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Bonomo S, Marchetti P, Fasola S, Vesentini R, Marcon A, Ferrante G, Antonicelli L, Battaglia S, Bono R, Squillacioti G, Murgia N, Pirina P, Villani S, La Grutta S, Verlato G, Viegi G. Asthma incidence can be influenced by climate change in Italy: findings from the GEIRD study-a climatological and epidemiological assessment. Sci Rep 2023; 13:19047. [PMID: 37923929 PMCID: PMC10624678 DOI: 10.1038/s41598-023-46423-2] [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: 08/10/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
An association between climatic conditions and asthma incidence has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation of the Summer North Atlantic Oscillation (S-NAO) index and the self-calibrated palmer drought severity index (scPDSI) with asthma incidence over the period from 1957 to 2006 in Italy. To this aim, an analysis of non-stationary and non-linear signals was performed on the time series of the Italian databases on respiratory health (ISAYA and GEIRD) including 36,255 individuals overall, S-NAO, and scPDSI indices to search for characteristic periodicities. The ISAYA (Italian Study on Asthma in Young Adults) and GEIRD (Gene Environment Interactions in Respiratory Diseases) studies collected information on respiratory health in general population samples, born between 1925 and 1989 and aged 20-84 years at the time of the interview, from 13 Italian centres. We found that annual asthma total incidence shared the same periodicity throughout the 1957-2006 time interval. Asthma incidence turned out to be correlated with the dynamics of the scPDSI, modulated by the S-NAO, sharing the same averaged 6 year-periodicity. Since climate patterns appear to influence asthma incidence, future studies aimed at elucidating the complex relationships between climate and asthma incidence are warranted.
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Affiliation(s)
- S Bonomo
- CNR Institute of Environmental Geology and Geo-Engineering (CNR-IGAG), Montelibretti, Rome, Italy.
| | - P Marchetti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Fasola
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - R Vesentini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Marcon
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | | | - S Battaglia
- Dipartimento PROMISE, University of Palermo, Palermo, Italy
| | - R Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - G Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - N Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - P Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | - S Villani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - S La Grutta
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - G Verlato
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (CNR-IFC), Pisa, Italy
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2
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Accordini S, Lando V, Calciano L, Bombieri C, Malerba G, Margagliotti A, Minelli C, Potts J, van der Plaat DA, Olivieri M. SNPs in FAM13Aand IL2RBgenes are associated with FeNO in adult subjects with asthma. J Breath Res 2023; 18:016001. [PMID: 37733009 DOI: 10.1088/1752-7163/acfbf1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/21/2023] [Indexed: 09/22/2023]
Abstract
Nitric oxide has different roles in asthma as both an endogenous modulator of airway function and a pro-inflammatory mediator. Fractional exhaled nitric oxide (FeNO) is a reliable, quantitative, non-invasive, simple, and safe biomarker for assessing airways inflammation in asthma. Previous genome-wide and genetic association studies have shown that different genes and single nucleotide polymorphisms (SNPs) are linked to FeNO. We aimed at identifying SNPs in candidate genes or gene regions that are associated with FeNO in asthma. We evaluated 264 asthma cases (median age 42.8 years, female 47.7%) who had been identified in the general adult population within the Gene Environment Interactions in Respiratory Diseases survey in Verona (Italy; 2008-2010). Two hundred and twenty-one tag-SNPs, which are representative of 50 candidate genes, were genotyped by a custom GoldenGate Genotyping Assay. A two-step association analysis was performed without assuming ana priorigenetic model: step (1) a machine learning technique [gradient boosting machine (GBM)] was used to select the 15 SNPs with the highest variable importance measure; step (2) the GBM-selected SNPs were jointly tested in a linear regression model with natural log-transformed FeNO as the normally distributed outcome and with age, sex, and the SNPs as covariates. We replicated our results within an independent sample of 296 patients from the European Community Respiratory Health Survey III. We found that SNP rs987314 in family with sequence similarity 13 member A (FAM13A) and SNP rs3218258 in interleukin 2 receptor subunit beta (IL2RB) gene regions are significantly associated with FeNO in adult subjects with asthma. These genes are involved in different mechanisms that affect smooth muscle constriction and endothelial barrier function responses (FAM13A), or in immune response processes (IL2RB). Our findings contribute to the current knowledge on FeNO in asthma by identifying two novel SNPs associated with this biomarker of airways inflammation.
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Affiliation(s)
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
| | - Valentina Lando
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
| | - Cristina Bombieri
- Biology and Genetics Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona 37134, Italy
| | - Giovanni Malerba
- Biology and Genetics Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona 37134, Italy
| | - Antonino Margagliotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona 37134, Italy
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, United Kingdom
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, United Kingdom
| | - Diana A van der Plaat
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, United Kingdom
| | - Mario Olivieri
- Retired Professor of Occupational Medicine, University of Verona, Verona, Italy
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3
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Lando V, Calciano L, Minelli C, Bombieri C, Ferrari M, Malerba G, Margagliotti A, Murgia N, Nicolis M, Olivieri M, Potts J, Tardivo S, Accordini S. IL18 Gene Polymorphism Is Associated with Total IgE in Adult Subjects with Asthma. J Clin Med 2023; 12:3963. [PMID: 37373658 DOI: 10.3390/jcm12123963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
The allergic asthma phenotype is characterized by a T helper type 2 (Th2) immune response, based on Immunoglobulin E (IgE)-mediated type 1 hypersensitivity reactions. Total IgE is the sum of all IgE types produced by the human body and is used as a biomarker of inflammation in asthma. We analysed data collected in 143 asthma cases (median age 42.1 years) from the general Italian population (GEIRD survey; 2008-2010) to identify single nucleotide polymorphisms (SNPs) in candidate genes that are associated with total IgE in adult subjects with asthma. These patients reported respiratory symptoms in response to perennial allergens and provided data on 166 SNPs tagging 50 candidate genes or gene regions. Replication of the statistically significant results was performed in 842 asthma cases from other European countries (ECRHS II survey; 1998-2002). SNP rs549908 in interleukin 18 (IL18) gene was significantly associated with total IgE in GEIRD, and this result was replicated in ECRHS II. SNP rs1063320 in the human leukocyte antigen G (HLA-G) gene was identified in GEIRD, but this association was not replicated in ECRHS II. Further investigating IL18 and its biological pathways could be important for developing new therapeutic targets, due to its involvement in inflammatory response processes.
