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Sun X, Lin X, Yao J, Tian T, Li Z, Chen S, Hu W, Jiang J, Tang H, Cai H, Guo T, Chen X, Chen Z, Zhang M, Sun Y, Lin S, Qu Y, Deng X, Lin Z, Xia L, Jin Y, Zhang W. Potential causal links of long-term exposure to PM 2.5 and its chemical components with the risk of nasopharyngeal carcinoma recurrence: A 10-year cohort study in South China. Int J Cancer 2024. [PMID: 38863244 DOI: 10.1002/ijc.35047] [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: 03/25/2024] [Revised: 04/27/2024] [Accepted: 05/10/2024] [Indexed: 06/13/2024]
Abstract
There is a lack of evidence from cohort studies on the causal association of long-term exposure to ambient fine particulate matter (PM2.5) and its chemical components with the risk of nasopharyngeal carcinoma (NPC) recurrence. Based on a 10-year prospective cohort of 1184 newly diagnosed NPC patients, we comprehensively evaluated the potential causal links of ambient PM2.5 and its chemical components including black carbon (BC), organic matter (OM), sulfate (SO4 2-), nitrate (NO3 -), and ammonium (NH4 +) with the recurrence risk of NPC using a marginal structural Cox model adjusted with inverse probability weighting. We observed 291 NPC patients experiencing recurrence during the 10-year follow-up and estimated a 33% increased risk of NPC recurrence (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.02-1.74) following each interquartile range (IQR) increase in PM2.5 exposure. Each IQR increment in BC, NH4 +, OM, NO3 -, and SO4 2- was associated with HRs of 1.36 (95%CI: 1.13-1.65), 1.35 (95%CI: 1.07-1.70), 1.33 (95%CI: 1.11-1.59), 1.32 (95%CI: 1.06-1.64), 1.31 (95%CI: 1.08-1.57). The elderly, patients with no family history of cancer, no smoking history, no drinking history, and those with severe conditions may exhibit a greater likelihood of NPC recurrence following exposure to PM2.5 and its chemical components. Additionally, the effect estimates of the five components are greater among patients who were exposed to high concentration than in the full cohort of patients. Our study provides solid evidence for a potential relationship between long-term exposure to PM2.5 and its components and the risk of NPC recurrence.
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Affiliation(s)
- Xurui Sun
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jijin Yao
- The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Biomedical Imaging, Zhuhai, China
| | - Tian Tian
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shimin Chen
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Jie Jiang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Hui Tang
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Huanle Cai
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Tong Guo
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xudan Chen
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhibing Chen
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Man Zhang
- Hospital Infection Control Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yongqing Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xinlei Deng
- Analytics Department, Novartis Pharmaceuticals UK Ltd, Novartis Pharma AG, London, UK
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Liangping Xia
- VIP Region, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yanan Jin
- The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Biomedical Imaging, Zhuhai, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Health & Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
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Li D, Shi T, Meng L, Zhang X, Li R, Wang T, Zhao X, Zheng H, Ren X. An association between PM 2.5 components and respiratory infectious diseases: A China's mainland-based study. Acta Trop 2024; 254:107193. [PMID: 38604327 DOI: 10.1016/j.actatropica.2024.107193] [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: 12/12/2023] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
The particulate matter with diameter of less than 2.5 µm (PM2.5) is an important risk factor for respiratory infectious diseases, such as scarlet fever, tuberculosis, and similar diseases. However, it is not clear which component of PM2.5 is more important for respiratory infectious diseases. Based on data from 31 provinces in mainland China obtained between 2013 and 2019, this study investigated the effects of different PM2.5 components, i.e., sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), and organic matter (OM), and black carbon (BC), on respiratory infectious diseases incidence [pulmonary tuberculosis (PTB), scarlet fever (SF), influenza, hand, foot, and mouth disease (HFMD), and mumps]. Geographical probes and the Bayesian kernel machine regression (BKMR) model were used to investigate correlations, single-component effects, joint effects, and interactions between components, and subgroup analysis was used to assess regional and temporal heterogeneity. The results of geographical probes showed that the chemical components of PM2.5 were associated with the incidence of respiratory infectious diseases. BKMR results showed that the five components of PM2.5 were the main factors affecting the incidence of respiratory infectious diseases (PIP>0.5). The joint effect of influenza and mumps by co-exposure to the components showed a significant positive correlation, and the exposure-response curve for a single component was approximately linear. And single-component modelling revealed that OM and BC may be the most important factors influencing the incidence of respiratory infections. Moreover, respiratory infectious diseases in southern and southwestern China may be less affected by the PM2.5 component. This study is the first to explore the relationship between different components of PM2.5 and the incidence of five common respiratory infectious diseases in 31 provinces of mainland China, which provides a certain theoretical basis for future research.
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Affiliation(s)
- Donghua Li
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Tianshan Shi
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Lei Meng
- Gansu Provincial Center for Disease Control and Prevention, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Xiaoshu Zhang
- Gansu Provincial Center for Disease Control and Prevention, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Rui Li
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Tingrong Wang
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Xin Zhao
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Hongmiao Zheng
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China
| | - Xiaowei Ren
- School of Public Health, Lanzhou University, Chengguan District, Lanzhou City, Gansu Province 730000, China.
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Chen S, Liu D, Huang L, Guo C, Gao X, Xu Z, Yang Z, Chen Y, Li M, Yang J. Global associations between long-term exposure to PM 2.5 constituents and health: A systematic review and meta-analysis of cohort studies. JOURNAL OF HAZARDOUS MATERIALS 2024; 474:134715. [PMID: 38838524 DOI: 10.1016/j.jhazmat.2024.134715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
Existing studies on the most impactful component remain controversial, hindering the optimization of future air quality standards that concerns particle composition. We aimed to summarize the health risk associated with PM2.5 components and identify those components with the greatest health risk. We performed a meta-analysis to quantify the combined health effects of PM2.5 components, and used the meta-smoothing to produce the pooled concentration-response (C-R) curves. Out of 8954 initial articles, 80 cohort studies met the inclusion criteria, including a total of 198.08 million population. The pooled C-R curves demonstrated approximately J-shaped association between total mortality and exposure to BC, and NO3-, but U-shaped and inverted U-shaped relationship withSO42- and OC, respectively. In addition, this study found that exposure to various elements, including BC,SO42-NO3-, NH4+, Zn, Ni, and Si, were significantly associated with an increased risk of total mortality, with Ni presenting the largest estimate. And exposure to NO3-, Zn, and Si was positively associated with an increased risk of respiratory mortality, while exposure to BC, SO42-, and NO3- showed a positive association with risk of cardiovascular mortality. For health outcome of morbidity, BC was notably associated with a higher incidence of asthma, type 2 diabetes and stroke. Subgroup analysis revealed a higher susceptibility to PM2.5 components in Asia compared to Europe and North America, and females showed a higher vulnerability. Given the significant health effects of PM2.5 components, governments are advised to introduce them in regional monitoring and air quality control guidelines. ENVIRONMENTAL IMPLICATION: PM2.5 is a complex mixture of chemical components from various sources, and each component has unique physicochemical properties and uncertain toxicity, posing significant threat to public health. This study systematically reviewed cohort studies on the association between long-term exposure to 13 PM2.5 components and the risk of morbidity and mortality. And we applied the meta-smoothing approach to establish the pooled concentration-response associations between PM2.5 components and mortality globally. Our findings will provide strong support for PM2.5 components monitoring and the improvement of air quality-related regulations. This will aid in helping to enhance health intervention strategies and mitigating public exposure to detrimental particulate matter.
