Role of Saharan dust in the relationship between particulate matter and short-term daily mortality among the elderly in Madrid (Spain)

Unravelling the interplay between Harmattan wind and baroreflex functions: implications on environmental health and cardiovascular pathophysiology

Harmattan is a season characterized by dust, cold, and sub-humid trade winds in Sub-Saharan countries. It’s similar to meteorological phenomena like Asian dust storms, Santa Ana winds, Australian bushfires, and Saharan dust in the Caribbean. It causes profound changes in the cardiorespiratory system in apparently healthy individuals and increases the risk of hospitalization in susceptible individuals. Exposure to these extreme conditions has been associated with alterations in autonomic function and baroreceptor sensitivity thus resulting in dysregulation of blood pressure control mechanisms. Baroreceptors are critical regulators of hemodynamics and cardiovascular function. They play a vital role in the short-term responses to blood pressure perturbation and are essential for acute restoration of blood pressure following cold exposure. Harmattan wind contains a barrage of chemicals, dust, and particulate matters depending on industrialization, natural and human activities. Particulate matter from Harmattan dust can trigger systemic inflammation and oxidative stress, exacerbating endothelial dysfunction and impairing vascular reactivity thus contributing to the pathogenesis of alterations in baroreceptor insensitivity, and cardiovascular diseases, including hypertension and atherosclerosis. Furthermore, fine particulate matter from dust may penetrate deep into the respiratory tract, activating pulmonary sensory receptors and eliciting reflex responses that influence autonomic tone. The presence of rich acrolein smokes and non-essential heavy metals such as cadmium, lead, and mercury in Harmattan wind also reduces baroreflex sensitivity, culminating in a sustained increase in diastolic and systolic blood pressure. This integrated review aims to provide valuable insights into how changes in each of these environmental constituents alter vital pathophysiologic and immunologic mechanisms of the body leading to baroreceptor instability and ultimately hemodynamic imbalance using available primary studies. Understanding this intricate interplay is crucial for implementing targeted interventions and informed public health strategies to mitigate the adverse effects of extreme environmental exposure and ultimately reduce poor health outcomes in the affected regions.

Ambient dust pollution with all-cause, cardiovascular and respiratory mortality: A systematic review and meta-analysis

A severe health crisis has been well-documented regarding dust particle exposure. We aimed to present the risk of all-cause, cardiovascular, and respiratory mortality due to particulate matter (PM) exposure during non-dust and dust storm events by performing a meta-analysis. A systematic review of the literature was conducted by an online search of the databases (Google Scholar, Web of Science, Scopus, and PubMed) with no restrictions according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines until December 2022. We performed a random-effects model to compute the pooled rate ratio (RR) of mortality with 95 % confidence intervals (CI). The Office of Health Assessment and Translation (OHAT) risk of bias rating tool was prepared to assess the quality of the individual study. The registration number in PROSPERO was CRD42023423212. We found a 16 % (95 % CI: 0.7 %, 24 %) increase in all-cause, 25 % (95 % CI: 14 %, 37 %) increase in cardiovascular, and 18 % (95 % CI: 13 %, 22 %) increase in respiratory mortality per 10 μg/m3 increment in dust exposure. Furthermore, the RRs per 10 μg/m3 increment in PM10-2.5 were 1.046 (95 % CI: 1.019, 1.072)¸ 1.085 (95 % CI: 1.045, 1.0124), and 1.089 (95 % CI: 0.939, 1.24) for all-cause, cardiovascular, and respiratory mortality, respectively. PM10 during dust days significantly increased the all-cause (1.013, 95 % CI: 1.007, 1.018) cardiovascular mortality risk (1.014, 95 % CI: 1.009, 1.02). We also found significant evidence for all-cause, cardiovascular, and respiratory mortality among females and the elderly age group due to dust particle (PM10-2.5 and PM10) exposure. Our results provided significant evidence about high concentrations of PM10-2.5 and PM10 during dust storm events related to mortality risk.

Construction and demolition waste in cement matrices as sinkholes of atmospheric pollution: Effect of the 2022 airborne dust in the Iberian Peninsula

The coincidence of a study on different ecocements to environmental exposition in Madrid (Spain) with the airborne dust from the Sahara desert in the same location, during the year 2022, facilitated the knowledge of the ecocement permeability to different sources of contamination. In general, mortars with a siliceous composition are more compact and less permeable to environmental particles compared to those with a calcareous composition. Binary mortars with glass have an intermediate response to pollutants and the most favorable for the incidence of contamination are ternary sulfoaluminate cements. The analysis of the ions penetration in the different cements studied has been followed by XRF, XRD-Rietveld and SEM/EDX analyses.

Exploring the impact of particulate matter on mortality in coastal Mediterranean environments

Air pollution is one of the most important problems the world is facing nowadays, adversely affecting public health and causing millions of deaths every year. Particulate matter is a criteria pollutant that has been linked to increased morbidity, as well as all-cause and cause-specific mortality. However, this association remains under-investigated in smaller-size cities in the Eastern Mediterranean, which are also frequently affected by heat waves and dust storms. This study explores the impact of particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀) and ≤ 2.5 μm (PM_2.5) on mortality (all-cause, cardiovascular, respiratory) in two coastal cities in the Eastern Mediterranean; Thessaloniki, Greece and Limassol, Cyprus. Generalized additive Poisson models were used to explore overall and gender-specific associations, controlling for long- and short-term patterns, day of week and the effect of weather variables. Moreover, the effect of different lags, season, co-pollutants and dust storms on primary associations was investigated. A 10 μg/m³ increase in PM_2.5 resulted in 1.10 % (95 % CI: -0.13, 2.34) increase in cardiovascular mortality in Thessaloniki, and in 3.07 % (95 % CI: -0.90, 7.20) increase in all-cause mortality in Limassol on the same day. Additionally, significant positive associations were observed between PM_2.5 as well as PM₁₀ and mortality at different lags up to seven days. Interestingly, an association with dust storms was observed only in Thessaloniki, having a protective effect, while the gender-specific analysis revealed significant associations only for the males in both cities. The outcome of this study highlights the need of city- or county-specific public health interventions to address the impact of climate, population lifestyle behaviour and other socioeconomic factors that affect the exposure to air pollution and other synergistic effects that alter the effect of PM on population health.

Stratospheric impacts on dust transport and air pollution in West Africa and the Eastern Mediterranean

Saharan dust intrusions strongly impact Atlantic and Mediterranean coastal regions. Today, most operational dust forecasts extend only 2-5 days. Here we show that on timescales of weeks to months, North African dust emission and transport are impacted by sudden stratospheric warmings (SSWs), which establish a negative North Atlantic Oscillation-like surface signal. Chemical transport models show a large-scale dipolar dust response to SSWs, with the burden in the Eastern Mediterranean enhanced up to 30% and a corresponding reduction in West Africa. Observations of inhalable particulate (PM10) concentrations and aerosol optical depth confirm this dipole. On average, a single SSW causes 680-2460 additional premature deaths in the Eastern Mediterranean and prevents 1180-2040 premature deaths in West Africa from exposure to dust-source fine particulate (PM2.5). Currently, SSWs are predictable 1-2 weeks in advance. Altogether, the stratosphere represents an important source of subseasonal predictability for air quality over West Africa and the Eastern Mediterranean.