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Affiliation(s)
- Valentina Lando
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK
| | - Cristina Bombieri
- Biology and Genetics Section, Department of Neuroscience, Biomedicine and Movement, University of Verona, 37134 Verona, Italy
| | - Marcello Ferrari
- Respiratory Diseases Section, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Giovanni Malerba
- Biology and Genetics Section, Department of Neuroscience, Biomedicine and Movement, University of Verona, 37134 Verona, Italy
| | - Antonino Margagliotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK
| | - Stefano Tardivo
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
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Marchetti P, Miotti J, Locatelli F, Antonicelli L, Baldacci S, Battaglia S, Bono R, Corsico A, Gariazzo C, Maio S, Murgia N, Pirina P, Silibello C, Stafoggia M, Torroni L, Viegi G, Verlato G, Marcon A. Long-term residential exposure to air pollution and risk of chronic respiratory diseases in Italy: The BIGEPI study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 884:163802. [PMID: 37127163 DOI: 10.1016/j.scitotenv.2023.163802] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
Long-term exposure to air pollution has adverse respiratory health effects. We investigated the cross-sectional relationship between residential exposure to air pollutants and the risk of suffering from chronic respiratory diseases in some Italian cities. In the BIGEPI project, we harmonised questionnaire data from two population-based studies conducted in 2007-2014. By combining self-reported diagnoses, symptoms and medication use, we identified cases of rhinitis (n = 965), asthma (n = 328), chronic bronchitis/chronic obstructive pulmonary disease (CB/COPD, n = 469), and controls (n = 2380) belonging to 13 cohorts from 8 Italian cities (Pavia, Turin, Verona, Terni, Pisa, Ancona, Palermo, Sassari). We derived mean residential concentrations of fine particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and summer ozone (O3) for the period 2013-2015 using spatiotemporal models at a 1 km resolution. We fitted logistic regression models with controls as reference category, a random-intercept for cohort, and adjusting for sex, age, education, BMI, smoking, and climate. Mean ± SD exposures were 28.7 ± 6.0 μg/m3 (PM10), 20.1 ± 5.6 μg/m3 (PM2.5), 27.2 ± 9.7 μg/m3 (NO2), and 70.8 ± 4.2 μg/m3 (summer O3). The concentrations of PM10, PM2.5, and NO2 were higher in Northern Italian cities. We found associations between PM exposure and rhinitis (PM10: OR 1.62, 95%CI: 1.19-2.20 and PM2.5: OR 1.80, 95%CI: 1.16-2.81, per 10 μg/m3) and between NO2 exposure and CB/COPD (OR 1.22, 95%CI: 1.07-1.38 per 10 μg/m3), whereas asthma was not related to environmental exposures. Results remained consistent using different adjustment sets, including bi-pollutant models, and after excluding subjects who had changed residential address in the last 5 years. We found novel evidence of association between long-term PM exposure and increased risk of rhinitis, the chronic respiratory disease with the highest prevalence in the general population. Exposure to NO2, a pollutant characterised by strong oxidative properties, seems to affect mainly CB/COPD.
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Affiliation(s)
- Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jessica Miotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Angelo Corsico
- Respiratory Diseases Division, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Italy
| | - Pietro Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | | | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service ASL Roma 1, Roma, Italy
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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5
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Lu C, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Wang J, Liu W, Sun Y, Norbäck D, Deng Q. Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma. ENVIRONMENT INTERNATIONAL 2022; 167:107456. [PMID: 35952466 DOI: 10.1016/j.envint.2022.107456] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although mounting evidence has associated air pollution and environmental temperature with children's health problems, it is unclear whether there is an interaction between these factors on childhood asthma. OBJECTIVES To explore the effects of temperature-pollution interactions during pre- and post-natal periods on asthma among pre-schoolers. METHODS A retrospective cohort study of 39,782 pre-schoolers was performed during 2010-2012, in seven cities in China. Exposure to three temperature indicators (TI) and three critical ambient air pollutants, including particulate matter with aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) as proxies of industrial and vehicular air pollution, was estimated by an inverse distance weighted (IDW) method. Two-level logistical regression analysis was used to examine the association between both pre- and post-natal exposure and childhood asthma in terms of odds ratio (OR) and 95 % confidence interval (CI). RESULTS Asthma prevalence in pre-schoolers at age of 3-6 years (6.9 %) was significantly associated with traffic-related air pollutant (NO2) exposure, with ORs (95 % CI) of 1.17 (1.06, 1.28), 1.19 (1.05-1.34) and 1.16 (1.03-1.31) for an IQR increase in NO2 exposure during lifetime, pregnancy, and entire postnatal period respectively. Furthermore, childhood asthma was positively associated with exposure to increased temperature during lifetime, pregnancy, and entire postnatal period with ORs (95 % CI) = 1.89 (1.66, 2.16), 1.47 (1.34, 1.61), and 1.15 (1.11, 1.18) respectively, while was negatively associated with decreased temperatures. Childhood asthma was positively related with exposure to extreme heat days (EHD) during postnatal period particularly in first year of life respectively with ORs (95 % CI) = 1.23 (1.04, 1.46) and 1.26 (1.07, 1.47), but was not related with extreme cold days (ECD) exposure. A combination of high air pollutant levels and high temperatures significantly increased the risk of asthma during both pre- and post-natal periods. Strikingly, we found a significantly positive interaction of temperature and PM10 or SO2 on asthma risk among boys and younger children. CONCLUSIONS Prenatal and postnatal exposure to ambient air pollution and high temperatures are independently and jointly associated with asthma risk in early childhood.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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Wang H, Li XB, Chu XJ, Cao NW, Wu H, Huang RG, Li BZ, Ye DQ. Ambient air pollutants increase the risk of immunoglobulin E-mediated allergic diseases: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:49534-49552. [PMID: 35595897 PMCID: PMC9122555 DOI: 10.1007/s11356-022-20447-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/21/2022] [Indexed: 05/06/2023]
Abstract
Immunoglobulin E (IgE)-mediated allergic diseases, including eczema, atopic dermatitis (AD), and allergic rhinitis (AR), have increased prevalence in recent decades. Recent studies have proved that environmental pollution might have correlations with IgE-mediated allergic diseases, but existing research findings were controversial. Thus, we performed a comprehensive meta-analysis from published observational studies to evaluate the risk of long-term and short-term exposure to air pollutants on eczema, AD, and AR in the population (per 10-μg/m3 increase in PM2.5 and PM10; per 1-ppb increase in SO2, NO2, CO, and O3). PubMed, Embase, and Web of Science were searched to identify qualified literatures. The Cochran Q test was used to assess heterogeneity and quantified with the I2 statistic. Pooled effects and the 95% confidence intervals (CIs) were used to evaluate outcome effects. A total of 55 articles were included in the study. The results showed that long-term and short-term exposure to PM10 increased the risk of eczema (PM10, RRlong = 1.583, 95% CI: 1.328, 1.888; RRshort = 1.006, 95% CI: 1.003-1.008) and short-term exposure to NO2 (RRshort = 1.009, 95% CI: 1.008-1.011) was associated with eczema. Short-term exposure to SO2 (RRshort: 1.008, 95% CI: 1.001-1.015) was associated with the risk of AD. For AR, PM2.5 (RRlong = 1.058, 95% CI: 1.014-1.222) was harmful in the long term, and short-term exposure to PM10 (RRshort: 1.028, 95% CI: 1.008-1.049) and NO2 (RRshort: 1.018, 95% CI: 1.007-1.029) were risk factors. The findings indicated that exposure to air pollutants might increase the risk of IgE-mediated allergic diseases. Further studies are warranted to illustrate the potential mechanism for air pollutants and allergic diseases.