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Affiliation(s)
- Sujuan Chen
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, China; School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Di Liu
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Lin Huang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Cui Guo
- Department of Urban Planning and Design, Faculty of Architecture, the University of Hong Kong, Hong Kong SAR
| | - Xiaoke Gao
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yu Chen
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Mengmeng Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, China; School of Public Health, Guangzhou Medical University, Guangzhou 511436, China.
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Mansouri R, Lavigne E, Talarico R, Smargiassi A, Rodriguez-Villamizar LA, Villeneuve PJ. Residential surrounding greenness and the incidence of childhood asthma: Findings from a population-based cohort in Ontario, Canada. ENVIRONMENTAL RESEARCH 2024; 249:118316. [PMID: 38301756 DOI: 10.1016/j.envres.2024.118316] [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: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Several epidemiological studies have investigated the possible role that living in areas with greater amounts of greenspace has on the incidence of childhood asthma. These findings have been inconsistent, and few studies explored the relevance of timing of exposure. We investigated the role of residential surrounding greenness on the risk of incident asthma using a population-based retrospective cohort study. We included 982,131 singleton births in Ontario, Canada between 2006 and 2013. Two measures of greenness, the Normalized Difference Vegetation Index (NDVI) and the Green View Index (GVI), were assigned to the residential histories of these infants from pregnancy through to 12 years of age. Longitudinally-based diagnoses of asthma were determined by using provincial administrative health data. The extended Cox hazards model was used to characterize associations between greenness measures and asthma (up to age 12 years) while adjusting for several risk factors. In a fully adjusted model, that included a term for traffic-related air pollution (NO2), we found no association between an interquartile range increase (0.08) of the NDVI during childhood and asthma incidence (HR = 0.99; 95 % CI = 0.99-1.01). In contrast, we found that an 0.08 increase in NDVI during childhood reduced the risk of asthma in children 7-12 years of age by 14 % (HR = 0.86, 95 % CI:0.79-0.95). Seasonal differences in the association between greenness and asthma were noted. Our findings suggest that residential proximity to greenness reduces the risk of asthma in children aged 7-12.
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Affiliation(s)
- Razieh Mansouri
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, 960 Carling Avenue, Ottawa, Ontario, Canada.
| | - Robert Talarico
- Institute for Clinical Evaluative Sciences, 1053 Carling Avenue, Ottawa, Ontario, Canada.
| | - Audrey Smargiassi
- Center for Public Health Research (CReSP), University of Montreal and CIUSSS Du Centre-Sud-de-l'Île-de-Montréal, 7101 Av Du Parc, Montreal, Quebec, Canada.
| | - Laura A Rodriguez-Villamizar
- Department of Public Health, Universidad Industrial de Santander, Carrera 32 29-31, Bucaramanga, Colombia; Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada.
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Zhou X, Sampath V, Nadeau KC. Effect of air pollution on asthma. Ann Allergy Asthma Immunol 2024; 132:426-432. [PMID: 38253122 PMCID: PMC10990824 DOI: 10.1016/j.anai.2024.01.017] [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: 01/12/2024] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
Asthma is a chronic inflammatory airway disease characterized by respiratory symptoms, variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Exposure to air pollution has been linked to an increased risk of asthma development and exacerbation. This review aims to comprehensively summarize recent data on the impact of air pollution on asthma development and exacerbation. Specifically, we reviewed the effects of air pollution on the pathogenic pathways of asthma, including type 2 and non-type 2 inflammatory responses, and airway epithelial barrier dysfunction. Air pollution promotes the release of epithelial cytokines, driving TH2 responses, and induces oxidative stress and the production of proinflammatory cytokines. The enhanced type 2 inflammation, furthered by air pollution-induced dysfunction of the airway epithelial barrier, may be associated with the exacerbation of asthma. Disruption of the TH17/regulatory T cell balance by air pollutants is also related to asthma exacerbation. As the effects of air pollution exposure may accumulate over time, with potentially stronger impacts in the development of asthma during certain sensitive life periods, we also reviewed the effects of air pollution on asthma across the lifespan. Future research is needed to better characterize the sensitive period contributing to the development of air pollution-induced asthma and to map air pollution-associated epigenetic biomarkers contributing to the epigenetic ages onto asthma-related genes.
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Affiliation(s)
- Xiaoying Zhou
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Vanitha Sampath
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kari C Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Chen Y, Guo C, Chung MK, Yi Q, Wang X, Wang Y, Jiang B, Liu Y, Lan M, Lin L, Cai L. The Associations of Prenatal Exposure to Fine Particulate Matter and Its Chemical Components with Allergic Rhinitis in Children and the Modification Effect of Polyunsaturated Fatty Acids: A Birth Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47010. [PMID: 38630604 PMCID: PMC11060513 DOI: 10.1289/ehp13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFAs) have been shown to protect against fine particulate matter < 2.5 μ m in aerodynamic diameter (PM 2.5 )-induced hazards. However, limited evidence is available for respiratory health, particularly in pregnant women and their offspring. OBJECTIVES We aimed to investigate the association of prenatal exposure to PM 2.5 and its chemical components with allergic rhinitis (AR) in children and explore effect modification by maternal erythrocyte PUFAs. METHODS This prospective birth cohort study involved 657 mother-child pairs from Guangzhou, China. Prenatal exposure to residential PM 2.5 mass and its components [black carbon (BC), organic matter (OM), sulfate (SO 4 2 - ), nitrate (NO 3 - ), and ammonium (NH 4 + )] were estimated by an established spatiotemporal model. Maternal erythrocyte PUFAs during pregnancy were measured using gas chromatography. The diagnosis of AR and report of AR symptoms in children were assessed up to 2 years of age. We used Cox regression with the quantile-based g-computation approach to assess the individual and joint effects of PM 2.5 components and examine the modification effects of maternal PUFA levels. RESULTS Approximately 5.33 % and 8.07% of children had AR and related symptoms, respectively. The average concentration of prenatal PM 2.5 was 35.50 ± 5.31 μ g / m 3 . PM 2.5 was positively associated with the risk of developing AR [hazard ratio ( HR ) = 1.85 ; 95% confidence interval (CI): 1.16, 2.96 per 5 μ g / m 3 ] and its symptoms (HR = 1.79 ; 95% CI: 1.22, 2.62 per 5 μ g / m 3 ) after adjustment for confounders. Similar associations were observed between individual PM 2.5 components and AR outcomes. Each quintile change in a mixture of components was associated with an adjusted HR of 3.73 (95% CI: 1.80, 7.73) and 2.69 (95% CI: 1.55, 4.67) for AR and AR symptoms, with BC accounting for the largest contribution. Higher levels of n-3 docosapentaenoic acid and lower levels of n-6 linoleic acid showed alleviating effects on AR symptoms risk associated with exposure to PM 2.5 and its components. CONCLUSION Prenatal exposure to PM 2.5 and its chemical components, particularly BC, was associated with AR/symptoms in early childhood. We highlight that PUFA biomarkers could modify the adverse effects of PM 2.5 on respiratory allergy. https://doi.org/10.1289/EHP13524.