Pollution, sources, and human health risk assessment of heavy metals in urban areas around industrialization and urbanization-Northwest China

Heavy metal pollution in urban soils and dust is mostly caused by extensive anthropogenic activity during urbanization and industrialization. In this research study, the pollution characteristics, sources, ecological and human health risks of heavy metals in urban soil, and dust have been thoroughly evaluated. The research findings demonstrate that dust has a higher level of contamination than urban soil, such as Pb, Cu, and Zn metals are more contaminated in both urban soil and dust throughout the city, and Hg and As are also found in locations with a high concentration of heavy industrial companies. This implies that traffic emissions are still a significant source of metals in urban areas, though industrial companies also contribute. The health risk assessment model used to calculate human exposure revealed that the non-carcinogenic and carcinogenic risks of selected metals in soil and dust were generally in the low range, except for the carcinogenic risk from Cr in children. Statistical analysis revealed that Cr and Ni concentrations were mainly of natural origin, Cu and Zn have been sourced from traffic, whereas Pb, Hg, and As have been sourced from industrial activities. The overall recommendation is that the road traffic environment and municipal construction facilities need to be improved to ensure the sustainable development of the city's environment, while pollution from industrial waste is strongly controlled.

Heavy metal pollution levels, source apportionment and risk assessment in dust storms in key cities in Northwest China

In this study, the potential hazards of heavy metals in dust storms were investigated by collecting dust storm samples, measuring their heavy metal concentrations, and using index evaluation, spatial analysis, positive matrix factorization (PMF) model and risk assessment model. Heavy metals in dust storms were contaminated by anthropogenic sources leading to their concentrations being higher than the background values. The enrichment factors and geoaccumulation indices showed that the heavy metals came from both natural and anthropogenic sources, Cu, Ni, Zn and Pb are strongly influenced by anthropogenic sources. Heavy metals in dust storms were divided into four sources: Cu and Ni were attributed to industrial sources mainly from local mining and metal processing; Cr was mainly contributed by industrial sources related to industrial production such as coal combustion; Pb and Zn were mainly contributed by transportation sources; and Ti, V, Mn, Fe, and As were from natural and agricultural sources. The level of comprehensive ecological risk of heavy metals in dust storms were low, but there were moderate and above risks at individual sites. Both adults and children had the highest carcinogenic and non-carcinogenic risks from the ingestion route, and the risk for children was higher than that for adults.

Contribution of anthropogenic and natural sources in PM10 during North African dust events in Southern Europe

The influence of North African (NAF) dust events on the air quality at the regional level (12 representative monitoring stations) in Southern Europe during a long time series (2007-2014) was studied. PM10 levels and chemical composition were separated by Atlantic (ATL) and NAF air masses. An increase in the average PM10 concentrations was observed on sampling days with NAF dust influence (42 μg m^-3) when compared to ATL air masses (29 μg m^-3). Major compounds such as crustal components and secondary inorganic compounds (SIC), as well as toxic trace elements derived from industrial emissions, also showed higher concentrations of NAF events. A source contribution analysis using positive matrix factorisation (PMF) 5.0 of the PM10 chemical data, discriminating ATL and NAF air mass origins, allowed the identification of five sources: crustal, sea salt, traffic, regional, and industrial. A higher contribution (74%) of the natural sources to PM10 concentrations was confirmed under NAF episodes compared with ATL. Furthermore, there was an increase in anthropogenic sources during these events (51%), indicating the important influence of the NAF air masses on these sources. The results of this study highlight that environmental managers should take appropriate actions to reduce local emissions during NAF events to ensure good air quality.

Effect of Dust Storms on Non-Accidental, Cardiovascular, and Respiratory Mortality: A Case of Dezful City in Iran

BACKGROUND

Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019.

METHODS

In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality.

RESULTS

During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag4: 34.17% and 15-64 years of age groups, lag5: 32.19%, lag6: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag6: 5.49%).

CONCLUSION

The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

North African dust intrusions and increased risk of respiratory diseases in Southern Portugal

The study of dust intrusions in Portugal is still a subject on which little investigation has been made, especially in terms of their effects. Thus, this work aims to achieve two goals: firstly, to characterize the dust intrusions in the study area; and secondly, to evaluate the possible statistical association between the dust intrusion days and hospital admissions due to respiratory diseases. Dust intrusions in Portugal are prevalent during the summer season. During this season, the dust plumes tend to cover broader areas than in the other seasons and they have origin in the North African countries. In the study area for the period between 2005 and 2015, the relative risk of urgent hospitalizations due to respiratory diseases was 12.6% higher during dust intrusion days. In order to obtain this statistical association, a Distributed Lag Nonlinear Model was developed. With this work, we expect to help the development of further studies regarding North African dust intrusions in Portugal, more precisely their effects on human health.

Particulate matter concentrations and their association with COVID-19-related mortality in Mexico during June 2020 Saharan dust event

The present study evaluated the impact of Saharan dust event on particulate matter (PM: PM₁₀ and PM_2.5) concentrations by analyzing the daily average PM data between Saharan dust days (June 23-29, 2020) and non-Saharan dust days (June 15 to June 22 and June 30 to July 12, 2020) for four majorly affected regions in Mexico and by comparing with three major previous events (2015, 2018, and 2019). The results showed that PM₁₀ and PM_2.5 concentrations were 2-5 times higher during the Saharan dust event with the highest daily averages of 197 μg/m³ and 94 μg/m³, respectively, and exceeded the Mexican standard norm (NOM-020-SSA1-2014). When comparing with the previous Saharan dust episodes of 2015, 2018, and 2019, the levels of PM₁₀ and PM_2.5 considerably increased and more than doubled across Mexico. The correlation analysis revealed a positive association of PM levels with the number of daily COVID-19 cases and deaths during Saharan dust event. Furthermore, the human health risk assessment showed that the chronic daily intake and hazard quotient values incremented during Saharan dust days compared to non-Saharan days, indicating potential health effects and importance of taking necessary measures to ensure better air quality following the COVID-19 pandemic.

Global Health Impacts of Dust Storms: A Systematic Review

BACKGROUND

Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue.

METHOD

In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table.

RESULTS

The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular.

CONCLUSION

The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.Registration: PROSPERO registration number CRD42018093325.

Short-term exposure to extreme temperature and risk of hospital admission due to cardiovascular diseases

Objective: Numerous epidemiological studies have reported relevance of morbidity and mortality from cardiovascular diseases with short-term exposure to environmental temperature. In this study, we examined the hypothesis between temperature indices and hospital admission because of cardiovascular diseases. Methods: The daily number of CVDs was obtained from all hospitals of the Sabzevar city. A semi-parametric generalized additive model (GAM) following a quasi-Poisson distribution with distributed lag non-linear model (dlnm) was selected as a modeling framework for time-series analysis. Results: The overall CVD risk comparing the 1st percentile and the 99th percentile relative to the mean temperature (at lag 0) was 1.33 (95% CI, 1.11: 1.61), and 1.34 (95% CI, 1.10: 1.64), respectively. For all indicators, the extremely cold effects persisted for the initial 7 days. Conclusions: Our results suggest that extremely cold and extremely hot temperatures increase the relative risk of cardiovascular diseases.

