Effects of ambient air pollution on daily hospital admissions for respiratory and cardiovascular diseases in Bangkok, Thailand

Anxiety in breathing: the impact of air pollution on the mental health of adolescents

Introduction

Nearly all global populations (99%) are exposed to air quality levels that exceed the guidelines set by the World Health Organization, posing significant health risks. Concurrently, mental health issues among adolescents are prevalent. However, existing research on the impact of air pollution on mental health has predominantly focused on older age groups, with limited attention to adolescents.

Methods

This study explores the relationship between air pollution and adolescent mental health by utilizing data from the China Family Panel Studies and county-level air pollution statistics. To address potential endogeneity issues, this paper employs the two-stage least squares (2SLS) method for estimations.

Results

The research reveals a negative impact of air pollution on adolescent mental well-being. Specifically, a one-unit increase in Particulate Matter 2.5 corresponds to a 0.319-point increase in the mental health score, based on an 8-item scale designed to rapidly assess depressive symptoms; higher scores indicate more severe depressive tendencies.

Discussion

Mechanism discussions show that air pollution adversely affects adolescent mental health by negatively influencing height and weight, increasing the risk of chronic diseases, extending computer use time, reducing the likelihood of walking to school, and disrupting sleep quality. Furthermore, the findings indicate that the impact of air pollution is more pronounced among females, urban students, and those below high school level.

Assessment of disease burden and mortality attributable to air pollutants in northwestern Iran using the AirQ+ software

It is well known that one of the main causes of mortality and reduced life expectancy is air pollution, which carries the highest burden of diseases attributed to environmental factors. The poor air quality in Iranian cities leads to a wide range of acute and chronic health effects. This study estimates the natural deaths, ALRI, COPD, lung cancer, IHD, and strokes caused by air pollutants in Bukan, a southern city in West Azerbaijan Province, from 2011 to 2019. Population data was obtained from government organizations, and pollutant data for 2011-2019 was collected from the Bukan Environmental Protection Organization. Analyses were performed using Excel, and the data was subsequently entered into the WHO's AirQ+ model to extract the results. The study found that long-term exposure to PM10, PM2.5, NO2, and O3 resulted in an estimated 316, 241, 14, and 52 deaths, respectively. By comparing the air quality over the 8-year period, it was determined that the air quality in Bukan city is not in good condition, with particulate matter levels exceeding relevant standards. Given the increasing trend of air pollution and associated health impacts, it is essential to implement effective control policies to improve the city's air quality. This information provides a crucial step for city managers, policymakers, and health officials to mitigate the health effects caused by air pollution.

Combined effects of ambient air pollution and temperature on mortality in Thailand

This study aimed to investigate the combined effects of air pollution and temperature on mortality in 34 provinces of Thailand by modeling temperature as a confounding factor and effect modifier, estimating the effects of air pollution at low, moderate, and high temperature categories defined by the 1st and 99th province-specific temperature percentiles. When the temperature was modeled as a confounding factor, the relative risk (RR) of mortality associated with a 10 µg/m3 increase in PM10 and PM2.5 (lag 0-2), and a 10-ppb increase in NO2 (lag 0-2) and O3 (lag 0-7) was respectively 1.0096 (95% Confidence Interval (CI): 1.0073, 1.0118), 1.0134 (95% CI: 1.0099, 1.0170), 1.0172 (95% CI: 1.0122, 1.0222), and 1.0164 (95% CI: 1.0093, 1.0236). Regarding temperature as an effect modifier, the combined effects of air pollution and temperature were observed as a U-shaped pattern, where the effects of PM10, PM2.5, NO2, and O3 on mortality were greater at low (< 1st percentile) and high (> 99th percentile) temperature days compared to those at moderate temperature days (1st - 99th percentile). The pattern of combined effects of air pollution and temperature remained robust even when different temperature percentiles were employed, except for that of NO2. Furthermore, the estimated effects of PM10, PM2.5, NO2, and O3 on mortality at high-temperature days were mitigated by high green density. Findings of this study revealed that extreme temperature (both hot and cold) could exacerbate the effect of air pollution on mortality, and higher green density mitigate the combined effects of air pollution and high temperature.

Climate, Air Quality and Their Contribution to Cardiovascular Disease Morbidity and Mortality in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Background

Increasing exposure to climatic features is strongly linked to various adverse health outcomes and mortality. While the link between these features and cardiovascular outcomes is well established, most studies are from high-income countries.

Objectives

This review synthesizes evidence as well as research gaps on the relationship between climate indicators, household/ambient air pollution, and all-cause cardiovascular disease (CVD) morbidity and mortality in low- and middle-income countries (LMICs).

Methods

Seven electronic databases were searched up to June 15, 2024. Articles were included if they focused on LMICs, addressed all-cause CVD morbidity and/or mortality, and studied climate or environmental exposures. Studies were selected using ASReview LAB, extracted and analyzed with random effect meta-analysis performed if sufficient articles were identified.

Results & Conclusion

Out of 7,306 articles, 58 met the inclusion criteria: 26 on morbidity, 29 on mortality, and 3 on both. Exposures included PM10, PM2.5, NO2, SO2, BC, O3, CO, solid fuel usage, and temperature variation. Short-term exposure to PM2.5 was significantly associated with CVD morbidity (RR per 10 µg/m3 increase:1.006, 95% CI 1.003-1.009) and mortality (RR:1.007, 95% CI 1.002-1.012). Short-term exposure to NO2 and O3 also increased CVD mortality risk. Long-term exposure to PM2.5 elevated CVD morbidity (RR per 10 µg/m3 increase:1.131, 95% CI 1.057-1.210) and mortality (RR:1.092, 95% CI 1.030-1.159). High and low temperatures and long-term solid fuel use were linked to CVD deaths. The bulk of studies were from mainland China (72%), which may not accurately reflect the situation in other LMICs. Sub-Saharan Africa was particularly lacking, representing a major research gap.

Development of the national Air Quality Health Index based on short-term effects of ambient air pollution on mortality in Thailand

The Air Quality Health Index (AQHI) has long been introduced as an environmental health risk communication tool. Based on an epidemiological approach, it considers the combined effects of many air pollutants. However, comprehensive AQHI development for Thailand remains. This study aimed to develop the national AQHI in Thailand and determine whether sex- and age-specific AQHIs should be developed. The AQHI was constructed by examining the mortality risk associated with short-term exposure to multiple air pollutants using a time-stratified case-crossover design with the conditional Poisson regression model. This analysis utilized data from 31 provinces in Thailand from 2017 to 2020. The mortality risk associated with five criteria air pollutants-particulate matter with either 10 μm (PM10) or 2.5 μm (PM2.5) in aerodynamic diameter, as well as nitrogen dioxide (NO2), sulfur dioxide (SO2), ground-level ozone (O3), and carbon monoxide (CO)-was calculated to construct the national AQHI and scaled it to a range from 0 to 10. The AQHIs were developed separately for age and sex, and the mortality risk associated with this established AQHI was explored and compared with that associated with the Air Quality Index (AQI). We found that the total AQHI and sex- and age-specific AQHIs were highly correlated with a similar association with mortality. The effects of AQHI on mortality were slightly more potent than AQI's, but their model fit statistics were comparable. In conclusion, developing specific AQHIs is unnecessary because their distributions and effects are similar to total AQHIs. The AQHI seems to be the better tool for communicating health risks related to air pollution, as the mortality risk associated with AQHI was more pronounced than that associated with AQI.

Short-term effects of air pollutants on hospitalization for childhood respiratory diseases in Suzhou City: a time-stratified case-crossover study

BACKGROUND

Short-term exposure to air pollution has been demonstrated in previous studies to correlate with respiratory disease (RD) in children. Due to regional heterogeneity, our objective was to explore the correlation between short-term exposure to ambient air pollution and hospital admissions for respiratory ailments in children in Suzhou City from January 1, 2017, to December 31, 2022, alongside assessing the influence of the COVID-19 pandemic on this relationship.

METHODS

We collected data on air pollutant levels and hospital admissions for childhood respiratory disease (RD) in Suzhou, China, from 2017 to 2022. We utilized a time-stratified case-crossover design along with a conditional logistic regression model to assess the short-term impacts of air pollutants on RD in children through stratified analysis and sensitivity analysis.

RESULTS

A total of 13,408 children with respiratory diseases were included in the study. The findings revealed significant associations between hospitalization for respiratory diseases in children and exposure to PM2.5, PM10, SO2, NO2, and CO. The maximum effect values (95%CI, best lag days) for each 10 µg/m3 increase in the concentrations of PM2.5, PM10, SO2, and NO2 were as follows: 1.017 (1.003-1.031, lag0-2), 1.015 (1.004-1.026, lag0-2), 1.117 (1.001-1.247, lag0-1), and 1.036 (1.009-1.064, lag0-7). Additionally, the maximum effect value (95%CI, best lag days) for each 1 mg/m3 increase in CO concentration was found to be 1.267 1.017-1.579, lag0-7). Stratified analysis indicated that sex, season of admission, and stage of admission did not modify these correlations significantly; however, differential effects on various age groups and sexes were primarily observed among school-age and older children as well as boys.

CONCLUSIONS

The short-term exposure to PM2.5, PM10, SO2, NO2, and CO in Suzhou, China, exhibited a positive correlation with RD hospitalization. Prior to the COVID-19 pandemic, the adverse impacts of air pollutants on hospitalizations for childhood respiratory disease were mitigated compared to the period following the pandemic. Local governments should continue promoting decisions and measures for air pollution prevention and control to reduce further pollutant concentration, which is crucial for public health in reducing the burden of childhood respiratory diseases.