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Affiliation(s)
- Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Hong Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Rong-Gui Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
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7
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Savouré M, Lequy É, Bousquet J, Chen J, de Hoogh K, Goldberg M, Vienneau D, Zins M, Nadif R, Jacquemin B. Long-term exposures to PM 2.5, black carbon and NO 2 and prevalence of current rhinitis in French adults: The Constances Cohort. ENVIRONMENT INTERNATIONAL 2021; 157:106839. [PMID: 34454361 DOI: 10.1016/j.envint.2021.106839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/09/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Rhinitis is one of the most common disease worldwide with a high and increasing prevalence. There is limited knowledge on the link between long-term exposure to air pollution and rhinitis. OBJECTIVES We aim to study the associations between long-term exposure to air pollutants and self-reported current rhinitis among adults from Constances, a large French population-based cohort. METHODS Current rhinitis was defined at inclusion from questionnaire by the presence of sneezing, runny or blocked nose in the last 12 months without a cold or the flu. Annual concentrations of nitrogen dioxide (NO2), particulate matter ≤ 2.5 µm (PM2.5) and black carbon (BC) were estimated at the participants' residential address by European land-use regression models. Cross-sectional associations between annual exposure to each air pollutant and current rhinitis were estimated using logistic models adjusted for age, sex, smoking, education level and French deprivation index. The health prevention centers were taken into account by marginal models with generalized estimating equations. Several supplementary analyses were performed. RESULTS Analyses were performed on 127,108 participants (47 years old on average, 54% women, 19% current smokers). The prevalence of current rhinitis, allergic (AR) and non-allergic (NAR) rhinitis were 36%, 25% and 11% respectively. Adjusted ORs for current rhinitis were 1.13 (1.08, 1.17), 1.12 (1.07, 1.17), and 1.11 (1.06, 1.17) per one interquartile range increase of PM2.5 (4.85 µg/m3), BC (0.88 · 10-5 m-1) and NO2 (17.3 µg/m3) respectively. Significant and positive associations were also found for both AR and NAR. Results were similar in men and women, and in the different smoking strata, and were consistent with meta-analysis or after imputing missing covariates. DISCUSSION An increase of modeled annual average residential exposure to PM2.5, BC, and NO2 was significantly associated with an increase of prevalence of current rhinitis in adults in the French general population. The results suggest that among air pollutants, BC may be of special interest.
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Affiliation(s)
- Marine Savouré
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France; Agence de l'environnement et de la Maîtrise de l'Energie, 20, avenue du Grésillé - BP 90406, 49004 Angers Cedex 01, France.
| | - Émeline Lequy
- Université Paris-Saclay, Université de Paris, UVSQ, Inserm, Cohortes Epidémiologiques en population, 94807 Villejuif, France.
| | - Jean Bousquet
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France.
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Marcel Goldberg
- Université Paris-Saclay, Université de Paris, UVSQ, Inserm, Cohortes Epidémiologiques en population, 94807 Villejuif, France.
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Marie Zins
- Université Paris-Saclay, Université de Paris, UVSQ, Inserm, Cohortes Epidémiologiques en population, 94807 Villejuif, France.
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807 Villejuif, France.
| | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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8
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Association between Glucose-6-Phosphate Dehydrogenase Deficiency and Asthma. J Clin Med 2021; 10:jcm10235639. [PMID: 34884340 PMCID: PMC8658649 DOI: 10.3390/jcm10235639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Among the determinants contributing to the pathogenesis of asthma, antioxidant genetic factors play a leading role. Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is competent to detoxify free radicals. Although a relationship between G6PD deficiency and asthma has been previously reported, the literature is still scanty. In this study, we test this hypothesis in a large cohort of patients from Sardinia, Italy. Methods: A retrospective case–control study was performed using data from 11,829 clinical records of outpatients referred to a teaching hospital for a medical visit. In total, 455 cases (asthma-positive) and 11,374 controls (asthma-negative) were compared for G6PD status using multivariable analysis, adjusting for all covariates. Results: Overall, G6PD deficiency was detected in 11.2% of study participants and was associated with an increased risk of asthma (odds ratio (OR) 1.63; 95% confidence interval (CI) 1.27–2.10). Additional variables significantly associated with asthma were female sex (OR 1.66; 95% CI 1.34–2.06), overweight/obesity (OR 1.56; 95% CI 1.27–1.92), smoking (OR 1.44; 95% CI 1.449–3.963), and high socioeconomic status (OR 1.40; 95% CI 1.16–1.70), whereas age was inversely related with asthma (OR 0.49; 95% CI 0.39–0.61). Conclusions: Our study shows that G6PD deficiency is an independent risk for asthma. These findings suggest that G6PD should be assessed in asthmatic patients for better risk stratification.