When Land Is Under Pressure Health Is Under Stress

The land provides vital resources to support life on Earth. Land ecosystems services have social, cultural, and spiritual benefits and promote human health and well-being. However, human activities, particularly ongoing unsustainable land practices, are negatively impacting ecosystems through desertification, land degradation and drought (DLDD). This article highlights the pressures and impacts of DLDD on human health through exposure pathways, including water security and safety; sanitation and hygiene; food security and safety; air quality; and soil quality. We describe the impacts on 19 health outcomes in three groups: non-communicable diseases; injuries; and infections, parasitic and nutritional diseases. The magnitude of these health impacts is mediated by social, economic, and health system-related factors. We propose actions for the health sector to respond to the DLDD challenges.

Peaks of Fine Particulate Matter May Modulate the Spreading and Virulence of COVID-19

A probe of a patient, seeking help in an emergency ward of a French hospital in late December 2019 because of Influenza like symptoms, was retrospectively tested positive to COVID-19. Despite the early appearance of the virus in Europe, the prevalence and virulence appeared to be low for several weeks, before the spread and severity of symptoms increased exponentially, yet with marked spatial and temporal differences. Here, we compare the possible linkages between peaks of fine particulate matter (PM2.5) and the sudden, explosive increase of hospitalizations and mortality rates in the Swiss Canton of Ticino, and the Greater Paris and London regions. We argue that these peaks of fine particulate matter are primarily occurring during thermal inversion of the boundary layer of the atmosphere. We also discuss the influence of Saharan dust intrusions on the COVID-19 outbreak observed in early 2020 on the Canary Islands. We deem it both reasonable and plausible that high PM2.5 concentrations-favored by air temperature inversions or Saharan dust intrusions-are not only modulating but even more so boosting severe outbreaks of COVID-19. Moreover, desert dust events-besides enhancing PM2.5 concentrations-can be a vector for fungal diseases, thereby exacerbating COVID-19 morbidity and mortality. We conclude that the overburdening of the health services and hospitals as well as the high over-mortality observed in various regions of Europe in spring 2020 may be linked to peaks of PM2.5 and likely particular weather situations that have favored the spread and enhanced the virulence of the virus. In the future, we recommended to monitor not only the prevalence of the virus, but also to consider the occurrence of weather situations that can lead to sudden, very explosive COVID-19 outbreaks.

Response of plant reflectance spectrum to simulated dust deposition and its estimation model

To quantitatively reflect the relationship between dust and plant spectral reflectance. Dust from different sources in the city were selected to simulate the spectral characteristics of leaf dust. Taking Euonymus japonicus as the research object. Prediction model of leaf dust deposition was established based on spectral parameters. Results showed that among the three different dust pollutants, the reflection spectrum has 6 main reflection peaks and 7 main absorption valleys in 350-2500 nm. A steep reflection platform appears in the 692-763 nm band. In 760-1400 nm, the spectral reflectance gradually decreases with the increase of leaf dust coverage, and the variation range was coal dust > cement dust > pure soil dust. The spectral reflectance in 680-740 nm gradually decreases with the increase of leaf dust coverage. In the near infrared band, the fluctuation amplitude and slope of its first derivative spectrum gradually decrease with the increase of leaf dust. The biggest amplitude of variation was cement dust. With the increase of dust retention, the red edge position generally moves towards short wave direction, and the red edge slope generally decreases. The blue edge position moved to the short wave direction first and then to the long side direction, while the blue edge slope generally shows a decreasing trend. The yellow edge position moved to the long wave direction first and then to the short wave direction (coal dust, cement dust), and generally moved to the long side direction (pure soil dust). The yellow edge slope increases first and then decreases. The R2 values of the determination coefficients of the dust deposition prediction model have reached significant levels, which indicated that there was a relatively stable correlation between the spectral reflectance and dust deposition. The best prediction model of leaf dust deposition was leaf water content index model (y = 1.5019x - 1.4791, R2 = 0.7091, RMSE = 0.9725).

Health Effects of Asian Dust: A Systematic Review and Meta-Analysis

BACKGROUND

Potential adverse health effects of Asian dust exposure have been reported, but systematic reviews and quantitative syntheses are lacking.

OBJECTIVE

We reviewed epidemiologic studies that assessed the risk of mortality, hospital admissions, and symptoms/dysfunction associated with exposure to Asian dust.

METHODS

We performed a systematic search of PubMed and Web of Science to identify studies that reported the association between Asian dust exposure and human health outcomes. We conducted separate meta-analyses using a random-effects model for mortality and hospital admissions for a specific health outcome and assessed pooled estimates for each lag when at least three studies were available for a specific lag.

RESULTS

We identified 89 studies that met our inclusion criteria for the systematic review, and 21 studies were included in the meta-analysis. The pooled estimates (percentage changes) of mortality from circulatory and respiratory causes for Asian dust days vs. non-Asian dust days were 2.33% [95% confidence interval (CI): 0.76, 3.93] increase at lag 0 and 3.99% (95% CI: 0.08, 8.06) increase at lag 3, respectively. The increased risk for hospital admissions for respiratory disease, asthma, and pneumonia peaked at lag 3 by 8.85% (95% CI: 0.80, 17.55), 14.55% (95% CI: 6.74, 22.94), and 8.51% (95% CI: 2.89, 14.44), respectively. Seven of 12 studies reported reduced peak expiratory flow, and 16 of 21 studies reported increased respiratory symptoms associated with Asian dust exposure. There were substantial variations between the studies in definitions of Asian dust, study designs, model specifications, and confounder controls.

DISCUSSION

We found evidence of increased mortality and hospital admissions for circulatory and respiratory events. However, the number of studies included in the meta-analysis was not large and further evidences are merited to strengthen our conclusions. Standardized protocols for epidemiological studies would facilitate interstudy comparisons. https://doi.org/10.1289/EHP5312.

Saharan dust intrusions in the Iberian Peninsula: Predominant synoptic conditions

The Iberian Peninsula (IP) is recurrently affected by dust transport from the Sahara Desert and from the semi-arid Sahel regions. African dust is one of the most important sources of particulate matter in the southern Mediterranean. Therefore, it is vital to understand the underlying processes that lead to episodes of air pollution associated to the occurrence of dust intrusions. This work proposes to make an extended characterization of the preferential circulation weather patterns associated to the onset of dust events affecting the IP between 2006 and 2016. Saharan dust intrusions were analysed and an automatic objective classification procedure was used to classify circulation weather patterns associated to dust events. The spatial distribution of intrusion episodes is not homogeneous throughout the IP, occurring less frequently at northern and northwestern locations than at central and southern sites. Moreover, days with Saharan dust intrusions were more frequent in summer months, and more probable to occur under regimes with a southerly component. Finally, two extreme events with high concentration of particulate matter were analysed relatively to their life-cycle and particle trajectories. The distinct extreme episodes can be associated to different synoptic situations. However, and despite different large-scale configurations, a south or south-easterly component over the region is responsible for the establishment of a dust transport from the Saharan region towards Iberia, and thus leading to the intrusion onset. These results were supported by the calculation of back-trajectories which allowed to source apportioning the particles' origin, through a clear trajectory of air parcels originating from northern Africa in both events. The proposed framework can be useful to the prediction of dust and air pollution events based on the forecast of circulation weather patterns, as the results show that these events across the IP are mainly induced by specific patterns.