Oxidative stress response to gasoline generator exhaust emission in adult male wistar rats

Petroleum-powered generators are commonly used in many developing countries as an alternative to meet utility demands. Generator exhaust emission significantly contributes to air pollution, which remains a constant threat to human health due to the presence of aromatic hydrocarbons and other harmful gases. This study assessed oxidative stress parameters in response to exhaust emission from gasoline generator engine in adult male wistar rats. Forty-eight (48) adult wistar rats weighing between 180-200g were randomly allocated to four (4) groups (A-D) of twelve (12) rats each. After the acclimatization period, the control group (A) were kept unexposed, whereas rats in groups (C-D) were exposed daily at 2, 4, and 8-hour intervals for 4, 8, and 12 weeks, respectively. Tissue samples were obtained at four weeks intervals. Fresh lung tissues weighing 1g were rinsed twice in phosphate-buffered saline (PBS, pH 8.0), homogenized and centrifuged at 3000 revolutions per minute for 20 min at 4°C. Supernatant levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione S-transferase (GST), reduced glutathione (GSH), nitric oxide (NO), hydrogen peroxide (H2O2), catalase (CAT), and total antioxidant status (TAS) were determined using standard protocols. The findings revealed elevated oxidant levels of MDA, NO, and H2O2, whereas SOD, GPX, GST, GSH, CAT, and TAS were significantly reduced across the exposure time points compared to the unexposed control rats (p < 0.05). The research findings revealed that exposure to emissions from gasoline generators induced oxidative stress in the exposed rats, with the extent of disruption to their oxidative balance dependent on the duration and length of exposure time.

Impact of Indoor Air Pollutants on the Cardiovascular Health Outcomes of Older Adults: Systematic Review

Indoor air pollution accounts for approximately 3.8 million inopportune deaths annually at global level. Due to spending more time indoors, children and older adults are especially susceptible to the health risks of indoor air pollution. This review seeks to summarise existing knowledge on the cardiovascular health effects of three common indoor air pollutants, namely carbon monoxide (CO), particulate matter (PM2.5 and PM10), and Nitrogen dioxide (NO2), focusing on older adults. We systematically reviewed the literature (PROSPERO CRD42024479220) on PubMed, Google Scholar, Scopus, Web of Science and Embase. The search yielded 20,914 records. Two independent reviewers screened the articles using titles, abstracts, and full-length articles written in English. Upon a detailed assessment of all the records, the review considered 38 full-length articles. Several studies reported mortality, myocardial infarction, stroke, increased hospitalisation and increased emergency room visits due to exposure to indoor air pollution. A few studies reported arrhythmias, hypertension and Ischaemic heart disease due to exposure to indoor air pollutants. The increased mortality, morbidity, hospitalization, and emergency rooms visits resulting from indoor air pollution associated CVDs makes indoor air pollution a health risk for older adults. There is, therefore, a need to synthesize information on studies relate d to how the selected indoor air pollutants affected the cardiovascular health of older adults.

The effect of air pollutants on COPD-hospitalized patients in Lanzhou, China (2015-2019)

BACKGROUND

Lanzhou is the largest heavy industrial city in northwest China and it is a typical geographical valley-like city. However, there are few studies on the relationship between air pollutants and COPD, and their respective sample sizes are small, resulting in inconsistent results. The aim of this study is to analyze the effects of air pollutants on COPD hospitalizations in Lanzhou, China.

METHODS

An ecological time series study with distributed lag non-linear model (DLNM) was used for analysis. Daily COPD hospitalization data in Lanzhou from 1 January 2015 to 31 December 2019 were collected from 25 hospitals, as well as air pollutant data and meteorological data.

RESULTS

A total of 18,275 COPD hospitalizations were enrolled. For 10 μg/m3 increase in PM2.5, PM10, SO2, NO2, and 1 mg/m3 increase in CO at lag 07 day, the RR95%CI of COPD hospitalizations were 1.048 (1.030, 1.067), 1.008 (1.004, 1.013), 1.091 (1.048, 1.135), 1.043 (1.018, 1.068), and 1.160 (1.084, 1.242), respectively. The exposure-response curves between air pollutants (except O3-8h) and COPD hospitalizations were approximately linear with no thresholds. Female, and the harmful effect of PM on aged <65 years, the effect of gaseous pollutant on those aged ≥65 years, were stronger, particularly in the cold season. Exposure to air pollutants (except O3-8h) might increase the risk of COPD hospitalizations. O3-8h has a weak and unstable effect on COPD.

CONCLUSION

Exposure to air pollutants (except O3-8h) increases the risk of COPD hospitalizations. O3-8h has a weak and unstable effect on COPD hospital admissions. The harmful effect of gaseous pollutants (except O3-8h) on COPD-hospitalized patients was stronger than that of PM.

Association between P M 10 and respiratory diseases admission in peninsula Malaysia during haze

Numerous studies have been conducted in other countries on the health effects of exposure to particulate matter with a diameter of 10 microns or less P M 10 , but little research has been conducted in Malaysia, particularly during the haze season. This study intends to investigate how exposure of P M 10 influenced hospital admissions for respiratory diseases during the haze period in peninsula Malaysia and it was further stratified by age group, gender and respiratory diseases categories. The study includes data from all patients with respiratory diseases in 92 government hospitals, as well as P M 10 concentration and meteorological data from 92 monitoring stations in Peninsula Malaysia starting from 1st January 2000 to 31st December 2019. A quasi-poison time series regression with distributed lag nonlinear model (DLNM) was employed in this study to examine the relationship between exposure of P M 10 and hospital admissions for respiratory diseases during the haze period. Haze period for this study has been defined from June to September each year. According to the findings of this study, P M 10 was positively associated with hospitalisation of respiratory disease within 30 lag days under various lag patterns, with lag 25 showing the strongest association (RR = 1.001742, CI 1.001029,1.002456). Using median as a reference, it was discovered that females were more likely than males to be hospitalized for P M 10 exposure. Working age group will be the most affected by the increase in P M 10 exposure with a significant cumulative RR from lag 010 to lag 030. The study found that P M 10 had a significant influence on respiratory hospitalisation in peninsula Malaysia, particularly for lung diseases caused by external agents(CD5). Therefore, it is important to implement effective intervention measures to control P M 10 and reduce the burden of respiratory disease admissions.

Temperature modification of air pollutants and their synergistic effects on respiratory diseases in a semi-arid city in Northwest China

Air pollutants and temperature are significant threats to public health, and the complex linkages between the environmental factors and their interactions harm respiratory diseases. This study is aimed to analyze the impact of air pollutants and meteorological factors on respiratory diseases and their synergistic effects in Dingxi, a city in northwestern China, from 2018 to 2020 using a generalized additive model (GAM). Relative risk (RR) was employed to quantitatively evaluate the temperature modification on the short-term effects of PM2.5 and O3 and the synergistic effects of air pollutants (PM2.5 and O3) and meteorological elements (temperature and relative humidity) on respiratory diseases. The results indicated that the RRs per inter-quatile range (IQR) rise in PM2.5 and O3 concentrations were (1.066, 95% CI: 1.009-1.127, lag2) and (1.037, 95% CI: 0.975-1.102, lag4) for respiratory diseases, respectively. Temperature stratification suggests that the influence of PM2.5 on respiratory diseases was significantly enhanced at low and moderate temperatures, and the risk of respiratory diseases caused by O3 was significantly increased at high temperatures. The synergy analysis demonstrated significant a synergistic effect of PM2.5 with low temperature and high relative humidity and an antagonistic effect of high relative humidity and O3 on respiratory diseases. The findings would provide a scientific basis for the impact of pollutants on respiratory diseases in Northwest China.

Short-term associations of PM10 attributed to biomass burning with respiratory and cardiovascular hospital admissions in Peninsular Malaysia

BACKGROUND

Biomass burning (BB) is a major source of air pollution and particulate matter (PM) in Southeast Asia. However, the health effects of PM smaller than 10 µm (PM10) originating from BB may differ from those of other sources. This study aimed to estimate the short-term association of PM10 from BB with respiratory and cardiovascular hospital admissions in Peninsular Malaysia, a region often exposed to BB events.

METHODS

We obtained and analyzed daily data on hospital admissions, PM10 levels and BB days from five districts from 2005 to 2015. We identified BB days by evaluating the BB hotspots and backward wind trajectories. We estimated PM10 attributable to BB from the excess of the moving average of PM10 during days without BB hotspots. We fitted time-series quasi-Poisson regression models for each district and pooled them using meta-analyses. We adjusted for potential confounders and examined the lagged effects up to 3 days, and potential effect modification by age and sex.

RESULTS

We analyzed 210 960 respiratory and 178 952 cardiovascular admissions. Almost 50% of days were identified as BB days, with a mean PM10 level of 53.1 µg/m3 during BB days and 40.1 µg/m3 during normal days. A 10 µg/m3 increment in PM10 from BB was associated with a 0.44% (95% CI: 0.06, 0.82%) increase in respiratory admissions at lag 0-1, with a stronger association in adults aged 15-64 years and females. We did not see any significant associations for cardiovascular admissions.

CONCLUSIONS

Our findings suggest that short-term exposure to PM10 from BB increased the risk of respiratory hospitalizations in Peninsular Malaysia.

Air pollution and cancer daily mortality in Hangzhou, China: an ecological research

BACKGROUND

Long-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.

OBJECTIVES

This study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter <10 mm (PM10) and PM2.5) and cancer daily mortality.

METHODS

This study used air quality, meteorological and daily cancer death data from 2014 to 2019 in Hangzhou, China. Generalised additive models (GAM) with quasi-Poisson regression were used to analyse the associations between air pollutants and cancer mortality with adjustment for confounding factors including time trends, day of week, temperature and humidity. Then, we conducted stratified analyses by sex, age, season and education. In addition, stratified analyses of age, season and education were performed within each sex to determine whether sex difference was modified by such factors.

RESULTS

After adjusting for potential confounders, the GAM results indicated a statistically significant relationship between increased cancer mortality and elevated air pollution concentrations, but only in the female population. For every 10 μg/m3 rise in pollutant concentration, the increased risk of cancer death in females was 6.82% (95% CI 3.63% to 10.10%) for SO2 on lag 03, and 2.02% (95% CI 1.12% to 2.93%) for NO2 on lag 01 and 0.89% (95% CI 0.46% to 1.33%) for PM10 on lag 03 and 1.29% (95% CI 0.64% to 1.95%) for PM2.5 on lag 03. However, no statistically significant association was found among males. Moreover, the differences in effect sizes between males and females were more pronounced during the cold season, among the elderly and among subjects with low levels of education.