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9
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Velasquez N, Gardiner L, Cheng TZ, Moore JA, Boudreau RM, Presto AA, Lee SE. Relationship between socioeconomic status, exposure to airborne pollutants, and chronic rhinosinusitis disease severity. Int Forum Allergy Rhinol 2021; 12:172-180. [PMID: 34510788 DOI: 10.1002/alr.22884] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/01/2021] [Accepted: 07/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Air pollution directly interacts with airway mucosa, yet little is known about how pollutants affect upper airway inflammation. Studies have shown increased incidence of chronic rhinosinusitis (CRS), rhinitis, and asthma in areas with higher traffic pollution, and these neighborhoods are often associated with lower socioeconomic status (SES). The Area Deprivation Index (ADI) assesses neighborhood-level SES by zip code. The purpose of this study was to assess the relationship between SES and exposure to inhaled pollutants and CRS disease severity. METHODS CRS patients with and without nasal polyps (CRSwNP and CRSsNP, respectively) were identified (total patients = 234; CRSwNP patients = 138; CRSsNP patients = 96). Pollutant concentrations, including particulate matter 2.5 (PM2.5 ), black carbon (BC), and nitrogen dioxide (NO2 ), were measured at 70 sites within the defined countywide sites and used to estimate patient exposures. SES was measured by ADI state deciles. Disease severity metrics included the modified Lund-Mackay score (LMS), the need for systemic steroids, and functional endoscopic sinus surgery (FESS). Associations were analyzed and identified using linear, logistic, and Poisson multivariable regression. RESULTS The distribution of CRSsNP and CRSwNP patients across ADI state deciles was similar. ADI, however, was a predictor of exposure to airborne pollutants (PM2.5 , BC, and NO2 ) with a 1.39%, 2.39%, and 2.49% increase in PM2.5 , BC, and NO2 per increasing decile increment (p < 0.0001), respectively, which demonstrated a direct correlation between deprived neighborhoods and higher levels of exposure to PM2.5 , BC, and NO2 with an increase in pollutant levels per increase in ADI decile. Furthermore, ADI was a predictor for increased steroid treatment. CONCLUSION Lower SES predicted higher exposure to air pollution and increased disease severity in patients with CRS as demonstrated by the increased need for steroid treatment.
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Affiliation(s)
| | - Lauren Gardiner
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
| | - Tracy Z Cheng
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
| | - John A Moore
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
| | - Robert M Boudreau
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Albert A Presto
- Center for Atmospheric Particle Studies and Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA
| | - Stella E Lee
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
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10
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Abstract
Objective To summarize the main updated evidence about the health effects of air pollution, with a special focus on Southern Europe. Data sources Literature was obtained through PubMed Central and the official websites of European Agencies and Scientific Societies. Study selection Recent shreds of evidence about the health effects of air pollution coming from international reports and original research were collected and described in this review. Results Air pollution is an avoidable risk factor that causes a huge burden for society, in terms of death, health disorders, and huge socio-economic costs. The southern European countries face a more threatening problem because they experience the effects of both anthropogenic pollutants and natural dusts (particulate matter [PM]). The European Environment Agency reported the number of premature deaths in the 28 countries of the European Union attributable to air pollutant exposure in the year 2016: 374,000 for PM2.5, 68,000 for nitrogen dioxide, and 14,000 for ozone. In Italy, time series and analytical epidemiological studies showed increased cardio-respiratory hospital admissions and mortality, as well as increased risk of respiratory diseases in people living in urban areas. Conclusions Based on abundant evidence, the World Health Organization, which hosts the Global Alliance against Chronic Respiratory Diseases (GARD), the scientific respiratory societies, and the patients’ associations, as well as others in the health sector, must increase their engagement in advocacy for clean air policies.
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11
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Kim SH, Lee J, Oh I, Oh Y, Sim CS, Bang JH, Park J, Kim Y. Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea. PLoS One 2021; 16:e0248624. [PMID: 33735252 PMCID: PMC7971526 DOI: 10.1371/journal.pone.0248624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this study was to examine the association of allergic rhinitis with air pollutant concentrations using the follow-up data of elementary school children in Ulsan, Korea. Methods All students of four elementary schools in Ulsan, South Korea were surveyed at two-year intervals. The survey used data collected five times, over a nine-year period from June 2009 to April 2018. The questionnaire used in the survey was a modified version of the ISAAC (International society of asthma and allergy of children) questionnaire. A skin prick test (SPT) was performed with 24 standard antigens. To estimate the levels of exposure to outdoor air pollution, the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter 10 μm or less in diameter (PM10) were used. As a dependent variable, a history of allergic rhinitis diagnosed by a doctor during the last 1-year was considered. Logistic regression analysis was used to select variables suitable for the statistical model. The selected variables were then used to assess their association with the dependent variable using the generalized estimation equation. Results Among environmental factors, SO2 was associated with a high risk and PM10 was associated with a low risk of allergic rhinitis. The risk of allergic rhinitis from living in a house built within the last year was high, and the risk from living in a multi-family house or apartment was higher than that from living in a segregated house. History of allergic diseases in the family was a high-risk factor for allergic rhinitis. There was a relationship between a history of bronchiolitis at less than 2 years of age and a high risk of allergic rhinitis. Boys were at a higher risk than girls. Conclusion From the follow-up data of elementary school students in Ulsan, Korea, the concentration of SO2, which is an indicator of the degree of industrialization, was related to the prevalence of allergic rhinitis. Among all the risk factors, history of allergic disease in the parents was the most important factor, and the study reconfirmed the results of the previous studies.
