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Tsukada YT, Aoki-Kamiya C, Mizuno A, Nakayama A, Ide T, Aoyama R, Honye J, Hoshina K, Ikegame T, Inoue K, Bando YK, Kataoka M, Kondo N, Maemura K, Makaya M, Masumori N, Mito A, Miyauchi M, Miyazaki A, Nakano Y, Nakao YM, Nakatsuka M, Nakayama T, Oginosawa Y, Ohba N, Otsuka M, Okaniwa H, Saito A, Saito K, Sakata Y, Harada-Shiba M, Soejima K, Takahashi S, Takahashi T, Tanaka T, Wada Y, Watanabe Y, Yano Y, Yoshida M, Yoshikawa T, Yoshimatsu J, Abe T, Dai Z, Endo A, Fukuda-Doi M, Ito-Hagiwara K, Harima A, Hirakawa K, Hosokawa K, Iizuka G, Ikeda S, Ishii N, Izawa KP, Kagiyama N, Umeda-Kameyama Y, Kanki S, Kato K, Komuro A, Konagai N, Konishi Y, Nishizaki F, Noma S, Norimatsu T, Numao Y, Oishi S, Okubo K, Ohmori T, Otaki Y, Shibata T, Shibuya J, Shimbo M, Shiomura R, Sugiyama K, Suzuki T, Tajima E, Tsukihashi A, Yasui H, Amano K, Kohsaka S, Minamino T, Nagai R, Setoguchi S, Terada K, Yumino D, Tomoike H. JCS/JCC/JACR/JATS 2024 Guideline on Cardiovascular Practice With Consideration for Diversity, Equity, and Inclusion. Circ J 2025; 89:658-739. [PMID: 39971310 DOI: 10.1253/circj.cj-23-0890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Affiliation(s)
| | - Chizuko Aoki-Kamiya
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center
| | - Atsushi Mizuno
- Department of Cardiology, St. Luke's International Hospital
| | | | - Tomomi Ide
- Department of Cardiovascular Medicine, Kyushu University
| | - Rie Aoyama
- Department of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Junko Honye
- Cardiovascular Center, Kikuna Memorial Hospital
| | | | | | - Koki Inoue
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka Metropolitan University
| | - Yasuko K Bando
- Department of Molecular Physiology and Cardiovascular Biology, Mie University Graduate School of Medicine
| | - Masaharu Kataoka
- The Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | | | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal-Reproductive Medicine, National Center for Child Health and Development
| | - Mizuho Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Aya Miyazaki
- Department of Pediatric Cardiology, Department of Adult Congenital Heart Disease, Seirei Hamamatsu General Hospital
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoko M Nakao
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University
| | - Mikiya Nakatsuka
- Faculty of Health Sciences, Okayama University Graduate School of Medicine
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University
| | - Yasushi Oginosawa
- The Second Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | | | - Maki Otsuka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Hiroki Okaniwa
- Department of Technology, Gunma Prefectural Cardiovascular Center
| | - Aya Saito
- Department of Surgery, Division of Cardiovascular Surgery, Yokohama City University, Graduate School of Medicine
| | - Kozue Saito
- Department of Neurology, Stroke Center, Nara Medical University
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | - Kyoko Soejima
- Department of Cardiovascular Medicine, Kyorin University School of Medicine
| | | | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University
| | - Toshihiro Tanaka
- Department of Human Genetics and Disease Diversity, Tokyo Medical and Dental University
| | - Yuko Wada
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine
| | | | - Yuichiro Yano
- Department of General Medicine, Juntendo University Faculty of Medicine
| | - Masayuki Yoshida
- Department of Life Sciences and Bioethics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU)
| | - Toru Yoshikawa
- Research Center for Overwork-Related Disorders (RECORDs), National Institute of Occuatopnal Safety and Health, Japan (JNIOSH)
| | - Jun Yoshimatsu
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center
| | - Takahiro Abe
- Department of Rehabilitation Medicine, Hokkaido University Hospital
| | - Zhehao Dai
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Ayaka Endo
- Department of Cardiology, Tokyo Saiseikai Central Hospital
| | - Mayumi Fukuda-Doi
- Department of Data Science, National Cerebral and Cardiovascular Center
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
| | | | | | - Kyoko Hirakawa
- Department of Cardiovascular Medicine, Kumamoto University
| | | | | | - Satoshi Ikeda
- Stroke and Cardiovascular Diseases Support Center, Nagasaki University Hospital
