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Lin G, Wang Z, Zhang X, Stein A, Maji KJ, Cheng C, Osei F, Yang FF. Comparison of the association between different ozone indicators and daily respiratory hospitalization in Guangzhou, China. Front Public Health 2023; 11:1060714. [PMID: 36794065 PMCID: PMC9922759 DOI: 10.3389/fpubh.2023.1060714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
Background Epidemiological studies have widely proven the impact of ozone (O3) on respiratory mortality, while only a few studies compared the association between different O3 indicators and health. Methods This study explores the relationship between daily respiratory hospitalization and multiple ozone indicators in Guangzhou, China, from 2014 to 2018. It uses a time-stratified case-crossover design. Sensitivities of different age and gender groups were analyzed for the whole year, the warm and the cold periods. We compared the results from the single-day lag model and the moving average lag model. Results The results showed that the maximum daily 8 h average ozone concentration (MDA8 O3) had a significant effect on the daily respiratory hospitalization. This effect was stronger than for the maximum daily 1 h average ozone concentration (MDA1 O3). The results further showed that O3 was positively associated with daily respiratory hospitalization in the warm season, while there was a significantly negative association in the cold season. Specifically, in the warm season, O3 has the most significant effect at lag 4 day, with the odds ratio (OR) equal to 1.0096 [95% confidence intervals (CI): 1.0032, 1.0161]. Moreover, at the lag 5 day, the effect of O3 on the 15-60 age group was less than that on people older than 60 years, with the OR value of 1.0135 (95% CI: 1.0041, 1.0231) for the 60+ age group; women were more sensitive than men to O3 exposure, with an OR value equal to 1.0094 (95% CI: 0.9992, 1.0196) for the female group. Conclusion These results show that different O3 indicators measure different impacts on respiratory hospitalization admission. Their comparative analysis provided a more comprehensive insight into exploring associations between O3 exposure and respiratory health.
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Affiliation(s)
- Geng Lin
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
| | - Zhuoqing Wang
- Department of Scientific Research and Discipline Development, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,*Correspondence: Zhuoqing Wang ✉
| | - Xiangxue Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China,Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands,Xiangxue Zhang ✉
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Kamal Jyoti Maji
- School of Civil and Environment Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Changxiu Cheng
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing, China,National Tibetan Plateau Data Center, Beijing, China
| | - Frank Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Fiona Fan Yang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, China
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Zhang X, Maji KJ, Wang Z, Yang FF, Wang G, Cheng C. Associations between Different Ozone Indicators and Cardiovascular Hospital Admission: A Time-Stratified Case-Crossover Analysis in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032056. [PMID: 36767423 PMCID: PMC9916254 DOI: 10.3390/ijerph20032056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/13/2023] [Indexed: 05/17/2023]
Abstract
Epidemiological studies reported that ozone (O3) is associated with cardiovascular diseases. However, only few of these studies examined the impact of multiple O3 indicators on cardiovascular hospital admissions. This study aimed to explore and compare the impacts of different O3 indicators on cardiovascular hospital admissions in Guangzhou, China. Based upon the data on daily cardiovascular hospital admissions, air pollution, and meteorological factors in Guangzhou from 2014 to 2018, a time-stratified case-crossover design model was used to analyze the associations between different O3 indicators and cardiovascular hospital admissions. Moreover, the sensitivities of different age and gender groups were analyzed for the whole year and different seasons (i.e., warm and cold). During the warm season, for the single-pollutant model, the odds ratio (OR) value of cardiovascular hospital admissions was 1.0067 (95% confidence interval (CI): 1.0037, 1.0098) for every IQR increase in MDA8 O3 at a lag of five days. The effect of O3 on people over 60 year was stronger than that on the 15-60 years age group. Females were more sensitive than males to O3 exposure. These results provided valuable references for further scientific research and environmental improvement in Guangzhou. Given that short-term O3 exposure poses a threat to human health, the government should therefore pay attention to prevention and control policies to reduce and eliminate O3 pollution and protect human health.