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Affiliation(s)
- Suk Hwan Kim
- POSCO Health Center, POSCO, Pohang, Republic of Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Inbo Oh
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Yeonsuh Oh
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Chang Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jin-Hee Bang
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
- * E-mail:
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12
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Filippini T, Rothman KJ, Cocchio S, Narne E, Mantoan D, Saia M, Goffi A, Ferrari F, Maffeis G, Orsini N, Baldo V, Vinceti M. Associations between mortality from COVID-19 in two Italian regions and outdoor air pollution as assessed through tropospheric nitrogen dioxide. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 760:143355. [PMID: 33187703 PMCID: PMC7609227 DOI: 10.1016/j.scitotenv.2020.143355] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/24/2020] [Accepted: 10/25/2020] [Indexed: 05/15/2023]
Abstract
After the appearance of COVID-19 in China last December 2019, Italy was the first European country to be severely affected by the outbreak. The first diagnosis in Italy was on February 20, 2020, followed by the establishment of a light and a tight lockdown on February 23 and on March 8, 2020, respectively. The virus spread rapidly, particularly in the North of the country in the 'Padan Plain' area, known as one of the most polluted regions in Europe. Air pollution has been recently hypothesized to enhance the clinical severity of SARS-CoV-2 infection, acting through adverse effects on immunity, induction of respiratory and other chronic disease, upregulation of viral receptor ACE-2, and possible pathogen transportation as a virus carrier. We investigated the association between air pollution and subsequent COVID-19 mortality rates within two Italian regions (Veneto and Emilia-Romagna). We estimated ground-level nitrogen dioxide through its tropospheric levels using data available from the Sentinel-5P satellites of the European Space Agency Copernicus Earth Observation Programme before the lockdown. We then examined COVID-19 mortality rates in relation to the nitrogen dioxide levels at three 14-day lag points after the lockdown, namely March 8, 22 and April 5, 2020. Using a multivariable negative binomial regression model, we found an association between nitrogen dioxide and COVID-19 mortality. Although ecological data provide only weak evidence, these findings indicate an association between air pollution levels and COVID-19 severity.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Kenneth J Rothman
- RTI Health Solutions, Research Triangle Park, NC, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Silvia Cocchio
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Italy
| | | | - Domenico Mantoan
- Department for Health and Social Affairs of Veneto Region, Venice, Italy
| | - Mario Saia
- Azienda Zero of Veneto Region, Padua, Italy
| | | | | | | | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Vincenzo Baldo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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13
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Wang J, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Deng Q, Lu C, Qian H, Yang X, Sun Y, Sundell J, Norbäck D. Asthma and allergic rhinitis among young parents in China in relation to outdoor air pollution, climate and home environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 751:141734. [PMID: 32882555 DOI: 10.1016/j.scitotenv.2020.141734] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/14/2020] [Indexed: 05/14/2023]
Abstract
We estimated associations between ambient air pollution, home environment and asthma as well as rhinitis among adults across China. A total of 40,279 young adults from eight Chinese cities participated in a questionnaire survey (participation rate 75%). There were questions on health and home environment. Information on city level gross domestic product (GDP) per capita, ambient temperature and PM10 and NO2 were collected from registers. Two-level logistic regression models were used to study health associations. Totally 1.6% reported asthma and 6.6% reported allergic rhinitis (AR). Higher temperature was associated with more asthma but less AR. Higher GDP was associated with less asthma but more AR. Higher degree of urbanization, higher level of NO2 and living near heavily trafficked road were risk factors for asthma and AR. Participants in older buildings reported more asthma. Redecoration and buying new furniture were related to more asthma and AR (OR = 1.15-1.91). Using natural gas (OR = 1.34) and biomass (OR = 1.35) for cooking were risk factors for AR. Burning mosquito coils and incense increased the risk of asthma and AR. Cat keeping (OR = 2.88), dog keeping (OR = 2.04), cockroaches (OR = 1.54) and rats or mice (OR = 1.46) were associated with asthma. Cockroaches increased the risk of AR (OR = 1.22). Air humidifier and air cleaner were linked to asthma and AR. Frequent cleaning and exposing bedding to sunshine were protective. In conclusion, urbanization, NO2 and traffic exhaust can increase the risk of adult asthma and AR. Higher ambient temperature was related to more asthma but less AR. Indoor animals such as cats, dogs, rats/mice and presence of cockroaches were associated with asthma or AR. Indoor chemical sources such as redecoration and new furniture were other risk factors. Cooking with natural gas or biomass and burning mosquito coils and incense were associated with asthma or AR. Frequent cleaning and exposing bedding to sunshine were protective.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Qihong Deng
- Xiangya School of Public Health, Central South University, Changsha, China; School of Energy Science and engineering, Central South University, Changsha, China
| | - Chan Lu
- Xiangya School of Public Health, Central South University, Changsha, China; School of Energy Science and engineering, Central South University, Changsha, China
| | - Hua Qian
- School of Energy Environment, Southeast University, Nanjing, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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14
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Filippini T, Rothman KJ, Goffi A, Ferrari F, Maffeis G, Orsini N, Vinceti M. Satellite-detected tropospheric nitrogen dioxide and spread of SARS-CoV-2 infection in Northern Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 739:140278. [PMID: 32758963 PMCID: PMC7297152 DOI: 10.1016/j.scitotenv.2020.140278] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 05/17/2023]
Abstract
Following the outbreak of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) last December 2019 in China, Italy was the first European country to be severely affected, with the first local case diagnosed on 20 February 2020. The virus spread quickly, particularly in the North of Italy, with three regions (Lombardy, Veneto and Emilia-Romagna) being the most severely affected. These three regions accounted for >80% of SARS-CoV-2 positive cases when the tight lockdown was established (March 8). These regions include one of Europe's areas of heaviest air pollution, the Po valley. Air pollution has been recently proposed as a possible risk factor of SARS-CoV-2 infection, due to its adverse effect on immunity and to the possibility that polluted air may even carry the virus. We investigated the association between air pollution and subsequent spread of the SARS-CoV-2 infection within these regions. We collected NO2 tropospheric levels using satellite data available at the European Space Agency before the lockdown. Using a multivariable restricted cubic spline regression model, we compared NO2 levels with SARS-CoV-2 infection prevalence rate at different time points after the lockdown, namely March 8, 22 and April 5, in the 28 provinces of Lombardy, Veneto and Emilia-Romagna. We found little association of NO2 levels with SARS-CoV-2 prevalence up to about 130 μmol/m2, while a positive association was evident at higher levels at each time point. Notwithstanding the limitations of the use of aggregated data, these findings lend some support to the hypothesis that high levels of air pollution may favor the spread of the SARS-CoV-2 infection.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Kenneth J Rothman
- RTI Health Solutions, Research Triangle Park, NC, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | | | | | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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15
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Biomarkers of Oxidative Stress and Inflammation in Chronic Airway Diseases. Int J Mol Sci 2020; 21:ijms21124339. [PMID: 32570774 PMCID: PMC7353047 DOI: 10.3390/ijms21124339] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
Introduction: The global burden of chronic airway diseases represents an important public health concern. The role of oxidative stress and inflammation in the pathogenesis of these diseases is well known. The aim of this study is to evaluate the behavior of both inflammatory and oxidative stress biomarkers in patients with chronic bronchitis, current asthma and past asthma in the frame of a population-based study. Methods: For this purpose, data collected from the Gene Environment Interactions in Respiratory Diseases (GEIRD) Study, an Italian multicentre, multicase-control study, was evaluated. Cases and controls were identified through a two-stage screening process of individuals aged 20-65 years from the general population. Out of 16,569 subjects selected from the general population in the first stage of the survey, 2259 participated in the clinical evaluation. Oxidative stress biomarkers such as 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG), 8-isoprostane and glutathione and inflammatory biomarkers such as Fractional Exhaled Nitric Oxide (FENO) and white blood cells were evaluated in 1878 subjects. Results: Current asthmatics presented higher levels of FENO (23.05 ppm), leucocytes (6770 n/µL), basophils (30.75 n/µL) and eosinophils (177.80 n/µL), while subjects with chronic bronchitis showed higher levels of GSH (0.29 mg/mL) and lymphocytes (2101.6 n/µL). The multivariable multinomial logistic regression confirmed high levels of leucocytes (RRR = 1.33), basophils (RRR = 1.48), eosinophils (RRR = 2.39), lymphocytes (RRR = 1.26) and FENO (RRR = 1.42) in subjects with current asthma. Subjects with past asthma had a statistically significant higher level of eosinophils (RRR = 1.78) with respect to controls. Subjects with chronic bronchitis were characterized by increased levels of eosinophils (RRR = 2.15), lymphocytes (RRR = 1.58), GSH (RRR = 2.23) and 8-isoprostane (RRR = 1.23). Conclusion: In our study, current asthmatics show a greater expression of the inflammatory profile compared to subjects who have had asthma in the past and chronic bronchitis. On the other hand, chronic bronchitis subjects showed a higher rate of expression of oxidative stress biomarkers compared to asthmatic subjects. In particular, inflammatory markers such as circulating inflammatory cells and FENO seem to be more specific for current asthma, while oxidative stress biomarkers such as glutathione and 8-isoprostane appear to be more specific and applicable to patients with chronic bronchitis.