| | - Noriko Ishii
- Department of Nursing, Sakakibara Heart Institute
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University
| | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | | | - Sachiko Kanki
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical and Pharmaceutical University
| | - Katsuhito Kato
- Department of Hygiene and Public Health, Nippon Medical School
| | - Aya Komuro
- Department of Geriatric Medicine, The University of Tokyo Hospital
| | - Nao Konagai
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center
| | - Yuto Konishi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Fumie Nishizaki
- Department of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine
| | - Satsuki Noma
- Department of Cardiovascular Medicine, Nippon Medical School
| | | | - Yoshimi Numao
- Department of Cardiology, Itabasih Chuo Medical Center
| | | | - Kimie Okubo
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine Itabashi Hospital
| | | | - Yuka Otaki
- Department of Radiology, Sakakibara Heart Institute
| | | | - Junsuke Shibuya
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
| | - Mai Shimbo
- Department of Cardiovascular Medicine, Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo
| | - Reiko Shiomura
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
| | | | - Takahiro Suzuki
- Department of Cardiovascular Medicine, St. Luke's International Hospital
| | - Emi Tajima
- Department of Cardiology, Tokyo General Hospital
| | - Ayako Tsukihashi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Haruyo Yasui
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | | | - Soko Setoguchi
- Division of Education, Department of Medicine, Rutgers Robert Wood Johnson Medical School
- Division of Cardiovascular Disease and Hypertension, Department of Medicine, Rutgers Robert Wood Johnson Medical School
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Yang X, Chen G, Liao W, Zhang Z, Liu X, Li R, Hou X, Yuchi Y, Mao Z, Huo W, Guo Y, Li S, Wang C, Hou J. Physical activity alleviated associations of oxidation capacity of the atmosphere with platelet-based inflammatory indicators: findings from the Henan Rural Cohort Study. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2025; 27:463-472. [PMID: 39841503 DOI: 10.1039/d4em00611a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2025]
Abstract
Background: several adverse effects of ozone (O3) and nitrogen dioxide (NO2) are assessed using combined oxidant capacity (Ox) and redox-weighted oxidant capacity (Owtx) as surrogates. However, the associations of oxidant capacity (Ox and Owtx) with platelet-based inflammatory indicators and the potential modifying role of physical activity (PA) remain unclear. Methods: 31 318 participants were selected from the baseline survey of the Henan Rural Cohort Study. The Ox and Owtx were calculated based on O3 and NO2. The International Physical Activity Questionnaire was used to evaluate PA. Platelet-based inflammatory indicators were obtained from the data of physical examination. Generalized linear models were applied to explore associations between atmospheric oxidation capacity indicators (O3, Ox, Owtx, and NO2) and platelet-based inflammatory indicators and whether PA modified these associations. Results: O3, Ox, and Owtx were positively associated with platelet-based inflammatory indicators (PCT, PLT, PLR, SII, MLR and SIRI). The estimated β values and 95% confidence intervals (CIs) for PLT in response to a 5 μg m-3 increment in O3, Ox, and Owtx were 19.267 × 109 L-1 (95% CI: 17.493, 21.041 × 109 L-1), 6.226 × 109 L-1 (95% CI: 5.502, 6.950 × 109 L-1), and 14.664 × 109 L-1 (95% CI: 13.101, 16.227 × 109 L-1), respectively. The corresponding values for SIRI were 0.134 × 109 L-1 (95% CI: 0.111, 0.156 × 109 L-1), 0.064 × 109 L-1 (95% CI: 0.055, 0.073 × 109 L-1), and 0.135 × 109 L-1 (95% CI: 0.115, 0.155 × 109 L-1). And similar results were observed for NO2. Furthermore, we observed positive associations of O3, Ox, Owtx, and NO2 with platelet-based inflammatory indicators attenuated by increased PA levels. Conclusions: exposure to O3, Ox, Owtx, and NO2 was positively associated with platelet-based inflammatory indicators, and these associations were modified by PA. The findings suggested that a healthy lifestyle of PA might be an effective measure against early adverse effects of air pollution.