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Affiliation(s)
- Xiangxue Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, 7514 AE Enschede, The Netherlands
| | - Kamal Jyoti Maji
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Zhuoqing Wang
- Department of Scientific Research & Discipline Development, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Fiona Fan Yang
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
| | - Guobin Wang
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
| | - Changxiu Cheng
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China
- National Tibetan Plateau Data Center, Beijing 100101, China
- Correspondence:
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Albano GD, Gagliardo RP, Montalbano AM, Profita M. Overview of the Mechanisms of Oxidative Stress: Impact in Inflammation of the Airway Diseases. Antioxidants (Basel) 2022; 11:2237. [PMID: 36421423 PMCID: PMC9687037 DOI: 10.3390/antiox11112237] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 08/01/2023] Open
Abstract
Inflammation of the human lung is mediated in response to different stimuli (e.g., physical, radioactive, infective, pro-allergenic or toxic) such as cigarette smoke and environmental pollutants. They often promote an increase in inflammatory activities in the airways that manifest themselves as chronic diseases (e.g., allergic airway diseases, asthma, chronic bronchitis/chronic obstructive pulmonary disease (COPD) or even lung cancer). Increased levels of oxidative stress (OS) reduce the antioxidant defenses, affect the autophagy/mitophagy processes, and the regulatory mechanisms of cell survival, promoting inflammation in the lung. In fact, OS potentiate the inflammatory activities in the lung, favoring the progression of chronic airway diseases. OS increases the production of reactive oxygen species (ROS), including superoxide anions (O2-), hydroxyl radicals (OH) and hydrogen peroxide (H2O2), by the transformation of oxygen through enzymatic and non-enzymatic reactions. In this manner, OS reduces endogenous antioxidant defenses in both nucleated and non-nucleated cells. The production of ROS in the lung can derive from both exogenous insults (cigarette smoke or environmental pollution) and endogenous sources such as cell injury and/or activated inflammatory and structural cells. In this review, we describe the most relevant knowledge concerning the functional interrelation between the mechanisms of OS and inflammation in airway diseases.
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Yang L, Yang J, Liu M, Sun X, Li T, Guo Y, Hu K, Bell ML, Cheng Q, Kan H, Liu Y, Gao H, Yao X, Gao Y. Nonlinear effect of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China: A time-series analysis. ENVIRONMENTAL RESEARCH 2022; 209:112754. [PMID: 35074347 DOI: 10.1016/j.envres.2022.112754] [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: 09/06/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Many studies have illustrated adverse effects of short-term exposure to air pollution on human health, which usually assumes a linear exposure-response (E-R) function in the delineation of health effects due to air pollution. However, nonlinearity may exist in the association between air pollutant concentrations and health outcomes such as adult pneumonia hospital visits, and there is a research gap in understanding the nonlinearity. Here, we utilized both the distributed lag model (DLM) and nonlinear model (DLNM) to compare the linear and nonlinear impacts of air pollution on adult pneumonia hospital visits in the coastal city of Qingdao, China. While both models show adverse effects of air pollutants on adult pneumonia hospital visits, the DLNM shows an attenuation of E-R curves at high concentrations. Moreover, the DLNM may reveal delayed health effects that may be missed in the DLM, e.g., ozone exposure and pneumonia hospital visits. With the stratified analysis of air pollutants on adult pneumonia hospital visits, both models consistently reveal that the influence of air pollutants is higher during the cold season than during the warm season. Nevertheless, they may behave differently in terms of other subgroups, such as age, gender and visit types. For instance, while no significant impact due to PM2.5 in any of the subgroups abovementioned emerges based on DLM, the results from DLNM indicate statistically significant impacts for the subgroups of elderly, female and emergency department (ED) visits. With respect to adjustment by two-pollutants, PM10 effect estimates for pneumonia hospital visits were the most robust in both DLM and DLNM, followed by NO2 and SO2 based on the DLNM. Considering the estimated health effects of air pollution relying on the assumed E-R functions, our results demonstrate that the traditional linear association assumptions may overlook some potential health risks.
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Affiliation(s)
- Lingyue Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Jiuli Yang
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Mingyang Liu
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China
| | - Xiaohui Sun
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, 266100, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing,100021, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, 06511, USA
| | - Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200433, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huiwang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Xiaohong Yao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China
| | - Yang Gao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, and Key Laboratory of Marine Environmental Science and Ecology, Ministry of Education, Ocean University of China, Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266100, China.
