249 in China from 2017 to 2020, 5.7 times higher than the annual average excess deaths attributed to the concurrent events from 2013 to 2016. The annual average proportion of excess deaths attributed to the concurrent events in the total excess deaths caused by three types of events (heatwave-only events, high O 3 pollution-only events, and concurrent events) increased significantly in 2017-2020 (31.50%; 95% CI: 26.73%, 35.53%) compared with 2013-2016 (9.65%; 95% CI: 5.67%, 10.81%). Relative excess risk due to interaction revealed positive additive interaction considering the concurrent effect of heatwaves and high O 3 pollution. DISCUSSION Our findings may provide scientific basis for establishing a concurrent event early warning system to reduce the adverse health impact of the concurrent heatwaves and high O 3 pollution. https://doi.org/10.1289/EHP13790.
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Affiliation(s)
- Hang Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meilin Yan
- Department of Environmental Science and Engineering, School of Light Industry Science and Engineering, Beijing Technology and Business University, Beijing, China
| | - Xin Liu
- Energy Foundation China, Beijing, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kailai Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Smagulov N, Zhamantayev O, Konkabayeva A, Adilbekova A, Zhanalina G, Shintayeva N, Aubakirova D. The Role of Climatic, Environmental and Socioeconomic Factors in the Natural Movement of Urban Populations in Kazakhstan, 2012-2020: An Analysis from a Middle-Income Country in Central Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:416. [PMID: 38673328 PMCID: PMC11050110 DOI: 10.3390/ijerph21040416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This study addresses the importance of identifying key characteristics influencing demographic indicators for urban populations, emphasizing the need to consider regional climatic features and ecological factors. The research utilized data from ten main regional cities across the Republic of Kazakhstan. METHODS This study involved a retrospective analysis based on secondary data from official sources spanning 2012-2020. We employed correlation analysis and multidimensional regression models. RESULTS Noteworthy predictors for crude birth rate included the influence of effective temperature (β = 0.842, p < 0.0001), marriage rate (β = 0.780, p < 0.0001), Gini coefficient (β = -27.342, p = 0.020) and divorce rate (β = -2.060, p < 0.0001), with overall strong model performance (R2 = 0.940). The degree of atmospheric pollution (β = -0.949, p = 0.044), effective temperature (β = -0.294, p < 0.0001) and Gini coefficient (β = 19.923, p = 0.015) were the predictors for crude mortality rate, with a high model fit (R2 = 0.796). CONCLUSIONS The study unveils significant relationships between demographic indicators (crude birth rate, mortality rate) and variables like effective temperature, marriage rate, divorce rate, Gini coefficient, physician density and others. This analysis of climatic, environmental, and socioeconomic factors influencing demographic indicators may help in promoting specific measures to address public health issues in Kazakhstan.
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Affiliation(s)
- Nurlan Smagulov
- Research Park of Biotechnology and Eco-Monitoring, Karaganda Buketov University, Karaganda 100028, Kazakhstan
| | - Olzhas Zhamantayev
- School of Public Health, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Aiman Konkabayeva
- Faculty of Biology and Geography, Karaganda Buketov University, Karaganda 100028, Kazakhstan
| | - Ainur Adilbekova
- Department of Morphology and Physiology, Karaganda Medical University, Karaganda 100000, Kazakhstan;
| | - Gulmira Zhanalina
- School of Public Health, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Nurzhamal Shintayeva
- School of Public Health, Karaganda Medical University, Karaganda 100000, Kazakhstan
| | - Dinara Aubakirova
- School of Public Health, Karaganda Medical University, Karaganda 100000, Kazakhstan
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Riggs DW, Baumgartner KB, Baumgartner R, Boone S, Judd SE, Bhatnagar A. Long-term exposure to air pollution and risk of stroke by ecoregions: The REGARDS study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123367. [PMID: 38280465 PMCID: PMC10996890 DOI: 10.1016/j.envpol.2024.123367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
Several cohort studies have found associations between long-term exposure to air pollution and stroke risk. However, it is unclear whether the surrounding ecology may modify these associations. This study evaluates associations of air pollution with stroke risk by ecoregions, which are areas of similar type, quality, and quantity of environmental resources in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. We assessed the incidence of stroke in 26,792 participants (45+ yrs) from the REGARDS study, a prospective cohort recruited across the contiguous United States. One-yr and 3-yr means of PM2.5, PM10, O3, NO2, SO2, and CO were estimated at baseline using data from the Center for Air, Climate, & Energy Solution, and assigned to participants at the census block group level. Incident stroke was ascertained through September 30, 2020. Relations of air pollutants with the risk of incident stroke were estimated using Cox proportional hazards models, adjusting for relevant demographics, behavioral risk factors, and neighborhood urbanicity. Models were stratified by EPA designated ecoregions. A 5.4 μg/m3 (interquartile range) increase in 1-yr PM10 was associated with a hazard ratio (95 %CI) for incident stroke of 1.07 (1.003, 1.15) in the overall study population. We did not find evidence of positive associations for PM2.5, O3, NO2, SO2, and CO in the fully adjusted models. In our ecoregion-specific analysis, associations of PM2.5 with stroke were stronger in the Great Plains ecoregion (HR = 1.44) than other ecoregions, while associations for PM10 were strongest in the Eastern Temperate Forests region (HR = 1.15). The associations between long-term exposure to air pollution and risk of stroke varied by ecoregion. Our results suggests that the type, quality, and quantity of the surrounding ecology can modify the effects of air pollution on risk of stroke.
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Affiliation(s)
- Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States.
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Richard Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Stephanie Boone
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
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Cheng C, Liu Y, Han C, Fang Q, Cui F, Li X. Effects of extreme temperature events on deaths and its interaction with air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170212. [PMID: 38246371 DOI: 10.1016/j.scitotenv.2024.170212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/17/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Both extreme temperature events (ETEs) and air pollution affected human health, and their effects were often not independent. Previous studies have provided limited information on the interactions between ETEs and air pollution. METHODS We collected data on deaths (non-accidental, cardiovascular, and respiratory) in Zibo City along with daily air pollution and meteorological data from January 2015 to December 2019. Distributed lag non-linear model was used to explore the health effects of ETEs on deaths. Non-parametric binary response model, hierarchical model and joint effect model were used to further explore the interaction between ETEs and air pollution in different seasons. Meanwhile, subgroup analysis by gender and age (≥ 65 years old and < 65 years old) was conducted to identify the vulnerable population. RESULTS ETEs increased death risk, especially for cardiovascular and respiratory deaths. Heat waves had a stronger impact than cold spells. Cold spells had a longer lag and fluctuating trend. Heat waves had a short-term impact, followed by a decrease. Females and those aged ≥ 65 were more affected, but subgroup differences were not significant. During ETEs and non-ETEs, there were different effects on deaths with per IQR increase in air pollutant concentrations. Joint effect models revealed that there was a significant interaction between ETEs and air pollution on non-accidental deaths. The interaction between PM2.5 and cold spells was antagonistic in the cold season. In the warm season, the health effects of heat waves and high O3 concentration were enhanced. The relative excess risk due to interaction (RERI) of cold spells and PM2.5 in total population was -0.09 (95 % CI: -0.17, -0.01), and 9 % (95 % CI: 1 %, 17 %) of the total effect was attributable to interaction. Subgroup analysis confirmed the interactions in females and those aged ≥ 65. CONCLUSIONS Significant association observed between ETEs and deaths. Females and ≥ 65 age groups were vulnerable. There were interactions between ETEs and air pollution. The effect of PM2.5 on deaths decreased during cold spells, while the effect of O3 increased during heat waves. In addition to improving air quality, it is necessary to further strengthen the prevention and control of ETEs.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Ma'anshan Center for Disease Control and Prevention, Ma'anshan 243000, Anhui, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Yang C, Lei L, Li Y, Huang C, Chen K, Bao J. Bidirectional modification effects on nonlinear associations of summer temperature and air pollution with first-ever stroke morbidity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116034. [PMID: 38310820 DOI: 10.1016/j.ecoenv.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
High temperature and air pollution may induce stroke morbidity. However, whether associations between high temperature and air pollution with stroke morbidity are modified by each other is still unclear. Data on 23,578 first-ever stroke patients in Shenzhen, China, during the summers of 2014-2018 were collected. Distributed lag nonlinear models were used to assess the modifying effects of air pollution stratified by the median for the associations between summer temperature and stroke morbidity at 0-3 lag days; modifying effects of temperature stratified by the minimum morbidity temperature on the associations between air pollution and stroke morbidity at the same lags were also estimated. The attributable risks of high temperature and high pollution on stroke morbidity were quantified. Stratified analyses of gender, age, migration type, and complication type were conducted to assess vulnerable population characteristics. Summer high temperature may induce stroke morbidity at high-level PM2.5, PM10, O3, SO2, and NO2 conditions, with attributable fraction (AF) of 2.982% (95% empirical confidence interval [eCI]: 0.943, 4.929), 3.113% (0.948, 5.200), 2.841% (0.943, 4.620), 3.617% (1.539, 5.470), and 2.048% (0.279, 3.637), respectively. High-temperature effects were statistically insignificant at corresponding low-level air pollution conditions. High-level PM2.5, PM10, and O3 may induce stroke morbidity at high-temperature conditions, with AF of 3.664% (0.036, 7.196), 4.129% (0.076, 7.963), and 4.574% (1.009, 7.762), respectively. High-level PM2.5, PM10, and O3 were not associated with stroke morbidity at low-temperature conditions. The effects of high temperature and high pollution on stroke morbidity were statistically significant among immigrants and patients with hypertension, dyslipidemia, or diabetes but insignificant among natives and patients without complications. The associations of summer temperature and air pollution with first-ever stroke morbidity may be enhanced bidirectionally. Publicity on the health risks of combined high temperature and high pollution events should be strengthened to raise protection awareness of relevant vulnerable populations.
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Affiliation(s)
- Chenlu Yang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yike Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, China.
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11
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Zhang C, Wang X, Sun D, Li Y, Feng Y, Zhang R, Zheng Y, Kou Z, Liu Y. Modification effects of long-term air pollution levels on the relationship between short-term exposure to meteorological factors and hand, foot, and mouth disease: A distributed lag non-linear model-based study in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116060. [PMID: 38310825 DOI: 10.1016/j.ecoenv.2024.116060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/06/2024]
Abstract
The occurrence of hand, foot, and mouth disease (HFMD) is closely related to meteorological factors. However, location-specific characteristics, such as persistent air pollution, may increase the complexity of the impact of meteorological factors on HFMD, and studies across different areas and populations are largely lacking. In this study, a two-stage multisite time-series analysis was conducted using data from 16 cities in Shandong Province from 2015 to 2019. In the first stage, we obtained the cumulative exposure-response curves of meteorological factors and the number of HFMD cases for each city. In the second stage, we merged the estimations from the first stage and included city-specific air pollution variables to identify significant effect modifiers and how they modified the short-term relationship between HFMD and meteorological factors. High concentrations of air pollutants may reduce the risk effects of high average temperature on HFMD and lead to a distinct peak in the cumulative exposure-response curve, while lower concentrations may increase the risk effects of high relative humidity. Furthermore, the effects of average wind speed on HFMD were different at different levels of air pollution. The differences in modification effects between subgroups were mainly manifested in the diversity and quantity of significant modifiers. The modification effects of long-term air pollution levels on the relationship between sunshine hours and HFMD may vary significantly depending on geographical location. The people in age<3 and male groups were more susceptible to long-term air pollution. These findings contribute to a deepening understanding of the relationship between meteorological factors and HFMD and provide evidence for relevant public health decision-making.