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Affiliation(s)
- Xiaohuan Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Ziyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
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Hua Q, Meng X, Gong J, Qiu X, Shang J, Xue T, Zhu T. Ozone exposure and cardiovascular disease: A narrative review of epidemiology evidence and underlying mechanisms. FUNDAMENTAL RESEARCH 2025; 5:249-263. [PMID: 40166088 PMCID: PMC11955045 DOI: 10.1016/j.fmre.2024.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/02/2025] Open
Abstract
Ozone (O3) poses a significant global public health concern as it exerts adverse effects on human cardiovascular health. Nevertheless, there remains a lack of comprehensive understanding regarding the relationships between O3 exposure and the risk of cardiovascular diseases (CVD), as well as the underlying biological mechanisms. To address this knowledge gap, this narrative review meticulously summarizes the existing epidemiological evidence, susceptibility, and potential underlying biological mechanisms linking O3 exposure with CVD. An increasing body of epidemiological studies has demonstrated that O3 exposure heightens the incidence and mortality of CVD, including specific subtypes such as ischemic heart disease, hypertension, and heart failure. Certain populations display heightened vulnerability to these effects, particularly children, the elderly, obese individuals, and those with pre-existing conditions. Proposed biological mechanisms suggest that O3 exposure engenders respiratory and systemic inflammation, oxidative stress, disruption of autonomic nervous and neuroendocrine systems, as well as impairment of coagulation function, glucose, and lipid metabolism. Ultimately, these processes contribute to vascular dysfunction and the development of CVD. However, some studies have reported the absence of associations between O3 and CVD, or even potentially protective effects of O3. Inconsistencies among the literature may be attributed to inaccurate assessment of personal O3 exposure levels in epidemiologic studies, as well as confounding effects stemming from co-pollutants and temperature. Consequently, our findings underscore the imperative for further research, including the development of reliable methodologies for assessing personal O3 exposure, exploration of O3 exposure's impact on cardiovascular health, and elucidation of its biological mechanisms. These endeavors will consolidate the causal relationship between O3 and cardiovascular diseases, subsequently aiding efforts to mitigate the risks associated with O3 exposure.
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Affiliation(s)
- Qiaoyi Hua
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Xin Meng
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Jicheng Gong
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Xinghua Qiu
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Jing Shang
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
| | - Tao Xue
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100871, China
| | - Tong Zhu
- SKL-ESPC & SEPKL-AERM, College of Environmental Sciences and Engineering and Center for Environment and Health, Peking University, Beijing 100871, China
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Khajavi A, Hashemi-Madani N, Hassanvand MS, Naddafi K, Khamseh ME. Ambient Air Pollution and Incident Cardiovascular Disease in People With Type 2 Diabetes Mellitus: A Cohort Study. J Occup Environ Med 2024; 66:e500-e505. [PMID: 39016278 DOI: 10.1097/jom.0000000000003193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
OBJECTIVES We aimed to assess the effect of air pollution on incident cardiovascular disease (CVD) in people with type 2 diabetes mellitus (T2DM). METHODS We tracked 486 T2DM patients from 2012 to 2021. Cox regression models were applied to assess the hazard of exposure to particulate matter, carbon monoxide (CO), ozone, nitrogen dioxide, and sulfur dioxide (SO 2 ) on incident CVD, revealing hazard ratios (HRs). RESULTS CVD incidents occurred in 73 individuals. Among men, each 1-ppm increase in CO levels raised the risk of CVD (HR: 2.66, 95% CI: 1.30-5.44). For women, a 5-ppb rise in SO 2 increased CVD risk (HR: 1.60, 95% CI: 1.11-2.30). No notable impact of particulate pollutants was found. CONCLUSIONS Persistent exposure to gaseous air pollutants, specifically CO and SO 2 , is linked to the development of CVD in men and women with T2DM.
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Affiliation(s)
- Alireza Khajavi
- From the School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (A.K.); Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, (N.H.-M., M.E.K.); Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (M.S.H., K.N.); and Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran (M.S.H., K.N.)
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Mohd Zulkifli SWH, Samsudin HB, Majid N. Association between P M 10 and respiratory diseases admission in peninsula Malaysia during haze. Sci Rep 2024; 14:21030. [PMID: 39251631 PMCID: PMC11385522 DOI: 10.1038/s41598-024-63591-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 05/30/2024] [Indexed: 09/11/2024] Open
Abstract
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.