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Lin CH, Wong LT, Hsu JY, Chao WC. Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan. BMJ Open 2022; 12:e050861. [PMID: 35165108 PMCID: PMC8845173 DOI: 10.1136/bmjopen-2021-050861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The convergence of asthma and air pollutants in ageing populations is currently a growing health issue worldwide, and hence there is an essential need to investigate the association between exposure to air pollution, particularly ozone (O3), and exacerbation requiring admission in patients with asthma. SETTING A case-control study at a tertiary referral hospital in central Taiwan. PARTICIPANTS We used an asthma cohort, which included 11 400 patients with asthma, for the period 2006-2018 at Taichung Veterans General Hospital. PRIMARY AND SECONDARY OUTCOME MEASURES We identified patients who had admitted for exacerbation as cases and selected patients with asthma without exacerbation, matching (1:4) the cases for age, gender and season of exacerbation, as controls. Data on hourly level of air pollutants were obtained from the Taiwan Environmental Protection Administration. We used conditional logistic regression and calculated adjusted ORs (adjORs) with 95% CIs. RESULTS We enrolled 11 400 participants with asthma, and 4.4% (501) of them had been admitted for exacerbation. Participants with asthma with exacerbation requiring hospitalisation were exposed to a higher level of O3 8-hour daily maximum (adjOR 1.009, 95% CI 1.001 to 1.016) and were more likely to have high Charlson Comorbidity Index (CCI ≥3; adjOR 2.198, 95% CI 1.729 to 2.794) and asthma-chronic obstructive pulmonary disease overlap (adjOR 4.542, 95% CI 3.376 to 6.611) compared with those without exacerbation. The aforementioned associations between exacerbation of asthma requiring hospitalisation and exposure to O3 were similar when defined by either O3 1-hour daily maximum or O3 24-hour average. Moreover, the O3 relevant exacerbation of asthma mainly existed in those aged older than 65 years and patients with medical comorbidities, including gastrointestinal diseases, cardiovascular diseases, neurological diseases, diabetes and renal disease. CONCLUSIONS Our findings highlight the need for vigilance of exposure to O3 among elderly with asthma, particularly those with medical comorbidities. Further studies are warranted to investigate the underlying mechanisms.
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Affiliation(s)
- Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
| | - Li-Ting Wong
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jeng-Yuan Hsu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Physical Therapy, Chung-Shan Medical University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Cheng Chao
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Colledge of Medicine, Chung Hsing University, Taichung, Taiwan
- Big Data Center, Chung Hsing University, Taichung, Taiwan
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
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Effects of Air Pollutants on Airway Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189905. [PMID: 34574829 PMCID: PMC8465980 DOI: 10.3390/ijerph18189905] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
Air pollutants include toxic particles and gases emitted in large quantities from many different combustible materials. They also include particulate matter (PM) and ozone, and biological contaminants, such as viruses and bacteria, which can penetrate the human airway and reach the bloodstream, triggering airway inflammation, dysfunction, and fibrosis. Pollutants that accumulate in the lungs exacerbate symptoms of respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). Asthma, a heterogeneous disease with complex pathological mechanisms, is characterized by particular symptoms such as shortness of breath, a tight chest, coughing, and wheezing. Patients with COPD often experience exacerbations and worsening of symptoms, which may result in hospitalization and disease progression. PM varies in terms of composition, and can include solid and liquid particles of various sizes. PM concentrations are higher in urban areas. Ozone is one of the most toxic photochemical air pollutants. In general, air pollution decreases quality of life and life expectancy. It exacerbates acute and chronic respiratory symptoms in patients with chronic airway diseases, and increases the morbidity and risk of hospitalization associated with respiratory diseases. However, the mechanisms underlying these effects remain unclear. Therefore, we reviewed the impact of air pollutants on airway diseases such as asthma and COPD, focusing on their underlying mechanisms.