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Affiliation(s)
- Chao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Dapeng Sun
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yan Li
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yiping Feng
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Rongguo Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Yongxiao Zheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Yunxia Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China; Climate Change and Health Center, Shandong University, Jinan, Shandong 250012, China.
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12
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Li Z, Wan J, Peng S, Wang R, Dai Z, Liu C, Feng Y, Xiang H. Associations between cold spells of different time types and coronary heart disease severity. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123100. [PMID: 38070638 DOI: 10.1016/j.envpol.2023.123100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/15/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
Limited evidence showed the association between cold spells and the severity of coronary heart disease (CHD). This study was to investigate the association between cold spells with their different time types and CHD severity. We collected data on CHD patients admitted to the Zhongnan Hospital, Wuhan, China from 2016 to 2021. CHD severity was quantified using the SYNTAX score and transformed into a binomial variable. Daily mean, maximum and minimum temperature were collected during the study period. We first used daily mean temperature to find the optimum definition among multiple thresholds and durations. The daily maximum and minimum temperatures were used to define different types of cold spells (daytime, nighttime and compound) based on the optimum definition. Annual cold spell days were included to assess individual exposure to cold spells. Logistic regression models were performed to fit the association between cold spell days and CHD severity stratified by different tertiles of PM2.5 and NDVI. In this study, 1937 CHD patients were included. The cold spell defined as at least four consecutive days with daily mean temperature below the 5th percentile exhibited the optimum model. We found that a 4-day increase in cold spell days was associated with more severe CHD (OR = 1.170, 95% CI: 1.074, 1.282). Such an association was more pronounced under higher levels of PM2.5 by OR = 1.270 (1.086, 1.494) and lower levels of greenness by OR = 1.240 (1.044, 1.476). Compared with daytime and compound cold spells, nighttime cold spells showed the strongest association with CHD severity by OR = 1.141 (1.026, 1.269). This study showed that exposure to cold spells was positively associated with CHD severity, especially the nighttime cold spells. The association between cold spells and CHD severity was more significant in high levels of PM2.5 and low levels of greenness.
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Affiliation(s)
- Zhaoyuan Li
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Jing Wan
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Shouxin Peng
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Ruonan Wang
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Zhongli Dai
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Cuiyi Liu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Yujia Feng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Hao Xiang
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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13
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Zafeiratou S, Samoli E, Analitis A, Dimakopoulou K, Giannakopoulos C, Varotsos KV, Schneider A, Stafoggia M, Aunan K, Katsouyanni K. Modification of heat-related effects on mortality by air pollution concentration, at small-area level, in the Attica prefecture, Greece. Environ Health 2024; 23:10. [PMID: 38267931 PMCID: PMC10809516 DOI: 10.1186/s12940-024-01053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The independent effects of short-term exposure to increased air temperature and air pollution on mortality are well-documented. There is some evidence indicating that elevated concentrations of air pollutants may lead to increased heat-related mortality, but this evidence is not consistent. Most of these effects have been documented through time-series studies using city-wide data, rather than at a finer spatial level. In our study, we examined the possible modification of the heat effects on total and cause-specific mortality by air pollution at municipality level in the Attica region, Greece, during the warm period of the years 2000 to 2016. METHODS A municipality-specific over-dispersed Poisson regression model during the warm season (May-September) was used to investigate the heat effects on mortality and their modification by air pollution. We used the two-day average of the daily mean temperature and daily mean PM10, NO2 and 8 hour-max ozone (O3), derived from models, in each municipality as exposures. A bivariate tensor smoother was applied for temperature and each pollutant alternatively, by municipality. Α random-effects meta-analysis was used to obtain pooled estimates of the heat effects at different pollution levels. Heterogeneity of the between-levels differences of the heat effects was evaluated with a Q-test. RESULTS A rise in mean temperature from the 75th to the 99th percentile of the municipality-specific temperature distribution resulted in an increase in total mortality of 12.4% (95% Confidence Interval (CI):7.76-17.24) on low PM10 days, and 21.25% (95% CI: 17.83-24.76) on high PM10 days. The increase on mortality was 10.09% (95% CI: - 5.62- 28.41) on low ozone days, and 14.95% (95% CI: 10.79-19.27) on high ozone days. For cause-specific mortality an increasing trend of the heat effects with increasing PM10 and ozone levels was also observed. An inconsistent pattern was observed for the modification of the heat effects by NO2, with higher heat effects estimated in the lower level of the pollutant. CONCLUSIONS Our results support the evidence of elevated heat effects on mortality at higher levels of PM10 and 8 h max O3. Under climate change, any policy targeted at lowering air pollution levels will yield significant public health benefits.
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Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Giannakopoulos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens, Greece
| | - Konstantinos V Varotsos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens, Greece
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Massimo Stafoggia
- Department of Epidemiology of the Lazio Region Health Service (ASL ROMA 1), Rome, Italy
| | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, London, UK.
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14
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Xie XY, Huang LY, Cheng GR, Liu D, Hu FF, Zhang JJ, Han GB, Liu XC, Wang JY, Zhou J, Zeng DY, Liu J, Nie QQ, Song D, Yu YF, Hu CL, Fu YD, Li SY, Cai C, Cui YY, Cai WY, Li YQ, Fan RJ, Wan H, Xu L, Ou YM, Chen XX, Zhou YL, Chen YS, Li JQ, Wei Z, Wu Q, Mei YF, Tan W, Song SJ, Zeng Y. Association Between Long-Term Exposure to Ambient Air Pollution and the Risk of Mild Cognitive Impairment in a Chinese Urban Area: A Case-Control Study. J Alzheimers Dis 2024; 98:941-955. [PMID: 38489185 DOI: 10.3233/jad-231186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background As a prodromal stage of dementia, significant emphasis has been placed on the identification of modifiable risks of mild cognitive impairment (MCI). Research has indicated a correlation between exposure to air pollution and cognitive function in older adults. However, few studies have examined such an association among the MCI population inChina. Objective We aimed to explore the association between air pollution exposure and MCI risk from the Hubei Memory and Aging Cohort Study. Methods We measured four pollutants from 2015 to 2018, 3 years before the cognitive assessment of the participants. Logistic regression models were employed to calculate odds ratios (ORs) to assess the relationship between air pollutants and MCI risk. Results Among 4,205 older participants, the adjusted ORs of MCI risk for the highest quartile of PM2.5, PM10, O3, and SO2 were 1.90 (1.39, 2.62), 1.77 (1.28, 2.47), 0.56 (0.42, 0.75), and 1.18 (0.87, 1.61) respectively, compared with the lowest quartile. Stratified analyses indicated that such associations were found in both males and females, but were more significant in older participants. Conclusions Our findings are consistent with the growing evidence suggesting that air pollution increases the risk of mild cognitive decline, which has considerable guiding significance for early intervention of dementia in the older population. Further studies in other populations and broader geographical areas are warranted to validate these findings.
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Affiliation(s)
- Xin-Yan Xie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lin-Ya Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gui-Rong Cheng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-Fei Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Jing-Jing Zhang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gang-Bin Han
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Xiao-Chang Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Jun-Yi Wang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Juan Zhou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - De-Yang Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Jing Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Qian-Qian Nie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Song
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ya-Fu Yu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Chen-Lu Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yi-Di Fu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Shi-Yue Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Cheng Cai
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Yang Cui
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Wan-Ying Cai
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yi-Qing Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ren-Jia Fan
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Hong Wan
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yang-Ming Ou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yan-Ling Zhou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Shan Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Jin-Quan Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhen Wei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Wu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Fei Mei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Shao-Jun Song
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
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15
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Tong M, Wang M, Li P, Gong J, Zhu T, Xue T. The short-term effect of ozone on pregnancy loss modified by temperature: Findings from a nationwide epidemiological study in the contiguous United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 902:166088. [PMID: 37549698 PMCID: PMC10592165 DOI: 10.1016/j.scitotenv.2023.166088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Pregnancy loss, a major health issue that affects human sustainability, has been linked to short-term exposure to ground-surface ozone (O3). However, the association is inconsistent, possibly because of the co-occurrence of O3 and heat episodes, as increased temperature is a risk factor for pregnancy loss. To explain this inconsistency, the effect of O3 on pregnancy loss needs to be examined jointly with that of high temperature. METHODS A total of 247,305 pregnancy losses during the warm season were extracted from fetal death certificates from the 386 counties in contiguous United States from 1989 to 2005. We assessed environmental exposure based on the daily maximum 8 h average of O3 from Air Quality System monitors and the 24 h average temperature from the North American Regional Reanalysis product. We conducted a bidirectional, time-stratified case-crossover study of the association between pregnancy loss and exposures to O3 and temperature and their multiplicative interaction. The main time window for the exposure assessment was the day of case occurrence and the preceding 3 days. To estimate the association, we used conditional logistic regression with adjustment for relative humidity, height of the planetary boundary layer, and holidays. Sensitivity analyses were performed on the lagged structure, nonlinearity, and between-subpopulation heterogeneity of the estimated joint effect. RESULTS The joint effect was first estimated by the regression against categorical exposure by tertile. Compared to the low-low exposure group (O3 ≤ 78 μg/m3 and temperature ≤ 18 °C), the odds of pregnancy loss was significantly higher by 6.0 % (95 % confidence interval [CI] 2.4-9.7 %), 9.8 % (6.1-13.8 %), and 7.5 % (4.7-10.3 %) in the high-low (>104 μg/m3 and ≤18 °C), low-high (≤78 μg/m3 and >23 °C), and high-high (>104 μg/m3 and >23 °C) groups. The model of linear exposure and the multiplicative interaction yielded similar results. Each increment of 10 μg/m3 in O3 and 1 °C in temperature was associated with a 3.0 % (2.0 %-4.0 %) and 3.9 % (3.5 %-4.3 %), respectively, increase in the odds of pregnancy loss. A decrease in odds of 0.2 % (0.1 %-0.2 %) was associated with the temperature × O3 interaction. The finding of an antagonistic interaction between temperature and O3 was confirmed by models parametrizing the joint exposure as alternative nonlinear terms (i.e., a two-dimensional spline term or a varying-coefficient term) and was robust to a variety of exposure lags and stratifications. Therefore, the marginal effect of O3 was estimated to vary by climate zone. A significant association between O3 and pregnancy loss was observed in the northern, but not southern, United States. CONCLUSION Joint exposure to O3 and high temperature can increase the risk for pregnancy loss. The adverse effect of O3 is potentially modified by ambient temperature. In high-latitude cities, controlling for O3 pollution could protect maternal health.