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Affiliation(s)
- Siti Wafiah Hanin Mohd Zulkifli
- Department of Mathematical Science Faculty of Science and Technology, National University of Malaysia, Bangi, 43600, Selangor, Malaysia
| | - Humaida Banu Samsudin
- Department of Mathematical Science Faculty of Science and Technology, National University of Malaysia, Bangi, 43600, Selangor, Malaysia.
| | - Noriza Majid
- Department of Mathematical Science Faculty of Science and Technology, National University of Malaysia, Bangi, 43600, Selangor, Malaysia
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Wu S, Zhang H, Liu C, Yang Q, Sun J, Yuan C, Xiang H, Zhang J, Lu E, Guo J, Shao Q, Zhao B, Yang G. Impact of surface ultraviolet radiation intensity on hospital admissions for ischemic and hemorrhagic stroke: A large-scale database study using distributed lag nonlinear analysis, 2015-2022, in Harbin, China. J Stroke Cerebrovasc Dis 2024; 33:107908. [PMID: 39094717 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/27/2024] [Accepted: 07/30/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVES Our aim is to evaluate the impact of surface ultraviolet radiation intensity on hospital admissions for stroke and to compare the correlation and differences among different subtypes of strokes. MATERIALS AND METHODS We collected daily data on surface ultraviolet radiation intensity, temperature, air pollution, and hospital admissions for stroke in Harbin from 2015 to 2022. Using a distributed lag non-linear model, we determined the correlation between daily surface ultraviolet radiation intensity and the stroke admission rate. Relative risks (RR) with 95% confidence intervals (CI) and attributable fractions (AF) with 95% CI were calculated based on stroke subtypes, gender, and age groups. RESULTS A total of 132,952 hospitalized stroke cases (including hemorrhagic and ischemic strokes) were included in the study. We assessed the non-linear effects of ultraviolet intensity on hospitalized patients with ischemic and hemorrhagic strokes. Compared to the maximum morbidity benchmark ultraviolet intensity (19.2 × 10^5 for ischemic stroke and 20.25 for hemorrhagic stroke), over the 0-10 day lag period, the RR for extreme low radiation (1st percentile) was 0.86 (95% CI: 0.77, 0.96), and the RR for extreme high radiation (99th percentile) was 0.86 (95% CI: 0.77, 0.96). In summary, -4.842% (95% CI: -7.721%, -2.167%) and -1.668% (95% CI: -3.061%, -0.33%) of ischemic strokes were attributed to extreme low radiation intensity with a lag of 0 to 10 days and extreme high radiation intensity with a lag of 0 to 5 days, respectively. The reduction in stroke hospitalization rates due to low or high ultraviolet intensity was more pronounced in females and younger individuals compared to males and older individuals. None of the mentioned ultraviolet intensity intensities and lag days had a statistically significant impact on hemorrhagic stroke. CONCLUSIONS Our study fundamentally suggests that both lower and higher levels of surface ultraviolet radiation intensity in Harbin, China, contribute to a reduced incidence of ischemic stroke, with this effect lasting approximately 10 days. This finding holds significant potential for public health and clinical relevance.
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Affiliation(s)
- Shouyue Wu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Hongli Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Chunyang Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Qiunan Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jianda Sun
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Chao Yuan
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Huan Xiang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jian Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Enzhou Lu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jinyi Guo
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Qi Shao
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Boxian Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Guang Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China.
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Riggs DW, Baumgartner KB, Baumgartner R, Boone S, Judd SE, Bhatnagar A. Long-term exposure to air pollution and risk of stroke by ecoregions: The REGARDS study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123367. [PMID: 38280465 PMCID: PMC10996890 DOI: 10.1016/j.envpol.2024.123367] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
Several cohort studies have found associations between long-term exposure to air pollution and stroke risk. However, it is unclear whether the surrounding ecology may modify these associations. This study evaluates associations of air pollution with stroke risk by ecoregions, which are areas of similar type, quality, and quantity of environmental resources in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. We assessed the incidence of stroke in 26,792 participants (45+ yrs) from the REGARDS study, a prospective cohort recruited across the contiguous United States. One-yr and 3-yr means of PM2.5, PM10, O3, NO2, SO2, and CO were estimated at baseline using data from the Center for Air, Climate, & Energy Solution, and assigned to participants at the census block group level. Incident stroke was ascertained through September 30, 2020. Relations of air pollutants with the risk of incident stroke were estimated using Cox proportional hazards models, adjusting for relevant demographics, behavioral risk factors, and neighborhood urbanicity. Models were stratified by EPA designated ecoregions. A 5.4 μg/m3 (interquartile range) increase in 1-yr PM10 was associated with a hazard ratio (95 %CI) for incident stroke of 1.07 (1.003, 1.15) in the overall study population. We did not find evidence of positive associations for PM2.5, O3, NO2, SO2, and CO in the fully adjusted models. In our ecoregion-specific analysis, associations of PM2.5 with stroke were stronger in the Great Plains ecoregion (HR = 1.44) than other ecoregions, while associations for PM10 were strongest in the Eastern Temperate Forests region (HR = 1.15). The associations between long-term exposure to air pollution and risk of stroke varied by ecoregion. Our results suggests that the type, quality, and quantity of the surrounding ecology can modify the effects of air pollution on risk of stroke.