Identification of inhalable rutile and polycyclic aromatic hydrocarbons (PAHs) nanoparticles in the atmospheric dust

Addressing the presence of rutile nanoparticles (NPs) in the air is a work in progress, and the development of methodologies for the identification of NPs in atmospheric dust is essential for the assessment of its toxicological effects. To address this issue, we selected the fast growing desertic city of Hermosillo in northern Mexico. Road dust (n = 266) and soils (n = 10) were sampled and bulk Ti-contents were tested by portable X-ray fluorescence. NPs were extracted from atmospheric dust by PM_1.0-PTFE filters and further characterized by Confocal Raman Microscopy, Energy-dispersive X-ray spectroscopy (EDS) coupled to Transmission Electron Microscopy (TEM) and Scanning Electron Microscopy (SEM). Results showed (i) the average concentration of Ti in road dust (3447 mg kg^-1) was similar to natural values and worldwide urban dusts; (ii) the bulk geochemistry was not satisfactory for Ti-NPs identification; (iii) 76% of the total extracted PM_1.0 sample corresponded to NPs; (iv) mono-microaggregates of rutile NPs were identified; (v) ubiquitous polycyclic aromatic hydrocarbons (PAHs) were linked to NPs. The genotoxicity of rutile and PAHs, in connection with NPs content, make us aware of a crucial emerging environmental issue of significant health concern, justifying further research in this field.

Impacts of climate change on the public health of the Mediterranean Basin population - Current situation, projections, preparedness and adaptation

The Mediterranean Basin is undergoing a warming trend with longer and warmer summers, an increase in the frequency and the severity of heat waves, changes in precipitation patterns and a reduction in rainfall amounts. In this unique populated region, which is characterized by significant gaps in the socio-economic levels particularly between the North (Europe) and South (Africa), parallel with population growth and migration, increased water demand and forest fires risk - the vulnerability of the Mediterranean population to human health risks increases significantly. Indeed, climatic changes impact the health of the Mediterranean population directly through extreme heat, drought or storms, or indirectly by changes in water availability, food provision and quality, air pollution and other stressors. The main health effects are related to extreme weather events (including extreme temperatures and floods), changes in the distribution of climate-sensitive diseases and changes in environmental and social conditions. The poorer countries, particularly in North Africa and the Levant, are at highest risk. Climate change affects the vulnerable sectors of the region, including an increasingly older population, with a larger percentage of those with chronic diseases, as well as poor people, which are therefore more susceptible to the effects of extreme temperatures. For those populations, a better surveillance and control systems are especially needed. In view of the climatic projections and the vulnerability of Mediterranean countries, climate change mitigation and adaptation become ever more imperative. It is important that prevention Health Action Plans will be implemented, particularly in those countries that currently have no prevention plans. Most adaptation measures are "win-win situation" from a health perspective, including reducing air pollution or providing shading solutions. Additionally, Mediterranean countries need to enhance cross-border collaboration, as adaptation to many of the health risks requires collaboration across borders and also across the different parts of the basin.

Short-term effects of Saharan dust intrusions and biomass combustion on birth outcomes in Spain

The objective of this study is to analyze the short-term effects of atmospheric pollutant concentrations (PM₁₀, NO₂ and O₃) and heat and cold waves on the number of pre-term births and cases of low birth weight related to Saharan dust advection and biomass combustion. The dependent variables used in this analysis were the total number of births, births with low weight (>2.500 g) and pre-term births (<37 weeks), that occurred at the province level. Data provided by the NSI included: days with Saharan dust intrusion or biomass advection classified in terms of information provided by MITECO for each of the nine regions in Spain. A representative city was selected for reach region in which the registered average daily concentrations of PM₁₀, NO₂ and O₃ (μg/m³) were used. These were also provided by MITECO. The daily maximum and daily minimum temperature (°C) used was those registered by the meteorological observatory station located in each province capital, provided by AEMET. Using Poisson log linear regression models, the associated relative risks (RR) were measured as well as the population attributable risk (PAR) corresponding to the variables that resulted statistically significant at p < 0.05 for days with and without intrusion of natural particulate matter. The results obtained show that the days with Saharan dust intrusion or advections due to biomass combustion- beyond the impact of PM₁₀, primary pollutants such as NO₂ (in Saharan intrusions), heat waves and O₃ - are associated with the number of births, low birth weight and pre-term birth. The RR and percent PAR of the pollutants and the heat waves are greater than those obtained for PM₁₀. The results of this study indicate that days with natural particulate matter due to biomass combustion or advection of Saharan dust put pregnant women at risk.

The difference in effect of ambient particles on mortality between days with and without yellow dust events: Using a larger dataset in Seoul, Korea from 1998 to 2015

BACKGROUND

Yellow Dust (YD) is a natural source of particulate matter (PM) in Korea. It remarkably increases the concentration of PM. However, characteristics of PM in YD period are different from those of PM in non-YD period.

OBJECTIVES

To investigate whether the association of PM with mortality is different between all days and non-YD days in Seoul, Korea, 1998-2015.

METHODS

We applied time-stratified case-crossover design to estimate effects of PM₁₀ and PM_2.5 on non-accidental cardiovascular and respiratory mortality. Effect estimates of PM were compared for all days in the study period and days without YD events. To identify whether different effect estimates between all days and non-YD days were not merely caused by the exclusion of high PM concentrations but rather by YD itself, we estimated effects of PM by randomly excluding the same number of days as days of YD.

RESULTS

A total of 4,509,392 deaths were observed during the study period. A 10 μg/m³ increase in PM₁₀ or PM_2.5 was associated with a 0.15% (95% CI: 0.06% to 0.24%) or 0.27% (95% CI: 0.07% to 0.47%) increase in risk of non-accidental mortality for all days, respectively. These associations were changed to 0.30% (95% CI: 0.18% to 0.42%) and 0.33% (95% CI: 0.10% to 0.55%) when YD days were excluded from analyses. We also found that effect estimates of PM were larger when YD days were excluded than those when high PM concentrations were randomly excluded.

CONCLUSIONS

The effect estimates of PM differed between all days and non-YD days. Our study suggests that including YD days in the analyses is likely to attenuate the effect of PM in a usual urban environment.

African dust and air quality over Spain: Is it only dust that matters?

The 2001-2016 contribution of African dust outbreaks to ambient regional background PM10 and PM2.5 levels over Spain, as well as changes induced in the PMx composition over NE Spain in 2009-2016, were investigated. A clear decrease in PMx dust contributions from the Canary Islands to N Iberia was found. A parallel increase in the PM2.5/PM10 ratio (30% in the Canary Islands to 57% in NW Iberia) was evidenced, probably due to size segregation and the larger relative contribution of the local PMx with increasing distance from Africa. PM1-10 and PM2.5-10 measured in Barcelona during African dust outbreaks (ADOs) were 43-46% higher compared to non-ADO days. The continental background contribution prevailed in terms of both PM1-10 and PM2.5-10 during ADO days (62 and 69%, respectively, and 31 and 27% for non-ADO days). The relative contributions of Al₂O₃/Fe₂O₃/CaO to PMx fraction showed that Al₂O₃ is a suitable tracer for African dust in our context; while CaO at the urban site is clearly affected by local resuspension, construction and road dust, and Fe₂O₃ by dust from vehicle brake discs. The results also provide evidence that PM increases during ADOs are caused not only by the mineral dust load, but by an increased accumulation of locally emitted or co-transported anthropogenic pollutants as compared with non-ADO days. Possible causes for this accumulation are discussed. We recommend that further epidemiological studies should explore independently the potential effects of mineral dust and the anthropogenic PM during ADOs, because, at least over SW Europe, not only mineral dust affects the air quality during African dust episodes.