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16
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Dietary flavonoids and respiratory diseases: a population-based multi-case-control study in Italian adults. Public Health Nutr 2020; 23:2548-2556. [PMID: 31996276 DOI: 10.1017/s1368980019003562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To analyse the associations between chronic respiratory diseases and intakes of total flavonoids and their major subclasses (flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymers and proanthocyanidins). DESIGN Multi-case-control study. SETTING The analysis was conducted in the frame of the Genes Environment Interaction in Respiratory Diseases (GEIRD) study. The European Prospective Investigation into Cancer and Nutrition FFQ was used to ascertain dietary intake. Multinomial regression models adjusting for age, sex, centre, BMI, smoking habit, alcohol intake, education, total energy intake, vitamin C intake and total fruit intake were used to examine the associations between dietary exposures and the relative risk ratio (RRR) of being a case. PARTICIPANTS Individuals (n 990) hierarchically defined as follows: cases with asthma (current, n 159; past, n 78), chronic bronchitis (n 47), rhinitis (allergic rhinitis, n 167; non-allergic rhinitis, n 142) and controls (n 97). RESULTS An increase of 1 sd in flavanones was associated with a reduced risk of non-allergic rhinitis (adjusted RRR = 0·68, 95 % CI 0·47, 0·97); a similar result was found comparing the highest v. lowest quartile of flavanones intake (adjusted RRR = 0·24, 95 % CI 0·10, 0·59). CONCLUSIONS Flavonoids contained in fruits and vegetables, especially flavanones, might reduce the risk of non-allergic rhinitis. No associations were found between other flavonoids and the considered outcomes.
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17
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Mostafavi N, Jeong A, Vlaanderen J, Imboden M, Vineis P, Jarvis D, Kogevinas M, Probst-Hensch N, Vermeulen R. The mediating effect of immune markers on the association between ambient air pollution and adult-onset asthma. Sci Rep 2019; 9:8818. [PMID: 31217483 PMCID: PMC6584571 DOI: 10.1038/s41598-019-45327-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/05/2019] [Indexed: 11/09/2022] Open
Abstract
We aim to investigate to what extent a set of immune markers mediate the association between air pollution and adult-onset asthma. We considered long-term exposure to multiple air pollution markers and a panel of 13 immune markers in peripheral blood samples collected from 140 adult cases and 199 controls using a nested-case control design. We tested associations between air pollutants and immune markers and adult-onset asthma using mixed-effects (logistic) regression models, adjusted for confounding variables. In order to evaluate a possible mediating effect of the full set of immune markers, we modelled the relationship between asthma and air pollution with a partial least square path model. We observed a strong positive association of IL-1RA [OR 1.37; 95% CI (1.09, 1.73)] with adult-onset asthma. Univariate models did not yield any association between air pollution and immune markers. However, mediation analyses indicated that 15% of the effect of air pollution on risk of adult-onset asthma was mediated through the immune system when considering all immune markers as a latent variable (path coefficient (β) = 0.09; 95% CI: (-0.02, 0.20)). This effect appeared to be stronger for allergic asthma (22%; β = 0.12; 95% CI: (-0.03, 0.27)) and overweight subjects (27%; β = 0.19; 95% CI: (-0.004, 0.38)). Our results provides supportive evidence for a mediating effect of the immune system in the association between air pollution and adult-onset asthma.
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Affiliation(s)
- Nahid Mostafavi
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM, Utrecht, the Netherlands
| | - Ayoung Jeong
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Jelle Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM, Utrecht, the Netherlands
| | - Medea Imboden
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Paolo Vineis
- Italian Institute for Genomic Medicine (IIGM), Turin, Italy.,Medical Research Council-Public Health England Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Debbie Jarvis
- Department of Public Health Sciences, King's College, London, UK
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health (TPH) Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, 3584 CM, Utrecht, the Netherlands. .,Medical Research Council-Public Health England Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Cazzoletti L, Zanolin ME, Spelta F, Bono R, Chamitava L, Cerveri I, Garcia-Larsen V, Grosso A, Mattioli V, Pirina P, Ferrari M. Dietary fats, olive oil and respiratory diseases in Italian adults: A population-based study. Clin Exp Allergy 2019; 49:799-807. [PMID: 30689281 DOI: 10.1111/cea.13352] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fat intake has been associated with respiratory diseases, with conflicting results. OBJECTIVE We studied the association between asthma and rhinitis with dietary fats, and their food sources in an Italian population. METHODS Clinical and nutritional information was collected for 871 subjects (aged 20-84) from the population-based multi-case-control study Genes Environment Interaction in Respiratory Diseases (GEIRD): 145 with current asthma (CA), 77 with past asthma (PA), 305 with rhinitis and 344 controls. Food intake was collected using the EPIC (European Investigation into Cancer and Nutrition) Food Frequency Questionnaire. The associations between fats and respiratory diseases were estimated by multinomial models. Fats and their dietary sources were analysed both as continuous variables and as quartiles. RESULTS Monounsaturated fatty acids and oleic acid were associated with a reduced risk of CA in both continuous (RRR = 0.68, 95%CI: 0.48; 0.96; RRR = 0.69; 95%CI: 0.49; 0.97, per 10 g, respectively) and per-quartile analyses (p for trend = 0.028 and 0.024, respectively). Olive oil was associated with a decreased risk of CA (RRR = 0.80; 95%CI: 0.65; 0.98 per 10 g). An increased risk of rhinitis was associated with moderate total fat and SFA intake. CONCLUSIONS High dietary intakes of oleic acid and of olive oil are associated with a lower risk of asthma but not of rhinitis.