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Affiliation(s)
- Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States.
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Richard Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Stephanie Boone
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
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Yang C, Lei L, Li Y, Huang C, Chen K, Bao J. Bidirectional modification effects on nonlinear associations of summer temperature and air pollution with first-ever stroke morbidity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116034. [PMID: 38310820 DOI: 10.1016/j.ecoenv.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
High temperature and air pollution may induce stroke morbidity. However, whether associations between high temperature and air pollution with stroke morbidity are modified by each other is still unclear. Data on 23,578 first-ever stroke patients in Shenzhen, China, during the summers of 2014-2018 were collected. Distributed lag nonlinear models were used to assess the modifying effects of air pollution stratified by the median for the associations between summer temperature and stroke morbidity at 0-3 lag days; modifying effects of temperature stratified by the minimum morbidity temperature on the associations between air pollution and stroke morbidity at the same lags were also estimated. The attributable risks of high temperature and high pollution on stroke morbidity were quantified. Stratified analyses of gender, age, migration type, and complication type were conducted to assess vulnerable population characteristics. Summer high temperature may induce stroke morbidity at high-level PM2.5, PM10, O3, SO2, and NO2 conditions, with attributable fraction (AF) of 2.982% (95% empirical confidence interval [eCI]: 0.943, 4.929), 3.113% (0.948, 5.200), 2.841% (0.943, 4.620), 3.617% (1.539, 5.470), and 2.048% (0.279, 3.637), respectively. High-temperature effects were statistically insignificant at corresponding low-level air pollution conditions. High-level PM2.5, PM10, and O3 may induce stroke morbidity at high-temperature conditions, with AF of 3.664% (0.036, 7.196), 4.129% (0.076, 7.963), and 4.574% (1.009, 7.762), respectively. High-level PM2.5, PM10, and O3 were not associated with stroke morbidity at low-temperature conditions. The effects of high temperature and high pollution on stroke morbidity were statistically significant among immigrants and patients with hypertension, dyslipidemia, or diabetes but insignificant among natives and patients without complications. The associations of summer temperature and air pollution with first-ever stroke morbidity may be enhanced bidirectionally. Publicity on the health risks of combined high temperature and high pollution events should be strengthened to raise protection awareness of relevant vulnerable populations.
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Affiliation(s)
- Chenlu Yang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yike Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, China.
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Wang X, Lv Y, Luo W, Duan X. Patterns of Resident Activity and Their Impact on Environmental Parameters in Residential Apartments: Case Study and Implications for Design and Management. INDOOR AIR 2024; 2024. [DOI: 10.1155/2024/4404849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 08/24/2024] [Indexed: 01/04/2025]
Abstract
In the quest to optimize residential environments for health and sustainability, understanding the interaction between pedestrian dynamics and environmental parameters is crucial. This study delves into this intersection by conducting a detailed spatial‐temporal analysis within an apartment building. The research reveals pivotal insights about the relationship between pedestrian flow and environmental quality. Key findings reveal distinct patterns in pedestrian traffic, with two main peaks in early morning and late evening, accounting for approximately 24% of daily movement. The study identifies a pronounced preference for upward elevator use, reflecting residents’ lifestyle and floor‐level choices. Importantly, we observed variable correlations between pedestrian flow and environmental pollutants. Pollutants like PM2.5 and carbon monoxide exhibited weak correlations, while noise, TVOC, formaldehyde, and ozone showed stronger associations with human movement. The research uncovered significant spatial differences in pollutant levels across the building, with higher particulate matter and ozone levels in the seventh‐floor elevator room. The data suggest a need for tailored pollution management strategies, especially for noise and hazardous compounds like formaldehyde and ozone, which exceed safety limits in certain areas. Our findings offer critical insights for the design and management of residential environments, emphasizing the importance of considering both pedestrian flow and environmental factors in optimizing living spaces for health and efficiency.