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Li A, Zhou Q, Xu Q. Prospects for ozone pollution control in China: An epidemiological perspective. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 285:117670. [PMID: 34380231 DOI: 10.1016/j.envpol.2021.117670] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/17/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Severe surface ozone pollution has become widespread in China. To protect public health, Chinese scientific communities and government agencies have striven to mitigate ozone pollution. However, makers of pollution mitigation policies rarely consider epidemiological research, and communication between epidemiological researchers and the government is poor. Therefore, this article reviews the current mitigation policies and the National Ambient Air Quality Standard (NAAQS) for ozone from an epidemiological perspective and proposes recommendations for researchers and policy makers on the basis of epidemiological evidence. We review current nationwide ozone control measures for mitigating ozone pollution from four dimensions: the integration of ozone and particulate matter control, ozone precursors control, ozone control in different seasons, and regional cooperation on the prevention of ozone pollution. In addition, we present environmental and epidemiological evidence and propose recommendations and discuss relevant ozone metrics and the criteria values of the NAAQS. We finally conclude that the disease burden attributable to ozone exposure in China may be underestimated and that the epidemiological research regarding the health effects of integrating ozone and particulate matter control is insufficient. Furthermore, atmospheric volatile organic compounds are severely detrimental to health, and related control policies are urgently required in China. We recommend a greater focus on winter ozone pollution and conclude that the health benefits of regional cooperation on ozone control and prevention are salient. We argue that daily average ozone concentration may be a more biologically relevant ozone metric than those currently used by the NAAQS, and accumulating epidemiological evidence supports revision of the standards. This review provides new insight for ozone mitigation policies and related epidemiological studies in China.
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Affiliation(s)
- Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China.
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Zafirah Y, Lin YK, Andhikaputra G, Deng LW, Sung FC, Wang YC. Mortality and morbidity of asthma and chronic obstructive pulmonary disease associated with ambient environment in metropolitans in Taiwan. PLoS One 2021; 16:e0253814. [PMID: 34228742 PMCID: PMC8259956 DOI: 10.1371/journal.pone.0253814] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study investigated risks of mortality from and morbidity (emergency room visits (ERVs) and outpatient visits) of asthma and chronic obstructive pulmonary disease (COPD) associated with extreme temperatures, fine particulate matter (PM2.5), and ozone (O3) by sex, and age, from 2005 to 2016 in 6 metropolitan cities in Taiwan. Methods The distributed lag non-linear model was employed to assess age (0–18, 19–39, 40–64, and 65 years and above), sex-cause-specific deaths, ERVs, and outpatient visits associated with extreme high (99th percentile) and low (5th percentile) temperatures and PM2.5 and O3 concentrations at 90th percentile. Random-effects meta-analysis was adopted to investigate cause-specific pooled relative risk (RR) and 95% confidence intervals (CI) for the whole studied areas. Results Only the mortality risk of COPD in the elderly men was significantly associated with the extreme low temperatures. Exposure to the 90th percentile PM2.5 was associated with outpatient visits for asthma in 0–18 years old boys [RR = 1.15 (95% CI: 1.09–1.22)]. Meanwhile, significant elevation of ERVs of asthma for females aged 40–64 years was associated with exposure to ozone, with the highest RR of 1.21 (95% CI: 1.05–1.39). Conclusions This study identified vulnerable subpopulations who were at risk to extreme events associated with ambient environments deserving further evaluation for adaptation.