CONCLUSIONS

Increased cancer mortality was only observed in females with rising concentrations of air pollutants. Further research is required to confirm this sex difference. Advocate for the reduction of air pollutant emissions to protect vulnerable groups.

Influence of Environmental Risk Exposure on the Determinants of COVID-19 Booster Vaccination in an Urban Thai Population

This study aimed to identify the influence of environmental risk exposure levels on the predictive factors of COVID-19 booster dose vaccination in an urban Thai population in the post-pandemic era. Six study locations, including the three provinces with the highest environmental risk levels and the three provinces with the lowest environmental risk levels, were selected by calculating the environmental risk exposure indexes. Participants from the capital district of each province were chosen via the simple random sampling technique and interviewed using a structured questionnaire. A total of 1315 individuals were included in a sample in this study, and the best predictors of booster dose vaccination were determined using multiple regression analysis. The results showed that a high level of environmental risk exposure occurred in the provinces with a high number of total days exceeding the limits set for PM10 and high rates of mortality for lung cancer. The number of COVID-19 booster vaccinations given amount to 43.4% of the population during the post-COVID-19 pandemic period. Our multivariate analysis indicated that individuals in the working age group (≥25 years old); those with higher education (diploma degree and above); full-time employment (government and private sectors); those with high monthly incomes (≥USD144.1); and those in areas with the lowest risk level of environmental exposure significantly contributed to the number of booster dose vaccinations given during the post-pandemic period. To summarize, the rate of COVID-19 booster dose vaccination acceptance in Thailand was influenced by socio-economic factors with environmental concerns. These findings improve our understating of both the global pandemic and how environmental exposure affects behavioral change patterns and could improve the effectiveness of post-pandemic management.

Health effects of exposure to urban ambient particulate matter: A spatial-statistical study on 3rd-trimester pregnant women

Pregnant women are highly vulnerable to environmental stressors such as ambient particulate matter (PM). Particularly during their 3rd trimester, their bodies undergo significant oxidative stresses. To further consolidate this dialogue into practice, the current study evaluated healthy pregnant women (n = 150 housewives; 18-40 years old; gestation age >36 weeks) from the highly polluted city of Yazd, Iran, from September to November 2021. The aerosol optical depth (AOD) data retrieved from the Moderate Resolution Imaging Spectroradiometer (MODIS) were employed as influencing variables and validated using field-collected PM10 data (r = 0.62, p-value <0.01). The links between blood platelet count, enzymes (SGOT, SGPT, LDH, bilirubin), metabolic products (urea and acid uric) and different combinations of AOD data were assessed using the Generalized Additive Model. The results showed a high temporal variability in AOD (0.94 ± 0.51) but a spatially stable distribution pattern. The mean AOD during the 3rd trimester, followed by that of the three-month peak, were identified as the most significant non-linear predictors, while the mean AOD during the 1st trimester and throughout the entire pregnancy showed no significant associations with any of the biomarkers. Considering the associations found between AOD variables and maternal oxidative stresses, urgent planning is required to improve the urban air quality for sensitive subpopulations.

Effect of short-term exposure to air pollution on hospital admission for cardiovascular disease: A time-series study in Xiangyang, China

BACKGROUND

Data on the relationship between short-term exposure to air pollution and cardiovascular diseases (CVDs) and the potential modifying factors are limited and inconsistent.

OBJECTIVE

To explore the relationship between short-term exposure to air pollution and CVD risk, and potential modification effect factors.

METHOD

A time series study was conducted on 52,991 hospital admissions for CVD from 2015 to 2019 in Xiangyang City, China. Air pollution data from four national fixed monitoring stations were collected to estimate exposure level in Xiangyang City. A quasi-Poisson generalized additive model incorporating a distributed lag nonlinear model was applied to evaluate the association between air pollution and CVD risk. The potential modification effect of sex, age, and season on the above associations was also evaluated.

RESULTS

CVD risk was positively associated with air pollution. Peak associations in single lag day structures were observed for particulate matter ≤10 μm in aerodynamic (PM10; RR: 1.040, 95 % CI: 0.996-1.087), PM2.5 (1.025, 1.004-1.045), nitrogen dioxide (NO2; 1.074, 1.039-1.111), and sulfur dioxide (SO2; 1.079, 1.019-1.141) at Lag 0 and ozone (O3; 1.018, 1.004-1.031) at Lag 4. In cumulative lag day structures, the highest RRs were 1.225 (1.079,1.392) for PM10 at Lag 06, 1.054 (1.013, 1.098) for PM2.5 at Lag 03, 1.200 (1.119, 1.287) for NO2 at Lag 04, and 1.135 (1.025, 1.257) for SO2 at Lag 02. Moreover, the association between air pollution and CVD risk was modified by sex and age (P < 0.05). Females and individuals aged ≤65 years were more vulnerable to NO2 and had a higher CVD risk.

CONCLUSION

Short-term exposure to air pollution was positively associated with CVD risk. Moreover, sex and age could modify the effect of air pollution on CVD risk. Females and individuals aged ≤65 years had a higher NO2 exposure-induced CVD risk.

Is environment destiny? Spatial analysis of the relationship between geographic factors and obesity in Türkiye

This study aims to evaluate the relationship of geographical factors, including precipitation, slope, air pollution and elevation with adult obesity prevalence in Türkiye (TR) using a cross-regional study design. Ordinary least squares (OLS) and geographically weighted regression (GWR) were performed to evaluate the spatial variation in the relationship between all geographic factors and obesity prevalence. In the model, a positive relationship was found between obesity prevalence and slope, whereas a negative significant relationship was determined between obesity prevalence and elevation (p < 0.05). These results, revealing spatially varying associations, were very useful in refining the interpretations of the statistical results on adult obesity. This research suggests that geographical factors should be considered as one of the components of the obesogenic environment. In addition, it is recommended that national and international strategies to overcome obesity should be restructured by taking into account the geographical characteristics of the region.

Effect of ambient air pollution on hospital admission for respiratory diseases in Hanoi children during 2007-2019

Air pollution poses a threat to children's respiratory health. This study aims to quantify the association between short-term air pollution exposure and respiratory hospital admissions among children in Hanoi, Vietnam, and estimate the population-attributable burden using local data. A case-crossover analysis was conducted based on the individual records where each case is their own control. The health data was obtained from 13 hospitals in Hanoi and air pollution data was collected from four monitoring stations from 2007 to 2019. We used conditional logistic regression to estimate Percentage Change (PC) and 95% Confidence Interval (CI) in odd of hospital admissions per 10 μg/m3 increase in daily average particulate matter (e.g. PM1, PM2.5, PM10), Sulfur Dioxide (SO2), Nitrogen Dioxide (NO2), 8-h maximum Ozone and per 1000 μg/m3 increase in daily mean of Carbon Monoxide (CO). We also calculated the number and fraction of admissions attributed to air pollution in Hanoi by using the coefficient at lag 0. A 10 μg/m3 increase in the concentration of PM10, PM2.5, PM1, SO2, NO2, O3 8-h maximum and 1000 μg/m3 increase in CO concentration was associated with 0.6%, 1.2%, 1.4%, 0.8%, 1.6%, 0.3%, and 1.7% increase in odd of admission for all respiratory diseases among children under 16 years at lag 0-2. All PM metrics and NO2 are associated with childhood admission for pneumonia and bronchitis. Admissions due to asthma and upper respiratory diseases are related to increments in NO2 and CO. For attributable cases, PM2.5 concentrations in Hanoi exceeding the World Health Organization Air Quality Guidelines accounted for 1619 respiratory hospital admissions in Hanoi children in 2019. Our findings show that air pollution has a detrimental impact on the respiratory health of Hanoi children and there will be important health benefits from improved air quality management planning to reduce air pollution in Vietnam.

Association Between Air Pollution and Cardiovascular Disease Hospitalizations in Lanzhou City, 2013-2020: A Time Series Analysis

Extensive evidence has shown that air pollution increases the risk of cardiovascular disease (CVD) admissions. We aimed to explore the short-term effect of air pollution on CVD admissions in Lanzhou residents and their lag effects. Meteorological data, air pollution data, and a total of 309,561 daily hospitalizations for CVD among urban residents in Lanzhou were collected from 2013 to 2020. Distributed lag non-linear model was used to analyze the relationship between air pollutants and CVD admissions, stratified by gender, age, and season. PM2.5, NO2, and CO have the strongest harmful effects at lag03, while SO2 at lag3. The relative risks of CVD admissions were 1.0013(95% CI: 1.0003, 1.0023), 1.0032(95% CI: 1.0008, 1.0056), and 1.0040(95% CI: 1.0024, 1.0057) when PM2.5, SO2, and NO2 concentrations were increased by 10 μg/m³, respectively. Each 1 mg/m3 increase in CO concentration was associated with a relative risk of cardiovascular hospitalization of risk was 1.0909(95% CI: 1.0367, 1.1479). We observed a relative risk of 0.9981(95% CI: 0.9972, 0.9991) for each 10 μg/m³ increase in O3 for CVD admissions at lag06. We found a significant lag effects of air pollutants on CVD admissions. NO2 and CO pose a greater risk of hospitalization for women, while PM2.5 and SO2 have a greater impact on men. PM2.5, NO2, and CO have a greater impact on CVD admissions in individuals aged <65 years, whereas SO2 affects those aged ≥65 years. Our research indicates a possible short-term impact of air pollution on CVD. Local public health and environmental policies should take these preliminary findings into account.