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Li Z, Lv S, Lu F, Guo M, Wu Z, Liu Y, Li W, Liu M, Yu S, Jiang Y, Gao B, Wang X, Li X, Wang W, Liu X, Guo X. Causal Associations of Air Pollution With Cardiovascular Disease and Respiratory Diseases Among Elder Diabetic Patients. GEOHEALTH 2023; 7:e2022GH000730. [PMID: 37351309 PMCID: PMC10282596 DOI: 10.1029/2022gh000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/24/2023]
Abstract
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.
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Affiliation(s)
- Zhiwei Li
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Shiyun Lv
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Feng Lu
- Beijing Municipal Health Commission Information CenterBeijingChina
| | - Moning Guo
- Beijing Municipal Health Commission Information CenterBeijingChina
| | - Zhiyuan Wu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Yue Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Weiming Li
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Mengmeng Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Siqi Yu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Yanshuang Jiang
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Bo Gao
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xiaonan Wang
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xia Li
- Department of Mathematics and StatisticsLa Trobe UniversityMelbourneAustralia
| | - Wei Wang
- School of Medical Sciences and HealthEdith Cowan UniversityPerthAustralia
| | - Xiangtong Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xiuhua Guo
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
- School of Medical Sciences and HealthEdith Cowan UniversityPerthAustralia
- National Institute for Data Science in Health and MedicineCapital Medical UniversityBeijingChina
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11
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Su B, Liu C, Chen L, Wu Y, Li J, Zheng X. Long-term exposure to PM 2.5 and O 3 with cardiometabolic multimorbidity: Evidence among Chinese elderly population from 462 cities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114790. [PMID: 36948004 DOI: 10.1016/j.ecoenv.2023.114790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Cardiometabolic multimorbidity (CMM) refers to the presence of multiple cardiovascular and metabolic diseases (CMDs), such as hypertension, diabetes, and cardio-cerebrovascular diseases (CCVD), in the same individual, and has emerge as a significant global health concern due to population aging. Although previous research has demonstrated the association between cardiovascular and metabolic diseases and air pollutants, evidence on the link between CMM and air pollution exposure among Chinese older adults is limited. To address this research gap, we conducted a national representative survey of 222,179 adults aged 60 and older to investigate the epidemiology of CMM and its association with long-term exposure to PM2.5 and O3 in China's elderly population. We found that the prevalence of CMM among Chinese older adults was 16.9%, and hypertension and CCVD were the most common CMM cluster (10.8%). After adjusting for confounding variables, we observed a significant positive association between PM2.5 exposure and the prevalence of hypertension, diabetes, and CCVD, with a respective excess risk increase of 3.2%, 3.6%, and 5.5% for every 10-unit increase. Moreover, every 10-unit increase in PM2.5 was linked to a higher risk of hypertension and diabetes (2.2%), hypertension and CCVD (5.4%), diabetes and CCVD (5.6%), and hypertension, diabetes, and CCVD combined (7.6%). We also found a U-shaped curve relationship between O3 exposure and the occurrence of hypertension, diabetes, and CCVD, as well as different subtypes of CMM, with the lowest risk of O3 exposure was observed near 75-80 μg/m3. Furthermore, we identified that female and rural residents are more vulnerable to the health risks of air pollution than male and urban residents. Given the increasing aging of the population and rising prevalence of multimorbidity, policymakers should focus more attention on the female and rural elderly population to prevent and control CMM. This study provides compelling evidence that reducing air pollution levels can be an effective strategy to prevent and manage CMM among older adults.
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Affiliation(s)
- Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China
| | - Chen Liu
- Peking University Third Hospital, Beijing, People's Republic of China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China
| | - Jun Li
- Institute of Quantitative and Technological Economics, Chinese Academy of Social Sciences, Beijing, People's Republic of China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China.