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Affiliation(s)
- Yasmin Zafirah
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, University of Taipei College of City Management, Taipei, Taiwan
| | - Gerry Andhikaputra
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Li-Wen Deng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
- Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan
- * E-mail: ,
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Shao M, Yu L, Xiao C, Deng J, Yang H, Xu W, Chen Y, Liu X, Ni J, Pan F. Short-term effects of ambient temperature and pollutants on the mortality of respiratory diseases: A time-series analysis in Hefei, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 215:112160. [PMID: 33773152 DOI: 10.1016/j.ecoenv.2021.112160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/27/2021] [Accepted: 03/13/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND The air pollution has become an important environmental health problem due to its adverse health effect. The objective of this study was to investigate the effects of ambient temperature and pollutants on mortality of respiratory diseases (RD) in Hefei, China, a typical inland city. METHODS Nonlinear exposure-response dependencies and delayed effects of urban daily mean temperature (DMT) and pollutants were evaluated by distributed lag non-linear models (DLNM). To further explore this effect, different genders and ages were also examined by stratified analysis. RESULTS A total of 12876 deaths from RD were collected from January 1, 2014 to December 31, 2018 in Hefei, China. There was a U-shaped correlation between DMT and RD mortality, and the RD mortality rised by 11.6% (95% CI: 2.2-22.0%) when the DMT was 35.8 °C (reference temperature is 20 °C). The results show that risk of death with short-term exposure to elevated concentrations of PM10 and SO2 was not significant. The maximum hysteresis and cumulative relative risk (RR) of RD mortality were 1.012 (95% CI: 1.003 ~ 1.021, lag 0 day) and 1.072 (95% CI: 1.014 ~1.133, lag 10 days) for each 10 μg/m3 augment in NO2; 1.005 (95% CI: 1.001-1.009, lag 0 day) and 1.027 (95% CI: 1.004-1.051, lag 10 days) for each 10 μg/m3 augment in O3; a negative association between CO exposure and the cumulative risk of death was observed (RR = 0.964, 95% CI: 0.935-0.993, lag 07 days). Subgroup analysis showed the effect of high temperatures, NO2, O3 and CO exposure was still statistically significant for the elderly and male. CONCLUSION The present study found that short-term exposure to high temperature, NO2, O3 and CO were significantly associated with the risk of RD mortality and male as well as elderly are more susceptible to these factors.
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Affiliation(s)
- Ming Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Lingxiang Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Changchun Xiao
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui 230032, China
| | - Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Hui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Wei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui 230032, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Xincheng Road, Dongguan, Guangdong 523808, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
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王 新, 王 梅, 王 金, 田 海, 钟 翠. [Research on the correlation between otorhinolaryngologic diseases and environmental meteorological factors in children]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:546-553. [PMID: 32842189 PMCID: PMC10128322 DOI: 10.13201/j.issn.2096-7993.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Indexed: 11/12/2022]
Abstract
Objective:To explore the correlation between acute otitis media(AOM), acute pharyngitis(AP) and allergic rhinitis(AR) and environmental-meteorological factors in children in Lanzhou. Method:Data were collected in 2015-2017 from the outpatient department and emergency department of Otolaryngology of one hospital in Lanzhou. The association between clinical data and the environmental meteorological factors during the same period, including the air quality index(AQI), PM2.5, PM10, CO, NO₂, SO₂, O3, average temperature, average air pressure, average wind speed, average humidity in Lanzhou, was analyzed. Result:The incidence of AOM was positively correlated with AQI, PM2.5, PM10, CO, NO₂, SO₂, average air pressure, and was negatively correlated with O3, average wind speed and average air temperature, but not correlated with average humidity. The incidence of AP was positively correlated with average temperature and average humidity, and not correlated with other 9 factors. The incidence of AR was correlated with all 10 environmental meteorological factors except for O3.The number of children with AOM, AP and AR varied with different seasons. Environmental meteorological factors have single lag and cumulative lag effects on the incidence of children with AOM, AP and AR, and difference between the single lag and cumulative lag time was observed. Conclusion:There may be some correlation between the environmental meteorological factors and the incidence of AOM, AP, AR in children, and there is a lag effect. The incidence of pediatric AOM, AP and AR is affected by seasonal factors.