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Affiliation(s)
- Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Maria Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesco Spelta
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy.,Long-term care Unit, Fracastoro Hospital - ULSS 9, Verona, Italy
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Liliya Chamitava
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Vanessa Garcia-Larsen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amelia Grosso
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Veronica Mattioli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Pietro Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Marcello Ferrari
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy
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Time and age trends in smoking cessation in Europe. PLoS One 2019; 14:e0211976. [PMID: 30730998 PMCID: PMC6366773 DOI: 10.1371/journal.pone.0211976] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/24/2019] [Indexed: 11/24/2022] Open
Abstract
Background Smoking is the main risk factor for most of the leading causes of death. Cessation is the single most important step that smokers can take to improve their health. With the aim of informing policy makers about decisions on future tobacco control strategies, we estimated time and age trends in smoking cessation in Europe between 1980 and 2010. Methods Data on the smoking history of 50,228 lifetime smokers from 17 European countries were obtained from six large population-based studies included in the Ageing Lungs in European Cohorts (ALEC) consortium. Smoking cessation rates were assessed retrospectively, and age trends were estimated for three decades (1980–1989, 1990–1999, 2000–2010). The analyses were stratified by sex and region (North, East, South, West Europe). Results Overall, 21,735 subjects (43.3%) quit smoking over a total time-at-risk of 803,031 years. Cessation rates increased between 1980 and 2010 in young adults (16–40 years), especially females, from all the regions, and in older adults (41–60 years) from North Europe, while they were stable in older adults from East, South and West Europe. In the 2000s, the cessation rates for men and women combined were highest in North Europe (49.9 per 1,000/year) compared to the other regions (range: 26.5–32.7 per 1,000/year). A sharp peak in rates was observed for women around the age of 30, possibly as a consequence of pregnancy-related smoking cessation. In most regions, subjects who started smoking before the age of 16 were less likely to quit than those who started later. Conclusions Our findings suggest an increasing awareness on the detrimental effects of smoking across Europe. However, East, South and West European countries are lagging behind North Europe, suggesting the need to intensify tobacco control strategies in these regions. Additional efforts should be made to keep young adolescents away from taking up smoking, as early initiation could make quitting more challenging during later life.
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Cappa V, Marcon A, Di Gennaro G, Chamitava L, Cazzoletti L, Bombieri C, Nicolis M, Perbellini L, Sembeni S, de Marco R, Spelta F, Ferrari M, Zanolin ME. Health-related quality of life varies in different respiratory disorders: a multi-case control population based study. BMC Pulm Med 2019; 19:32. [PMID: 30732605 PMCID: PMC6367788 DOI: 10.1186/s12890-019-0796-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Health-related quality of life (HRQL) in respiratory diseases has been generally investigated in clinical settings, focusing on a single disorder. In this study on a general population sample, we assessed the relationship between HRQL and several respiratory diseases studied simultaneously (COPD, current (CA) and past (PA) asthma, allergic (AR) and non-allergic (NAR) rhinitis and chronic bronchitis (CB). METHODS Controls (n = 328) and cases of NAR (n = 95), AR (n = 163), CB (n = 48), CA (n = 224), PA (n = 126) and COPD (n = 28) were recruited in the centre of Verona in the frame of the Italian multi-case control GEIRD (Gene Environment Interactions in Respiratory Diseases) study; HRQL was measured through the SF-36 questionnaire. The relationships between HRQL (in terms of Physical (PCS) and Mental Component Scores (MCS)), respiratory diseases, and covariates were evaluated. RESULTS With respect to controls, the adjusted PCS median score was worse in subjects suffering from current asthma (- 1.7; 95%CI:-2.8;-0.6), CB (- 3.8; 95%CI:-5.7;-1.9), and COPD (- 5.6; 95%CI:-8.1;-3.1). MCS was worse in current asthmatics (- 2.2; 95%CI:-4.1;-0.3), CB (- 5.5; 95%CI:-8.7;-2.2), and COPD cases (- 4.6; 95%CI:-8.8;-0.5) as well. CONCLUSIONS To our knowledge, this is the first study in the general population that analyzed HRQL performing a simultaneous comparison of HRLQ in several respiratory disorders. We found that subjects suffering from COPD, CA, and CB had the poorest HRQL. Clinicians should carefully consider the possible impact of respiratory disorders as CB and not only that of CA and COPD.
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Affiliation(s)
- Veronica Cappa
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Gianfranco Di Gennaro
- Department of Pathology and Diagnostics, University Hospital of Verona, Verona, Italy
| | - Liliya Chamitava
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Cristina Bombieri
- Unit of Biology and Genetics, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Luigi Perbellini
- Unit of Occupational Medicine, Azienda Ospedaliero Universitaria di Verona, Verona, Italy
| | - Silvia Sembeni
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Francesco Spelta
- Department of Medicine, Unit of Respiratory Medicine, University of Verona, Verona, Italy
| | - Marcello Ferrari
- Department of Medicine, Unit of Respiratory Medicine, University of Verona, Verona, Italy
| | - Maria Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
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Chamitava L, Garcia-Larsen V, Cazzoletti L, Degan P, Pasini A, Bellisario V, Corsico AG, Nicolis M, Olivieri M, Pirina P, Ferrari M, Stasinopoulos MD, Zanolin ME. Determination of adjusted reference intervals of urinary biomarkers of oxidative stress in healthy adults using GAMLSS models. PLoS One 2018; 13:e0206176. [PMID: 30352092 PMCID: PMC6198964 DOI: 10.1371/journal.pone.0206176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
In this study we aimed at identifying main demographic, laboratory and environmental factors influencing the level of urinary biomarkers (DNA-derived 8-oxodG and lipid membrane-derived 8-isoprostane), and deriving their adjusted 95% reference intervals (RI) in a sample of healthy people from the general population. Data from 281 healthy subjects from the Gene Environment Interactions in Respiratory Diseases survey were used in this study. Generalized additive models for location, scale and shape (GAMLSS) were used to find determinants of the biomarkers among gender, age, season and distance from collection (DFC), and to predict their RI. The RI of the biomarkers stratified by season and adjusted for DFC showed a slight statistically significant decrease in the biomarkers at the increasing DFC in two seasons, except the 8-oxodG during the warm season: median levels at the min and max values of DFC were (ng/mgcreat) 7.0–1.1 in the cold and 3.9–3.9 in the warm seasons for 8-oxodG, 0.7–0.2 in the cold and 1.3–0.6 in the warm seasons for 8-isoprostane. Both the biomarkers should be evaluated in association with the DFC and season in large epidemiological studies. The (semi)parametric GAMLSS method is a useful and flexible technique, which makes it possible to estimate adjusted RI.
