Acute exposure to total and source-specific ambient fine particulate matter and risk of respiratory disease hospitalization in Kuwait

A comparative analysis of three PM2.5 exposure metrics and their impact on respiratory disease hospitalizations in Lanzhou, China

Research on the associations between PM2.5 and total respiratory diseases (RD) in Lanzhou is limited. We investigated the short-term impact of PM2.5 on total RD hospitalizations in Lanzhou (2015-2019) using various exposure metrics. We collected data on hospitalizations, daily air pollutant concentrations, and meteorological factors during the study period. Daily excessive concentration hours (DECH) were calculated according to the World Health Organization's air quality guidelines. A distributional lag nonlinear model (DLNM) based on a generalized additive model (GAM) was used to comparatively analyze the association between three PM2.5 exposure metrics (DECH (DECH PM2.5), daily mean concentration (Mean PM2.5), and hourly peak concentration (Peak PM2.5)) and RD hospitalizations. Subgroup analyses and sensitivity analyses were also performed. We found similar effects on RD hospitalizations using DECH PM2.5 and Mean PM2.5, but relatively weak associations observed using Peak PM2.5. The cumulative lag effect increased daily. Subgroup analyses showed that females and children aged 0-17 years were more susceptible to PM2.5 pollution and that the association was enhanced during the cold season. Our research strengthened the evidence that exposure to ambient PM2.5 increases the risk of RD. This study revalidated the reliability of the new metrics and confirmed that DECH PM2.5 effect estimates for exposure-disease were more accurate than the Mean PM2.5.

Association of acute exposure to PM2.5 constituents and sources with kidney injury: A longitudinal panel study of Nrf2 promoter polymorphism

Evidence on the effects of fine particulate matter (PM2.5) constituents and sources on kidney injury is limited. We designed a panel study with 4 repeated measurements to investigate the association of acute exposure to chemical constituents and source-specific PM2.5 with kidney function and renal tubular injury. We further evaluated the modifying effect of Nrf2 promoter polymorphism. In this study, a total of 64 participants were recruited and ambient PM2.5 constituents were monitored at a fixed-site station. We used a positive matrix factorization (PMF) model to identify emission sources and linear mixed-effect models to explore the associations. An interquartile range (IQR) increase in PM2.5 concentration was associated with a 1.40 % and 3.15 % decrease in eGFR-Cr (eGFR assessed by creatinine) and eGFR-Cys (eGFR assessed by cystatin-C), respectively, and 10.2 % higher kidney injury molecule 1 (KIM-1) levels. Carbonaceous components (EC and OC), metallic elements (Cr, K, Pb, Zn) and Cl- were robustly responsible for kidney injury. Per IQR increase in these constituents accounted for 0.57 % to 1.62 % declines in eGFR-Cr; 1.36 % to 3.66 % declines in eGFR-Cys; and 7.50 % to 19.83 % increments in KIM-1. Specific source analysis revealed that PM2.5 emitted by combustion was associated with the largest reduction in eGFR, while the secondary source played a more prominent role in renal tubular injury. The dominant models showed that the magnitudes of the effect estimates of PM2.5 and its constituents were generally larger in the participants with minor alleles of the Nrf2 promoter. These findings suggest that acute exposure to EC, OC, Cl- and several metallic constituents may be responsible for kidney injury induced by PM2.5, especially in individuals with unfavorable Nrf2 genotypes. PM2.5 from combustion and secondary sources impairs kidney health, highlighting the importance of source-oriented PM2.5 control strategies.

Combined impact of heat and dust on diabetes hospitalization in Kuwait

INTRODUCTION

In Kuwait, a severe diabetes and obesity epidemic coexists with intense dust storms and harsh summer heat. While, theoretically, this interplay between dust, heat, and diabetes presents a serious public health problem, the empirical understanding of the actual risks remains limited. We hypothesized that increased exposure to heat and dust, independently and jointly, exacerbates the risk of hospitalization for diabetes patients.

RESEARCH DESIGN AND METHODS

We placed custom-designed particle samplers in Kuwait to collect daily dust samples for 2 years from 2017 to 2019. Samples were analyzed for elemental concentrations to identify and quantify dust pollution days. Temperature data were collected from meteorological stations. We then collected hospitalization data for unplanned diabetic admissions in all public hospitals in Kuwait. We used a case-crossover study design and conditional quasi-Poisson models to compare hospitalization days to control days within the same subject. Finally, we fitted generalized additive models to explore the smoothed interaction between temperature and dust days on diabetes hospitalization.