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Affiliation(s)
- 新兰 王
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940 Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
- 宁夏医科大学临床学院研究生院Graduate School of Clinical Medicine, Ningxia Medical University
| | - 梅 王
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940 Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
- 宁夏医科大学临床学院研究生院Graduate School of Clinical Medicine, Ningxia Medical University
| | - 金艳 王
- 兰州大学大气学院From the School of Atmospheric Sciences, Lanzhou University
| | - 海月 田
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940 Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
| | - 翠萍 钟
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940 Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
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11
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Hu F, Jing L, Shi R. Analysis of related factors and disease costs of respiratory infection and environmental pollution in children. Technol Health Care 2020; 28:355-360. [PMID: 32364168 PMCID: PMC7369095 DOI: 10.3233/thc-209036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In recent years, air pollution and the number of children with respiratory tract infections increased. This also increased the burden related to the treatment of disease, so the government and relevant departments need to strengthen their management. OBJECTIVE The aim of the present study was to quantitatively analyze the relationship between respiratory infection and air quality in children and gain insight into the burden of related diseases. METHODS Data regarding outpatient and emergency department visits in children of 14 years or younger in 16 public and private medical institutions were collected for four months. Routine air quality monitoring data in Shanghai from the same period were correlated with these medical data by descriptive statistics, Pearson's correlation analysis and multivariate linear regression analysis. RESULTS There was a positive correlation between respiratory tract infections in 73376 children and Air Quality Index (AQI), PM2.5, SO2 and NO2 levels. The total medical expense per patient was 80.22 yuan, and the average compensation ratio of medical insurance per patient was 18.95%. The increase in AQI and the concentration of major air pollutants will lead to increased medical treatment for children with respiratory diseases. CONCLUSION It is suggested that the intensity of air pollution control should be increased, so that the special period of childhood respiratory protection is strengthened. Moreover, child medical insurance coverage should also be moderately increased to safeguard the rights and interests of children's health.
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Affiliation(s)
| | | | - Rong Shi
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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12
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Liu C, Liu Y, Zhou Y, Feng A, Wang C, Shi T. Short-term effect of relatively low level air pollution on outpatient visit in Shennongjia, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:419-426. [PMID: 30453140 DOI: 10.1016/j.envpol.2018.10.120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 10/28/2018] [Accepted: 10/28/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Many cities in China are currently experiencing severe air pollution due to modernization. Previous studies investigating the effects of air pollutants exposure were particularly conducted in severe air polluted area and studies in low pollution areas were sparse. METHODS To quantitatively assess the short-term effects of ambient air pollutants (PM2.5, PM10, SO2, NO2, CO and O3) on outpatient visits in low pollution area, we conducted a time-series analysis from Jan 1, 2015 to Dec 31, 2016 in Shennongjia, China. Generalized additive model (GAM) was used to evaluate the influence of PM2.5 on daily hospital outpatient visits with different lag structures. We also conducted stratified analysis to explore the association between PM2.5 concentration and outpatient visits in different seasons. RESULTS In the present study, per IQR increment of PM2.5, PM10, NO2, CO and O3 were related with 1.92% (0.76%-3.09%), 1.92% (0.77%-3.07%), 2.74% (95% CI: 1.65%-3.83%), 1.89% (95% CI: 0.68%-3.10%) and 2.30% (95% CI: 0.65%-3.95%) increase on respiratory outpatient visits. Significant associations were found between PM2.5, PM10, NO2 and respiratory outpatient visits at lag0:1, lag0:2 days. The effects of PM2.5 were more evident in the cool season than in the warm season. CONCLUSIONS Our study showed that short-term exposures to PM2.5, PM10, NO2, CO and O3 were related with increased risk of outpatient visits of respiratory diseases, and highlighted the adverse effect of air pollutants exposure, especially PM2.5 exposure in cool season on health in low pollution area.
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Affiliation(s)
- Chenchen Liu
- School of Health Sciences, Wuhan University, Wuhan 430071, DongHu Road 115, Wuhan, 430071, PR China; Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei, 430079, PR China
| | - Yuewei Liu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei, 430079, PR China
| | - Yide Zhou
- Shennongjia Center for Disease Control and Prevention, 30 Songbai Road, Songbai, Shennongjia, 442400, PR China
| | - Anhui Feng
- Shennongjia Center for Disease Control and Prevention, 30 Songbai Road, Songbai, Shennongjia, 442400, PR China
| | - Chunhong Wang
- School of Health Sciences, Wuhan University, Wuhan 430071, DongHu Road 115, Wuhan, 430071, PR China
| | - Tingming Shi
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan North Road, Wuhan, Hubei, 430079, PR China.
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13
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The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020178. [PMID: 29360738 PMCID: PMC5858253 DOI: 10.3390/ijerph15020178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022]
Abstract
Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits.