ATR-FTIR Spectral Analysis and Soluble Components of PM10 And PM2.5 Particulate Matter over the Urban Area of Palermo (Italy) during Normal Days and Saharan Events

Several epidemiological studies have shown a close relationship between the mass of particulate matter (PM) and its effects on human health. This study reports the identification of inorganic and organic components by attenuated total reflectance-Fourier-transform infrared spectroscopy (ATR-FTIR) analysis in PM₁₀ and PM_2.5 filters collected from three air quality monitoring stations in the city of Palermo (Sicily, Italy) during non-Saharan dust events and Saharan events. It also provides information on the abundance and types of water-soluble species. ATR-FTIR analysis identified sulfate, ammonium, nitrate, and carbonate matter characterized by vibrational frequencies at 603, 615, 670, and 1100 cm^–1 (SO₄^2–); at 1414 cm^–1 (NH₄⁺); at 825 and 1356 cm^–1 (NO₃^–); and at 713, 730, and 877 cm^–1 (CO₃^2–) in PM₁₀ and PM_2.5 filters. Moreover, aliphatic hydrocarbons were identified in the collected spectra. Stretching frequencies at 2950 cm^–1 were assigned to CH₃ aliphatic carbon stretching absorptions, while frequencies at 2924 and 2850 cm^–1 indicated CH₂ bonds. In filters collected during Saharan dust events, the analysis also showed the presence of absorbance peaks typical of clay minerals. The measurement of soluble components confirmed the presence of a geogenic component (marine spray and local rocks) and secondary particles ((NH₄)₂SO₄, NH₄NO₃) in the PM filters. ATR-FTIR characterization of solid surfaces is a powerful analytical technique for identifying inorganic and organic compounds in samples of particulate matter.

Unusual winter Saharan dust intrusions at Northwest Spain: Air quality, radiative and health impacts

Saharan air masses can transport high amounts of mineral dust particles and biological material to the Iberian Peninsula. During winter, this kind of events is not very frequent and usually does not reach the northwest of the Peninsula. However, between 21 and 22 February 2016 and between 22 and 23 February 2017, two exceptional events were registered in León (Spain), which severely affected air quality. An integrative approach including: i) typical synoptic conditions; ii) aerosol chemical composition; iii) particle size distributions; iv) pollen concentration; v) aerosol optical depth (AOD); vi) radiative forcing and vii) estimation of the impact of aerosols in the respiratory tract, was carried out. In the global characterization of these events, the exceedance of the PM₁₀ daily limit value, an increase in the coarse mode and a rise in the iron concentration were observed. On the 2016 event, an AOD and extinction-related Ångström exponent clearly characteristic of desert aerosol (1.1 and 0.05, respectively) were registered. Furthermore, pollen grains not typical of flowering plants in this period were identified. The chemical analysis of the aerosol from the 2017 event allowed us to confirm the presence of the main elements associated with mineral sources (aluminum, calcium, and silica concentrations). An increase in the SO₄^2-, NO₃^- and Cl^- concentrations during the Saharan dust intrusion was also noted. However, in this event, there was no presence of atypical pollen types. The estimated dust radiative forcing traduced a cooling effect for surface and atmosphere during both events, corroborated by trends of radiative flux measurements. The estimated impact on the respiratory tract regions of the high levels of particulate matter during both Saharan dust intrusions showed high levels for the respirable fraction.

Impact on mortality of biomass combustion from wildfires in Spain: A regional analysis

Studies that analyse the impact on mortality of particulate matter (PM) produced by biomass combustion from wildfires mostly focus on a single city or on cities in different countries, with very few concentrating on one country as a whole. Accordingly, the aim of this paper was to analyse the impact that PM has on daily mortality in Spain on days with biomass combustion from wildfires. To analyse natural PM advections the Ministry of Agriculture and Fishing, Food & Environment divides Spain into 9 geographical regions. One province representative of each region for was selected analysis purposes, with provincial daily natural-cause mortality across the period 2004-2009 as the dependent variable, and daily mean PM concentrations in the provincial capital as the independent variable. We controlled for the effect of other chemical pollutants (NO₂ and O₃), maximum daily temperature on heat-wave days, day of the week, trends, seasonalities and the autoregressive nature of the series, using generalised linear models with the Poisson regression link to calculate relative risks (RRs) and the increase in RR (IRR) of PM-related mortality. The analysis was performed for days with and without biomass advections (DBA and DNBA respectively), with a breakdown by year, summer, and the remainder of the year (i.e., excluding summer). The results indicated that daily mean PM concentrations were higher on DBA than on DNBA, with statistically significant differences in most provinces. Furthermore, PM₁₀ was associated with higher daily mortality on DBA in regions where wildfires were most frequent, but not in the remaining provinces. This translated as an IRR per 10μg/m³ of PM of 7.93 (2.36-13.81) in the North-west, 3.76 (1.36-6.22) in the Centre and 4.46 (2.99-5.94) in the South-west, values which in all cases were statistically higher than those obtained on DNBA. The increase in PM caused by biomass advections from wildfires is linked to a significant IRR of mortality in Spain. Hence, the fact that wildfires are likely to become increasingly frequent in the context of climate change makes this type of analysis particularly necessary.

Lung health in era of climate change and dust storms

Dust storms are strong winds which lead to particle exposure over extensive areas. These storms influence air quality on both a local and global scale which lead to both short and long-term effects. The frequency of dust storms has been on the rise during the last decade. Forecasts suggest that their incidence will increase as a response to the effects of climate change and anthropogenic activities. Elderly people, young children, and individuals with chronic cardiopulmonary diseases are at the greatest risk for health effects of dust storms. A wide variety of infectious and non-infectious diseases have been associated with dust exposure. Influenza A virus, pulmonary coccidioidomycosis, bacterial pneumonia, and meningococcal meningitis are a few examples of dust-related infectious diseases. Among non-infectious diseases, chronic obstructive pulmonary disease, asthma, sarcoidosis and pulmonary fibrosis have been associated with dust contact. Here, we review two molecular mechanisms of dust induced lung disease for asthma and sarcoidosis. We can also then further understand the mechanisms by which dust particles disturb airway epithelial and immune cells.

Desert dust outbreaks and respiratory morbidity in Athens, Greece

BACKGROUND

Ambient particulate matter (PM) has an adverse effect on respiratory morbidity. Desert dust outbreaks contribute to increased PM levels but the toxicity of desert dust mixed with anthropogenic pollutants needs clarification.

METHODS

We identified 132 days with desert dust episodes and 177 matched days by day of the week, season, temperature and humidity between 2001 and 2006 in Athens, Greece. We collected data on regulated pollutants and daily emergency outpatient visits and admissions for respiratory causes. We applied Poisson regression models adjusting for confounding effects of seasonality, meteorology, holidays and influenza epidemics. We evaluated the sensitivity of our results to co-pollutant exposures and effect modification by age and sex.

RESULTS

A 10 μg/m³ increase in PM₁₀ concentration was associated with 1.95% (95% confidence interval (CI): 0.02%, 3.91%) increase in respiratory emergency room visits. No significant interaction with desert dust episodes was observed. Compared with non-dust days, there was a 47% (95% CI: 29%, 68%) increase in visits in dust days not adjusting for PM₁₀. Desert dust days were associated with higher numbers of emergency room visits for asthma, chronic obstructive pulmonary disease and respiratory infections with increases of 38%, 57% and 60%, respectively (p < 0.001 for all comparisons). Analyses of respiratory hospital admissions provided similar results. PM₁₀ effects decreased when adjusting for desert dust days and were further confounded by co-pollutants.