Effects of the lockdown measure amid COVID-19 pandemic on outpatient department visits associated with air pollution reduction in Thailand

We investigated the effects of COVID-19 lockdown on air quality and its consequences health and economic benefits in Thailand. The conditional Poisson regression model was applied to examine the association between air pollution and outpatient department (OPD) visits in each province and pooled the province-specific estimates using the random-effects meta-analysis to derive the national estimates. We then applied a random forest model with meteorological normalization approach to predict the concentration of air pollutants by means of business as usual during the lockdown period (April 3-May 3) in 2020 and further calculated the changes in the number of OPD visits and their consequent expenditure attributable to air pollution reduction using the obtained risk function performed earlier. The number of cardiovascular OPD visits attributed to PM10, PM2.5 and NO2 decreased by 4,414 (95% CI 982, 8,401), 4,040 (95% CI 326, 7,770), and 13,917 (95% CI 1,675, 27,278) cases, respectively, leading to reduced medical expenditure by 14,7180.21, 13,4708.31, and 46,4025.04 USD, respectively. The number of respiratory OPD visits attributed to PM10, PM2.5, NO2, and O3 reduction decreased by 2,298 (95% CI 1,223, 3,375), 2,056 (95% CI 740, 3,252), 3,326 (95% CI 542, 6,295), and 1,160 (95% CI 5,26, 1,804) cases, respectively, where the consequent medical expenditure was reduced by 76,618.48, 68,566.36, 11,0908.31, and 38,685.50 USD, respectively. Finding from this study showed that air quality during the lockdown period in Thailand was improved, contributing to the reduction of cardiovascular and respiratory OPD visits, and consequent medical service costs attributable to air pollution.

Ambient carbon monoxide and the risk of cardiovascular disease emergency room visits: a time-series study in Lanzhou, China

Until now, the epidemiological evidence on the association between short-term exposure to ambient carbon monoxide (CO) and cardiovascular diseases (CVDs) is relatively lacking and controversial. This study aims to examine the relationship between ambient CO and daily emergency room visits (ERVs) for total and cause-specific CVD in Lanzhou, China. A distributed lag nonlinear model was used to examine the association. For every 1 mg/m3 increase in the CO concentration, the relative risks of daily ERVs were 1.041 (95% CI: 1.017, 1.065) for total CVD, 1.065 (95% CI: 1.018, 1.114) for ischemic heart disease (IHD), 1.083 (95% CI: 1.020, 1.149) for heart rhythm disturbances (HRD), 1.062 (95% CI: 1.011, 1.115) for heart failure (HF), and 1.057 (95% CI: 1.017, 1.098) for cerebrovascular diseases (CD). For the two different gender subgroups, the short-term impact of CO on total CVD, IHD, and CD was relatively stronger for the females than for the males, while the opposite was true for HRD and HF. In the age subgroup analyses, the effect of ambient CO on total CVD and IHD appeared to be greater for the age ≥ 65 years group, while the opposite was true for HRD, HF, and CD. The associations for all disease categories were stronger in cold seasons than in warm seasons. We also observed a nearly linear correlation between CO and CVD ERVs. In conclusion, the study showed that exposure to ambient CO may increase the risks of ERVs for total and cause-specific CVD. Besides, CO-ERVs associations may vary by gender and age.

The impact of ambient air pollution on hospital admissions, length of stay and hospital costs for patients with diabetes mellitus and comorbid respiratory diseases in Panzhihua, Southwest China

Background

There is limited evidence on association between air pollutants and hospital admissions, hospital cost and length of stay (LOS) among patients with diabetes mellitus (DM) and comorbid respiratory diseases (RD), especially in low- and middle-income countries (LMICs) with low levels of air pollution.

Methods

Daily data on RD-DM patients were collected in Panzhihua from 2016 to 2020. A generalised additive model (GAM) was used to explore the effect of air pollutants on daily hospital admissions, LOS and hospital cost. Attributable risk was employed to estimate RD-DM's burden due to exceeding air pollution exposure, using both 0 microgrammes per cubic metre (μg/m3) and WHO's 2021 air quality guidelines as reference.

Results

For each 10 ug/m3 increase of particles with an aerodynamic diameter <2.5 micron (μm) (PM2.5), particles with an aerodynamic diameter <10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3), the admissions of RD-DM patients increased by 7.25% (95% CI = 4.26 to 10.33), 5.59% (95% CI = 3.79 to 7.42), 10.10% (95% CI = 7.29 to 12.98), 12.33% (95% CI = 8.82 to 15.95) and -2.99% (95% CI = -4.08 to -1.90); per 1 milligramme per cubic metre (mg/m3) increase of carbon monoxide (CO) corresponded to a 25.77% (95% CI = 17.88 to 34.19) increment for admissions of RD-DM patients. For LOS and hospital cost, the six air pollutants showed similar effect. Given 0 μg/m3 as the reference, NO2 showed the maximum attributable fraction of 32.68% (95% CI = 25.12 to 39.42%), corresponding to an avoidable burden of 5661 (95% CI = 3611 to 5860) patients with RD-DM.

Conclusions

There is an association between PM2.5, PM10, SO2, NO2, and CO with increased hospital admissions, LOS and hospital cost in patients with RD-DM. Disease burden of RD-DM may be improved by formulating policies related to air pollutants exposure reduction, especially in LMICs with low levels of air pollution.

Surface ozone risk to human health and vegetation in tropical region: The case of Thailand

Tropospheric ozone (O3) is a threat to vegetation and human health over the world, in particular in Asia. Knowledge on O3 impacts on tropical ecosystems is still very limited. An O3 risk assessment to crops, forests, and people from 25 monitoring stations across the tropical and subtropical Thailand during 2005-2018 showed that 44% of sites exceeded the critical levels (CLs) of SOMO35 (i.e., the annual Sum Of daily maximum 8-h Means Over 35 ppb) for human health protection. The concentration-based AOT40 CL (i.e., sum of the hourly exceedances above 40 ppb for daylight hours during the assumed growing season) was exceeded at 52% and 48% of the sites where the main crops rice and maize are present, respectively, and at 88% and 12% of the sites where evergreen or deciduous forests are present, respectively. The flux-based metric PODY (i.e., Phytotoxic Ozone Dose above a threshold Y of uptake) was calculated and was found to exceed the CLs at 1.0%, 1.5%, 20.0%, 1.5%, 0% and 68.0% of the sites where early rice, late rice, early maize, late maize, evergreen forests, and deciduous forests can grow, respectively. Trend analysis indicated that AOT40 increased over the study period (+5.9% year-1), while POD1 decreased (- 5.3% year-1), suggesting that the role of climate change in affecting the environmental factors that control stomatal uptake cannot be neglected. These results contribute novel knowledge on O3 threat to human health, forest productivity, and food security in tropical and subtropical areas.

Urban-rural differences in the association between long-term exposure to ambient particulate matter (PM) and malnutrition status among children under five years old: A cross-sectional study in China

Background

The evidence regarding the relationship between postnatal exposure of air pollution and child malnutrition indicators, as well as the corresponding urban-rural disparities, is limited, especially in low-pollution area of low- and middle-income countries (LMICs). Therefore, our aim was to contrast the effect estimates of varying ambient particulate matter (PM) on malnutrition indicators between urban and rural areas in Tibet, China.

Methods

Six malnutrition indicators were evaluated in this study, namely, Z-scores of height for age (HFA), Z-scores of weight for age (WFA), Z-scores of weight for height (WFH), stunting, underweight, and wasting. Exposure to particles with an aerodynamic diameter ≤2.5 micron (μm) (PM2.5), particles with an aerodynamic diameter ≤10 μm (PM10) and particles with an aerodynamic diameter between 2.5 and 10 μm (PMc) was estimated using satellite-based random forest models. Linear regression and logistic regression models were used to assess the associations between PM and the above malnutrition indicators. Furthermore, the effect estimates of different PM were contrasted between urban and rural areas.

Results

A total of 2511 children under five years old were included in this study. We found long-term exposure to PM2.5, PMc, and PM10 was associated with an increased risk of stunting and a decreased risk of underweight. Of these air pollutants, PMc had the strongest association for Z-scores of HFA and stunting, while PM2.5 had the strongest association for underweight. The results showed that the odds ratio (OR) for stunting were 1.36 (95% confidence interval (CI) = 1.06 to 1.75) per interquartile range (IQR) microgrammes per cubic metre (μg/m3) increase in PM2.5, 1.80 (95% CI = 1.30 to 2.50) per IQR μg/m3 increase in PMc and 1.55 (95% CI = 1.17 to 2.05) per IQR μg/m3 increase in PM10. The concentrations of PM were higher in urban areas, and the effects of PM on malnutrition indicators among urban children were higher than those of rural children.

Conclusions

Our results suggested that PM exposure might be an important trigger of child malnutrition. Further prospective researches are needed to provide important scientific literature for understanding child malnutrition risk concerning postnatal exposure of air pollutants and formulating synthetically social and environmental policies for malnutrition prevention.

Short-term effects of air pollution on hospital admissions of respiratory diseases in Hamadan, Iran, 2015 to 2021

The short-term effects of air pollution on respiratory diseases have been reported in many countries. Urban areas are most affected because of the many sources of pollution and the large number of people living there. This study aims to investigate the effect of short-term exposure to air pollutants on respiratory hospital admissions in the city of Hamadan. In this ecological study, daily hospital admission data were collected from Shahid Beheshti Hospital in Hamadan. Daily information on air pollutants (CO, SO2, NO2, O3, PM2.5 and PM10) from Hamadan Department of Environment (DoE) organization and of climate factors from Hamadan Meteorological Office were collected. A negative binomial regression model was used to examine the effect of air pollution on daily respiratory hospitalizations. The effect of exposure to pollutants was measured whit different time lags (0-7 days). Furthermore, the effect of meteorological variables was controlled. Subgroup analyses were performed by sex and age group. A total of 12,454 hospitalizations for respiratory diseases were recorded. Results showed a strong and immediate effect of CO on respiratory hospital admissions with highest association at lag 7 (relative risk (RR) = 1.38, 95% CI: 1.33, 1.42). The effects of CO and SO2 on respiratory hospitalizations are greater for men than women. Regarding the short-term effects of PM2.5, SO2 and O3, adults (aged less than 65) were more prone to hospitalization for respiratory diseases. These results show that exposure to air pollution, particularly CO, may increase hospital admissions due to respiratory illness. So reducing the concentration of these pollutants can reduce the number of hospital admissions.