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Affiliation(s)
- Mingkun Tong
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, United States; Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, NY 14214, United States; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98115, United States
| | - Pengfei Li
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China; National Institute of Health Data Science, Peking University, Beijing, China
| | - Jicheng Gong
- College of Environmental Sciences and Engineering, Peking University, Beijing, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China
| | - Tong Zhu
- College of Environmental Sciences and Engineering, Peking University, Beijing, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Center, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
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16
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Weismann D, Möckel M, Paeth H, Slagman A. Modelling variations of emergency attendances using data on community mobility, climate and air pollution. Sci Rep 2023; 13:20595. [PMID: 37996460 PMCID: PMC10667222 DOI: 10.1038/s41598-023-47857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023] Open
Abstract
Air pollution is associated with morbidity and mortality worldwide. We investigated the impact of improved air quality during the economic lockdown during the SARS-Cov2 pandemic on emergency room (ER) admissions in Germany. Weekly aggregated clinical data from 33 hospitals were collected in 2019 and 2020. Hourly concentrations of nitrogen and sulfur dioxide (NO2, SO2), carbon and nitrogen monoxide (CO, NO), ozone (O3) and particulate matter (PM10, PM2.5) measured by ground stations and meteorological data (ERA5) were selected from a 30 km radius around the corresponding ED. Mobility was assessed using aggregated cell phone data. A linear stepwise multiple regression model was used to predict ER admissions. The average weekly emergency numbers vary from 200 to over 1600 cases (total n = 2,216,217). The mean maximum decrease in caseload was 5 standard deviations. With the enforcement of the shutdown in March, the mobility index dropped by almost 40%. Of all air pollutants, NO2 has the strongest correlation with ER visits when averaged across all departments. Using a linear stepwise multiple regression model, 63% of the variation in ER visits is explained by the mobility index, but still 6% of the variation is explained by air quality and climate change.
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Affiliation(s)
- Dirk Weismann
- Intensive Care Unit, Department of Internal Medicine I, University Hospital of Wuerzburg, University of Wuerzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Germany.
| | - Martin Möckel
- Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Heiko Paeth
- Geographical Institute, University of Wuerzburg, Wuerzburg, Germany
| | - Anna Slagman
- Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charite-Universitätsmedizin Berlin, Berlin, Germany
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17
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Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell ML, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, Dszs Coelho M, Correa PM, Diaz MH, Entezari A, Forsberg B, Garland RM, Leon Guo Y, Guo Y, Hashizume M, Holobaca IH, Íñiguez C, Jaakkola JJK, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares ADL, Pan SC, Pascal M, Ragettli MS, Rao S, Raz R, Roye D, Ryti N, Hn Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, Dlc Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, De' Donato FK. Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. ENVIRONMENT INTERNATIONAL 2023; 181:108258. [PMID: 37837748 PMCID: PMC10702017 DOI: 10.1016/j.envint.2023.108258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. OBJECTIVES To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. METHODS We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. RESULTS We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. CONCLUSIONS Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | | | - Hanne Krage Carlsen
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gabriel Carrasco
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Micheline Dszs Coelho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia M Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Magali H Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Yue Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Nicolás V Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | | | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Paulo Hn Saldiva
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - César Dlc Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Francesca K De' Donato
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
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Sun Y, Zhang M, Wu W, Liu R, Zhang Y, Su S, Zhang E, Sun L, Yue W, Wu Q, Chen G, Zhang W, Yin C. Ambient cold exposure amplifies the effect of ambient PM 1 on blood pressure and hypertensive disorders of pregnancy among Chinese pregnant women: A nationwide cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 897:165234. [PMID: 37400028 DOI: 10.1016/j.scitotenv.2023.165234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 05/05/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Little evidence exists regarding the combined effect between ambient temperature and air pollution exposure on maternal blood pressure (BP) and hypertensive disorders of pregnancy (HDP). OBJECTIVES To assess effect modification by temperature exposure on the PM1-BP/HDP associations among Chinese pregnant women based on a nationwide study. METHODS We conducted a cross-sectional country-based population study in China, enrolling 86,005 participants from November 2017 to December 2021. BP was measured with standardized sphygmomanometers. HDP was defined according to the American College of Obstetricians and Gynecologists' recommendations. Daily temperature data were obtained from the European Centre for Medium-Range Weather Forecasts. PM1 concentrations were evaluated using generalized additive model. Generalized linear mixed models were used to examine the health effects, controlling for multiple covariates. We also performed a series of stratified and sensitivity analyses. RESULTS The pro-hypertensive effect of PM1 was observed in the first trimester. Cold exposure amplifies the first-trimester PM1-BP/HDP associations, with adjusted estimate (aβ) for systolic blood pressure (SBP) of 3.038 (95 % CI: 2.320-3.755), aβ for diastolic blood pressure (DBP) of 2.189 (95 % CI: 1.503-2.875), and aOR for HDP of 1.392 (95 % CI: 1.160-1.670). Pregnant women who were educated longer than 17 years or living in urban areas appeared to be more vulnerable to the modification in the first trimester. These findings remained robust after sensitivity analyses. CONCLUSIONS First trimester maybe the critical exposure window for the PM1-BP/HDP associations among Chinese pregnant women. Cold exposure amplifies the associations, and those with higher education level or living in urban areas appeared to be more vulnerable.
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Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Man Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ruixia Liu
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yue Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shaofei Su
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Enjie Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Lijuan Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wentao Yue
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC3004, Australia.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
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19
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Wang J, Li W, Huang W, Gao Y, Liu Y, Teng QH, Zhao Q, Chen M, Guo Y, Ma W. The associations of ambient fine particles with tuberculosis incidence and the modification effects of ambient temperature: A nationwide time-series study in China. JOURNAL OF HAZARDOUS MATERIALS 2023; 460:132448. [PMID: 37683354 DOI: 10.1016/j.jhazmat.2023.132448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
Ambient fine particulate matter (PM2.5) is a major air pollutant that poses significant risks to human health. However, little is known about the association of PM2.5 with tuberculosis (TB) incidence, and whether temperature modifies the association.This study aimed to explore the association between ambient PM2.5 exposure and TB incidence in China and the modification effects of temperature. Weekly meteorological data, PM2.5 concentrations, and TB incidence numbers were collected for 22 cities across Mainland China, from 2011 to 2020. A quasi-Poisson regression with the distributed lag non-linear model was used to assess city-specific PM2.5-TB associations. A multivariate meta-regression model was then used to pool the city-specific effect estimates, at the national and regional levels. A J-shaped PM2.5-TB relationship was observed at the national level for China. Compared to those with minimum PM2.5-TB risk, people who were exposed to the highest PM2.5 concentrations had a 26 % (RR:1.26, 95 % confidence interval [CI]: 1.05, 1.52) higher risk for TB incidence. J-shaped PM2.5-TB associations were also observed for most sub-groups, however, no significant modifying effects were found. While a trend was observed between low temperatures and increased exposure-response associations, these results were not significant. Overall, approximately 20 % of TB cases in the 22 study cities, over the period 2011-2020, could be attributed to PM2.5 exposure. Strengthening the monitoring and emission control of PM2.5 could aid the prevention and control of TB incidence.
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Affiliation(s)
- Jia Wang
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuan Gao
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yanming Liu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qian Hui Teng
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China
| | - Mingting Chen
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China.
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20
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Alahmad B, Khraishah H, Althalji K, Borchert W, Al-Mulla F, Koutrakis P. Connections Between Air Pollution, Climate Change, and Cardiovascular Health. Can J Cardiol 2023; 39:1182-1190. [PMID: 37030516 PMCID: PMC11097327 DOI: 10.1016/j.cjca.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
Globally, more people die from cardiovascular disease than any other cause. Climate change, through amplified environmental exposures, will promote and contribute to many noncommunicable diseases, including cardiovascular disease. Air pollution, too, is responsible for millions of deaths from cardiovascular disease each year. Although they may appear to be independent, interchangeable relationships and bidirectional cause-and-effect arrows between climate change and air pollution can eventually lead to poor cardiovascular health. In this topical review, we show that climate change and air pollution worsen each other, leading to several ecosystem-mediated effects. We highlight how increases in hot climates as a result of climate change have increased the risk of major air pollution events such as severe wildfires and dust storms. In addition, we show how altered atmospheric chemistry and changing patterns of weather conditions can promote the formation and accumulation of air pollutants: a phenomenon known as the climate penalty. We demonstrate these amplified environmental exposures and their associations to adverse cardiovascular health outcomes. The community of health professionals-and cardiologists, in particular-cannot afford to overlook the risks that climate change and air pollution bring to the public's health.
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Affiliation(s)
- Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Environmental and Occupational Health Department, College of Public Health, Kuwait University, Kuwait City, Kuwait; Dasman Diabetes Institute (DDI), Kuwait City, Kuwait.
| | - Haitham Khraishah
- Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Khalid Althalji
- Jaber Alahmad Hospital, Ministry of Health, Kuwait City, Kuwait
| | - William Borchert
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Fahd Al-Mulla
- Dasman Diabetes Institute (DDI), Kuwait City, Kuwait
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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21
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Zhang S, Breitner S, Rai M, Nikolaou N, Stafoggia M, De' Donato F, Samoli E, Zafeiratou S, Katsouyanni K, Rao S, Palomares ADL, Gasparrini A, Masselot P, Aunan K, Peters A, Schneider A. Assessment of short-term heat effects on cardiovascular mortality and vulnerability factors using small area data in Europe. ENVIRONMENT INTERNATIONAL 2023; 179:108154. [PMID: 37603993 DOI: 10.1016/j.envint.2023.108154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Short-term associations between heat and cardiovascular disease (CVD) mortality have been examined mostly in large cities. However, different vulnerability and exposure levels may contribute to spatial heterogeneity. This study assessed heat effects on CVD mortality and potential vulnerability factors using data from three European countries, including urban and rural settings. METHODS We collected daily counts of CVD deaths aggregated at the small-area level in Norway (small-area level: municipality), England and Wales (lower super output areas), and Germany (district) during the warm season (May-September) from 1996 to 2018. Daily mean air temperatures estimated by spatial-temporal models were assigned to each small area. Within each country, we applied area-specific Quasi-Poisson regression using distributed lag nonlinear models to examine the heat effects at lag 0-1 days. The area-specific estimates were pooled by random-effects meta-analysis to derive country-specific and overall heat effects. We examined individual- and area-level heat vulnerability factors by subgroup analyses and meta-regression, respectively. RESULTS We included 2.84 million CVD deaths in analyses. For an increase in temperature from the 75th to the 99th percentile, the pooled relative risk (RR) for CVD mortality was 1.14 (95% CI: 1.03, 1.26), with the country-specific RRs ranging from 1.04 (1.00, 1.09) in Norway to 1.24 (1.23, 1.26) in Germany. Heat effects were stronger among women [RRs (95% CIs) for women and men: 1.18 (1.08, 1.28) vs. 1.12 (1.00, 1.24)]. Greater heat vulnerability was observed in areas with high population density, high degree of urbanization, low green coverage, and high levels of fine particulate matter. CONCLUSION This study provides evidence for the heat effects on CVD mortality in European countries using high-resolution data from both urban and rural areas. Besides, we identified individual- and area-level heat vulnerability factors. Our findings may facilitate the development of heat-health action plans to increase resilience to climate change.