CONCLUSIONS

Desert dust episode days are associated with higher respiratory emergency room visits and hospital admissions. This effect is insufficiently explained by increased PM₁₀ levels.

Saharan dust intrusions in Spain: Health impacts and associated synoptic conditions

BACKGROUND

A lot of papers have been published about the impact on mortality of Sahara dust intrusions in individual cities. However, there is a lack of studies that analyse the impact on a country and scarcer if in addition the analysis takes into account the meteorological conditions that favour these intrusions.

OBJECTIVES

The main aim is to examine the effect of Saharan dust intrusions on daily mortality in different Spanish regions and to characterize the large-scale atmospheric circulation anomalies associated with such dust intrusions.

METHODS

For determination of days with Saharan dust intrusions, we used information supplied by the Ministry of Agriculture, Food & Environment, it divides Spain into 9 main areas. In each of these regions, a representative province was selected. A time series analysis has been performed to analyse the relationship between daily mortality and PM₁₀ levels in the period from 01.01.04 to 31.12.09, using Poisson regression and stratifying the analysis by the presence or absence of Saharan dust advections.

RESULTS

The proportion of days on which there are Saharan dust intrusions rises to 30% of days. The synoptic pattern is characterised by an anticyclonic ridge extending from northern Africa to the Iberian Peninsula. Particulate matter (PM) on days with intrusions are associated with daily mortality, something that does not occur on days without intrusions, indicating that Saharan dust may be a risk factor for daily mortality. In other cases, what Saharan dust intrusions do is to change the PM-related mortality behaviour pattern, going from PM_2.5.

CONCLUSIONS

A study such as the one conducted here, in which meteorological analysis of synoptic situations which favour Saharan dust intrusions, is combined with the effect on health at a city level, would seem to be crucial when it comes to analysing the differentiated mortality pattern in situations of Saharan dust intrusions.

Evaluation of short-term mortality attributable to particulate matter pollution in Spain

According to the WHO, 3 million deaths are attributable to air pollution due to particulate matter (PM) world-wide. However, there are no specific updated studies which calculate short-term PM-related cause specific mortality in Spain. The objective is to quantify the relative risks (RRs) and attributable risks (ARs) of daily mortality associated with PM₁₀ concentrations, registered in Spanish provinces and to calculate the number of PM-related deaths. We calculated daily mortality due to natural (ICD-10: A00 R99), circulatory (ICD-10: I00 I99) and respiratory causes (ICD-10: J00 J99) for each province across the period 2000-2009. Mean daily concentrations of PM₁₀, NO₂ and O₃ was used. For the estimate of RRs and ARs, we used generalised linear models with a Poisson link. A meta-analysis was used to estimate RRs and ARs in the provinces with statically significant results. The overall RRs obtained for these provinces, corresponding to increases of 10 μ g/m³ in PM₁₀ concentrations were 1.009 (95% CI: 1.006 1011) for natural, 1.026 (95% CI: 1.019 1033) for respiratory, and 1.009 (95% CI: 1.006 1012) for circulatory-cause mortality. This amounted to an annual overall total of 2683 deaths (95% CI: 852 4354) due to natural, 651 (95% CI: 359 1026) due to respiratory, and 556 (95% CI: 116 1012) due to circulatory causes, with 90% of this mortality lying below the WHO guideline values. This study provides an updated estimate of the effect had by this type of pollutant on causes of mortality, and constitutes an important basis for reinforcing public health measures.

Saharan dust and the impact on adult and elderly allergic patients: the effect of threshold values in the northern sector of Gran Canaria, Spain

Gran Canaria Island is frequently impacted by Saharan dust, a health hazard of particular concern to the island population and health agencies. Airborne mineral dust has the severest impact on the higher age groups of the population, and those with respiratory conditions; despite that, on average, the ambient particulate matter (PM) concentrations fall within international PM guidelines. During 2010 and 2011, an epidemiological survey, in parallel with an air quality study, was conducted at the Dr Negrín hospital in Gran Canaria. This included the quarterly monitoring of outpatients and recording of emergency patients with respiratory diseases, together with the measurement of aerosol, meteorological, and PM-related air quality levels. The finer more toxic particles were collected with PM_2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) aerosol samplers. The filter samples were gravimetrically and chemically analyzed for their elemental, water-soluble ions, carbon, and mineralogical contents. Individual particle morphology was measured by Scanning Electron Microscopy. Statistical analysis of the chemical and clinical data included the analysis of variance and calculation of Spearman correlation coefficients. No statistically significant relations were found between the allergic control group, the emergency room admissions, pulmonary conditions, medication, and elevated Saharan dust levels. However, changing environmental conditions, such as an increase in humidity or a reduction in ambient air temperature made a significant difference to the outcomes recorded on the health statements of the allergic and respiratory illness groups of the Gran Canary population.

Mortality and emergency hospitalizations associated with atmospheric particulate matter episodes across the UK in spring 2014

Exposure to particulate air pollution is known to have negative impacts on human health. Long-term exposure to anthropogenic particulate matter is associated with the equivalent of around 29,000 deaths a year in the UK. However, short-lived air pollution episodes on the order of a few days are also associated with increased daily mortality and emergency hospital admissions for respiratory and cardiovascular conditions. The UK experienced widespread high levels of particulate air pollution in March-April 2014; observations of hourly mean PM_2.5 concentrations reached up to 83μgm^-3 at urban background sites. We performed an exposure and health impact assessment of the spring air pollution, focusing on two episodes with the highest concentrations of PM_2.5 (12-14 March and 28 March-3 April 2014). Across these two episodes of elevated air pollution, totalling 10days, around 600 deaths were brought forward from short-term exposure to PM_2.5, representing 3.9% of total all-cause (excluding external) mortality during these days. Using observed levels of PM_2.5 from other years, we estimate that this is 2.0 to 2.7 times the mortality burden associated with typical urban background levels of PM_2.5 at this time of year. Our results highlight the potential public health impacts and may aid planning for health care resources when such an episode is forecast.

Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter

Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

Linking Endotoxins, African Dust PM10 and Asthma in an Urban and Rural Environment of Puerto Rico

African Dust Events (ADE) are a seasonal phenomenon that has been suggested to exacerbate respiratory and proinflammatory diseases in Puerto Rico (PR). Increases in PM₁₀ concentration and the effects of biological endotoxins (ENX) are critical factors to consider during these storms. ENX promote proinflammatory responses in lungs of susceptible individuals through activation of the Toll-like receptors (TLR2/4) signaling pathways. The objective of the study was to evaluate the toxicological and proinflammatory responses stimulated by ADE PM₁₀ ENX reaching PR using human bronchial epithelial cells. PM₁₀ organic extracts from a rural and urban site in PR (March 2004) were obtained from ADE and non-ADE and compared. A retrospective data analysis (PM₁₀ concentration, aerosol images, and pediatric asthma claims) was performed from 2000 to 2012 with particular emphasis in 2004 to classify PM samples. Urban extracts were highly toxic, proinflammatory (IL-6/IL-8 secretion), and induced higher TLR4 expression and NF-κB activation compared to rural extracts. ENX were found to contribute to cytotoxicity and inflammatory responses provoked by urban ADE PM₁₀ exposure suggesting a synergistic potency of local and natural ENX incoming from ADE. The contribution of ADE PM₁₀ ENX is valuable in order to understand interactions and action mechanisms of airborne pollutants as asthma triggers in PR.