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Affiliation(s)
- Yujing Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Cuihua Guo
- Department of Children Health Care, Dongguan Children’s Hospital, Dongguan, Guangdong, China
| | - Ming Kei Chung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Quanying Yi
- Department of Children Health Care, Dongguan Children’s Hospital, Dongguan, Guangdong, China
| | - Xin Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, Guangdong, China
| | - Yuxuan Wang
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Bibo Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Minyan Lan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lizi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Vaccarella E, Piacentini D, Falasca G, Canepari S, Massimi L. In-vivo exposure of a plant model organism for the assessment of the ability of PM samples to induce oxidative stress. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 900:165694. [PMID: 37516174 DOI: 10.1016/j.scitotenv.2023.165694] [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: 04/17/2023] [Revised: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
This study aims to propose an innovative, simple, rapid, and cost-effective method to study oxidative stress induced by PM through in-vivo exposure of the plant model organism Arabidopsis thaliana. A. thaliana seedlings were exposed to urban dust certified for its elemental content and to PM2.5 samples collected in an urban-industrial area of Northern Italy. An innovative technique for the detachment and suspension in water of the whole intact dust from membrane filters was applied to expose the model organism to both the soluble and insoluble fractions of PM2.5, which were analyzed for 34 elements by ICP-MS. Oxidative stress induced by PM on A. thaliana was assessed by light microscopic localization and UV-Vis spectrophotometric determination of superoxide anion (O2-) content on the exposed seedlings by using the nitro blue tetrazole (NBT) assay. The results showed a good efficiency and sensitivity of the method for PM mass concentrations >20 μg m-3 and an increase in O2- content in all exposed seedlings, which mainly depends on the concentration, chemical composition, and sources of the PM administered to the model organism. Particles released by biomass burning appeared to contribute more to the overall toxicity of PM. This method was found to be cost-effective and easy to apply to PM collected on membrane filters in intensive monitoring campaigns in order to obtain valuable information on the ability of PM to generate oxidative stress in living organisms.
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Affiliation(s)
- Emanuele Vaccarella
- Department of Environmental Biology, Sapienza University of Rome, P. le Aldo Moro, 5, Rome 00185, Italy
| | - Diego Piacentini
- Department of Environmental Biology, Sapienza University of Rome, P. le Aldo Moro, 5, Rome 00185, Italy
| | - Giuseppina Falasca
- Department of Environmental Biology, Sapienza University of Rome, P. le Aldo Moro, 5, Rome 00185, Italy
| | - Silvia Canepari
- Department of Environmental Biology, Sapienza University of Rome, P. le Aldo Moro, 5, Rome 00185, Italy; C.N.R. Institute of Atmospheric Pollution Research, Via Salaria, Km 29,300, Monterotondo St., Rome 00015, Italy
| | - Lorenzo Massimi
- Department of Environmental Biology, Sapienza University of Rome, P. le Aldo Moro, 5, Rome 00185, Italy; C.N.R. Institute of Atmospheric Pollution Research, Via Salaria, Km 29,300, Monterotondo St., Rome 00015, Italy.
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8
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Aithal SS, Sachdeva I, Kurmi OP. Air quality and respiratory health in children. Breathe (Sheff) 2023; 19:230040. [PMID: 37377853 PMCID: PMC10292770 DOI: 10.1183/20734735.0040-2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/14/2023] [Indexed: 06/29/2023] Open
Abstract
Air pollution is a leading modifiable risk factor for various cardio-respiratory outcomes globally, both for children and for adults. Children are particularly susceptible to the adverse effects of air pollution due to various physiological and behavioural factors. Children are at a higher risk of outcomes such as acute respiratory infections, asthma and decreased lung function due to air pollution exposure; the risk varies in different geographical regions, depending on the source of air pollution, duration of exposures and concentration. Prenatal exposure to air pollution may also contribute to adverse respiratory outcomes later in life.
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Affiliation(s)
| | - Ishaan Sachdeva
- Department of Mathematics and Sciences, Brock University, St. Catharines, ON, Canada
| | - Om P. Kurmi
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, ON, Canada
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare, McMaster University, Hamilton, ON, Canada
- Faculty Centre for Intelligent Healthcare, Coventry University, Coventry, UK
- Nexus Institute of Research and Innovation, Lalitpur, Nepal
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9
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Anita WM, Ueda K, Uttajug A, Seposo XT, Takano H. Association between Long-Term Ambient PM2.5 Exposure and under-5 Mortality: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3270. [PMID: 36833969 PMCID: PMC9961703 DOI: 10.3390/ijerph20043270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Studies have established a link between exposure to fine particles (PM2.5) and mortality in infants and children. However, few studies have explored the association between post-birth exposure to PM2.5 and under-5 mortality. We conducted a scoping review to identify relevant epidemiological evidence on the association between post-birth ambient PM2.5 exposure and under-5 mortality. We searched PubMed and Web of Science for articles published between 1970 and the end of January 2022 that explicitly linked ambient PM2.5 and under-5 mortality by considering the study area, study design, exposure window, and child age. Information was extracted on the study characteristics, exposure assessment and duration, outcomes, and effect estimates/findings. Ultimately, 13 studies on infant and child mortality were selected. Only four studies measured the effect of post-birth exposure to PM2.5 on under-5 mortality. Only one cohort study mentioned a positive association between post-birth ambient PM2.5 exposure and under-5 mortality. The results of this scoping review highlight the need for extensive research in this field, given that long-term exposure to ambient PM2.5 is a major global health risk and child mortality remains high in some countries.
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Affiliation(s)
- Wahida Musarrat Anita
- Graduate School of Global Environmental Studies (GSGES), Kyoto University, Kyoto 615-8540, Japan
| | - Kayo Ueda
- Graduate School of Global Environmental Studies (GSGES), Kyoto University, Kyoto 615-8540, Japan
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido 060-8638, Japan
| | - Athicha Uttajug
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido 060-8638, Japan
| | - Xerxes Tesoro Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido 060-8638, Japan
| | - Hirohisa Takano
- Graduate School of Global Environmental Studies (GSGES), Kyoto University, Kyoto 615-8540, Japan
- Graduate School of Engineering, Kyoto University, Kyoto 615-8540, Japan
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10
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Han Y, Yu X, Lu Y, Shen Y, Wang X, Wei H, Ni K, Qu J, Chen G. Di-(2-ethylhexyl) phthalate aggravates fine particulate matter-induced asthma in weanling mice due to T follicular helper cell-dependent response. Toxicology 2023; 484:153406. [PMID: 36549504 DOI: 10.1016/j.tox.2022.153406] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/15/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Environmental pollutants fine particulate matter and di-(2-ethylhexyl) phthalate (DEHP) are believed to be the risk factors for childhood asthma. Allergic asthma is basically an immediate hypersensitivity mediated by IgE, the product of humoral immune response. T follicular helper cells (Tfh) have been newly identified as the crucial T helper cells for supporting B cells to produce immunoglobulins in humoral immunity. Tfh cells are therefore potentially to serve as the diagnostic marker and therapeutic target of immune diseases. In this study, we examined the joint effects of fine particulate matter and DEHP on the initiation and progression of asthma and explored the fundamental role of Tfh cells during the process. Weanling C57BL/6 mice (both sexes) were concurrently exposed to DEHP (intragastric administration at 300 μg/kg) and fine atmospheric particulate matter (mean particle diameter < 4 µm, PM4) (oropharyngeal instillation at 2 mg/kg) once every three days for 30 days (10 times). We found that DEHP displayed adjuvant effects to potentiate PM4 allergen-induced expansion of Tfh and plasma cells, production of serum IgE and IgG1, and occurrence of airway hyper-responsiveness and inflammation. Then PM4 and DEHP co-exposure was performed to Cd4 knock-out mice reconstituted with normal wild-type adoptive Tfh cells or non-Tfh cells. The results of immune adoptive transfusion indicated that the joint immunotoxic effects of PM4 and DEHP were dependent on Tfh cells. We further proved that DEHP could adjuvantly boost PM4-induced expression of BCL-6 and c-MAF and secretion of IL-13 and IL-4 in Tfh cells. In conclusion, these data suggest that DEHP metabolites act in an adjuvant-like manner to aggravate PM4 allergen-induced asthma based on anaphylactic IgE response, resulting from excessive IL-13 and IL-4 synthesized by abnormally differentiated Tfh cells.