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Li J, Sun S, Tang R, Qiu H, Huang Q, Mason TG, Tian L. Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2016; 11:3079-3091. [PMID: 28003742 PMCID: PMC5161337 DOI: 10.2147/copd.s122282] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Short-term exposure to major air pollutants (O3, CO, NO2, SO2, PM10, and PM2.5) has been associated with respiratory risk. However, evidence on the risk of chronic obstructive pulmonary disease (COPD) exacerbations is still limited. The present study aimed at evaluating the associations between short-term exposure to major air pollutants and the risk of COPD exacerbations. Methods After a systematic search up until March 30, 2016, in both English and Chinese electronic databases such as PubMed, EMBASE, and CNKI, the pooled relative risks and 95% confidence intervals were estimated by using the random-effects model. In addition, the population-attributable fractions (PAFs) were also calculated, and a subgroup analysis was conducted. Heterogeneity was assessed by I2. Results In total, 59 studies were included. In the single-pollutant model, the risks of COPD were calculated by each 10 μg/m3 increase in pollutant concentrations, with the exception of CO (100 μg/m3). There was a significant association between short-term exposure and COPD exacerbation risk for all the gaseous and particulate pollutants. The associations were strongest at lag0 and lag3 for gaseous and particulate air pollutants, respectively. The subgroup analysis not only further confirmed the overall adverse effects but also reduced the heterogeneities obviously. When 100% exposure was assumed, PAFs ranged from 0.60% to 4.31%, depending on the pollutants. The adverse health effects of SO2 and NO2 exposure were more significant in low-/middle-income countries than in high-income countries: SO2, relative risk: 1.012 (95% confidence interval: 1.001, 1.023); and NO2, relative risk: 1.019 (95% confidence interval: 1.014, 1.024). Conclusion Short-term exposure to air pollutants increases the burden of risk of COPD acute exacerbations significantly. Controlling ambient air pollution would provide benefits to COPD patients.
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Affiliation(s)
- Jinhui Li
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Shengzhi Sun
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Robert Tang
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Qingyuan Huang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Minhang, Shanghai, People's Republic of China
| | - Tonya G Mason
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Linwei Tian
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
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Alimohammadi H, Fakhri S, Derakhshanfar H, Hosseini-Zijoud SM, Safari S, Hatamabadi HR. The Effects of Air Pollution on Ischemic Stroke Admission Rate. Chonnam Med J 2016; 52:53-8. [PMID: 26866000 PMCID: PMC4742610 DOI: 10.4068/cmj.2016.52.1.53] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 11/28/2022] Open
Abstract
The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2±13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM10 (p<0.001) and PM2.5 (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department.
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Affiliation(s)
- Hossein Alimohammadi
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Fakhri
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat Derakhshanfar
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mostafa Hosseini-Zijoud
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeed Safari
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Hatamabadi
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang YC, Lin YK. Temperature effects on outpatient visits of respiratory diseases, asthma, and chronic airway obstruction in Taiwan. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:815-825. [PMID: 25225115 DOI: 10.1007/s00484-014-0899-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/08/2014] [Accepted: 09/04/2014] [Indexed: 06/03/2023]
Abstract
This study evaluated the risk of outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified (CAO) associated with ambient temperatures and extreme temperature events from 2000 to 2008 in Taiwan. Based on geographical and socioeconomics characteristics, this study divided the whole island into seven areas. A distributed lag non-linear model was used to estimate the area-disease-specific cumulative relative risk (RR), and random-effect meta-analysis was used to estimate the pooled RR of outpatient visits, from lag 0 to lag 7 days, associated with daily temperature, and added effects of prolonged extreme heat and cold for population of all ages, the elderly and younger than 65 years. Pooled analyses showed that younger population had higher outpatient visits for exposing to low temperature of 18 °C, with cumulative 8-day RRs of 1.36 (95% confidence interval (CI) 1.31-1.42) for respiratory diseases, 1.10 (95% CI 1.03-1.18) for asthma, and 1.12 (95% CI 1.02-1.22) for CAO. The elderly was more vulnerable to high temperature of 30 °C with the cumulative 8-day RR of 1.08 (95% CI 1.03-1.13) for CAO. Elevated outpatient visits for all respiratory diseases and asthma were associated with extreme heat lasting for 6 to 8 days. On the contrary, the extreme cold lasting more than 8 days had significant negative association with outpatient visits of all respiratory diseases. In summary, elderly patients of respiratory diseases and CAO are vulnerable to high temperature. Cold temperature is associated with all types of respiratory diseases for younger patients.