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Affiliation(s)
- Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Nikolaos Nikolaou
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy
| | - Francesca De' Donato
- Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kristin Aunan
- CICERO Center for International Climate Research, Norway
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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22
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Vallabani NVS, Gruzieva O, Elihn K, Juárez-Facio AT, Steimer SS, Kuhn J, Silvergren S, Portugal J, Piña B, Olofsson U, Johansson C, Karlsson HL. Toxicity and health effects of ultrafine particles: Towards an understanding of the relative impacts of different transport modes. ENVIRONMENTAL RESEARCH 2023; 231:116186. [PMID: 37224945 DOI: 10.1016/j.envres.2023.116186] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
Exposure to particulate matter (PM) has been associated with a wide range of adverse health effects, but it is still unclear how particles from various transport modes differ in terms of toxicity and associations with different human health outcomes. This literature review aims to summarize toxicological and epidemiological studies of the effect of ultrafine particles (UFPs), also called nanoparticles (NPs, <100 nm), from different transport modes with a focus on vehicle exhaust (particularly comparing diesel and biodiesel) and non-exhaust as well as particles from shipping (harbor), aviation (airport) and rail (mainly subway/underground). The review includes both particles collected in laboratory tests and the field (intense traffic environments or collected close to harbor, airport, and in subway). In addition, epidemiological studies on UFPs are reviewed with special attention to studies aimed at distinguishing the effects of different transport modes. Results from toxicological studies indicate that both fossil and biodiesel NPs show toxic effects. Several in vivo studies show that inhalation of NPs collected in traffic environments not only impacts the lung, but also triggers cardiovascular effects as well as negative impacts on the brain, although few studies compared NPs from different sources. Few studies were found on aviation (airport) NPs, but the available results suggest similar toxic effects as traffic-related particles. There is still little data related to the toxic effects linked to several sources (shipping, road and tire wear, subway NPs), but in vitro results highlighted the role of metals in the toxicity of subway and brake wear particles. Finally, the epidemiological studies emphasized the current limited knowledge of the health impacts of source-specific UFPs related to different transport modes. This review discusses the necessity of future research for a better understanding of the relative potencies of NPs from different transport modes and their use in health risk assessment.
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Affiliation(s)
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Karine Elihn
- Department of Environmental Science, Stockholm University, 11418, Stockholm, Sweden
| | | | - Sarah S Steimer
- Department of Environmental Science, Stockholm University, 11418, Stockholm, Sweden
| | - Jana Kuhn
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Sanna Silvergren
- Environment and Health Administration, 104 20, Stockholm, Sweden
| | - José Portugal
- Institute of Environmental Assessment and Water Research, CSIC, 08034, Barcelona, Spain
| | - Benjamin Piña
- Institute of Environmental Assessment and Water Research, CSIC, 08034, Barcelona, Spain
| | - Ulf Olofsson
- Department of Machine Design, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Christer Johansson
- Department of Environmental Science, Stockholm University, 11418, Stockholm, Sweden; Environment and Health Administration, 104 20, Stockholm, Sweden
| | - Hanna L Karlsson
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
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Vicedo-Cabrera AM, Melén E, Forastiere F, Gehring U, Katsouyanni K, Yorgancioglu A, Ulrik CS, Hansen K, Powell P, Ward B, Hoffmann B, Andersen ZJ. Climate change and respiratory health: a European Respiratory Society position statement. Eur Respir J 2023; 62:2201960. [PMID: 37661094 DOI: 10.1183/13993003.01960-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/05/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Erik Melén
- Department of Clinical Sciences and Education, Karolinska Institutet, Stockholm, Sweden
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
- Science Policy and Epidemiology Environmental Research Group King's College London, London UK
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Klea Katsouyanni
- National and Kapodistrian University of Athens, Medical School, Athens, Greece
- Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - Arzu Yorgancioglu
- Celal Bayar University Medical Faculty Department of Pulmonology, Manisa, Turkey
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kjeld Hansen
- European Lung Foundation, Sheffield, UK
- Kristiania University College, Technology, Oslo, Norway
| | | | - Brian Ward
- European Respiratory Society, Brussels, Belgium
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Zorana Jovanovic Andersen
- Section of Environment and Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Zhao G, Zhang F, Zhong Y, Zhang Y, Zhang X, Zhu S, Zhang X, Li T, Zhu W, Li D. Independent and interactive effects of ozone and thermal inversion exposure on the risk of gestational diabetes mellitus in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:91315-91323. [PMID: 37477814 DOI: 10.1007/s11356-023-28855-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
The adverse effects of exposure to thermal inversion (TI) and ozone (O3) on human health have been reported; however, there are few studies have explored the independent and potential interactive effects of them on gestational diabetes mellitus (GDM). A total of 31,262 pregnant women from the Wuhan Children's Hospital covering the period from 2017 to 2021 were included in this study. The logistic regression adjusted for the covariates was applied to explore the independent effect of exposure to O3 and TI on GDM. The relative excess risk due to the interaction (RERI) analysis was applied to assess the possible interactive effect. Per 10 μg/m3 increased in O3 (OR = 1.069, 95% CI: 1.049, 1.089) during the first trimester and per 10 days increased in TI (OR = 1.041, 95% CI: 1.005, 1.080) in the second trimester were significantly associated with the risk of GDM. The synergistic effect of exposure to TI and O3 was larger than their sum effect (RERI = 0.330, 95% CI: 0.170, 0.476). This study added further support for public health-related policy to improve maternal health by curbing TI and O3.
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Affiliation(s)
- Gaichan Zhao
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
- Yuhua District Center for Disease Control and Prevebtion, Shijiazhuang, 050021, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Yuanyuan Zhong
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Xiaowei Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Wei Zhu
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
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Zhang R, Lai KY, Liu W, Liu Y, Cai W, Webster C, Luo L, Sarkar C. Association of climatic variables with risk of transmission of influenza in Guangzhou, China, 2005-2021. Int J Hyg Environ Health 2023; 252:114217. [PMID: 37418782 DOI: 10.1016/j.ijheh.2023.114217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Climatic variables constitute important extrinsic determinants of transmission and seasonality of influenza. Yet quantitative evidence of independent associations of viral transmissibility with climatic factors has thus far been scarce and little is known about the potential effects of interactions between climatic factors on transmission. OBJECTIVE This study aimed to examine the associations of key climatic factors with risk of influenza transmission in subtropical Guangzhou. METHODS Influenza epidemics were identified over a 17-year period using the moving epidemic method (MEM) from a dataset of N = 295,981 clinically- and laboratory-confirmed cases of influenza in Guangzhou. Data on eight key climatic variables were collected from China Meteorological Data Service Centre. Generalized additive model combined with the distributed lag non-linear model (DLNM) were developed to estimate the exposure-lag-response curve showing the trajectory of instantaneous reproduction number (Rt) across the distribution of each climatic variable after adjusting for depletion of susceptible, inter-epidemic effect and school holidays. The potential interaction effects of temperature, humidity and rainfall on influenza transmission were also examined. RESULTS Over the study period (2005-21), 21 distinct influenza epidemics with varying peak timings and durations were identified. Increasing air temperature, sunshine, absolute and relative humidity were significantly associated with lower Rt, while the associations were opposite in the case of ambient pressure, wind speed and rainfall. Rainfall, relative humidity, and ambient temperature were the top three climatic contributors to variance in transmissibility. Interaction models found that the detrimental association between high relative humidity and transmissibility was more pronounced at high temperature and rainfall. CONCLUSION Our findings are likely to help understand the complex role of climatic factors in influenza transmission, guiding informed climate-related mitigation and adaptation policies to reduce transmission in high density subtropical cities.
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Affiliation(s)
- Rong Zhang
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Wenhui Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yanhui Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Wenfeng Cai
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Urban Systems Institute, The University of Hong Kong, Hong Kong, China
| | - Lei Luo
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Department of Urban Planning and Design, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK; Urban Systems Institute, The University of Hong Kong, Hong Kong, China.
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26
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Gao P, Wu Y, He L, Wang L, Fu Y, Chen J, Zhang F, Krafft T, Martens P. Adverse short-term effects of ozone on cardiovascular mortalities modified by season and temperature: a time-series study. Front Public Health 2023; 11:1182337. [PMID: 37361179 PMCID: PMC10288843 DOI: 10.3389/fpubh.2023.1182337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Ambient ozone pollution becomes critical in China. Conclusions on the short-term effects of ozone on cardiovascular mortality have been controversial and limited on cause-specific cardiovascular mortalities and their interactions with season and temperature. This research aimed to investigate the short-term effects of ozone and the modifications of season and temperature on cardiovascular mortality. Methods Cardiovascular death records, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were analyzed. Daily 1-h maximum of ozone and daily maximum 8-h moving average of ozone were studied. Generalized additive models (GAMs) were applied to evaluate their associations with cardiovascular mortalities in sex and age groups. Effect modifications were assessed by stratifying season and temperature. Results Distributed lag impacts of ozone on total cardiovascular deaths and cumulative effects on mortality due to ischemic heart disease (IHD) were most significant. Population under 65 years old was most susceptible. Majority of significant effects were found in warm season, at high temperature, and at extreme heat. Ozone-associated risks in total deaths caused by hypertensive diseases reduced in warm season, while risks in IHD in males increased at high temperature. Extreme heat enhanced ozone effects on deaths caused by CVDs and IHD in the population under 65 years old. Discussion The revealed cardiovascular impacts of ozone below current national standard of air quality suggested improved standards and interventions in China. Higher temperature, particularly extreme heat, rather than warm season, could significantly enhance the adverse effects of ozone on cardiovascular mortality in population under 65 years old.
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Affiliation(s)
- Panjun Gao
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Yongsheng Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lihuan He
- China National Environmental Monitoring Centre, Beijing, China
| | - Li Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jinrong Chen
- China National Environmental Monitoring Centre, Beijing, China
| | - Fengying Zhang
- China National Environmental Monitoring Centre, Beijing, China
| | - Thomas Krafft
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Pim Martens
- University College Venlo, Maastricht University, Venlo, Netherlands
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27
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Andersen ZJ, Vicedo-Cabrera AM, Hoffmann B, Melén E. Climate change and respiratory disease: clinical guidance for healthcare professionals. Breathe (Sheff) 2023; 19:220222. [PMID: 37492343 PMCID: PMC10365076 DOI: 10.1183/20734735.0222-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/28/2023] [Indexed: 07/27/2023] Open
Abstract
Climate change is one of the major public health emergencies with already unprecedented impacts on our planet, environment and health. Climate change has already resulted in substantial increases in temperatures globally and more frequent and extreme weather in terms of heatwaves, droughts, dust storms, wildfires, rainstorms and flooding, with prolonged and altered allergen and microbial exposure as well as the introduction of new allergens to certain areas. All these exposures may have a major burden on patients with respiratory conditions, which will pose increasing challenges for respiratory clinicians and other healthcare providers. In addition, complex interactions between these different factors, along with other major environmental risk factors (e.g. air pollution), will exacerbate adverse health effects on the lung. For example, an increase in heat and sunlight in urban areas will lead to increases in ozone exposure among urban populations; effects of very high exposure to smoke and pollution from wildfires will be exacerbated by the accompanying heat and drought; and extreme precipitation events and flooding will increase exposure to humidity and mould indoors. This review aims to bring respiratory healthcare providers up to date with the newest research on the impacts of climate change on respiratory health. Respiratory clinicians and other healthcare providers need to be continually educated about the challenges of this emerging and growing public health problem and be equipped to be the key players in solutions to mitigate the impacts of climate change on patients with respiratory conditions. Educational aims To define climate change and describe major related environmental factors that pose a threat to patients with respiratory conditions.To provide an overview of the epidemiological evidence on climate change and respiratory diseases.To explain how climate change interacts with air pollution and other related environmental hazards to pose additional challenges for patients.To outline recommendations to protect the health of patients with respiratory conditions from climate-related environmental hazards in clinical practice.To outline recommendations to clinicians and patients with respiratory conditions on how to contribute to mitigating climate change.