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Affiliation(s)
- Yu Han
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China.
| | - Xiangjun Yu
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China
| | - Ying Lu
- Department of Nutrition and Food Hygiene, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China
| | - Yi Shen
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China
| | - Xiaoying Wang
- Department of Immunology, Medical College, Nantong University, Nantong 226001, Jiangsu, PR China
| | - Haiyan Wei
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China
| | - Kaihua Ni
- Department of Pediatrics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, PR China
| | - Jianhua Qu
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China.
| | - Gang Chen
- Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of Environmental Toxicology, College of Public Health, Nantong University, Nantong 226019, Jiangsu, PR China.
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11
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Chen IL, Chung HW, Hsieh HM, Chen SC, Chen HC, Lin YC, Hung CH. The prenatal and postnatal effects of air pollution on asthma in children with atopic dermatitis. Pediatr Pulmonol 2022; 57:2724-2734. [PMID: 35927981 DOI: 10.1002/ppul.26089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/21/2022] [Accepted: 07/16/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Air pollution is strongly associated with asthma, but has not been determined to induce new-onset asthma development in children with atopic dermatitis (AD). WORKING HYPOTHESIS To assess whether prenatal/postnatal exposure to air pollutants triggers new-onset asthma development in children with AD. STUDY DESIGN Retrospective cohort study. PATIENT-SUBJECT SELECTION Data of patients <age 18 years diagnosed with eczema or AD between 2009 and 2019 were extracted from the multicenter Kaohsiung Medical University Hospital Research Database. Patients diagnosed with new-onset asthma were in the asthma group and patients without asthma history were in the non-asthma group. METHODOLOGY The monthly average concentration of air pollutants for 1, 3, and 5 years before the index date, and 3, 6, and 9 months prenatally were analyzed and further stratified by age, immunoglobulin (Ig) E, and the percentage of eosinophil and eosinophil cationic protein (ECP). RESULTS Postnatal exposure to airborne particulate matter (PM2.5 , PM10 ), sulfur dioxide (SO2 ), ozone (O3 ), carbon monoxide (CO), nitric oxide (NO), nitric dioxide (NO2 ), and NOx , and prenatal exposure to PM2.5 , PM10 , SO2 , NO, and NOx were significantly higher in the asthma group than in the non-asthma group. Patients having IgE above 100 IU/ml and ECP less than 24 ng/ml were significantly influenced by postnatal exposure to PM2.5 and PM10 , especially CO, to develop asthma, and those having an eosinophil count >3% were significantly influenced by prenatal exposure to PM2.5 , especially SO2 , NO, and NO2 . CONCLUSIONS Prenatal and postnatal exposure to air pollution have an association with asthma development in AD patients.
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Affiliation(s)
- I-Lun Chen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Linkou, Taiwan
| | - Hao-Wei Chung
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Min Hsieh
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ching Lin
- Division of Pharmacology and Toxicology, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Doctoral Degree Program of Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Laboratory Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hsing Hung
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, Faculty of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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12
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Hu Y, Cheng J, Liu S, Tan J, Yan C, Yu G, Yin Y, Tong S. Evaluation of climate change adaptation measures for childhood asthma: A systematic review of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 839:156291. [PMID: 35644404 DOI: 10.1016/j.scitotenv.2022.156291] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
Global climate change (GCC) is widely accepted as the biggest threat to human health of the 21st century. Children are particularly vulnerable to GCC due to developing organ systems, psychological immaturity, nature of daily activities, and higher level of per-body-unit exposure. There is a rising trend in the disease burden of childhood asthma and allergies in many parts of the world. The associations of CC, air pollution and other environmental exposures with childhood asthma are attracting more research attention, but relatively few studies have focused on CC adaptation measures and childhood asthma. This study aimed to bridge this knowledge gap and conducted the first systematic review on CC adaptation measures and childhood asthma. We searched electronic databases including PubMed, Embase, and Web of Science using a set of MeSH terms and related synonyms, and identified 20 eligible studies included for review. We found that there were a number of adaptation measures proposed for childhood asthma in response to GCC, including vulnerability assessment, improving ventilation and heating, enhancing community education, and developing forecast models and early warning systems. Several randomized controlled trials show that improving ventilation and installing heating in the homes appear to be an effective way to relieve childhood asthma symptoms, especially in winter. However, the effectiveness of most adaptation measures, except for improving ventilation and heating, have not been explored and quantified. Given more extreme weather events (e.g., cold spells and heatwaves) may occur as climate change progresses, this finding may have important implications. Evidently, further research is urgently warranted to evaluate the impacts of CC adaptation measures on childhood asthma. These adaptation measures, if proven to be effective, should be integrated in childhood asthma control and prevention programs as GCC continues.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianguo Tan
- Shanghai Key Laboratory of Meteorology and Health (Shanghai Meteorological Service), Shanghai, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjun Yu
- Center for Biomedical Informatics, Shanghai Children's Hospital, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
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13
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Lawrence KG, Niehoff NM, Keil AP, Braxton Jackson W, Christenbury K, Stewart PA, Stenzel MR, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Curry MD, Engel LS, Sandler DP. Associations between airborne crude oil chemicals and symptom-based asthma. ENVIRONMENT INTERNATIONAL 2022; 167:107433. [PMID: 35921771 PMCID: PMC9378681 DOI: 10.1016/j.envint.2022.107433] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
RATIONALE The 2010 Deepwater Horizon (DWH) oil spill response and cleanup (OSRC) workers were exposed to airborne total hydrocarbons (THC), benzene, toluene, ethylbenzene, o-, m-, and p-xylenes and n-hexane (BTEX-H) from crude oil and PM2.5 from burning/flaring oil and natural gas. Little is known about asthma risk among oil spill cleanup workers. OBJECTIVES We assessed the relationship between asthma and several oil spill-related exposures including job classes, THC, individual BTEX-H chemicals, the BTEX-H mixture, and PM2.5 using data from the Gulf Long-Term Follow-up (GuLF) Study, a prospective cohort of 24,937 cleanup workers and 7,671 nonworkers following the DWH disaster. METHODS Our analysis largely focused on the 19,018 workers without asthma before the spill who had complete exposure, outcome, and covariate information. We defined incident asthma 1-3 years following exposure using both self-reported wheeze and self-reported physician diagnosis of asthma. THC and BTEX-H were assigned to participants based on measurement data and work histories, while PM2.5 used modeled estimates. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CIs) for associations between spill-related exposures and asthma and a quantile-based g-computation approach to explore the joint effect of the BTEX-H mixture on asthma risk. RESULTS OSRC workers had greater asthma risk than nonworkers (RR: 1.60, 95% CI: 1.38, 1.85). Higher estimated THC exposure levels were associated with increased risk in an exposure-dependent manner (linear trend test p < 0.0001). Asthma risk also increased with increasing exposure to individual BTEX-H chemicals and the chemical mixture: A simultaneous quartile increase in the BTEX-H mixture was associated with an increased asthma risk of 1.45 (95% CI: 1.35,1.55). With fewer cases, associations were less apparent for physician-diagnosed asthma alone. CONCLUSIONS THC and BTEX-H were associated with increased asthma risk defined using wheeze symptoms as well as a physician diagnosis.