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Keller K, Haghi SHR, Hahad O, Schmidtmann I, Chowdhury S, Lelieveld J, Münzel T, Hobohm L. Air pollution impacts on in-hospital case-fatality rate of ischemic stroke patients. Thromb Res 2023; 225:116-125. [PMID: 36990953 DOI: 10.1016/j.thromres.2023.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND A growing body of evidence suggests that air pollution exposure is associated with an increased risk for cardiovascular diseases. Data regarding the impact of long-term air pollution exposure on ischemic stroke mortality are sparse. METHODS The German nationwide inpatient sample was used to analyse all cases of hospitalized patients with ischemic stroke in Germany 2015-2019, which were stratified according to their residency. Data of the German Federal Environmental Agency regarding average values of air pollutants were assessed from 2015 to 2019 at district-level. Data were combined and the impact of different air pollution parameters on in-hospital case-fatality was analyzed. RESULTS Overall, 1,505,496 hospitalizations of patients with ischemic stroke (47.7% females; 67.4 % ≥70 years old) were counted in Germany 2015-2019, of whom 8.2 % died during hospitalization. When comparing patients with residency in federal districts with high vs. low long-term air pollution, enhanced levels of benzene (OR 1.082 [95%CI 1.034-1.132],P = 0.001), ozone (O3, OR 1.123 [95%CI 1.070-1.178],P < 0.001), nitric oxide (NO, OR 1.076 [95%CI 1.027-1.127],P = 0.002) and PM2.5 fine particulate matter concentrations (OR 1.126 [95%CI 1.074-1.180],P < 0.001) were significantly associated with increased case-fatality independent from age, sex, cardiovascular risk-factors, comorbidities, and revascularization treatments. Conversely, enhanced carbon monoxide, nitrogen dioxide, PM10, and sulphur dioxide (SO2) concentrations were not significantly associated with stroke mortality. However, SO2-concentrations were significantly associated with stroke-case-fatality rate of >8 % independent of residence area-type and area use (OR 1.518 [95%CI 1.012-2.278],P = 0.044). CONCLUSION Elevated long-term air pollution levels in residential areas in Germany, notably of benzene, O3, NO, SO2, and PM2.5, were associated with increased stroke mortality of patients. RESEARCH IN CONTEXT Evidence before this study: Besides typical, established risk factors, increasing evidence suggests that air pollution is an important and growing risk factor for stroke events, estimated to be responsible for approximately 14 % of all stroke-associated deaths. However, real-world data regarding the impact of long-term exposure to air pollution on stroke mortality are sparse. Added value of this study: The present study demonstrates that the long-term exposure to the air pollutants benzene, O3, NO, SO2 and PM2.5 are independently associated with increased case-fatality of hospitalized patients with ischemic stroke in Germany. Implications of all the available evidence: The results of our study support the urgent need to reduce the exposure to air pollution by tightening emission controls to reduce the stroke burden and stroke mortality.
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13
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Bai S, Du S, Liu H, Lin S, Zhao X, Wang Z, Wang Z. The causal and independent effect of ozone exposure during pregnancy on the risk of preterm birth: Evidence from northern China. ENVIRONMENTAL RESEARCH 2022; 214:113879. [PMID: 35835165 DOI: 10.1016/j.envres.2022.113879] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/15/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
The concentration of ozone (O3) in the environment is gradually increasing, but there are limited reports on the exposure to O3 during pregnancy on the risk of adverse birth outcomes. Our study aimed to examine the causal and independent effect of O3 exposure during pregnancy on the risk of preterm birth (PTB) and to identify the critical window. Based on the baseline population of the birth cohort in Jinan, northern China, we obtained the individual exposure for each subject during pregnancy of ambient 8-h moving average O3 through the inverse distance weighting model. The effect of O3 exposure during pregnancy on PTB was evaluated through the time-dependent Cox proportional-hazard models. And we assessed the causal relationship by controlling unknown confounding factors using the instrumental variable (IV) analysis, estimated the independent effect by principal component analysis, and identified the critical window period of exposure through the distributed lag model. Among 6501 subjects, 285 mothers delivered prematurely. The median (IQR) of O3 concentration during pregnancy was 109.51 (23.54) μg/m3. The high level of O3 exposure (>173.64 μg/m³) increased the risk of PTB, with HR of 1.92 (95% CI: 1.38-2.66). Furthermore, the HR (95% CI) of the O3 estimated value calculated by the IV (wind speed) on the risk of PTB was 2.63 (1.41-4.88). In addition, the high level of O3 exposure was associated with the risk of PTB in the 13th-18th gestational weeks. Therefore, the high level of O3 exposure during pregnancy may independently increase the risk of PTB, which may be a causal effect. The 13th to 18th week of gestation is a critical window for preventing this risk.