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Affiliation(s)
- Zorana Jovanovic Andersen
- Section of Environment and Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Erik Melén
- Department of Clinical Sciences and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
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28
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Bai S, Cui L, Du S, Zhao X, Lin S, Yang X, Zhang J, Liang Y, Wang Z. A life course approach to asthma and wheezing among young children caused by ozone: A prospective birth cohort in northern China. ENVIRONMENTAL RESEARCH 2023; 226:115687. [PMID: 36925033 DOI: 10.1016/j.envres.2023.115687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Given differences in vulnerability of children in early life, a life course approach to asthma and wheezing (AW) in young children caused by ozone (O3) is not fully understood. METHODS We conducted a birth cohort in Jinan, China from 2018 to 2021 to elucidate the onset model of childhood AW due to O3 exposure. An inverse distance weighted model was used for individual exposure assessment. The time-dependent Cox proportional-hazard model and logistic model were used to investigate the effects of O3 exposure on AW. Principal component analysis, interaction analysis, and distributed lag model were used to analyze the life course approach. RESULTS The cumulative incidence rate for AW among 6501 children aged 2 was 1.4%. A high level of O3 was related to AW (HR: 2.10, 95% CI: 1.31, 3.37). Only O3 exposure after birth was associated with AW, with an OR of 1.82 (1.08, 3.12), after adjusting for the effect before birth. Furthermore, adjusting for other air pollutants, the HR for the individual effect of high O3 exposure on AW was 2.44 (1.53, 3.89). Interestingly, P values for interactions for O3 and the principal components of other pollutants, as well as the characteristic variable of open windows were less than 0.1. Moreover, an increase in the IQR of O3 exposure at the 31st to 37th weeks before birth and the 1st to 105th weeks after birth was associated with an increase in the HRs for AW. CONCLUSIONS High-level of O3 exposure after birth could lead to AW among young children. Importantly, the AW onset model may include the risk factors accumulation and the sensitive period model. Specifically, there are two sensitive windows in early life, and the correlated insults between the high level of O3 and other pollutants as well as open windows in the asthma-inducing effect.
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Affiliation(s)
- Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Xiwei Yang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Jiatao Zhang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Yuxiu Liang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Zhiping Wang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
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29
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Gui SY, Qiao JC, Wang XC, Yang F, Hu CY, Tao FB, Yi XL, Jiang ZX. Long-term effects of meteorological factors and extreme weather on daily outpatient visits for conjunctivitis from 2013 to 2020: a time-series study in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:58041-58057. [PMID: 36977878 PMCID: PMC10047460 DOI: 10.1007/s11356-023-26335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/03/2023] [Indexed: 05/07/2023]
Abstract
Conjunctivitis is a common multifactorial inflammatory ocular surface disease characterized by symptoms such as congestion, edema, and increased secretion of conjunctival tissue, and the potential effects of meteorological factors as well as extreme meteorological factors on conjunctivitis and their lagging effects have not been fully evaluated. We obtained the electronic case information of 59,731 outpatients with conjunctivitis from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) for the period from January 1, 2013, to December 31, 2020. Meteorological data for daily mean temperature (°C), daily relative humidity (%), daily average wind speed (m/s), and atmospheric pressure (hPa) were obtained from the China Meteorological Data Sharing Service. The air pollutant data were obtained from 11 standard urban background fixed air quality monitors. A time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) were used to fit the effects of exposure to different meteorological factors and extreme weather on conjunctivitis outpatient visits. Subgroup analyses were performed on gender, age and season, and type of conjunctivitis. Univariate and multifactorial model results indicated that each 10-unit increase in mean temperature and relative humidity was associated with an increased risk of conjunctivitis outpatient visits, while each 10-unit increase in atmospheric pressure was associated with a decreased risk. The results of the extreme weather analysis suggested that extremely low levels of atmospheric pressure and relative humidity as well as extreme levels of temperature were associated with an increased risk of outpatient conjunctivitis visits, and extreme wind speeds were associated with a decreased risk. The results of the subgroup analysis suggested gender, age, and seasonal differences. We conducted the first large sample size time-series analysis in the large city furthest from the ocean in the world and confirmed for the first time that elevated mean temperature and extreme low levels of relative humidity in Urumqi were risk factors for local conjunctivitis outpatient visits, while elevated atmospheric pressure and extreme low levels of wind speed were protective factors, and there were lagged effects of temperature and atmospheric pressure. Multicenter studies with larger sample sizes are needed.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fan Yang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Ürümqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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30
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Ratter-Rieck JM, Roden M, Herder C. Diabetes and climate change: current evidence and implications for people with diabetes, clinicians and policy stakeholders. Diabetologia 2023; 66:1003-1015. [PMID: 36964771 PMCID: PMC10039694 DOI: 10.1007/s00125-023-05901-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/15/2023] [Indexed: 03/26/2023]
Abstract
Climate change will be a major challenge for the world's health systems in the coming decades. Elevated temperatures and increasing frequencies of heat waves, wildfires, heavy precipitation and other weather extremes can affect health in many ways, especially if chronic diseases are already present. Impaired responses to heat stress, including compromised vasodilation and sweating, diabetes-related comorbidities, insulin resistance and chronic low-grade inflammation make people with diabetes particularly vulnerable to environmental risk factors, such as extreme weather events and air pollution. Additionally, multiple pathogens show an increased rate of transmission under conditions of climate change and people with diabetes have an altered immune system, which increases the risk for a worse course of infectious diseases. In this review, we summarise recent studies on the impact of climate-change-associated risk for people with diabetes and discuss which individuals may be specifically prone to these risk conditions due to their clinical features. Knowledge of such high-risk groups will help to develop and implement tailored prevention and management strategies to mitigate the detrimental effect of climate change on the health of people with diabetes.
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Affiliation(s)
- Jacqueline M Ratter-Rieck
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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31
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Psistaki K, Achilleos S, Middleton N, Paschalidou AK. Exploring the impact of particulate matter on mortality in coastal Mediterranean environments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 865:161147. [PMID: 36587685 DOI: 10.1016/j.scitotenv.2022.161147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Air pollution is one of the most important problems the world is facing nowadays, adversely affecting public health and causing millions of deaths every year. Particulate matter is a criteria pollutant that has been linked to increased morbidity, as well as all-cause and cause-specific mortality. However, this association remains under-investigated in smaller-size cities in the Eastern Mediterranean, which are also frequently affected by heat waves and dust storms. This study explores the impact of particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5) on mortality (all-cause, cardiovascular, respiratory) in two coastal cities in the Eastern Mediterranean; Thessaloniki, Greece and Limassol, Cyprus. Generalized additive Poisson models were used to explore overall and gender-specific associations, controlling for long- and short-term patterns, day of week and the effect of weather variables. Moreover, the effect of different lags, season, co-pollutants and dust storms on primary associations was investigated. A 10 μg/m3 increase in PM2.5 resulted in 1.10 % (95 % CI: -0.13, 2.34) increase in cardiovascular mortality in Thessaloniki, and in 3.07 % (95 % CI: -0.90, 7.20) increase in all-cause mortality in Limassol on the same day. Additionally, significant positive associations were observed between PM2.5 as well as PM10 and mortality at different lags up to seven days. Interestingly, an association with dust storms was observed only in Thessaloniki, having a protective effect, while the gender-specific analysis revealed significant associations only for the males in both cities. The outcome of this study highlights the need of city- or county-specific public health interventions to address the impact of climate, population lifestyle behaviour and other socioeconomic factors that affect the exposure to air pollution and other synergistic effects that alter the effect of PM on population health.
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Affiliation(s)
- K Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada 68200, Greece
| | - S Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - N Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - A K Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada 68200, Greece.
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Jiao A, Sun Y, Sacks DA, Avila C, Chiu V, Molitor J, Chen JC, Sanders KT, Abatzoglou JT, Slezak J, Benmarhnia T, Getahun D, Wu J. The role of extreme heat exposure on premature rupture of membranes in Southern California: A study from a large pregnancy cohort. ENVIRONMENT INTERNATIONAL 2023; 173:107824. [PMID: 36809710 PMCID: PMC10917632 DOI: 10.1016/j.envint.2023.107824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 01/21/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Significant mortality and morbidity in pregnant women and their offspring are linked to premature rupture of membranes (PROM). Epidemiological evidence for heat-related PROM risk is extremely limited. We investigated associations between acute heatwave exposure and spontaneous PROM. METHODS We conducted this retrospective cohort study among mothers in Kaiser Permanente Southern California who experienced membrane ruptures during the warm season (May-September) from 2008 to 2018. Twelve definitions of heatwaves with different cut-off percentiles (75th, 90th, 95th, and 98th) and durations (≥ 2, 3, and 4 consecutive days) were developed using the daily maximum heat index, which incorporates both daily maximum temperature and minimum relative humidity in the last gestational week. Cox proportional hazards models were fitted separately for spontaneous PROM, term PROM (TPROM), and preterm PROM (PPROM) with zip codes as the random effect and gestational week as the temporal unit. Effect modification by air pollution (i.e., PM2.5 and NO2), climate adaptation measures (i.e., green space and air conditioning [AC] penetration), sociodemographic factors, and smoking behavior was examined. RESULTS In total, we included 190,767 subjects with 16,490 (8.6%) spontaneous PROMs. We identified a 9-14% increase in PROM risks associated with less intense heatwaves. Similar patterns as PROM were found for TPROM and PPROM. The heat-related PROM risks were greater among mothers exposed to a higher level of PM2.5 during pregnancy, under 25 years old, with lower education and household income level, and who smoked. Even though climate adaptation factors were not statistically significant effect modifiers, mothers living with lower green space or lower AC penetration were at consistently higher heat-related PROM risks compared to their counterparts. CONCLUSION Using a rich and high-quality clinical database, we detected harmful heat exposure for spontaneous PROM in preterm and term deliveries. Some subgroups with specific characteristics were more susceptible to heat-related PROM risk.