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Affiliation(s)
- Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Nicole M Niehoff
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Alexander P Keil
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA; Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | - Kate Christenbury
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew D Curry
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA; Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
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14
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Lu C, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Wang J, Liu W, Sun Y, Norbäck D, Deng Q. Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma. ENVIRONMENT INTERNATIONAL 2022; 167:107456. [PMID: 35952466 DOI: 10.1016/j.envint.2022.107456] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although mounting evidence has associated air pollution and environmental temperature with children's health problems, it is unclear whether there is an interaction between these factors on childhood asthma. OBJECTIVES To explore the effects of temperature-pollution interactions during pre- and post-natal periods on asthma among pre-schoolers. METHODS A retrospective cohort study of 39,782 pre-schoolers was performed during 2010-2012, in seven cities in China. Exposure to three temperature indicators (TI) and three critical ambient air pollutants, including particulate matter with aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) as proxies of industrial and vehicular air pollution, was estimated by an inverse distance weighted (IDW) method. Two-level logistical regression analysis was used to examine the association between both pre- and post-natal exposure and childhood asthma in terms of odds ratio (OR) and 95 % confidence interval (CI). RESULTS Asthma prevalence in pre-schoolers at age of 3-6 years (6.9 %) was significantly associated with traffic-related air pollutant (NO2) exposure, with ORs (95 % CI) of 1.17 (1.06, 1.28), 1.19 (1.05-1.34) and 1.16 (1.03-1.31) for an IQR increase in NO2 exposure during lifetime, pregnancy, and entire postnatal period respectively. Furthermore, childhood asthma was positively associated with exposure to increased temperature during lifetime, pregnancy, and entire postnatal period with ORs (95 % CI) = 1.89 (1.66, 2.16), 1.47 (1.34, 1.61), and 1.15 (1.11, 1.18) respectively, while was negatively associated with decreased temperatures. Childhood asthma was positively related with exposure to extreme heat days (EHD) during postnatal period particularly in first year of life respectively with ORs (95 % CI) = 1.23 (1.04, 1.46) and 1.26 (1.07, 1.47), but was not related with extreme cold days (ECD) exposure. A combination of high air pollutant levels and high temperatures significantly increased the risk of asthma during both pre- and post-natal periods. Strikingly, we found a significantly positive interaction of temperature and PM10 or SO2 on asthma risk among boys and younger children. CONCLUSIONS Prenatal and postnatal exposure to ambient air pollution and high temperatures are independently and jointly associated with asthma risk in early childhood.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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15
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Gheissari R, Liao J, Garcia E, Pavlovic N, Gilliland FD, Xiang AH, Chen Z. Health Outcomes in Children Associated with Prenatal and Early-Life Exposures to Air Pollution: A Narrative Review. TOXICS 2022; 10:toxics10080458. [PMID: 36006137 PMCID: PMC9415268 DOI: 10.3390/toxics10080458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/04/2023]
Abstract
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
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Affiliation(s)
- Roya Gheissari
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Nathan Pavlovic
- Sonoma Technology Inc., 1450 N. McDowell Blvd., Suite 200, Petaluma, CA 94954, USA
| | - Frank D. Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Anny H. Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91107, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
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16
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Yang Q, Yuan Q, Li T. Ultrahigh-resolution PM 2.5 estimation from top-of-atmosphere reflectance with machine learning: Theories, methods, and applications. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119347. [PMID: 35483482 DOI: 10.1016/j.envpol.2022.119347] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/08/2022] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
Intra-urban pollution monitoring requires fine particulate (PM2.5) concentration mapping at ultrahigh-resolution (dozens to hundreds of meters). However, current PM2.5 concentration estimation, which is mainly based on aerosol optical depth (AOD) and meteorological data, usually had a low spatial resolution (kilometers) and severe spatial missing problem, cannot be applied to intra-urban pollution monitoring. To solve these problems, top-of-atmosphere reflectance (TOAR), which contains both the information about land and atmosphere and has high resolution and large spatial coverage, may be efficiently used for PM2.5 estimation. This study aims to systematically evaluate the feasibility of retrieving ultrahigh-resolution PM2.5 concentration at a large scale (national level) from TOAR. Firstly, we make a detailed discussion about several important but unsolved theoretic problems on TOAR-based PM2.5 retrieval, including the band selection, scale effect, cloud impact, and mapping quality evaluation. Secondly, four types and eight retrieval models are compared in terms of quantitative accuracy, mapping quality, model generalization, and model efficiency, with the pros and cons of each type summarized. Deep neural network (DNN) model shows the highest retrieval accuracy, and linear models were the best in efficiency and generalization. As a compromise, ensemble learning shows the best overall performance. Thirdly, using the highly accurate DNN model (cross-validated R2 equals 0.93) and through combining Landsat 8 and Sentinel 2 images, a 90 m and ∼4-day resolution PM2.5 product was generated. The retrieved maps were used for analyzing the fine-scale interannual pollution change inner the city and the pollution variations during novel coronavirus disease 2019 (COVID-19). Results of this study proves that ultrahigh resolution can bring new findings of intra-urban pollution change, which cannot be observed at previous coarse resolution. Lastly, some suggestions for future ultrahigh-resolution PM2.5 mapping research were given.
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Affiliation(s)
- Qianqian Yang
- School of Geodesy and Geomatics, Wuhan University, Wuhan, Hubei, 430079, China
| | - Qiangqiang Yuan
- School of Geodesy and Geomatics, Wuhan University, Wuhan, Hubei, 430079, China; Key Laboratory of Geospace Environment and Geodesy, Ministry of Education, Wuhan University, Wuhan, Hubei, 430079, China.
| | - Tongwen Li
- School of Geospatial Engineering and Science, Sun Yat-Sen University, Zhuhai, Guangzhou, 519082, China
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17
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Chen T, Norback D, Deng Q, Huang C, Qian H, Zhang X, Sun Y, Wang T, Zhang Y, Li B, Kan H, Wei L, Liu C, Xu Y, Zhao Z. Maternal exposure to PM 2.5/BC during pregnancy predisposes children to allergic rhinitis which varies by regions and exclusive breastfeeding. ENVIRONMENT INTERNATIONAL 2022; 165:107315. [PMID: 35635966 DOI: 10.1016/j.envint.2022.107315] [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: 02/18/2022] [Revised: 05/02/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Increasing prevalence of childhood allergic rhinitis(AR) needs a deeper understanding on the potential adverse effects of early life exposure to air pollution. OBJECTIVES The main aim was to evaluate the effects of maternal exposure to PM2.5 and chemical constituents during pregnancy on preschool children's AR, and further to explore the modification effects of regions and exclusive breastfeeding. METHODS A multi-center population-based study was performed in 6 cities from 3 regions of China in 2011-2012. Maternal exposure to ambient PM2.5 and main chemical constituents(BC, OM, SO42-, NO3-, NH4+) during pregnancy was assessed and a longitudinal prospective analysis was applied on preschool children's AR. The modification effects of regions and exclusive breastfeeding were investigated. RESULTS A total of 8.8% and 9.8% of children reported doctor-diagnosed allergic rhinitis(DDAR) and current hay fever, respectively, and 48.6% had less than 6 months of exclusive breastfeeding. The means of PM2.5 during pregnancy were 52.7 μg/m3, 70.3 μg/m3 and 76.4 μg/m3 in the east, north and central south of China, respectively. Multilevel log-binomial model regression showed that each interquartile range(IQR) increase of PM2.5 during pregnancy was associated with an average increase in prevalence ratio (PR) of DDAR by 1.43(95% confidence interval(CI): 1.11, 1.84) and current hay fever by 1.79(95% CI: 1.26, 2.55), respectively. Among chemical constituents, black carbon (BC) had the strongest associations. Across 3 regions, the eastern cities had the highest associations, followed by those in the central south and the north. For those equal to or longer than 6 months of exclusive breastfeeding, the associations were significantly reduced. CONCLUSIONS Children in east of China had the highest risks of developing AR per unit increase of maternal exposure to PM2.5 during pregnancy, especially BC constituent. Remarkable decline was found in association with an increase in breastfeeding for ≥6 months, in particular in east of China.