Short-term effects of air pollution on hospitalization for acute lower respiratory infections in children: a time-series analysis study from Lanzhou, China

BACKGROUND

Short-term exposure to air pollution is associated with acute lower respiratory infections (ALRI) in children. We investigated the relationship between hospitalization for ALRI in children and air pollutant concentrations from January 1, 2014 to December 31, 2020 in Lanzhou City.

METHODS

We collected data on air pollutant concentrations and children's hospitalization data during the study period. A time series regression analysis was used to assess the short-term effects of air pollutants on ALRI in children, and subgroup analyses and sensitivity analyses were performed.

RESULTS

A total of 51,206 children with ALRI were studied, including 40,126 cases of pneumonia and 11,080 cases of bronchiolitis. The results of the study revealed that PM2.5, PM10, SO2 and NO2 were significantly associated with hospitalization for ALRI in children aged 0-14 years. For each 10 µg/m3 increase in air pollutant concentration in lag0-7, the relative risk of ALRI hospitalization in children due to PM2.5, PM10, SO2 and NO2 increased by 1.089 (95%CI:1.075, 1.103), 1.018 (95%CI:1.014, 1.021), 1.186 (95%CI:1.154. 1.219) and 1.149 (95%CI:1.130, 1.168), respectively.

CONCLUSIONS

PM2.5, PM10, SO2 and NO2 short-term exposures were positively associated with ALRI, pneumonia and bronchiolitis hospitalizations in Lanzhou, China. Local governments should make efforts to improve urban ambient air quality conditions to reduce hospitalization rates for childhood respiratory diseases.

Causal Associations of Air Pollution With Cardiovascular Disease and Respiratory Diseases Among Elder Diabetic Patients

Extensive researches have linked air pollutants with cardiovascular disease (CVD) and respiratory diseases (RD), however, there is limited evidence on causal effects of air pollutants on morbidity of CVD or RD with comorbidities, particularly diabetes mellitus in elder patients. We included hospital admissions for CVD or RD among elder (≥65 years) diabetic patients between 2014 and 2019 in Beijing. A time-stratified case-crossover design based on negative-control exposure was used to assess causal associations of short-term exposure to air pollutants with CVD and RD among diabetic patients with the maximum lag of 7 days. A random forest regression model was used to calculate the contribution magnitude of air pollutants. A total of 493,046 hospital admissions were recorded. Per 10 μg/m3 uptick in PM1, PM2.5, PM10, SO2, NO2, O3, and 1 mg/m3 in CO was associated with 0.29 (0.05, 0.53), 0.14 (0.02, 0.26), 0.06 (0.00, 0.12), 0.36 (0.01, 0.70), 0.21 (0.02, 0.40), -0.08 (-0.25, 0.09), and 4.59 (0.56, 8.61) causal effect estimator for admission of CVD among diabetic patients, corresponding to 0.12 (0.05, 0.18), 0.09 (0.05, 0.13), 0.05, 0.23 (0.06, 0.41), 0.10 (0.02, 0.19), -0.04 (-0.06, -0.01), and 3.91(1.81, 6.01) causal effect estimator for RD among diabetic patients. The effect of gaseous pollutants was higher than particulate pollutants in random forest model. Short-term exposure to air pollution was causally associated with increased admission of CVD and RD among elder diabetic patients. Gaseous pollutants had a greater contribution to CVD and RD among elder diabetic patients.

Meandered and muddled: a systematic review on the impact of air pollution on ocular health

From the years 1970-2023, a systematic overview of the diverse consequences of particulate matter on eye health and a disease classification according to acute, chronic, and genetic are presented using the PubMed, Research Gate, Google Scholar, and Science Direct databases. Various studies on medical aspects correlate with the eye and health. However, from an application perspective, there is limited research on the ocular surface and air pollution. The main objective of the study is to uncover the relationship between eye health and air pollution, particularly particulate matter, along with other external factors acting as aggravators. The secondary goal of the work is to examine the existing models for mimicking human eyes. The study is followed by a questionnaire survey in a workshop, in which the exposure-based investigation was tagged based on their activity. This paper establishes a relationship between particulate matter and its influence on human health, leading to numerous eye diseases like dry eyes, conjunctivitis, myopia, glaucoma, and trachoma. The results of the questionnaire survey indicate that about 68% of the people working in the workshop are symptomatic with tears, blurred vision, and mood swings, while 32% of the people were asymptomatic. Although there are approaches for conducting experiments, the evaluation is not well defined; empirical and numerical solutions for particle deposition on the eye are needed. There prevails a broad gap in the arena of ocular deposition modeling.

Temperature modifies the effects of air pollutants on respiratory diseases

Increasing studies have reported temperature modification effects on air pollutants-induced respiratory diseases. In the current study, daily data of respiratory emergency room visits (ERVs), meteorological factors, and concentrations of air pollutants were collected from 2013 to 2016 in Lanzhou, a northwest city in China. Daily average temperature was stratified into low (≤ 25 percentile, P₂₅), medium (25-75 percentile, P₂₅-P₇₅) and high (≥ 75 percentile, P₇₅) to explore how temperature modifies the effects of air pollutants (PM_2.5, PM₁₀, SO₂, and NO₂) on respiratory ERVs by using generalized additive Poisson regression model (GAM). Seasonal modification was also investigated. Results showed that (a) PM₁₀, PM_2.5, and NO₂ had the strongest effects on respiratory ERVs in low temperature; (b) males and 15-and-younger were more vulnerable in low temperature while females and those older than 46 years were highly affected in high temperature; (c) PM₁₀, PM_2.5, and NO₂ were mostly associated with the total and both males and females in winter, while SO₂ resulted in the highest risk for the total and males in autumn and females in spring. In conclusion, this study found significant temperature modification effects and seasonal differences on the risks of respiratory ERVs due to air pollutants in Lanzhou, China.

Fine particulate matter and its chemical constituents' levels: A troubling environmental and human health situation in Karachi, Pakistan

Like many urban centers in developing countries, the effect of air pollution in Karachi is understudied. The goal of this study was to determine the chemical characterization, temporal and seasonal variability, sources, and health impacts of fine particulate matter (PM_2.5) in Karachi, Pakistan. Daily samples of PM_2.5 were collected using a low-volume air sampler at two different sites (Makro and Karachi University) over the four seasons between October 2009 and August 2010. Samples were analyzed for black carbon (BC), trace metals, and water-soluble ions. Results showed that the annual average concentrations of PM_2.5 at Makro and Karachi University were 114 ± 115 and 71.7 ± 56.4 μg m^-3, respectively, about 22.8 and 14.3-fold higher than the World Health Organization annual guideline of 5 μg m^-3. BC concentrations were 3.39 ± 1.97 and 2.70 ± 2.06 μg m^-3, respectively. The concentrations of PM_2.5, BC, trace metals, and ions at the two sites showed clear seasonal trends, with higher concentrations in winter and lower concentrations in summer. The trace metals and ionic species with the highest concentrations were Pb, S, Zn, Ca, Si, Cl, Fe, and SO₄^2-. The air quality index in the fall and winter at both sites was about 68 %, which is "unhealthy" for the general population. Positive Matrix Factorization revealed the overall contribution to PM_2.5 at the Makro site came from three major sources - industrial emissions (13.3 %), vehicular emissions (59.1 %), and oil combustion (23.3 %). The estimates of expected number of deaths due to short-term exposure to PM_2.5 were high in the fall and winter at both sites, with an annual mean estimate of 3592 expected number of deaths at the Makro site. Attention should be paid to the reduction of inorganic pollutants from industrial facilities, vehicular traffic, and fossil fuel combustion, due to their extremely high contribution to PM_2.5 mass and health risks.

Association of air pollutants and hospital admissions for respiratory diseases in Lanzhou, China, 2014-2019

The aim of this study was to assess the effects of air pollutants on hospital admissions for respiratory disease (RD) by using distributed lag nonlinear model (DLNM) in Lanzhou during 2014-2019. In this study, the dataset of air pollutants, meteorological, and daily hospital admissions for RD in Lanzhou, from January 1st, 2014 to December 31st, 2019, were collected from three national environmental monitoring stations, China meteorological data service center, and three large general hospitals, respectively. A time-series analysis with DLNM was used to estimate the associations between air pollutants and hospital admissions for RD including the stratified analysis of age, gender, and season. The key findings were expressed as the relative risk (RR) with a 95% confidence interval (CI) for single-day and cumulative lag effects (0-7). A total of 90, 942 RD hospitalization cases were identified during the study period. The highest association (RR, 95% CI) of hospital admissions for RD and PM_2.5 (1.030, 1.012-1.049), and PM₁₀ (1.009, 1.001-1.015), and NO₂ (1.047, 1.024-1.071) were observed at lag 07 for an increase of 10 μg/m³ in the concentrations, and CO at lag07 (1.140, 1.052-1.236) for an increase of 1 mg/m³ in the concentration. We observed that the RR estimates for gaseous pollutants (e.g., CO and NO₂) were larger than those of particulate matter (e.g., PM_2.5 and PM₁₀). The harmful effects of PM_2.5, PM₁₀, NO₂, and CO were greater in male, people aged 0-14 group and in the cold season. However, no significant association was observed for SO₂, O₃8h, and total hospital admissions for RD. Therefore, some effective intervention strategies should be taken to strengthen the treatment of the ambient air pollutants, especially gaseous pollutants (e.g., CO and NO₂), thereby, reducing the burden of respiratory diseases.