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Affiliation(s)
- Anqi Jiao
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA; Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA
| | - Kelly T Sanders
- Department of Civil and Environmental Engineering, University of Southern California, CA, USA
| | | | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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Jiang Y, Chen R, Peng W, Luo Y, Chen X, Jiang Q, Han B, Su G, Duan Y, Huo J, Qu X, Fu Q, Kan H. Hourly Ultrafine Particle Exposure and Acute Myocardial Infarction Onset: An Individual-Level Case-Crossover Study in Shanghai, China, 2015-2020. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:1701-1711. [PMID: 36668989 DOI: 10.1021/acs.est.2c06651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Associations between ultrafine particles (UFPs) and hourly onset of acute myocardial infarction (AMI) have rarely been investigated. We aimed to evaluate the impacts of UFPs on AMI onset and the lag patterns. A time-stratified case-crossover study was performed among 20,867 AMI patients from 46 hospitals in Shanghai, China, between January 2015 and December 2020. Hourly data of AMI onset and number concentrations of nanoparticles of multiple size ranges below 0.10 μm (0.01-0.10, UFP/PNC0.01-0.10; 0.01-0.03, PNC0.01-0.03; 0.03-0.05, PNC0.03-0.05; and 0.05-0.10 μm, PNC0.05-0.10) were collected. Conditional logistic regressions were applied. Transient exposures to these nanoparticles were significantly associated with AMI onset, with almost linear exposure-response curves. These associations occurred immediately after exposure, lasted for approximately 6 h, and attenuated to be null thereafter. Each interquartile range increase in concentrations of total UFPs, PNC0.01-0.03, PNC0.03-0.05, and PNC0.05-0.10 during the preceding 0-6 h was associated with increments of 3.29, 2.08, 2.47, and 2.93% in AMI onset risk, respectively. The associations were stronger during warm season and at high temperatures and were robust after adjusting for criteria air pollutants. Our findings provide novel evidence that hourly UFP exposure is associated with immediate increase in AMI onset risk.
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Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenhui Peng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Yun Luo
- Department of Cardiology, Jiujiang No. 1 People's Hospital, Jiujiang 332000, China
| | - Xiaomin Chen
- Department of Cardiology, Ningbo First Hospital, Ningbo 315010, China
| | - Qianfeng Jiang
- Department of Cardiology, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi 563000, China
| | - Bingjiang Han
- Department of Cardiology, The Second Hospital of Jiaxing (The Second Affiliated Hospital of Jiaxing University), Jiaxing 314000, China
| | - Guohai Su
- Jinan Central Hospital, Jinan 250013, China
| | - Yusen Duan
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Juntao Huo
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China
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34
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Yan Z, Liu YM, Wu WD, Jiang Y, Zhuo LB. Combined exposure of heat stress and ozone enhanced cognitive impairment via neuroinflammation and blood brain barrier disruption in male rats. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159599. [PMID: 36280063 DOI: 10.1016/j.scitotenv.2022.159599] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Heat stress (HS) exposure has been linked to cognitive dysfunction. In reality, high temperature does not occur alone in environment, and ozone (O3) and heatwaves usually co-exist in atmospheric environment. However, whether O3 exposure exacerbates HS-induced cognitive impairment and the potential underlying mechanisms have not been explored experimentally. The aim of this study was to determine the co-effects and mechanisms of HS and O3 on the cognitive dysfunction. METHODS 48 Sprague Dawley male rats were randomly divided into 4 groups: control, HS, O3 and HS plus O3 (HO3) groups. Rats in HS and HO3 group were exposed to 40 °C every morning from 9:00 to 12:00 for 15 consecutive days. While rats in O3 and HO3 groups were exposed to 0.7 ppm O3 the same day from 14:00 to 17:00 for 15 days. Cognitive performance was examined with Morris water maze test. Neurodegeneration, glial activation, neuroinflammation, blood brain barrier (BBB) disruption and apoptosis were evaluated by Western blot, Elisa, immunohistochemistry and immunofluorescence staining. RESULTS HS induced cognitive decline and neuronal damage in rats. Further studies showed that exposure of rats to HS could also induce glial activation, neuroinflammation and neuronal apoptosis in hippocampus, and decrease in the expressions of ZO-1, claudin-5 and occluding, indicative of BBB disruption. Impressively, the neuronal effects induced by HS, as depicted above, could be worsened by co-exposure to O3 in rats. CONCLUSIONS Co-exposure to O3 promotes HS-induced cognitive impairment in rats possibly through glial-mediated neuroinflammation and BBB disruption.
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Affiliation(s)
- Zhen Yan
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Yu-Mei Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Wei-Dong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Yuhan Jiang
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, United States
| | - Lai-Bao Zhuo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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35
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Zhao Z, Chu J, Xu X, Cao Y, Schikowski T, Geng M, Chen G, Bai G, Hu K, Xia J, Ma W, Liu Q, Lu Z, Guo X, Zhao Q. Association between ambient cold exposure and mortality risk in Shandong Province, China: Modification effect of particulate matter size. Front Public Health 2023; 10:1093588. [PMID: 36684922 PMCID: PMC9850236 DOI: 10.3389/fpubh.2022.1093588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Numerous studies have reported the modification of particulate matters (PMs) on the association between cold temperature and health. However, it remains uncertain whether the modification effect may vary by size of PMs, especially in Shandong Province, China where the disease burdens associated with cold temperature and PMs are both substantial. This study aimed to examine various interactive effects of cold exposure and ambient PMs with diameters ≤1/2.5 μm (PM1 and PM2.5) on premature deaths in Shandong Province, China. Methods In the 2013-2018 cold seasons, data on daily mortality, PM1 and PM2.5, and weather conditions were collected from the 1822 sub-districts of Shandong Province. A time-stratified case-crossover study design was performed to quantify the cumulative association between ambient cold and mortality over lag 0-12 days, with a linear interactive term between temperature and PM1 and PM2.5 additionally added into the model. Results The mortality risk increased with temperature decline, with the cumulative OR of extreme cold (-16.9°C, the 1st percentile of temperature range) being 1.83 (95% CI: 1.66, 2.02), compared with the minimum mortality temperature. The cold-related mortality risk was 2.20 (95%CI: 1.83, 2.64) and 2.24 (95%CI: 1.78, 2.81) on high PM1 and PM2.5 days, which dropped to 1.60 (95%CI: 1.39, 1.84) and 1.60 (95%CI: 1.37, 1.88) on low PM1 and PM2.5 days. PM1 showed greater modification effect for per unit concentration increase than PM2.5. For example, for each 10?g/m3 increase in PM1 and PM2.5, the mortality risk associated with extreme cold temperature increased by 7.6% (95% CI: 1.3%, 14.2%) and 2.6% (95% CI: -0.7%, 5.9%), respectively. Discussion The increment of smaller PMs' modification effect varied by population subgroups, which was particularly strong in the elderly aged over 75 years and individuals with middle school education and below. Specific health promotion strategies should be developed towards the greater modification effect of smaller PMs on cold effect.
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Affiliation(s)
- Zhonghui Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Jie Chu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Xiaohui Xu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Yanwen Cao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Tamara Schikowski
- Department of Epidemiology, Leibniz Institute for Environmental Medicine (IUF)-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Mengjie Geng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guannan Bai
- Department of Child Health Care, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jingjing Xia
- School of Life Sciences, Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Qiyong Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China,Xiaolei Guo ✉
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China,Department of Epidemiology, Leibniz Institute for Environmental Medicine (IUF)-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany,*Correspondence: Qi Zhao ✉
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36
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Yang W, Johnson MB, Liao H, Liu Z, Zheng X, Lu C. Combined effect of preconceptional and prenatal exposure to air pollution and temperature on childhood pneumonia: A case-control study. ENVIRONMENTAL RESEARCH 2023; 216:114806. [PMID: 36375503 DOI: 10.1016/j.envres.2022.114806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
Mounting evidence have linked ambient air pollution and temperature with childhood pneumonia, but it is unclear whether there is an interaction between air pollution and temperature on childhood pneumonia. We aim to assess the combined effect of ambient air pollution and temperature exposure during preconception and pregnancy on pneumonia by a case-control study of 1510 children aged 0-14 years in Changsha, China. We obtained the data of childhood pneumonia from XiangYa Hospital electrical records. We estimated personal exposure to outdoor air pollution (PM10, SO2 and NO2) by inverse distance weighted (IDW) method and temperature indicators. Multiple logistic regression models were used to evaluate associations of childhood pneumonia with air pollution, temperature (T), and diurnal temperature variation (DTV). We found that exposure to industry-related air pollution (PM10 and SO2) during preconception and pregnancy were associated with childhood pneumonia, with ORs (95% CI) of 1.72 (1.48-1.98) and 2.96 (2.50-3.51) during 1 year before pregnancy and 1.83 (1.59-2.11) and 3.43 (2.83-4.17) in pregnancy. Childhood pneumonia was negatively associated with T exposure during 1 year before pregnancy and pregnancy, with ORs (95% CI) of 0.57 (0.41-0.80) and 0.85 (0.74-0.98). DTV exposure during pregnancy especially during the 1st and 2nd trimesters significantly increased pneumonia risk, with ORS (95% CI) of 1.77 (1.19-2.64), 1.47 (1.18-1.83), and 1.37 (1.07-1.76) respectively. We further observed interactions of PM10 and SO2 exposure with low T and high DTV during conception and pregnancy in relation to childhood pneumonia. This study suggests that there were interactions air pollution with temperature and DTV on pneumonia development.
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Affiliation(s)
- Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | | | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha 410078, China.
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Psistaki K, Dokas IM, Paschalidou AK. The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:555. [PMID: 36612877 PMCID: PMC9819162 DOI: 10.3390/ijerph20010555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.
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Affiliation(s)
- Kyriaki Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
| | - Ioannis M. Dokas
- Department of Civil Engineering, Democritus University of Thrace, 67100 Xanthi, Greece
| | - Anastasia K. Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
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Demoury C, De Troeyer K, Berete F, Aerts R, Van Schaeybroeck B, Van der Heyden J, De Clercq EM. Association between temperature and natural mortality in Belgium: Effect modification by individual characteristics and residential environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158336. [PMID: 36037893 DOI: 10.1016/j.scitotenv.2022.158336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is strong evidence of mortality being associated to extreme temperatures but the extent to which individual or residential factors modulate this temperature vulnerability is less clear. METHODS We conducted a multi-city study with a time-stratified case-crossover design and used conditional logistic regression to examine the association between extreme temperatures and overall natural and cause-specific mortality. City-specific estimates were pooled using a random-effect meta-analysis to describe the global association. Cold and heat effects were assessed by comparing the mortality risks corresponding to the 2.5th and 97.5th percentiles of the daily temperature, respectively, with the minimum mortality temperature. For cold, we cumulated the risk over lags of 0 to 28 days before death and 0 to 7 days for heat. We carried out stratified analyses and assessed effect modification by individual characteristics, preexisting chronic health conditions and residential environment (population density, built-up area and air pollutants: PM2.5, NO2, O3 and black carbon) to identify more vulnerable population subgroups. RESULTS Based on 307,859 deaths from natural causes, we found significant cold effect (OR = 1.42, 95%CI: 1.30-1.57) and heat effect (OR = 1.17, 95%CI: 1.12-1.21) for overall natural mortality and for respiratory causes in particular. There were significant effects modifications for some health conditions: people with asthma were at higher risk for cold, and people with psychoses for heat. In addition, people with long or frequent hospital admissions in the year preceding death were at lower risk. Despite large uncertainties, there was suggestion of effect modification by air pollutants: the effect of heat was higher on more polluted days of O3 and black carbon, and a higher cold effect was observed on more polluted days of PM2.5 and NO2 while for O3, the effect was lower. CONCLUSIONS These findings allow for targeted planning of public-health measures aiming to prevent the effects of extreme temperatures.