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Affiliation(s)
- Tianyi Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Dan Norback
- Department of Medical Sciences, Uppsala University, Uppsala SE-751, Sweden
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing 210096, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan 030006, China
| | - Yuexia Sun
- Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin University, Tianjin 300072, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing 400030, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China
| | - Lan Wei
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yanyi Xu
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China.
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18
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Zhang Y, Yin Z, Zhou P, Zhang L, Zhao Z, Norbäck D, Zhang X, Lu C, Yu W, Wang T, Zheng X, Zhang L, Zhang Y. Early-life exposure to PM 2.5 constituents and childhood asthma and wheezing: Findings from China, Children, Homes, Health study. ENVIRONMENT INTERNATIONAL 2022; 165:107297. [PMID: 35709580 DOI: 10.1016/j.envint.2022.107297] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/22/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Emerging evidence suggests that early-life (in-utero and first-year since birth) exposure to ambient PM2.5 is a risk factor for asthma onset and exacerbation among children, while the hazards caused by PM2.5 compositions remain largely unknown. OBJECTIVE To examine potential associations of early-life exposures to PM2.5 mass and its major chemical constituents with childhood asthma and wheezing. METHODS By conducting the Phase II of the China, Children, Homes, Health study, we investigated 30,325 preschool children aged 3-6 years during 2019-2020 in mainland China. Early-life exposure to PM2.5 mass and its constituents (i.e., black carbon [BC], organic matter [OM], nitrate, ammonium, sulfate) were calculated based on monthly estimates at a 1 km × 1 km resolution from satellite-based models. We adopted a novel quantile-based g-computation approach to assess the effect of a mixture of PM2.5 constituents on childhood asthma/wheezing. RESULTS The average PM2.5 concentrations during in-utero and the first year since birth were 64.7 ± 10.6 and 61.8 ± 10.5 µg/m3, respectively. Early-life exposures to a mixture of major PM2.5 constituents were significantly associated with increased risks of asthma and wheezing, while no evident compositions-wheezing associations were found in the first year. Each quintile increases in all five PM2.5 components exposures in utero was accordingly associated with an odds ratio of 1.18 [95% confidence interval: 1.07-1.29] for asthma and 1.08 [1.01-1.16] for wheezing. BC, OM and SO42- contributed more to risks of asthma and wheezing than the other PM2.5 constituents during early life, wherein the effects of BC were only observed during pregnancy. Sex subgroup analyses suggested stronger associations among girls of first-year exposures to PM2.5 components with childhood asthma. CONCLUSION Early-life exposures to ambient PM2.5, particularly compositions of BC, OM and SO42-, are associated with an increased risk of childhood asthma.
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Affiliation(s)
- Yuanyuan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhouxin Yin
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Peixuan Zhou
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Liansheng Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Xin Zhang
- Research Centre for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Chan Lu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wei Yu
- School of Civil Engineering, Chongqing University, Chongqing, China
| | - Tingting Wang
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Ling Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China.
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19
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Song X, Hu Y, Ma Y, Jiang L, Wang X, Shi A, Zhao J, Liu Y, Liu Y, Tang J, Li X, Zhang X, Guo Y, Wang S. Is short-term and long-term exposure to black carbon associated with cardiovascular and respiratory diseases? A systematic review and meta-analysis based on evidence reliability. BMJ Open 2022; 12:e049516. [PMID: 35504636 PMCID: PMC9066484 DOI: 10.1136/bmjopen-2021-049516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Adverse health effects of fine particles (particulate matter2.5) have been well documented by a series of studies. However, evidences on the impacts of black carbon (BC) or elemental carbon (EC) on health are limited. The objectives were (1) to explored the effects of BC and EC on cardiovascular and respiratory morbidity and mortality, and (2) to verified the reliability of the meta-analysis by drawing p value plots. DESIGN The systematic review and meta-analysis using adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and p value plots approach. DATA SOURCES PubMed, Embase and Web of Science were searched from inception to 19 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Time series, case cross-over and cohort studies that evaluated the associations between BC/EC on cardiovascular or respiratory morbidity or mortality were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcomes were analysed via a random effects model and reported as relative risk (RR) with 95% CI. The certainty of evidences was assessed by adapted GRADE. The reliabilities of meta-analyses were analysed by p value plots. RESULTS Seventy studies met our inclusion criteria. (1) Short-term exposure to BC/EC was associated with 1.6% (95% CI 0.4% to 2.8%) increase in cardiovascular diseases per 1 µg/m3 in the elderly; (2) Long-term exposure to BC/EC was associated with 6.8% (95% CI 0.4% to 13.5%) increase in cardiovascular diseases and (3) The p value plot indicated that the association between BC/EC and respiratory diseases was consistent with randomness. CONCLUSIONS Both short-term and long-term exposures to BC/EC were related with cardiovascular diseases. However, the impact of BC/EC on respiratory diseases did not present consistent evidence and further investigations are required. PROSPERO REGISTRATION NUMBER CRD42020186244.