Individual Effect Modifiers of Dust Exposure Effect on Cardiovascular Morbidity

Background

High concentrations of particulate matter (PM) air pollution have been associated with death and hospital admissions due to cardiovascular morbidity. However, it is not clear a) whether high levels of non-anthropogenic PM from dust storms constitute a health risk; and b) whether these health risks are exacerbated in a particular demographic.

Methods

This study comprised all patients above 18 years old admitted to Soroka University Medical Center (1000 bed tertiary hospital, Be’er- Sheva, Israel, 2001–2010) with a primary diagnosis of acute coronary syndrome (ACS). Data on meteorological parameters and PM₁₀ (particulate matter <10 μm in aerodiameter) were obtained from monitoring stations in the city of Be'er-Sheva. Data were analyzed using a case crossover analysis to examine the effect of dust exposure on hospitalization due to ACS and the interaction with co-morbidities and demographic factors.

Results

There were 16,734 hospitalizations due to ACS during the study period. The estimated odds of hospitalization due to ACS was significantly associated with PM₁₀ during non dust storm days at the same day of the exposure (lag0); OR = 1.014 (95%CI 1.001–1.027) for a 10 μg/m³ increase, while a delayed response (lag1) was found during the dust storm days; OR = 1.007 (95%CI 1.002–1.012). The effect size for the dust exposure association was larger for older (above the age of 65), female or Bedouin patients.

Conclusions

Exposure to non-anthropogenic PM is associated with cardiovascular morbidity. Health risk associated dust exposure is gender and age specific with older women and Bedouin patients being the most vulnerable groups.

Influence of advections of particulate matter from biomass combustion on specific-cause mortality in Madrid in the period 2004-2009

Approximately, 20 % of particulate and aerosol emissions into the urban atmosphere are of natural origin (including wildfires and Saharan dust). During these natural episodes, PM10 and PM2.5 levels usually exceed World Health Organisation (WHO) health protection thresholds. This study sought to evaluate the possible effect of advections of particulate matter from biomass fuel combustion on daily specific-cause mortality among the general population and the segment aged ≥ 75 years in Madrid. Ecological time-series study in the city of Madrid from January 01, 2004 to December 31, 2009. The dependent variable analysed was daily mortality due to natural (ICD-10:A00-R99), circulatory (ICD-10:I00-I99), and respiratory (ICD-10:J00-J99) causes in the population, both general and aged ≥ 75 years. The following independent and control variables were considered: a) daily mean PM2.5 and PM10 concentrations; b) maximum daily temperature; c) daily mean O3 and NO2 concentrations; d) advection of particulate matter from biomass combustion ( http://www.calima.ws/ ), using a dichotomous variable and e) linear trend and seasonalities. We conducted a descriptive analysis, performed a test of means and, to ascertain relative risk, fitted a model using autoregressive Poisson regression and stratifying by days with and without biomass advection, in both populations. Of the 2192 days analysed, biomass advection occurred on 56, with mean PM2.5 and PM10 values registering a significant increase during these days. PM10 had a greater impact on organic mortality with advection (RRall ages = 1.035 [1.011-1.060]; RR  ≥  75 years = 1.066 [1.031-1.103]) than did PM2.5 without advection (RRall ages = 1.017 [1.009-1.025]; RR  ≥  75 years = 1.012 [1.003-1.022]). Among specific causes, respiratory-though not circulatory-causes were associated with PM10 on days with advection in ≥ 75 year age group. PM10, rather than PM2.5, were associated with an increase in natural cause mortality on days with advection of particulate matter from biomass combustion, particularly in the ≥ 75 year age group.

Ambient ozone exposure and children's acute asthma in New York City: a case-crossover analysis

BACKGROUND

Childhood asthma morbidity has been associated with ambient ozone in case-crossover studies. Varying effects of ozone by child age and sex, however, have been less explored.

METHODS

This study evaluates associations between ozone exposure and asthma emergency department visits and hospitalizations among boys and girls aged 5-17 years in New York City for the 2005-2011 warm season period. Time-stratified case-crossover analysis was conducted and, for comparison, time-series analysis controlling for season, day-of-week, same-day and delayed effects of temperature and relative humidity were also performed.

RESULTS

We found associations between ambient ozone levels and childhood asthma emergency department visits and hospitalizations in New York City, although the relationships varied among boys and girls and by age group. For an increase of interquartile range (0.013 ppm) in ozone, there was a 2.9-8.4% increased risk for boys and 5.4-6.5% for girls in asthma emergency department visits; and 8.2% increased risk for girls in hospitalizations. Among girls, we observed stronger associations among older children (10-13 and 14-17 year age groups). We did not observe significant modification by age for boys. Boys exhibited a more prompt response (lag day 1) to ozone than did girls (lag day 3), but significant associations for girls were retained longer, through lag day 6.

CONCLUSIONS

Our study indicates significant variance in associations between short-term ozone concentrations and asthma events by child sex and age. Differences in ozone response for boys and girls, before and after puberty, may point towards both social (gendered) and biological (sex-linked) sources of effect modification.

Decomposing the profile of PM in two low polluted German cities--mapping of air mass residence time, focusing on potential long range transport impacts

This paper aims to decompose the profile of particulates in Karlsruhe and Potsdam (Germany), focusing on the localization of PM potential transboundary sources. An air mass cluster analysis was implemented, followed by a study of air mass residence time on a grid of a 0.5° × 0.5° resolution. Particulate/gaseous daily air pollution and meteorological data were used to indicate PM local sources. Four Principal Component Analysis (PCA) components were produced: traffic, photochemical, industrial/domestic and particulate. PM2.5/PM10 ratio seasonal trends, indicated production of PMCOARSE (PM10-PM2.5) from secondary sources in Potsdam during warm period (WP). The residing areas of incoming slow moving air masses are potential transboundary PM sources. For Karlsruhe those areas were mainly around the city. An air mass residence time secondary peak was observed over Stuttgart. For Potsdam, areas with increased dwelling time of the arriving air parcels were detected particularly above E/SE Germany.

Chemical characteristic and toxicity assessment of particle associated PAHs for the short-term anthropogenic activity event: During the Chinese New Year's Festival in 2013

PM10 and PM2.5 samples were simultaneously collected during a period which covered the Chinese New Year's (CNY) Festival. The concentrations of particulate matter (PM) and 16 polycyclic aromatic hydrocarbons (PAHs) were measured. The possible source contributions and toxicity risks were estimated for Festival and non-Festival periods. According to the diagnostic ratios and Multilinear Engine 2 (ME2), three sources were identified and their contributions were calculated: vehicle emission (48.97% for PM10, 53.56% for PM2.5), biomass & coal combustion (36.83% for PM10, 28.76% for PM2.5), and cook emission (22.29% for PM10, 27.23% for PM2.5). An interesting result was found: although the PAHs are not directly from the fireworks display, they were still indirectly influenced by biomass combustion which is affiliated with the fireworks display. Additionally, toxicity risks of different sources were estimated by Multilinear Engine 2-BaP equivalent (ME2-BaPE): vehicle emission (54.01% for PM10, 55.42% for PM2.5), cook emission (25.59% for PM10, 29.05% for PM2.5), and biomass & coal combustion source (20.90% for PM10, 14.28% for PM2.5). It is worth to be noticed that the toxicity contribution of cook emission was considerable in Festival period. The findings can provide useful information to protect the urban human health, as well as develop the effective air control strategies in special short-term anthropogenic activity event.