RESULTS

There were 11 155 unplanned diabetes hospitalizations over the study period. We found that each year, there was an excess of 282 diabetic admissions attributed to hot days (95% CI: -14 to 473). Additionally, for every 10 µg/m3 increase in dust levels, there were about 114 excess diabetic admissions annually (95% CI: 11 to 219). Compared with mild non-dusty days (33°C (0 µg/m3)), hot-dusty days jointly increased the relative risk of diabetic admissions from 1.11 at 42°C (85 µg/m3) to 1.36 at 42°C (150 µg/m3).

CONCLUSIONS

Both heat and dust seem to contribute to the increased diabetes morbidity, with combined hot-dusty conditions exacerbating these risks even further.

Synergistic approaches to elevate indoor air quality: A holistic examination of classroom refinement, air exchange optimization, and flooring material impact

This research endeavors to elevate indoor air quality within aging school environments by concentrating on refining interior finishing materials and windows. Renovations, encompassing window and floor remodeling in classrooms, aim to mitigate particulate matter (PM) infiltration and enhance air exchange rates. Utilizing SPS30 sensors for the analysis of 0.3-2.5 μm particles, with a focus on their implications for human health, the study evaluated air exchange rates, deposition rates, infiltration rates, and particle generation during classroom activities. Post-renovation results demonstrated a noteworthy decrease in air exchange rates, indicating an enhancement in airtightness. The investigation delves into particle generation with various flooring materials, accentuating the importance of opting for durable and low-particle-generating alternatives. Health risk assessments, considering multiple exposure routes (inhalation, dermal contact, and ingestion), revealed reduced risks post-renovation, particularly for children. To further optimize indoor air quality, the study suggests the implementation of air purification systems. Examination of PM generation during student activities showcased a substantial reduction post-renovation. This study underscores the positive influence of architectural enhancements on indoor air quality while acknowledging the necessity for holistic solutions and continuous research.

Evaluation of particle generation due to deterioration of flooring in schools

Particulate matter is harmful to humans. An important indoor source of such particles is the deterioration of floor materials brought about by occupants walking. Accordingly, an experiment was conducted to simulate the deterioration of floor material spacing. Considering a school schedule with repeated semesters and vacations, the experiment was conducted by repeating heat-and-rest cycles. Similar results were obtained for particle emission rates under each condition during the first and second deterioration periods. The PVC tiles generated more particles under aged conditions than under non-aged conditions, whereas the wood generated fewer particles under aged conditions. In addition to the quantitative results, a study was conducted on the characteristics of the generated particles, and the particulate matter found in plastic was confirmed in the PVC tiles. Schools where children are present for more than 6 h a day may be exposed to more particulate matter. Therefore, replacing plastic-based materials with eco-friendly building materials is expected to have long-term health benefits for children.

Identifying urban emission sources and their contribution to the oxidative potential of fine particulate matter (PM2.5) in Kuwait

In this study, we investigated the seasonal variations, chemical composition, sources, and oxidative potential of ambient PM2.5 (particles with a diameter of less than 2.5 μm) in Kuwait City. The sampling campaign was conducted within the premises of Kuwait Institute for Scientific Research from June 2022 to May 2023, covering different seasons throughout the year. The personal cascade impactor sampler (PCIS) operated at flow rate of 9 L/min was employed to collect weekly PM2.5 samples on PTFE and quarts filters. These collected samples were analyzed for carbonaceous species (i.e., elemental and organic carbon), metals and transition elements, inorganic ions, and DTT (dithiothreitol) redox activity. Furthermore, principal component analysis (PCA) and multi-linear regression (MLR) were used to identify the predominant emission sources and their percentage contribution to the redox activity of PM2.5 in Kuwait. The results of this study highlighted that the annual-averaged ambient PM2.5 mass concentrations in Kuwait (59.9 μg/m3) substantially exceeded the World Health Organization (WHO) guideline of 10 μg/m3. Additionally, the summer season displayed the highest PM2.5 mass concentration (75.2 μg/m3) compared to other seasons, primarily due to frequent dust events exacerbated by high-speed winds. The PCA identified four primary PM2.5 sources: mineral dust, fossil fuel combustion, road traffic, and secondary aerosols. The mineral dust was found to be the predominant source, contributing 36.1% to the PM2.5 mass, followed by fossil fuel combustion and traffic emissions with contributions of 23.7% and 20.3%, respectively. The findings of MLR revealed that road traffic was the most significant contributor to PM2.5 oxidative potential, accounting for 47% of the total DTT activity. In conclusion, this comprehensive investigation provides essential insights into the sources and health implications of PM2.5 in Kuwait, underscoring the critical need for effective air quality management strategies to mitigate the impacts of particulate pollution in the region.