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Affiliation(s)
- Xuping Song
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yue Hu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yan Ma
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Liangzhen Jiang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xinyi Wang
- Second Clinical College, Lanzhou University, Lanzhou, Gansu, China
| | - Anchen Shi
- Department of General Surgery, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Junxian Zhao
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yunxu Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yafei Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Tang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiayang Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoling Zhang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
| | - Yong Guo
- Department of Civil Affairs in Guizhou Province, Guizhou Province People's Government, Guiyang, Guizhou, China
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
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20
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Burbank AJ, Kesic MJ, Hernandez ML. From the farm to the big city: emerging health effects of agricultural emissions on asthma. J Allergy Clin Immunol 2022; 150:64-66. [PMID: 35483508 DOI: 10.1016/j.jaci.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Allison J Burbank
- Children's Research Institute, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC
| | - Matthew J Kesic
- Campbell University College of Pharmacy & Health Sciences, Physician Assistant Program, Buies Creek, NC
| | - Michelle L Hernandez
- Children's Research Institute, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC
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21
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Hu Y, Cheng J, Yin Y, Liu S, Tan J, Li S, Wu M, Yan C, Yu G, Hu Y, Tong S. Association of childhood asthma with intra-day and inter-day temperature variability in Shanghai, China. ENVIRONMENTAL RESEARCH 2022; 204:112350. [PMID: 34762926 DOI: 10.1016/j.envres.2021.112350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/28/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Short-term temperature variability (TV) is associated with the exacerbation of asthma, but little is known about the relative effects of intra- and inter-day TV. We aimed to assess the relative impacts of intra- and inter-day TV on childhood asthma and to explore the modification effects by season. METHODS A quasi-Poisson generalized linear regression model combined with a distributed lag nonlinear model was adopted to evaluate the nonlinear and lagged effects of TV on childhood asthma in Shanghai from 2009 to 2017. Intra- and inter-day TV was measured with diurnal temperature range (DTR) and temperature changes between neighboring days (TCN), respectively. RESULTS Increased DTR was associated with the elevated relative risk (RR) of daily outpatient visits for childhood asthma (DOVCA) in both the whole year (RRlag0-14 for the 99th percentile: 1.264, 95% confidence interval (CI): 1.052, 1.518) and cold season (RRlag0-12 for the 99th percentile: 1.411, 95% CI: 1.053, 1.889). Higher TCN in the warm season was associated with the increased RR of DOVCA (RRlag0-14 for the 99th percentile: 2.964, 95% CI: 1.636, 5.373). The number and fraction of DOVCA attributed to an interquartile range (IQR) increase of TCN were higher than those attributed to DTR in both the whole year period and warm season. However, the number and fraction of DOVCA attributed to an IQR increase of DTR were greater than those attributed to TCN in the cold season. CONCLUSIONS Our results provide novel evidence that both intra- and inter-day TV might be a trigger of childhood asthma. Higher DTR appeared to have greater impacts on childhood asthma in the cold season while an increase in TCN seemed to have bigger effects in the warm season.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Cheng
- School of Public Health, Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianguo Tan
- Shanghai Key Laboratory of Meteorology and Health (Shanghai Meteorological Service), Shanghai, China
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Meiqin Wu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjun Yu
- Center for Biomedical Informatics, Shanghai Children's Hospital, Shanghai, China
| | - Yi Hu
- Center for Biomedical Informatics, Shanghai Children's Hospital, Shanghai, China
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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22
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Gonzales T, Whalen E. Easy Breathing: A Review of the Impact of Air Quality on Pediatric Health Outcomes. J Pediatr Health Care 2022; 36:57-63. [PMID: 34922677 DOI: 10.1016/j.pedhc.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 10/19/2022]
Abstract
Preventable environmental factors such as exposure to poor air quality are predicted to affect 23% of all global deaths. Although there have been efforts to reduce air pollution through federal guidelines for vehicle and industrial emissions, the air in the United States remains far from clean. Children and pregnant women have been identified as high-risk populations who are particularly susceptible to the negative effects of poor air quality. This paper provides an overview of health concerns related to poor air quality, pediatric considerations from pregnancy through childhood, the importance of increased awareness of air quality assessment and prevention in patient encounters, and current advocacy efforts and legislation.
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23
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Wang X, Guo Y, Cai M, Qian ZM, Zhang S, Zhang Z, Yang Y, Vaughn MG, Aaron HE, Wu F, Zhang Y, Lin H. Constituents of fine particulate matter and asthma in six low- and middle-income countries. J Allergy Clin Immunol 2021; 150:214-222.e5. [PMID: 34971647 DOI: 10.1016/j.jaci.2021.12.779] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/19/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence concerning the effects of different chemical components of PM2.5 on asthma is limited, and the methodology to compare the relative importance of different PM2.5 components is lacking. OBJECTIVES To examine the associations between PM2.5 components and asthma, and investigate which constituent of PM2.5 possessed the most harmful effect on asthma. METHODS A total of 45,690 subjects were surveyed in six countries from 2007 to 2010. We geo-coded the residential community address of the participants, and used satellite remote sensing and chemical transport modeling to estimate their annual average concentrations. Mixed-effects generalized additive models were utilized to examine the associations between PM2.5 constituents and prevalence of asthma. We further used counterfactual analyses to determine the potential number of asthma cases. RESULTS We identified 6,178 asthma cases among the participants, producing a prevalence of 13.5%. The odds ratio (OR) for asthma associated with per standard deviation (SD) increment was 1.12 for PM2.5 mass, 1.12 for organic carbon (OC), 1.18 for black carbon (BC), 1.19 for sulfate, 1.28 for ammonium, and 1.21 for nitrate after controlling for potential confounders. Our counterfactual analyses suggested that ammonium was responsible for a substantial decline in asthma cases (1382, corresponding to 22.37% of overall cases) if the concentration was reduced to the 5th percentile of the current level. CONCLUSIONS Our study suggests that some chemical components (including BC, OC, sulfate, ammonium, and nitrate) of PM2.5 might be hazardous constituents contributing to the prevalence of asthma, among them, ammonium might be responsible for substantial proportion of asthma cases if reduced to a certain level.
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Affiliation(s)
- Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yanfei Guo
- Shanghai Municipal Centre for Disease Control and Prevention (Shanghai CDC), Shanghai, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Michael G Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, USA
| | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Fan Wu
- School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Yuqiang Zhang
- Nicholas School of the Environment, Duke University, Durham, NC, USA.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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24
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Zhao N, Al-Aly Z, Zheng B, van Donkelaar A, Martin RV, Pineau CA, Bernatsky S. Fine particles matter components and interstitial lung disease in rheumatoid arthritis. Eur Respir J 2021; 60:13993003.02149-2021. [PMID: 34949700 DOI: 10.1183/13993003.02149-2021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/28/2021] [Indexed: 11/05/2022]
Abstract
Exposure to ambient fine particulate matter (PM2.5) is a risk factor for pulmonary and systemic autoimmune diseases, however evidence on which PM2.5 chemical components are more harmful is still scant. Our goal is to investigate potential associations between PM2.5 components and interstitial lung disease (ILD) onset in rheumatoid arthritis (RA).New-onset RA subjects identified from a United States health care insurance database (MarketScan) were followed for new onset of RA associated ILD (RA-ILD) from 2011 to 2018. Annual ambient PM2.5 concentrations of its chemical components (i.e. sulfate, nitrate, ammonium, organic matter, black carbon, mineral dust, and sea salt) were estimated by combining satellite retrievals with chemical transport modelling and refined by geographically weighted regression. Exposures from 2006 up to one year before ILD onset or end of study were assigned to subjects based on their metropolitan division or core-based statistical area codes. A novel time-to-event quantile-based g(generalised)-computation approach was used to estimate potential associations between RA-ILD onset and the exposure mixture of all seven PM2.5 chemical components adjusting for age, sex, and prior chronic obstructive pulmonary disease (as a proxy for smoking).We followed 280 516 new-onset RA patients and detected 2194 RA-ILD cases across 1 394 385 person-years. The adjusted hazard ratio for RA-ILD onset was 1.54 (95% confidence interval 1.47-1.63) per every decile increase in all seven exposures. Ammonium, mineral dust, and black carbon contributed more to ILD risk than the other PM2.5 components.In conclusion, exposure to elements of PM2.5, particularly ammonium, increases ILD risk in RA.