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Affiliation(s)
- Yu-Chun Wang
- Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan,
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von Schneidemesser E, Monks PS, Allan JD, Bruhwiler L, Forster P, Fowler D, Lauer A, Morgan WT, Paasonen P, Righi M, Sindelarova K, Sutton MA. Chemistry and the Linkages between Air Quality and Climate Change. Chem Rev 2015; 115:3856-97. [PMID: 25926133 DOI: 10.1021/acs.chemrev.5b00089] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Paul S Monks
- ‡Department of Chemistry, University of Leicester, Leicester LE1 7RH, United Kingdom
| | | | | | | | - David Fowler
- ∇Centre for Ecology and Hydrology, Natural Environment Research Council, Edinburgh EH26 0QB, United Kingdom
| | - Axel Lauer
- †Institute for Advanced Sustainability Studies, 14467 Potsdam, Germany
| | | | - Pauli Paasonen
- ○Department of Physics, University of Helsinki, 00100 Helsinki, Finland
| | - Mattia Righi
- ◆Deutsches Zentrum für Luft- und Raumfahrt, Institut für Physik der Atmosphäre, 82234 Oberpfaffenhofen, Germany
| | - Katerina Sindelarova
- ¶UPMC Univ. Paris 06, Université Versailles St-Quentin; CNRS/INSU; LATMOS-IPSL, UMR 8190 Paris, France.,□Department of Atmospheric Physics, Faculty of Mathematics and Physics, Charles University, 116 36 Prague, Czech Republic
| | - Mark A Sutton
- ∇Centre for Ecology and Hydrology, Natural Environment Research Council, Edinburgh EH26 0QB, United Kingdom
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Shahi AM, Omraninava A, Goli M, Soheilarezoomand HR, Mirzaei N. The Effects of Air Pollution on Cardiovascular and Respiratory Causes of Emergency Admission. EMERGENCY (TEHRAN, IRAN) 2014; 2:107-114. [PMID: 26495360 PMCID: PMC4614571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Today, air pollution is one of the critical problems in metropolitans and necessary preparations are needed for confronting this crisis. The present study was based on the goal of determining the relationship of air pollutant levels with the rate of emergency admissions for respiratory and cardiovascular patients. METHODS In the present retrospective cross-sectional study, all respiratory and cardiovascular patients, referred to emergency department during 2012, were assessed. The meteorological and air pollution data were collected. Information regarding the numbers and dates (month, day) of admission for respiratory and cardiovascular diseases was achieved from the hospital's electronic registration system. The relation of air pollution and respiratory and cardiovascular admissions were analyzed by generalize additive model (GAM). RESULTS 5922 patients were assessed which included 4048 (68.36%) cardiovascular and 1874 (31.64%) respiratory. Carbon monoxide (CO) level was an independent risk factor of cardiovascular disease on the same day (RR=1.49; 95% CI: 1.25- 1.77; P<0.001), the day before (RR=1.22; 95% CI: 1.02- 1.45; P=0.03), and the last two days (RR=1.3; 95% CI: 1.09- 1.54; P<0.001). The same process was repeated for ozone (O3). In addition, the O3 level on the same day (RR=1.49; 95% CI: 1.25- 1.77; P<0.001), the day before (RR=1.22; 95% CI: 1.02- 1.45; P=0.03), the last two days (RR=1.3; 95% CI: 1.09- 1.54; P<0.001), and the last week (RR=1.004; 95% CI: 1.0007-1.008; P=0.02) were independent risk factors of respiratory admissions. The increased level of particulate matter less than 2.5 micrometers in diameter (PM2.5) like O3 led to growth in the admissions to emergency department. CONCLUSION The findings of the present study suggested that rising levels of CO and O3 during two days leads to a significant increase in cardiovascular admission on the third day. Furthermore, increase in O3, PM2.5, nitrogen dioxide (NO2), and CO levels causes a rise in respiratory admissions to emergency department.
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Affiliation(s)
- Ali Mohammad Shahi
- Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Omraninava
- Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mitra Goli
- Department of Geriatric Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Soheilarezoomand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Mirzaei
- Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
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