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Affiliation(s)
- Claire Demoury
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium.
| | | | - Finaba Berete
- Lifestyle and Chronic Diseases, Sciensano, Brussels, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Bert Van Schaeybroeck
- Department of Meteorological Research and Development, Royal Meteorological Institute of Belgium, Brussels, Belgium
| | | | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
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Zhang R, Peng Z, Meng Y, Song H, Wang S, Bi P, Li D, Zhao X, Yao X, Li Y. Temperature and influenza transmission: Risk assessment and attributable burden estimation among 30 cities in China. ENVIRONMENTAL RESEARCH 2022; 215:114343. [PMID: 36115415 DOI: 10.1016/j.envres.2022.114343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/19/2022] [Accepted: 09/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Many studies have explored the epidemiological characteristics of influenza. However, most previous studies were conducted in a specific region without a national picture which is important to develop targeted strategies and measures on influenza control and prevention. OBJECTIVES To explore the association between ambient temperature and incidence of influenza, to estimate the attributable risk from temperature in 30 Chinese cities with different climatic characteristics for a national picture, and to identify the vulnerable populations for national preventative policy development. METHODS Daily meteorological and influenza incidence data from the 30 Chinese cities over the period 2016-19 were collected. We estimated the city-specific association between daily mean temperature and influenza incidence using a distributed lag non-linear model and evaluated the pooled effects using multivariate meta-analysis. The attributable fractions compared with reference temperature were calculated. Stratified analyses were performed by region, sex and age. RESULTS Overall, an N-shape relationship between temperature and influenza incidence was found in China. The cumulative relative risk of the peak risk temperature (5.1 °C) was 2.13 (95%CI: 1.41, 3.22). And 60% (95%eCI: 54.3%, 64.3%) of influenza incidence was attributed to ambient temperature during the days with sensitive temperatures (1.6°C-14.4 °C). The ranges of sensitive temperatures and the attributable disease burden due to temperatures varied for different populations and regions. The residents in South China and the children aged ≤5 and 6-17 years had higher fractions attributable to sensitive temperatures. CONCLUSIONS Tailored preventions targeting on most vulnerable populations and regions should be developed to reduce influenza burden from sensitive temperatures.
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Affiliation(s)
- Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhibin Peng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yujie Meng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songwang Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Dan Li
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Zhao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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40
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Dawson LP, Andrew E, Nehme Z, Bloom J, Cox S, Anderson D, Stephenson M, Lefkovits J, Taylor AJ, Kaye D, Guo Y, Smith K, Stub D. Temperature-related chest pain presentations and future projections with climate change. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157716. [PMID: 35914598 DOI: 10.1016/j.scitotenv.2022.157716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Climate change has led to increased interest in studying adverse health effects relating to ambient temperatures. It is unclear whether incident chest pain is associated with non-optimal temperatures and how chest pain presentation rates might be affected by climate change. METHODS The study included ambulance data of chest pain presentations in Melbourne, Australia from 1/1/2015 to 30/6/2019 with linkage to hospital and emergency discharge diagnosis data. A time series quasi-Poisson regression with a distributed lag nonlinear model was fitted to assess the temperature-chest pain presentation associations overall and according to age, sex, socioeconomic status, and event location subgroups, with adjustment for season, day of the week and long-term trend. Future excess chest pain presentations associated with cold and heat were projected under six general circulation models under medium and high emission scenarios. RESULTS In 206,789 chest pain presentations, mean (SD) age was 61.2 (18.9) years and 50.3 % were female. Significant heat- and cold-related increased risk of chest pain presentations were observed for mean air temperatures above and below 20.8 °C, respectively. Excess chest pain presentations related to heat were observed in all subgroups, but appeared to be attenuated for older patients (≥70 years), patients of higher socioeconomic status (SES), and patients developing chest pain at home. We projected increases in heat-related chest pain presentations with climate change under both medium- and high-emission scenarios, which are offset by decreases in chest pain presentations related to cold temperatures. CONCLUSIONS Heat- and cold- exposure appear to increase the risk of chest pain presentations, especially among younger patients and patients of lower SES. This will have important implications with climate change modelling of chest pain, in particular highlighting the importance of risk mitigation strategies to minimise adverse health impacts on hotter days.
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Affiliation(s)
- Luke P Dawson
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Emily Andrew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
| | - Ziad Nehme
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Jason Bloom
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia
| | - Shelley Cox
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
| | - David Anderson
- Ambulance Victoria, Melbourne, Victoria, Australia; Department of Intensive Care Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Michael Stephenson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Jeffrey Lefkovits
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Andrew J Taylor
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Victoria, Australia
| | - David Kaye
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia; Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Dion Stub
- Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; The Baker Institute, Melbourne, Victoria, Australia.
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41
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Ng H, Li Y, Zhang T, Lu Y, Wong C, Ni J, Zhao Q. Association between multiple meteorological variables and seasonal influenza A and B virus transmission in Macau. Heliyon 2022; 8:e11820. [DOI: 10.1016/j.heliyon.2022.e11820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/03/2022] [Accepted: 11/15/2022] [Indexed: 11/26/2022] Open
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42
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Jin X, Xu Z, Liang Y, Sun X, Yan S, Wu Y, Li Y, Mei L, Cheng J, Wang X, Song J, Pan R, Yi W, Yang Z, Su H. The modification of air particulate matter on the relationship between temperature and childhood asthma hospitalization: An exploration based on different interaction strategies. ENVIRONMENTAL RESEARCH 2022; 214:113848. [PMID: 35817164 DOI: 10.1016/j.envres.2022.113848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
The influence of temperature on childhood asthma was self-evident, yet the issue of whether the relationship will be synergized by air pollution remains unclear. The study aimed to investigate whether the relationship between short-term temperature exposure and childhood asthma hospitalization was modified by particulate matter (PM). Data on childhood asthma hospitalization, meteorological factors, and air pollutants during 2013-2016 in Hefei, China, were collected. First, a basic Poisson regression model combined with a distributed lag nonlinear model was used to assess the temperature-childhood asthma hospitalization relationship. Then, two interactive strategies were applied to explore the modification effect of PM on the temperature-childhood asthma hospitalization association. We found a greater effect of cold (5th percentile of temperature) on asthma during days with higher PM2.5 (RR: 2.16, 95% CI: 1.38, 3.38) or PM10 (RR: 1.87, 95% CI:1.20, 2.91) than that during days with lower PM2.5 (RR: 1.64, 95% CI: 1.06, 2.54) or PM10 (RR: 1.52, 95% CI: 0.98, 2.36). In addition, we observed a greater modification effect of PM2.5 on the cold-asthma association than did PM10, with a per 10 μg/m3 increase in PM2.5 and PM10 associated with increases of 0.065 and 0.025 for the RR corresponding to the 5th temperature percentile, respectively. For the temperature-related AF, moderate cold showed the largest change magnitude with the PM levels rising compared with other temperature ranges. For the subgroup, Females and those aged 6-18 years were more sensitive to the modification effect of PM2.5 or PM10 on the cold-asthma association. Our findings demonstrated that particulate matter could modify the associations between temperature and childhood asthma hospitalization.
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Affiliation(s)
- Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xu Wang
- Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zeyu Yang
- Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Conte Keivabu R. Extreme Temperature and Mortality by Educational Attainment in Spain, 2012-2018. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2022; 38:1145-1182. [PMID: 36507237 PMCID: PMC9727019 DOI: 10.1007/s10680-022-09641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 08/23/2022] [Indexed: 11/05/2022]
Abstract
Extreme temperatures are a threat to public health, increasing mortality in the affected population. Moreover, there is substantial research showing how age and gender shape vulnerabilities to this environmental risk. However, there is only limited knowledge on how socioeconomic status (SES), operationalized using educational attainment, stratifies the effect of extreme temperatures on mortality. Here, we address this link using Poisson regression and administrative data from 2012 to 2018 for 50 Spanish Provinces on individuals aged above 65 matched with meteorological data provided by the E-OBS dataset. In line with previous studies, results show that hot and cold days increase mortality. Results on the interaction between SES and extreme temperatures show a positive and significant effect of exposure to heat and cold for individuals with medium and low SES level. Conversely, for high SES individuals we do not find evidence of a robust association with heat or cold. We further investigate how the local climate moderates these associations. A warmer climate increases risks with exposures to low temperatures and vice versa for hot temperatures in the pooled sample. Moreover, we observe that results are mostly driven by low SES individuals being particularly vulnerable to heat in colder climates and cold in warmer climates. In conclusion, results highlight how educational attainment stratifies the effect of extreme temperatures and the relevance of the local climate in shaping risks of low SES individuals aged above 65.
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Affiliation(s)
- Risto Conte Keivabu
- Department of Social and Political Sciences, European University Institute, Via della Badia dei Rocettini 9, 50014, San Domenico di Fiesole, Italy.
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Zhang Y, Tian Q, Feng X, Hu W, Ma P, Xin J, Wang S, Zheng C. Modification effects of ambient temperature on ozone-mortality relationships in Chengdu, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73011-73019. [PMID: 35618998 DOI: 10.1007/s11356-022-20843-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
A multitude of epidemiological studies have demonstrated that both ambient temperatures and air pollution are closely related to health outcomes. However, whether temperature has modification effects on the association between ozone and health outcomes is still debated. In this study, three parallel time-series Poisson generalized additive models (GAMs) were used to examine the effects of modifying ambient temperatures on the association between ozone and mortality (including non-accidental, respiratory, and cardiovascular mortality) in Chengdu, China, from 2014 to 2016. The results confirmed that the ambient high temperatures strongly amplified the adverse effects of ozone on human mortality; specifically, the ozone effects were most pronounced at > 28 °C. Without temperature stratification conditions, a 10-μg/m3 increase in the maximum 8-h average ozone (O3-8hmax) level at lag01 was associated with increases of 0.40% (95% confidence interval [CI] 0.15%, 0.65%), 0.61% (95% CI 0.27%, 0.95%), and 0.69% (95% CI 0.34%, 1.04%) in non-accidental, respiratory, and cardiovascular mortality, respectively. On days during which the temperature exceeded 28 °C, a 10-μg/m3 increase in O3-8hmax led to increases of 2.22% (95% CI 1.21%, 3.23%), 2.67% (95% CI 0.57%, 4.76%), and 4.13% (95% CI 2.34%, 5.92%) in non-accidental, respiratory, and cardiovascular mortality, respectively. Our findings validated that high temperature could further aggravate the health risks of O3-8hmax; thus, mitigating ozone exposure will be brought into the limelight especially under the context of changing climate.