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Affiliation(s)
- Naizhuo Zhao
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada
| | - Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA.,Department of Medicine, Washington University in Saint Louis, Saint Louis, MO, USA
| | - Boyang Zheng
- Division of Rheumatology, McGill University Health Center, Montreal, QC, Canada
| | - Aaron van Donkelaar
- Department of Energy, Environmental & Chemical Engineering, Washington University in Saint Louis, Saint Louis, MO, USA.,Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
| | - Randall V Martin
- Department of Energy, Environmental & Chemical Engineering, Washington University in Saint Louis, Saint Louis, MO, USA.,Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
| | - Christian A Pineau
- Division of Rheumatology, McGill University Health Center, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Sasha Bernatsky
- Division of Rheumatology, McGill University Health Center, Montreal, QC, Canada .,Department of Medicine, McGill University, Montreal, QC, Canada
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25
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Shen M, Gu X, Li S, Yu Y, Zou B, Chen X. Exposure to black carbon is associated with symptoms of depression: A retrospective cohort study in college students. ENVIRONMENT INTERNATIONAL 2021; 157:106870. [PMID: 34534788 DOI: 10.1016/j.envint.2021.106870] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/13/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies have revealed a significant association of fine particulate matter (PM2.5) with emotional disorders. However, as a crucial component of PM2.5, little is known about the potential effect of exposure to black carbon (BC) on the symptoms of depression and anxiety. OBJECTIVES To explore the associations of long-term exposure to BC during the past six years with the current symptoms of depression and anxiety in a group of incoming college students. METHODS This was a retrospective cohort study of incoming students in five universities of China. Symptoms of depression and anxiety during the past two weeks were measured by the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder Scale-2 (GAD-2), respectively. Levels of BC and other environmental factors during 2013 ∼ 2018 (six years prior to the recruitment) was obtained from public repositories and linked to individual data by home addresses. Averagely daily dose of BC exposure was estimated according to the respiratory rate. Demographic and behavioral variables were collected through a questionnaire. The associations of BC with symptoms of depression and anxiety were estimated by mixed linear models adjusting for socioeconomic and behavioral characteristics, and the principal components of multiple environmental exposures. Subgroup analysis was conducted to assess the effect modification by covariates. Overall effect of environmental mixture was evaluated by weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR). RESULTS A total of 20,079 participants was included in the current study. After adjustment for covariates, long-term BC exposure was significantly associated with symptoms of depression (β = 0.17, P < 0.001) but not anxiety (β = 0.07, P = 0.125). Effect modification by sex and parental educational level: BC was correlated with depressive symptoms in women (β = 0.23, P < 0.001) but not in men (β = 0.04, P = 0.581), and higher educational level was associated with decreased effect sizes of BC. Sensitivity analysis showed that the acute and short-term effects of BC on depression was consistent with its long-term exposure (β varied from 0.18 to 0.20). WQS identified BC as the primary pollutant in association with symptoms of depression but not anxiety. BKMR identified no significant interaction between BC and other exposures. CONCLUSION Exposure to BC is associated with symptoms of depression but not anxiety in college students, and the relationship is modified by sex and education.
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Affiliation(s)
- Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China.
| | - Xiaoyu Gu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Shenxin Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Yu Yu
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Bin Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China.
| | - Xiang Chen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China.
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26
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Olsson D, Forsberg B, Bråbäck L, Geels C, Brandt J, Christensen JH, Frohn LM, Oudin A. Early childhood exposure to ambient air pollution is associated with increased risk of paediatric asthma: An administrative cohort study from Stockholm, Sweden. ENVIRONMENT INTERNATIONAL 2021; 155:106667. [PMID: 34077855 DOI: 10.1016/j.envint.2021.106667] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Asthma is a complex, heterogeneous disease and one of the most common chronic diseases among children. Exposure to ambient air pollution in early life and childhood may influence asthma aetiology, but it is uncertain which specific components of air pollution and exposure windows are of importance. The role of socio-economic status (SES) is also unclear. The aims of the present study are, therefore, to investigate how various exposure windows of different pollutants affect risk-induced asthma in early life and to explore the possible effect SES has on that relationship. METHODS The study population was constructed using register data on all singleton births in the greater Stockholm area between 2006 and 2013. Exposure to ambient black carbon (BC), fine particulate matter (PM2.5), primary organic carbon (pOC) secondary organic aerosols (SOA), secondary inorganic aerosols, and oxidative potential at the residential address was modelled as mean values for the entire pregnancy period, the first year of life and the first three years of life. Swedish national registers were used to define the outcome: asthma diagnosis assessed at hospital during the first six years of life. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were modelled with Cox proportional hazards model with age as the underlying time-scale, adjusting for relevant potential confounding variables. RESULTS An increased risk for developing childhood asthma was observed in association with exposure to PM2.5, pOC and SOA during the first three years of life. With an interquartile range increase in exposure, the HRs were 1.06 (95% CI: 1.01-1.10), 1.05 (95% CI: 1.02-1.09) and 1.02 (95% CI: 1.00-1.04), for PM2.5, pOC and SOA, respectively, in the fully adjusted models. Exposure during foetal life or the first year of life was not associated with asthma risk, and the other pollutants were not statistically significantly associated with increased risk. Furthermore, the increase in risk associated with PM2.5 and the components BC, pOC and SOA were stronger in areas with lower SES. CONCLUSION Our results suggest that exposure to air pollution during the first three years of life may increase the risk for asthma in early childhood. The findings further imply a possible increased vulnerability to air pollution-attributed asthma among low SES children.
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Affiliation(s)
- David Olsson
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Lennart Bråbäck
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Camilla Geels
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Jørgen Brandt
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Jesper H Christensen
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Lise M Frohn
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden.
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Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157864. [PMID: 34360155 PMCID: PMC8345553 DOI: 10.3390/ijerph18157864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. OBJECTIVE The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. METHODS We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. RESULTS The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20-$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62-$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06-$144,269.18). CONCLUSION This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP's impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population's exposure.
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Zhang L, Wang X, Huang Y, Ai T, Liao H, Hu J, Tang W, Huang Y. Pediatric Asthma Situation in Chengdu, China, During the COVID-19 Pandemic: An Observational Study. J Asthma Allergy 2021; 14:829-838. [PMID: 34276218 PMCID: PMC8277453 DOI: 10.2147/jaa.s315695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/22/2021] [Indexed: 12/11/2022] Open
Abstract
Background To tackle the COVID-19 pandemic and mitigate viral transmission, mainland China has implemented various disease prevention measures and arrangements. We hypothesize that these measures may be pose challenges to the management of pediatric asthma. Here, we studied the situation of pediatric asthma in Chengdu during the COVID-19 pandemic and compared the pediatric asthma situation before so as to provide a reference for designing effective management plan for pediatric asthma patients in the future facing the outbreak of epidemic. Methods An observational study was done to compare the pediatric asthma situation in Chengdu from 2017 to 2019 to the situation under COVID-19 pandemic. Asthma incidence, severe asthma attack, air quality, temperature, and patient follow-up were examined. Results The number of monthly asthma cases decreased significantly in February 2020. The number of asthma cases in 2017-2019 positively correlated with levels of particulate matter PM 2.5 (p = 0.006) and PM10 (p = 0.005), while it negatively correlated with temperature (p = 0.048). No correlation was identified in 2020. A higher rate of severe asthma attack cases (9.69%) was observed among asthma patients in 2020 (p = 0.014). Differences were identified between the monthly severe asthma attack during the period 2017-2020 (p<0.001). The rate of severe asthma attack cases peaked in June and September 2020. The percentage of patients who failed to undergo pulmonary function tests was 34.5% in 2020, remarkably higher than in the previous 3 years (p<0.001). Conclusion The situation and management of pediatric asthma during the 2020 COVID-19 pandemic differed from those in previous years, with more emphasis placed on disease prevention practices and facilities. To design future pediatric asthma management practice, the environmental and psychological impact on asthma management should also be considered. Local areas should make good use of telemedicine to manage pediatric asthma effectively.
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Affiliation(s)
- Lei Zhang
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Xinglu Wang
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Yijie Huang
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Tao Ai
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Huiling Liao
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Jie Hu
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Wei Tang
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Yuanyuan Huang
- Department of Pediatric Pulmonology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
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