Effect modification by temperature on the association between O3 and emergency ambulance dispatches in Japan: A multi-city study

Numerous epidemiological studies have reported that ozone (O₃) and temperature are independently associated with health outcomes, but modification of the effects of O₃ on health outcomes by temperature, and vice versa, has not been fully described. This study aimed to investigate effect modification by temperature on the association between O₃ and emergency ambulance dispatches (EADs) in Japan. Data on daily air pollutants, ambient temperature, and EADs were obtained from eight Japanese cities from 2007 to 2015. A distributed lag non-linear model combined with Poisson regression was performed with temperature as a confounding factor and effect modifier to estimate the effects of O₃ on EADs at low (<25th percentile), moderate (25th-75th percentile), and high (>75th percentile) temperature for each city. The estimates obtained from each city were pooled by random-effects meta-analysis. When temperature was entered as a confounder, the estimated effects of O₃ on EADs for all acute, cardiovascular, and respiratory illnesses were largest at lag 0 (current-day lag). Therefore, this lag was used to further estimate the effects of O₃ on EADs in each temperature category. The estimated effects of O₃ on EADs for all acute, cardiovascular, and respiratory illnesses in all eight Japanese cities increased with increasing temperature. Specifically, a 10 ppb increase in O₃ was associated with 0.80 % (95 % CI: 0.25 to 1.35), 0.19 % (95 % CI: -0.85 to 1.25), and 1.14 % (95 % CI: -0.01 to 2.31) increases in the risk of EADs for all acute, cardiovascular, and respiratory illnesses, respectively, when city-specific daily temperature exceeded the 75th percentile. Our findings suggest that the association between O₃ and EADs for all acute, cardiovascular, and respiratory illnesses is the highest during high temperature. Finding of this study can be used to develop potential mitigation measures against O₃ exposure in high temperature environment to reduce its associated adverse health effects.

Science communication on the public health risks of air pollution: a computational scoping review from 1958 to 2022

BACKGROUND

Air pollutants are a health risk for the entire population. Particulate matter (PM) including the smallest fraction, ultra-fine particles (UFP), therefore continue to be the focus of scientific research in this area. To protect the population from the harmful effects of exposure to PM, communication and information of research results are of special relevance as individuals with heightened awareness of the harms of poor air quality are more likely to take action to improve their exposure.

METHODS

We conducted a scoping review of the scientific literature on science communication of public health information about risks associated with air pollutants to generate an initial over-view of existing research in this field. We searched the PubMed and Scopus databases and analyzed the data using a structured topic modeling (STM) approach.

RESULTS

The existing scientific literature dates back to 1958 but increases significantly from the 1990s onwards. Publications are mainly found in the discipline of environmental research and are primarily concerned with health effects. It is often stated that adequate communication of the results to the public would be important, but specific approaches are rare. Overall, the topic of risk communication seems to be underrepresented for both air pollutants and UFP.

CONCLUSIONS

To protect public health, it is important to conduct more intensive science and risk communication related to scientific findings on the risks of air pollutants. For adequate communication and information, further research is needed to provide specific approaches that also involve the affected population and take different target groups into account. In addition, the effectiveness of communication efforts should also be analyzed.

The Relationship between the Transmission of Different SARS-CoV-2 Strains and Air Quality: A Case Study in China

Coronavirus Disease 2019 (COVID-19) has been a global public health concern for almost three years, and the transmission characteristics vary among different virus variants. Previous studies have investigated the relationship between air pollutants and COVID-19 infection caused by the original strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, it is unclear whether individuals might be more susceptible to COVID-19 due to exposure to air pollutants, with the SARS-CoV-2 mutating faster and faster. This study aimed to explore the relationship between air pollutants and COVID-19 infection caused by three major SARS-CoV-2 strains (the original strain, Delta variant, and Omicron variant) in China. A generalized additive model was applied to investigate the associations of COVID-19 infection with six air pollutants (PM_2.5, PM₁₀, SO₂, CO, NO₂, and O₃). A positive correlation might be indicated between air pollutants (PM_2.5, PM₁₀, and NO₂) and confirmed cases of COVID-19 caused by different SARS-CoV-2 strains. It also suggested that the mutant variants appear to be more closely associated with air pollutants than the original strain. This study could provide valuable insight into control strategies that limit the concentration of air pollutants at lower levels and would better control the spread of COVID-19 even as the virus continues to mutate.

Ambient carbon monoxide and cardiovascular-related hospital admissions: A time-series analysis

Background and aims: Although several studies have investigated the association between air pollutants and cardiovascular diseases (CVDs) in recent years, a lack of evidence exists regarding carbon monoxide (CO) exposure, especially in the Eastern Mediterranean's polluted regions. In this study, we aimed to evaluate the short-term effect of CO exposure on daily CVD hospital admissions in Isfahan, a major city in Iran. Methods: Data were extracted from the CAPACITY study on daily CVD hospital admissions in Isfahan from March 2010 to March 2012. The 24-h mean CO concentrations were obtained from four local monitoring stations. In a time-series framework, the association between CO and daily hospitalizations for total and cause-specific CVDs in adults (ischemic heart disease (IHD), heart failure (HF), and cerebrovascular disease) was conducted using Poisson's (or negative binomial) regression, after adjusting for holidays, temperature, dew point, and wind speed, considering different lags and mean lags of CO. The robustness of the results was examined via two- and multiple-pollutant models. Stratified analysis was also conducted for age groups (18-64 and ≥65 years), sex, and seasons (cold and warm). Results: The current study incorporated a total of 24,335 hospitalized patients, (51.6%) male with a mean age of 61.9 ± 16.4 years. The mean CO concentration was 4.5 ± 2.3 mg/m³. For a 1 mg/m³ increase in CO, we found a significant association with the number of CVD hospitalizations. The largest adjusted percent change in HF cases was seen in lag0, 4.61% (2.23, 7.05), while that for total CVDs, IHD, and cerebrovascular diseases occurred in mean lag2-5, 2.31% (1.42, 3.22), 2.23% (1.04, 3.43), and 5.70% (3.59, 7.85), respectively. Results were found to be robust in two- and multiple-pollutant models. Although the associations changed for sex, age groups, and seasons, they remained significant for IHD and total CVD, except for the warm season, and for HF, except for the younger age group and cold seasons. Additionally, the exposure-response relationship curve of the CO concentrations with total and cause-specific CVD admissions showed non-linear relationships for IHD and total CVDs. Conclusions: Our results showed that exposure to CO contributed to an increase in the number of CVD hospitalizations. The associations were not independent of age groups, season, and sex.

Short-term associations between ambient air pollution and emergency department visits for Alzheimer's disease and related dementias

Dementia is a seriously disabling illness with substantial economic and social burdens. Alzheimer's disease and its related dementias (AD/ADRD) constitute about two-thirds of dementias. AD/ADRD patients have a high prevalence of comorbid conditions that are known to be exacerbated by exposure to ambient air pollution. Existing studies mostly focused on the long-term association between air pollution and AD/ADRD morbidity, while very few have investigated short-term associations. This study aims to estimate short-term associations between AD/ADRD emergency department (ED) visits and three common air pollutants: fine particulate matter (PM_2.5), nitrogen dioxide (NO₂), and warm-season ozone.

Methods

For the period 2005 to 2015, we analyzed over 7.5 million AD/ADRD ED visits in five US states (California, Missouri, North Carolina, New Jersey, and New York) using a time-stratified case-crossover design with conditional logistic regression. Daily estimated PM_2.5, NO_2, and warm-season ozone concentrations at 1 km spatial resolution were aggregated to the ZIP code level as exposure.

Results

The most consistent positive association was found for NO₂. Across five states, a 17.1 ppb increase in NO₂ concentration over a 4-day period was associated with a 0.61% (95% confidence interval = 0.27%, 0.95%) increase in AD/ADRD ED visits. For PM_2.5, a positive association with AD/ADRD ED visits was found only in New York (0.64%, 95% confidence interval = 0.26%, 1.01% per 6.3 µg/m³). Associations with warm-season ozone levels were null.

Conclusions

Our results suggest AD/ADRD patients are vulnerable to short-term health effects of ambient air pollution and strategies to lower exposure may reduce morbidity.

Determining factors affecting the perceived usability of air pollution detection mobile application "AirVisual" in Thailand: A structural equation model forest classifier approach

Air pollution has been evident worldwide. It presented numerous pieces of evidence that affect health-related adverse effects causing diseases and even death and the development of technology has helped monitor the exposure of people to air pollution. This research analyzed factors affecting the perceived usability of air pollution detection on the 'AirVisual' mobile application based on the integrated model of Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT2). A total of 416 participants voluntarily answered a self-administered survey consisting of adapted constructs covering factors such as Performance expectancy (PE), Effort expectancy (EE), Social influence (SI), Facilitating conditions (FC), Habit (HB), Perceived risk (PR), Perceived trust (PT), Intention to use (IU), and Perceived usability (PU). Structural Equation Modeling and Random Forest Classifier were utilized to determine factors affecting perceived usability of the 'AirVisual' mobile application. The results showed that PE, EE, SI, and FC were key factors leading to very high PU among users. Moreover, IU was seen to be the most significant factor affecting PU, followed by PT, PR, and HB. This study is one of the first studies that considered the evaluation of usability among health-related mobile applications covering air pollution. The results and the framework utilized in this model may be applied to evaluate other factors and applications related to health among people. Lastly, this study can also be extended to evaluate other mobile applications worldwide.

Health and economic impacts of ambient air pollution on hospital admissions for overall and specific cardiovascular diseases in Panzhihua, Southwestern China

Background

The associations of ambient air pollution with hospital admissions (HAs) for overall and specific causes of cardiovascular diseases (CVDs), as well as related morbidity and economic burdens remain understudied, especially in low-pollution areas of low- and middle-income countries (LMICs). We evaluated the short-term effects of exposure to PM_2.5 (particles with an aerodynamic diameter ≤2.5 μm), PM₁₀ (particles with an aerodynamic diameter ≤10 μm), and SO₂ (sulfur dioxide) on HAs for CVDs in Panzhihua, China, during 2016-2020, and calculated corresponding attributable risks and economic burden.