Desert dust and human health disorders

Dust storms may originate in many of the world's drylands and have an effect not only on human health in the drylands themselves but also in downwind environments, including some major urban centres, such as Phoenix, Kano, Athens, Madrid, Dubai, Jedda, Tehran, Jaipur, Beijing, Shanghai, Seoul, Taipei, Tokyo, Sydney, Brisbane and Melbourne. In some parts of the world dust storms occur frequently throughout the year. They can transport particulate material, pollutants, and potential allergens over thousands of km from source. The main sources include the Sahara, central and eastern Asia, the Middle East, and parts of the western USA. In some parts of the world, though not all, the frequency of dust storms is changing in response to land use and climatic changes, and in such locations the health implications may become more severe. Data on the PM10 and P2.5 loadings of dust events are discussed, as are various pollutants (heavy metals, pesticides, etc.) and biological components (spores, fungi, bacteria, etc.). Particulate loadings can far exceed healthy levels. Among the human health effects of dust storms are respiratory disorders (including asthma, tracheitis, pneumonia, allergic rhinitis and silicosis) cardiovascular disorders (including stroke), conjunctivitis, skin irritations, meningococcal meningitis, valley fever, diseases associated with toxic algal blooms and mortality and injuries related to transport accidents.

Short-term effect of dust storms on the risk of mortality due to respiratory, cardiovascular and all-causes in Kuwait

This study aimed to investigate the impact of dust storms on short-term mortality in Kuwait. We analyzed respiratory and cardiovascular mortality as well as all-cause mortality in relation to dust storm events over a 5-year study period, using data obtained through a population-based retrospective ecological time series study. Dust storm days were identified when the national daily average of PM10 exceeded 200 μg/m(3). Generalized additive models with Poisson link were used to estimate the relative risk (RR) of age-stratified daily mortality associated with dust events, after adjusting for potential confounders including weather variables and long-term trends. There was no significant association between dust storm events and same-day respiratory mortality (RR = 0.96; 95%CI 0.88-1.04), cardiovascular mortality (RR = 0.98; 95%CI 0.96-1.012) or all-cause mortality (RR = 0.99; 95%CI 0.97-1.00). Overall our findings suggest that local dust, that most likely originates from crustal materials, has little impact on short-term respiratory, cardiovascular or all-cause mortality.

Impact of Saharan dust particles on hospital admissions in Madrid (Spain)

Saharan dust intrusions make a major contribution to levels of particulate matter (PM) present in the atmosphere of large cities. We analysed the impact of different PM fractions during periods with and without Saharan dust intrusions, using time-series analysis with Poisson regression models, based on: concentrations of coarse PM (PM10 and PM10-2.5) and fine PM (PM2.5); and daily all-, circulatory- and respiratory-cause hospital admissions. While periods without Saharan dust intrusions were marked by a statistically significant association between daily mean PM2.5 concentrations and all- and circulatory-cause hospital admissions, periods with such intrusions saw a significant increase in respiratory-cause admissions associated with fractions corresponding to PM10 and PM10-2.5.

Peak event analysis: a novel empirical method for the evaluation of elevated particulate events

BACKGROUND

We report on a novel approach to the analysis of suspended particulate data in a rural setting in southern Ontario. Analyses of suspended particulate matter and associated air quality standards have conventionally focussed on 24-hour mean levels of total suspended particulates (TSP) and particulate matter <10 microns, <2.5 microns and <1 micron in diameter (PM10, PM2.5, PM1, respectively). Less emphasis has been placed on brief peaks in suspended particulate levels, which may pose a substantial nuisance, irritant, or health hazard. These events may also represent a common cause of public complaint and concern regarding air quality.

METHODS

Measurements of TSP, PM10, PM2.5, and PM1 levels were taken using an automated device following local complaints of dusty conditions in rural south-central Ontario, Canada. The data consisted of 126,051 by-minute TSP, PM10, PM2.5, and PM1 measurements between May and August 2012. Two analyses were performed and compared. First, conventional descriptive statistics were computed by month for TSP, PM10, PM2.5, and PM1, including mean values and percentiles (70th, 90th, and 95th). Second, a novel graphical analysis method, using density curves and line plots, was conducted to examine peak events occurring at or above the 99th percentile of per-minute TSP readings. We refer to this method as "peak event analysis". Findings of the novel method were compared with findings from the conventional approach.

RESULTS

Conventional analyses revealed that mean levels of all categories of suspended particulates and suspended particulate diameter ratios conformed to existing air quality standards. Our novel methodology revealed extreme outlier events above the 99th percentile of readings, with peak PM10 and TSP levels over 20 and 100 times higher than the respective mean values. Peak event analysis revealed and described rare and extreme peak dust events that would not have been detected using conventional descriptive statistics.

CONCLUSIONS

Peak event analysis underscored extreme particulate events that may contribute to local complaints regarding intermittently dusty conditions. These outlier events may not appear through conventional analytical approaches. In comparison with conventional descriptive approaches, peak event analysis provided a more analytical and data-driven means to identify suspended particulate events with meaningful and perceptible effects on local residents.

Time series regression studies in environmental epidemiology

Time series regression studies have been widely used in environmental epidemiology, notably in investigating the short-term associations between exposures such as air pollution, weather variables or pollen, and health outcomes such as mortality, myocardial infarction or disease-specific hospital admissions. Typically, for both exposure and outcome, data are available at regular time intervals (e.g. daily pollution levels and daily mortality counts) and the aim is to explore short-term associations between them. In this article, we describe the general features of time series data, and we outline the analysis process, beginning with descriptive analysis, then focusing on issues in time series regression that differ from other regression methods: modelling short-term fluctuations in the presence of seasonal and long-term patterns, dealing with time varying confounding factors and modelling delayed (‘lagged’) associations between exposure and outcome. We finish with advice on model checking and sensitivity analysis, and some common extensions to the basic model.

Desert dust impacts on human health: an alarming worldwide reality and a need for studies in West Africa

High desert dust concentrations raise concerns about adverse health effects on human populations. Based on a systematic literature review, this paper aims to learn more about the relationship between desert dust and human health in the world and to analyse the place of West Africa as a study area of interest. Papers focussing on the potential relationship between dust and health and showing quantitative analyses, published between January 1999 and September 2011, were identified using the ISI Web of Knowledge database (N = 50). A number of adverse health effects, including respiratory, cardiovascular and cardiopulmonary diseases, are associated with dust. This survey highlights obvious dust impacts on human health independently of the study area, health outcomes and method. Moreover, it reveals an imbalance between the areas most exposed to dust and the areas most studied in terms of health effects. None of these studies has been conducted in West Africa, despite the proximity of the Sahara, which produces about half of the yearly global mineral dust. In view of the alarming results in many parts of the world (Asia, Europe, America), this paper concludes by stressing the importance of carrying out impact studies of Saharan dust in West Africa, where dust events are more frequent and intense than anywhere else.