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Affiliation(s)
- Ying Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China.
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China.
| | - Qiqi Tian
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China
| | - Xinyuan Feng
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China
| | - Wendong Hu
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China
| | - Pan Ma
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China.
| | - Jinyuan Xin
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China.
| | - Shigong Wang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Plain Urban Meteorology and Environment Observation and Research Station of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, ChengduChengdu, 610225, Sichuan, China
| | - Canjun Zheng
- Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, 102206, China
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Luo C, Qian J, Liu Y, Lv Q, Ma Y, Yin F. Long-term air pollution levels modify the relationships between short-term exposure to meteorological factors, air pollution and the incidence of hand, foot and mouth disease in children: a DLNM-based multicity time series study in Sichuan Province, China. BMC Public Health 2022; 22:1484. [PMID: 35927638 PMCID: PMC9351082 DOI: 10.1186/s12889-022-13890-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies have investigated the short-term effects of meteorological factors and air pollution on the incidence of hand, foot, and mouth disease (HFMD). Several meteorological indicators, such as relative humidity and the diurnal temperature range (DTR), significantly modify the relationship between short-term exposure to temperature and HFMD incidence. However, it remains unclear whether (and how) long-term air pollution levels modify the short-term relationships of HFMD incidence with meteorological factors and air pollution. METHODS We obtained daily data on meteorological factors, air pollutants, and HFMD counts in children from 21 prefecture-level cities in Sichuan Province in Southwest China from 2015 to 2017. First, we constructed a distributed lag nonlinear model (DLNM) at each prefecture-level site to evaluate the short-term impacts of meteorological variables and air pollutants on HFMD incidence. Then, we assessed the pooled effects of the exposures and incorporated long-term city-specific air pollutant indicators as meta-predictors to examine their potential modification effects by performing multivariate meta-regression models. RESULTS We found that long-term SO2 and CO concentrations significantly modified the short-term relationships between climatic variables and HFMD incidence. Specifically, high concentrations of CO (P = 0.027) and SO2 (P = 0.039) reduced the risk of HFMD at low temperatures. The relationship between relative humidity and HFMD incidence was weakened at high SO2 concentrations (P = 0.024), especially when the relative humidity was below the median level. When the minimum relative humidity (32%) was compared to the median relative humidity (77%), the risk ratio (RR) was 0.77 (95% CI: 0.51-1.17) in the 90th percentile of SO2 (19.6 μg/m3) and 0.41 (95% CI: 0.27-0.64) in the 10th percentile of SO2 (10.6 μg/m3). CONCLUSION Our results indicated that long-term SO2 and CO levels modified the short-term associations between HFMD incidence in children and meteorological variables. These findings may inform health authorities to optimize targeted public health policies including reducing ambient air pollution and reinforcing self-protective actions to weaken the adverse health impacts of environmental factors on HFMD incidence.
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Affiliation(s)
- Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Jian Qian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
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Michetti M, Gualtieri M, Anav A, Adani M, Benassi B, Dalmastri C, D'Elia I, Piersanti A, Sannino G, Zanini G, Uccelli R. Climate change and air pollution: Translating their interplay into present and future mortality risk for Rome and Milan municipalities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 830:154680. [PMID: 35314224 DOI: 10.1016/j.scitotenv.2022.154680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Heat and cold temperatures associated with exposure to poor air quality lead to increased mortality. Using a generalized linear model with Poisson regression for overdispersion, this study quantifies the natural-caused mortality burden attributable to heat/cold temperatures and PM10 and O3 air pollutants in Rome and Milan, the two most populated Italian cities. We calculate local-specific mortality relative risks (RRs) for the period 2004-2015 considering the overall population and the most vulnerable age category (≥85 years). Combining a regional climate model with a chemistry-transport model under future climate and air pollution scenarios (RCP2.6 and RCP8.5), we then project mortality to 2050. Results show that for historical mortality the burden is much larger for cold than for warm temperatures. RR peaks during wintertime in Milan and summertime in Rome, highlighting the relevance of accounting for the effects of air pollution besides that of climate, in particular PM10 for Milan and O3 for Rome. Overall, Milan reports higher RRs while, in both cities, the elderly appear more susceptible to heat/cold and air pollution events than the average population. Two counterbalancing effects shape mortality in the future: an increase associated with higher and more frequent warmer daily temperatures - especially in the case of climate inaction - and a decrease due to declining cold-mortality burden. The outcomes highlight the urgent need to adopt more stringent and integrated climate and air quality policies to reduce the temperature and air pollution combined effects on health.
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Affiliation(s)
- M Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy.
| | - M Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - A Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - M Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - B Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - C Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - I D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, 00196 Rome, Italy
| | - A Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - G Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - G Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - R Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
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Koo GPY, Zheng H, Pek PP, Hughes F, Lim SL, Yeo JW, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148476. [PMID: 35886328 PMCID: PMC9318360 DOI: 10.3390/ijerph19148476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Office, Health Promotion Board, Singapore 168937, Singapore;
| | - Pin Pin Pek
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
| | - Fintan Hughes
- Department of Anesthesiology, Duke University Hospital, Duke University, Durham, NC 27710, USA;
| | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore;
- Department of Medicine, National University Singapore, Singapore 119228, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School Singapore, Singapore 169857, Singapore
- Correspondence:
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48
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Steenland K, Vu B, Scovronick N. Effect modification by maximum temperature of the association between PM 2.5 and short-term cardiorespiratory mortality and emergency room visits in Lima, Peru, 2010-2016. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:590-595. [PMID: 34657126 PMCID: PMC9012782 DOI: 10.1038/s41370-021-00393-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The health effects of fine particulate matter (PM2.5) may be worse at higher temperatures. OBJECTIVE To investigate temperature's effect on PM2.5-mortality/morbidity associations in Lima, Peru. METHODS Time-series regressions relating PM2.5 and temperature to mortality and emergency room (ER) visits during 2010-2016. Daily PM2.5 levels (assigned to 40 Lima districts) and daily maximum temperature (Lima-wide) were estimated based on ground monitors, remote sensing, and modeling. We analyzed all-cause, cardiovascular (ICD codes I00-I99), and respiratory (ICD codes J00-J99) mortality, and cardiovascular and respiratory causes for ER visits. RESULTS The average PM2.5 concentration was 20.9 µg/m3 (IQR 17.5-23.5). The mean daily maximum temperature was 23.8 °C (IQR 20.8-26.9). PM2.5's effect on all-cause, respiratory, and circulatory disease mortality was significantly (p < 0.05) stronger at temperatures above the maximum temperature median. The rate ratios per increase of 10 µg/m3 of PM2.5 for all cause, respiratory, and circulatory mortality respectively were 1.03 (1.00-1.06), 1.04 (0.98-1.10), and 1.04 (0.98-1.10) at temperatures below the median, vs. 1.08 (1.04-1.12), 1.11 (1.03-1.19), and 1.14 (1.05-1.25) when temperatures were above the median. Results were analogous for ER visits for respiratory but not circulatory disease. SIGNIFICANCE Results strengthen the evidence that air pollution may be more dangerous when temperatures are higher. IMPACT Our data contribute to a growing body of literature which indicates that the damaging effects of PM2.5 may be worse at higher temperature, adding new evidence from Lima, Peru.
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Affiliation(s)
| | - Bryan Vu
- Corresponding author: Kyle Steenland,
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Abstract
Rationale: Avoiding excess health damages attributable to climate change is a primary motivator for policy interventions to reduce greenhouse gas emissions. However, the health benefits of climate mitigation, as included in the policy assessment process, have been estimated without much input from health experts. Objectives: In accordance with recommendations from the National Academies in a 2017 report on approaches to update the social cost of greenhouse gases (SC-GHG), an expert panel of 26 health researchers and climate economists gathered for a virtual technical workshop in May 2021 to conduct a systematic review and meta-analysis and recommend improvements to the estimation of health impacts in economic-climate models. Methods: Regionally resolved effect estimates of unit increases in temperature on net all-cause mortality risk were generated through random-effects pooling of studies identified through a systematic review. Results: Effect estimates and associated uncertainties varied by global region, but net increases in mortality risk associated with increased average annual temperatures (ranging from 0.1% to 1.1% per 1°C) were estimated for all global regions. Key recommendations for the development and utilization of health damage modules were provided by the expert panel and included the following: not relying on individual methodologies in estimating health damages; incorporating a broader range of cause-specific mortality impacts; improving the climate parameters available in economic models; accounting for socioeconomic trajectories and adaptation factors when estimating health damages; and carefully considering how air pollution impacts should be incorporated in economic-climate models. Conclusions: This work provides an example of how subject-matter experts can work alongside climate economists in making continued improvements to SC-GHG estimates.
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Hu X, Han W, Wang Y, Aunan K, Pan X, Huang J, Li G. Does air pollution modify temperature-related mortality? A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 210:112898. [PMID: 35181304 DOI: 10.1016/j.envres.2022.112898] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION There is an increasing interest in understanding whether air pollutants modify the quantitative relationships between temperature and health outcomes. The results of available studies were, however, inconsistent. This study aims to sum up the current evidence and provide a comprehensive understanding of this topic. METHODS We conducted an electronic search in PubMed (MEDLINE), EMBASE, Web of Science Core Collection, and ProQuest Dissertations and Theses. The modified Navigation Guide was applied to evaluate the quality and strength of evidence. We calculated pooled temperature-related mortality at low and high pollutant levels respectively, using the random-effects model. RESULTS We identified 22 eligible studies, eleven of which were included in the meta-analysis. Significant effect modification was observed on heat effects for all-cause and non-accidental mortality by particulate matter with an aerodynamic diameter of <10 μm (PM10) and ozone (O3) (p < 0.05). The excess risks (ERs) for all-cause and non-accidental mortality were 5.4% (4.4%, 6.4%) and 6.3% (4.8%, 7.8%) at the low PM10 level, 8.8% (7.5%, 10.1%) and 11.4% (8.7%, 14.2%) at the high PM10 level, respectively. As for O3, the ERs for all-cause and non-accidental mortality were 5.1% (3.9%, 6.3%) and 3.6% (0.1%, 7.2%) at the low O3 level, 7.6% (6.3%, 9.0%) and 12.5% (4.7%, 20.9%) at the high O3 level, respectively. Surprisingly, the heat effects on cardiovascular mortality were found to be lower at high carbon monoxide (CO) levels [ERs = 5.4% (3.9%, 6.9%)] than that at low levels [ERs = 9.4% (7.0%, 11.9%)]. The heterogeneity varied, but the results of sensitivity analyses were generally robust. Significant effect modification by air pollutants was not observed for heatwave or cold effects. CONCLUSIONS PM10 and O3 modify the heat-related all-cause and non-accidental mortality, indicating that policymakers should consider air pollutants when establishing heat-health warning systems. Future studies with comparable designs and settings are needed.
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Affiliation(s)
- Xin Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wenxing Han
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Kristin Aunan
- CICERO Center for International Climate Research, N-0318, Oslo, Norway
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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