Methods

We used a generalized additive model (GAM) while controlling for time trends, meteorological conditions, holidays, and days of the week to estimate the associations. The cost of illness (COI) method was adopted to further assess corresponding hospitalization costs and productivity losses.

Results

A total of 27 660 HAs for CVDs were included in this study. PM₁₀ and SO₂ were significantly associated with elevated risks of CVDs hospitalizations. Each 10 μg/m³ increase in PM₁₀ and SO₂ at lag06 corresponded to an increase of 2.48% (95% confidence interval (CI) = 0.92%-4.06%), and 5.50% (95% CI = 3.09%-7.97%) in risk of HAs for CVDs, respectively. The risk estimates of PM₁₀ and SO₂ on CVD hospitalizations were generally robust after adjustment for other pollutants in two-pollutant models. We found stronger associations between air pollution (PM₁₀ and SO₂) and CVDs in cool seasons than in warm seasons. For specific causes of CVDs, significant associations of PM₁₀ and SO₂ exposure with cerebrovascular disease and ischaemic heart disease were observed. Using 0 μg/m³ as the reference concentrations, 11.91% (95%CI = 4.64%-18.56%) and 15.71% (95%CI = 9.30%-21.60%) of HAs for CVDs could be attributable to PM₁₀ and SO₂, respectively. During the study period, PM₁₀ and SO₂ brought 144.34 million Yuan economic losses for overall CVDs, accounting for 0.028% of local GDP.

Conclusions

Our results suggest that PM₁₀ and SO₂ exposure might be an important trigger of HAs for CVDs and accounted for substantial morbidity and economic burden.

Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study

BACKGROUND

Ozone (O₃) and nitrogen dioxide (NO₂) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear.

METHODS

We conducted a time-series study based on 144,326 ERVs for respiratory diseases of Peking University Third Hospital from 2014 to 2019 in Beijing, China. Generalized additive models with quasi-Poisson regression were performed to analyze the association of O₃, NO₂ and their composite indicators (O_x and O_x^wt) with ERVs for respiratory diseases. An interaction model was further performed to evaluate the interaction between O₃ and NO₂.

RESULTS

Exposure to O₃, NO₂, O_x and O_x^wt was positively associated with ERVs for total respiratory diseases and acute upper respiratory infection (AURI). For instance, a 10 μg/m³ increase in O₃ and NO₂ were associated with 0.93% (95%CI: 0.05%, 1.81%) and 5.87% (95%CI: 3.92%, 7.85%) increase in AURI at lag0-5 days, respectively. Significant linear exposure-response relationships were observed in O_x and O_x^wt over the entire concentration range. In stratification analysis, stronger associations were observed in the group aged < 18 years for both O₃ and NO₂, in the warm season for O₃, but in the cold season for NO₂. In interaction analysis, the effect of O₃ on total respiratory emergency room visits and AURI visits was the strongest at high levels (> 75% quantile) of NO₂ in the < 18 years group.

CONCLUSIONS

Short-term exposure to O₃ and NO₂ was positively associated with ERVs for respiratory diseases, particularly in younger people (< 18 years). This study for the first time demonstrated the synergistic effect of O₃ and NO₂ on respiratory ERVs, and O_x and O_x^wt may be potential proxies.

Air pollution and risk of respiratory and cardiovascular hospitalizations in a large city of the Mekong Delta Region

It is important to explore air pollution and health effects in developing cities for early prevention rather than waiting for conditions to deteriorate as in the current megacities. This study aims to investigate the short-term health effects of air pollution in a large city in the Mekong Delta Region (MDR) of Vietnam. Air pollution data from January 2015 to December 2018 were collected from the Environmental Monitoring Centre of Can Tho City. The data of respiratory and cardiovascular disease (CVD) admissions in 18 hospitals and medical centers were collected. A time-series regression analysis was conducted using distributed lag models to examine the relationship between the air pollutants and hospitalizations including the delayed effect up to 7 days. The research findings reveal that a 10 μg increase in PM₁₀ was associated with an increase of 2.5% in the risk of respiratory admission for all people and 2.2% in the risk of CVD admission for the elderly on the same day. The analysis stratified by age and sex indicates that PM10 resulted in a higher risk of respiratory admission among children (0-5 years old) and males compared with other groups. PM10 and NO₂ were significantly associated with CVD admission among the elderly at lag 4 and 6 days. The effects of other air pollutants (SO₂, O₃) were not observed in this study. As development continues in this region, there is an urgent need for intervention measures to minimize the health impacts associated with the expected increases in air pollution in the MDR.

Ambient air pollution and COVID-19 in Delhi, India: a time-series evidence

This study aimed to explore the short-term health effects of ambient air pollutants PM2.5, PM10, SO2, NO2, O3, and CO on COVID-19 daily new cases and COVID-19 daily new deaths. A time-series design used in this study. Data were obtained from 1 April 2020 to 31 December 2020 in the National Capital Territory (NCT) of Delhi, India. The generalized additive models (GAMs) were applied to explore the associations of six air pollutants with COVID-19 daily new cases and COVID-19 daily new deaths. The GAMs revealed statistically significant associations of ambient air pollutants with COVID-19 daily new cases and COVID-19 daily new deaths. These findings suggest that governments need to give greater considerations to regions with higher concentrations of PM2.5, PM10, SO2, NO2, O3, and CO, since these areas may experience a more serious COVID-19 pandemic or, in general, any respiratory disease.

Short-term effect of ambient ozone pollution on respiratory diseases in western China

Ambient air pollution has been regarded as an important cause of the morbidity and mortality of respiratory diseases. In the current work, a total of 469,490 respiratory emergency room (ER) visits in Lanzhou, China from Jan 1, 2013 to Dec 31, 2016 were collected. A generalized additive model (GAM) was used to investigate the association between O₃ and respiratory ER visits for the different gender and age subgroups. The results showed that: (a) with per inter-quartile range (IQR) (31 µg/m³) increase in O₃, the greatest relative risk (RR) of respiratory ER visits for the total was 1.014 (95% CI 1.008-1.020) at lag 4 days. Females and 16-to-45-year-olds were relatively more sensitive to O₃; (b) the significant lag effects were found in single-day lag models, with the highest RR values for different groups were observed at lag 3-lag 5 days. The multi-day cumulative lag effects were stronger for the total; (c) in the multiple-pollutant models, the effects of O₃ were generally increased when introducing other pollutants (PM₁₀, PM_2.5, SO₂ and NO₂) for adjustment. This study demonstrated that short-term exposure to O₃ increased the RR of respiratory ER visits in Lanzhou, China.

Environmental variable importance for under-five mortality in Malaysia: A random forest approach

BACKGROUND

Environmental factors have been associated with adverse health effects in epidemiological studies. The main exposure variable is usually determined via prior knowledge or statistical methods. It may be challenging when evidence is scarce to support prior knowledge, or to address collinearity issues using statistical methods. This study aimed to investigate the importance level of environmental variables for the under-five mortality in Malaysia via random forest approach.

METHOD

We applied a conditional permutation importance via a random forest (CPI-RF) approach to evaluate the relative importance of the weather- and air pollution-related environmental factors on daily under-five mortality in Malaysia. This study spanned from January 1, 2014 to December 31, 2016. In data preparation, deviation mortality counts were derived through a generalized additive model, adjusting for long-term trend and seasonality. Analyses were conducted considering mortality causes (all-cause, natural-cause, or external-cause) and data structures (continuous, categorical, or all types [i.e., include all variables of continuous type and all variables of categorical type]). The main analysis comprised of two stages. In Stage 1, Boruta selection was applied for preliminary screening to remove highly unimportant variables. In Stage 2, the retained variables from Boruta were used in the CPI-RF analysis. The final importance value was obtained as an average value from a 10-fold cross-validation.

RESULT

Some heat-related variables (maximum temperature, heat wave), temperature variability, and haze-related variables (PM10, PM10-derived haze index, PM10- and fire-derived haze index, fire hotspot) were among the prominent variables associated with under-five mortality in Malaysia. The important variables were consistent for all- and natural-cause mortality and sensitivity analyses. However, different most important variables were observed between natural- and external-cause under-five mortality.

CONCLUSION

Heat-related variables, temperature variability, and haze-related variables were consistently prominent for all- and natural-cause under-five mortalities, but not for external-cause.

Air pollution in Delhi, India: It’s status and association with respiratory diseases

The policymakers need research studies indicating the role of different pollutants with morbidity for polluted cities to install a strategic air quality management system. This study critically assessed the air pollution of Delhi for 2016–18 to found out the role of air pollutants in respiratory morbidity under the ICD-10, J00-J99. The critical assessment of Delhi air pollution was done using various approaches. The mean PM_2.5 and PM₁₀ concentrations during the measurement period exceeded both national and international standards by a wide margin. Time series charts indicated the interdependence of PM_2.5 and PM₁₀ and connection with hospital visits due to respiratory diseases. Violin plots showed that daily respiratory disease hospital visits increased during the winter and autumn seasons. The winter season was the worst from the city’s air pollution point of view, as revealed by frequency analyses. The single and multi-pollutant GAM models indicated that short-term exposure to PM₁₀ and SO₂ led to increased hospital visits due to respiratory diseases. Per 10 units increase in concentrations of PM₁₀ brought the highest increase in hospital visits of 0.21% (RR: 1.00, 95% CI: 1.001, 1.002) at lag0-6 days. This study found the robust effect of SO₂ persisted in Delhi from lag0 to lag4 days and lag01 to lag06 days for single and cumulative lag day effects, respectively. While every 10 μg m^-3 increase of SO₂ concentrations on the same day (lag0) led to 32.59% (RR: 1.33, 95% CI: 1.09, 1.61) rise of hospital visits, the cumulative concentration of lag0-1 led to 37.21% (RR: 1.37, 95% CI:1.11, 1.70) rise in hospital visits which further increased to even 83.33% (RR: 1.83, 95% CI:1.35, 2.49) rise at a lag0-6 cumulative concentration in Delhi. The role of SO₂ in inducing respiratory diseases is worrying as India is now the largest anthropogenic SO₂ emitter in the world.