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Affiliation(s)
- Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Haiping Liu
- Xianwen Community Health Service Center, Jinan, Shandong, PR China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Zhaojun Wang
- Shandong Jinan Ecological Environment Monitoring Center, Jinan, Shandong, PR China
| | - Zhiping Wang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
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14
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Xue W, Zhang J, Hu X, Yang Z, Wei J. Hourly Seamless Surface O3 Estimates by Integrating the Chemical Transport and Machine Learning Models in the Beijing-Tianjin-Hebei Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148511. [PMID: 35886364 PMCID: PMC9324222 DOI: 10.3390/ijerph19148511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/09/2022] [Accepted: 07/10/2022] [Indexed: 02/04/2023]
Abstract
Surface ozone (O3) is an important atmospheric trace gas, posing an enormous threat to ecological security and human health. Currently, the core objective of air pollution control in China is to realize the joint treatment of fine particulate matter (PM2.5) and O3. However, high-accuracy near-surface O3 maps remain lacking. Therefore, we established a new model to determine the full-coverage hourly O3 concentration with the WRF-Chem and random forest (RF) models combined with anthropogenic emission data and meteorological datasets. Based on this method, choosing the Beijing-Tianjin-Hebei (BTH) region in 2018 as an example, full-coverage hourly O3 maps were generated at a horizontal resolution of 9 km. The performance evaluation results indicated that the new model is reliable with a sample (station)-based 10-fold cross-validation (10-CV) R2 value of 0.94 (0.90) and root mean square error (RMSE) of 14.58 (19.18) µg m−3. In addition, the estimated O3 concentration is accurately determined at varying temporal scales with sample-based 10-CV R2 values of 0.96, 0.98 and 0.98 at the daily, monthly, and seasonal scales, respectively, which is highly superior to traditional derivation algorithms and other techniques in previous studies. An initial increase and subsequent decrease, which constitute the diurnal variation in the O3 concentration associated with temperature and solar radiation variations, were captured. The highest concentration reached approximately 112.73 ± 9.65 μg m−3 at 15:00 local time (1500 LT) in the BTH region. Summertime O3 posed a high pollution risk across the whole BTH region, especially in southern cities, and the pollution duration accounted for more than 50% of the summer season. Additionally, 43 and two days exhibited light and moderate O3 pollution, respectively, across the BTH region in 2018. Overall, the new method can be beneficial for near-surface O3 estimation with a high spatiotemporal resolution, which can be valuable for research in related fields.
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Affiliation(s)
- Wenhao Xue
- School of Economics, Qingdao University, Qingdao 266071, China; (W.X.); (Z.Y.)
| | - Jing Zhang
- College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China;
- Correspondence: (J.Z.); (J.W.)
| | - Xiaomin Hu
- College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China;
| | - Zhe Yang
- School of Economics, Qingdao University, Qingdao 266071, China; (W.X.); (Z.Y.)
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20742, USA
- Correspondence: (J.Z.); (J.W.)
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Sîrbu CA, Stefan I, Dumitru R, Mitrica M, Manole AM, Vasile TM, Stefani C, Ranetti AE. Air Pollution and Its Devastating Effects on the Central Nervous System. Healthcare (Basel) 2022; 10:1170. [PMID: 35885697 PMCID: PMC9324939 DOI: 10.3390/healthcare10071170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Air pollution is a real public health problem, it being one of the five most common causes of mortality in developing countries. However, pollution studies have focused on the cardiovascular and pulmonary systems in recent decades. Recently, researchers have moved towards a new direction, tracing a direct link between pollution and stroke. Stroke has many known risk factors such as smoking, a sedentary lifestyle, and hypertension. Pollution is universally widespread, already a matter of public interest, so that, although intuitive, it is difficult to connect the two. The particles found in the air that we breathe, regardless of their origin, can attack the body in different ways, causing inflammation, and triggering a true cascade of phenomena that end up attacking the central nervous system and other organs. This article tries to explain the series of phenomena that determine the harmful effect of particles present in the air, with an increased focus on the central nervous system and especially on strokes. A deeper understanding of these phenomena helps in guiding future studies and finding viable solutions to protect people at risk.
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Affiliation(s)
- Carmen Adella Sîrbu
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Ion Stefan
- Department of Infectious Diseases, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania
- Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Rodica Dumitru
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Marian Mitrica
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Aida Mihaela Manole
- Department of Neurology, Clinical Ambulatory, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
| | - Titus Mihai Vasile
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
- Department No. 5, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Aurelian Emil Ranetti
- Department No. 2, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
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