Interactive short-term effects of meteorological factors and air pollution on hospital admissions for cardiovascular diseases

A substantial number of studies have demonstrated the association between air pollution and adverse health effects. However, few studies have explored the potential interactive effects between meteorological factors and air pollution. This study attempted to evaluate the interactive effects between meteorological factors (temperature and relative humidity) and air pollution ([Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text]) on cardiovascular diseases (CVDs). Next, the high-risk population susceptible to air pollution was identified. We collected daily counts of CVD hospitalizations, air pollution, and weather data in Nanning from January 1, 2014, to December 31, 2015. Generalized additive models (GAMs) with interaction terms were adopted to estimate the interactive effects of air pollution and meteorological factors on CVD after controlling for seasonality, day of the week, and public holidays. On low-temperature days, an increase of [Formula: see text] in [Formula: see text], [Formula: see text], and [Formula: see text] was associated with increases of 4.31% (2.39%, 6.26%) at lag 2; 2.74% (1.65%, 3.84%) at lag 0-2; and 0.13% (0.02%, 0.23%) at lag 0-3 in CVD hospitalizations, respectively. During low relative humidity days, a [Formula: see text] increment of lag 0-3 exposure was associated with increases of 3.43% (4.61%, 2.67%) and 0.10% (0.04%, 0.15%) for [Formula: see text] and [Formula: see text], respectively. On high relative humidity days, an increase of [Formula: see text] in [Formula: see text] was associated with an increase of 5.86% (1.82%, 10.07%) at lag 0-2 in CVD hospitalizations. Moreover, elderly (≥ 65 years) and female patients were vulnerable to the effects of air pollution. There were interactive effects between air pollutants and meteorological factors on CVD hospitalizations. The risk that [Formula: see text], [Formula: see text], and [Formula: see text] posed to CVD hospitalizations could be significantly enhanced by low temperatures. For [Formula: see text] and [Formula: see text], CVD hospitalization risk increased in low relative humidity. The effects of [Formula: see text] were enhanced at high relative humidity.

Association between out-patient visits and air pollution in Chiang Mai, Thailand: Lessons from a unique situation involving a large data set showing high seasonal levels of air pollution

Chiang Mai is one of the most known cities of Northern Thailand, representative for various cities in the East and South-East Asian region exhibiting seasonal smog crises. While a few studies have attempted to address smog crises effects on human health in that geographic region, research in this regard is still in its infancy. We exploited a unique situation based on two factors: large pollutant concentration variations due to the Chiang Mai smog crises and a relatively large sample of out-patient visits. About 216,000 out-patient visits in the area of Chiang Mai during the period of 2011 to 2014 for upper (J30-J39) and lower (J44) respiratory tract diseases were evaluated with respect to associations with particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) concentrations using single-pollutant and multiple-pollutants Poisson regression models. All three pollutants were found to be associated with visits due to upper respiratory tract diseases (with relative risks RR = 1.023 at cumulative lag 05, 95% CI: 1.021–1.025, per 10 μg/m3 PM10 increase, RR = 1.123 at lag 05, 95% CI: 1.118–1.129, per 10 ppb O3 increase, and RR = 1.110 at lag 05, 95% CI: 1.102–1.119, per 10 ppb NO2 increase). Likewise, all three pollutants were found to be associated with visits due to lower respiratory tract diseases (with RR = 1.016 at lag 06, 95% CI: 1.015–1.017, per 10 μg/m3 PM10 increase, RR = 1.073 at lag 06, 95% CI: 1.070–1.076, per 10 ppb O3 increase, and RR = 1.046 at lag 06, 95% CI: 1.040–1.051, per 10 ppb NO2 increase). Multi-pollutants modeling analysis identified O3 as a relatively independent risk factor and PM10-NO2 pollutants models as promising two-pollutants models. Overall, these results demonstrate the adverse effects of all three air pollutants on respiratory morbidity and call for air pollution reduction and control.

Outpatient Department Visits and Mortality with Various Causes Attributable to Ambient Air Pollution in the Eastern Economic Corridor of Thailand

The Eastern Economic Corridor in Thailand is undergoing development, but industrial activities are causing serious air pollution. This study aimed to examine the effects of particulate matter (PM₁₀), fine particulate matter (PM_2.5), SO₂, NO₂, O₃, and CO on outpatient department (OPD) visits and mortality with various causes in the Eastern Economic Corridor, Thailand between 2013 and 2019 using a case-crossover design and conditional Poisson model. The corresponding burden of disease due to air pollution exposure was calculated. A 1 µg/m³ increase in the PM₁₀ was associated with significant increases in OPD visits for circulatory diseases (0.22, 95% CI 0.01, 0.34), respiratory diseases (0.21, 95% CI 0.13, 0.28), and skin and subcutaneous tissue diseases (0.18, 95% CI 0.10, 0.26). By contrast, a 1 µg/m³ increase in the PM₁₀ was associated with significant increases in mortality from skin and subcutaneous tissue diseases (0.79, 95% CI 0.04, 1.56). A 1 µg/m³ increase in PM_2.5 was associated with significant increases in mortality from circulatory diseases (0.75, 95% CI 0.20, 1.34), respiratory diseases (0.82, 95% CI 0.02, 1.63), and skin and subcutaneous tissue diseases (2.91, 95% CI 0.99, 4.86). The highest OPD burden was for circulatory diseases. Respiratory effects were attributed to PM₁₀ exceeding the national ambient air quality standards (NAAQS) of Thailand (120 μg/m³). The highest morbidity burden was for skin and subcutaneous tissue diseases attributed to PM_2.5 concentrations that exceeded the NAAQs (50 μg/m³). PM pollution in the EEC could strongly contribute to OPD visits and morbidity from various diseases. Preventing PM₁₀ concentrations from being higher than 60 µg/m³ could decrease OPD visits by more than 33,265 and 29,813 for circulatory and respiratory diseases, respectively. Our study suggests that such pollution increases the risks of OPD visits and mortality in various causes in the Thai EEC. Reducing the ambient air pollution concentration of NAAQSs in Thailand could reduce the health effect on the Thai population.

Short term exposure to ambient air pollutants and cardiovascular emergency department visits in Mexico city

Available data on the acute cardiovascular effect of ambient air pollution (AAP) in Latin America is limited considering that over 80% of its 1 billion inhabitants live in urban settlements with poor air quality. The study aim was to evaluate the association between Cardiovascular Emergency Department Visits (CEDVs) and AAP in Mexico City from 2016 to 2019 using generalized additive models with distributed lags to examine the percentage change of CEDVs and a backward approach of time-series model to calculate attributable fractions. A total of 48,891 CEDVs were recorded in a period of 1019 days. We estimated a significant percentage increase for each 10 μg/m³ of PM₁₀ at Lag0-5 (2.8%, 95%CI 0.6-5.0), PM_2.5 at Lag0-6 (3.7%, 95%CI 0.1-7.6), O₃ at Lag0-5 (1.1%, 95%CI 0.2-2.0), NO₂ at Lag0-4 (2.5%, 95%CI 0.3-4.7) and for each 1 mg/m³ of CO at Lag0 (6.6%, 95%CI 0.3-13.2). Overall, 10.3% of CEDVs in Mexico City may be related to PM¹⁰ exposure, 9.5% to PM_2.5, 10.3% to O₃, 11% to NO₂ and 5.7% to CO. AAP significantly increase cardiovascular morbidity impacting on emergency medical services.

Influence of Land Use and Meteorological Factors on PM2.5 and PM10 Concentrations in Bangkok, Thailand

Particulate matter (PM) is regarded a major problem worldwide because of the harm it causes to human health. Concentrations of PM with particle diameter less than 2.5 µm (PM2.5) and with particle diameter less than 10 µm (PM10) are based on various emission sources as well as meteorological factors. In Bangkok, where the PM2.5 and PM10 monitoring stations are few, the ability to estimate concentrations at any location based on its environment will benefit healthcare policymakers. This research aimed to study the influence of land use, traffic load, and meteorological factors on the PM2.5 and PM10 concentrations in Bangkok using a land-use regression (LUR) approach. The backward stepwise selection method was applied to select the significant variables to be included in the resultant models. Results showed that the adjusted coefficient of determination of the PM2.5 and PM10 LUR models were 0.58 and 0.57, respectively, which are in the same range as reported in the previous studies. The meteorological variables included in both models were rainfall and air pressure; wind speed contributed to only the PM2.5 LUR model. Further, the land-use types selected in the PM2.5 LUR model were industrial and transportation areas. The PM10 LUR model included residential, commercial, industrial, and agricultural areas. Traffic load was excluded from both models. The root mean squared error obtained by 10-fold cross validation was 9.77 and 16.95 for the PM2.5 and PM10 LUR models, respectively.

Impact of Short-Term Air Pollution on Respiratory Infections: A Time-Series Analysis of COVID-19 Cases in California during the 2020 Wildfire Season

The 2020 California wildfire season coincided with the peak of the COVID-19 pandemic affecting many counties in California, with impacts on air quality. We quantitatively analyzed the short-term effect of air pollution on COVID-19 transmission using county-level data collected during the 2020 wildfire season. Using time-series methodology, we assessed the relationship between short-term exposure to particulate matter (PM2.5), carbon monoxide (CO), nitrogen dioxide (NO2), and Air Quality Index (AQI) on confirmed cases of COVID-19 across 20 counties impacted by wildfires. Our findings indicate that PM2.5, CO, and AQI are positively associated with confirmed COVID-19 cases. This suggests that increased air pollution could worsen the situation of a health crisis such as the COVID-19 pandemic. Health policymakers should make tailored policies to cope with situations that may increase the level of air pollution, especially during a wildfire season.