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Affiliation(s)
- Liliya Chamitava
- Unit of Epidemiology and Medical Statistics (SESM), Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics (SESM), Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paolo Degan
- Epidemiology, Prevention and Special Functions, National Institute of Cancer Research AOU S. Martino IST, Genova, Italy
| | - Andrea Pasini
- Department of Internal Medicine, University of Verona, Verona, Italy
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Angelo G. Corsico
- Division of Respiratory Diseases, ERCS, S. Matteo, Hospital University of Pavia, Pavia, Italy
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, University of Verona, Verona, Italy
| | - Pietro Pirina
- Institute of Respiratory Diseases, University of Sassari, Piazza Università, Sassari, Italy
| | - Marcello Ferrari
- Department of Medicine, Unit of Respiratory Medicine, University of Verona, Verona, Italy
| | - Mikis D. Stasinopoulos
- Statistics, Operational Research and Mathematics Research Centre, London Metropolitan University, London, United Kingdom
| | - Maria E. Zanolin
- Unit of Epidemiology and Medical Statistics (SESM), Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- * E-mail:
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Health Impacts of Exposure to Gaseous Pollutants and Particulate Matter in Beijing-A Non-Linear Analysis Based on the New Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091969. [PMID: 30201896 PMCID: PMC6165060 DOI: 10.3390/ijerph15091969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 11/16/2022]
Abstract
This paper aimed to estimate health risks focusing on respiratory diseases from exposure to gaseous multi-pollutants based on new data and revealed new evidence after the most stringent air pollution control plan in Beijing which was carried out in 2013. It used daily respiratory diseases outpatient data from a hospital located in Beijing with daily meteorological data and monitor data of air pollutants from local authorities. All data were collected from 2014 to 2016. Distributed lag non-linear model was employed. Results indicated that NO2 and CO had positive association with outpatients number on the day of the exposure (1.045 (95% confidence interval (CI): 1.003, 1.089) for CO and 1.022 (95% CI: 1.008, 1.036) for NO2) (and on the day after the exposure (1.026 (95% CI: 1.005, 1.048) for CO and 1.013 (95% CI: 1.005, 1.021) for NO2). Relative risk (RR) generally declines with the number of lags; ozone produces significant effects on the first day (RR = 0.993 (95% CI: 0.989, 0.998)) as well as second day (RR = 0.995 (95% CI: 0.991, 0.999)) after the exposure, while particulate pollutants did not produce significant effects. Effects from the short-term exposure to gaseous pollutants were robust after controlling for particulate matters. Our results contribute to a comprehensive understanding of the dependencies between the change of air pollutants concentration and their health effects in Beijing after the implementation of promising air regulations in 2013. Results of the study can be used to develop relevant measures minimizing the adverse health consequences of air pollutants and supporting sustainable development of Beijing as well as other rapidly growing Asian cities.
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Burte E, Leynaert B, Bono R, Brunekreef B, Bousquet J, Carsin AE, De Hoogh K, Forsberg B, Gormand F, Heinrich J, Just J, Marcon A, Künzli N, Nieuwenhuijsen M, Pin I, Stempfelet M, Sunyer J, Villani S, Siroux V, Jarvis D, Nadif R, Jacquemin B. Association between air pollution and rhinitis incidence in two European cohorts. ENVIRONMENT INTERNATIONAL 2018; 115:257-266. [PMID: 29605678 DOI: 10.1016/j.envint.2018.03.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND The association between air pollution and rhinitis is not well established. AIM The aim of this longitudinal analysis was to study the association between modeled air pollution at the subjects' home addresses and self-reported incidence of rhinitis. METHODS We used data from 1533 adults from two multicentre cohorts' studies (EGEA and ECRHS). Rhinitis incidence was defined as reporting rhinitis at the second follow-up (2011 to 2013) but not at the first follow-up (2000 to 2007). Annual exposure to NO2, PM10 and PM2.5 at the participants' home addresses was estimated using land-use regression models developed by the ESCAPE project for the 2009-2010 period. Incidence rate ratios (IRR) were computed using Poisson regression. Pooled analysis, analyses by city and meta-regression testing for heterogeneity were carried out. RESULTS No association between long-term air pollution exposure and incidence of rhinitis was found (adjusted IRR (aIRR) for an increase of 10 μg·m-3 of NO2: 1.00 [0.91-1.09], for an increase of 5 μg·m-3 of PM2.5: 0.88 [0.73-1.04]). Similar results were found in the two-pollutant model (aIRR for an increase of 10 μg·m-3 of NO2: 1.01 [0.87-1.17], for an increase of 5 μg·m-3 of PM2.5: 0.87 [0.68-1.08]). Results differed depending on the city, but no regional pattern emerged for any of the pollutants. CONCLUSIONS This study did not find any consistent evidence of an association between long-term air pollution and incident rhinitis.
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Affiliation(s)
- Emilie Burte
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - Bénédicte Leynaert
- Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France
| | - Roberto Bono
- Dept of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jean Bousquet
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; University Hospital, Montpellier, France; MACVIA-France, Contre les MAladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - Anne-Elie Carsin
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Kees De Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Bertil Forsberg
- Environmental and Occupational Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Joachim Heinrich
- Ludwig Maximilians University Munich, University Hospital Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Germany
| | - Jocelyne Just
- Allergology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand-Trousseau, France; Université Paris 6 Pierre et Marie Curie, Paris, France
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mark Nieuwenhuijsen
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Isabelle Pin
- CHU de Grenoble Alpes, Pediatrie, Grenoble, France; Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France
| | - Morgane Stempfelet
- Santé Publique France, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
| | - Jordi Sunyer
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Dept of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia, Italy
| | - Valérie Siroux
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France
| | - Deborah Jarvis
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Rachel Nadif
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France
| | - Bénédicte Jacquemin
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Luenam A, Laohasiriwong W, Puttanapong N, Saengsuwan J, Phajan T. Socioeconomic disparities and chronic respiratory diseases in Thailand: The National Socioeconomics Survey. Inform Health Soc Care 2018; 43:348-361. [DOI: 10.1080/17538157.2017.1363760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Amornrat Luenam
- Faculty of Public Health and The Research and Training Center for Enhancing Quality of Life of Working-age People, Khon Kaen University, Khon Kaen, Thailand
| | - Wongsa Laohasiriwong
- Faculty of Public Health and Research and Training Center for Enhancing Quality of Life for Working Age People, Khon Kaen University, Khon Kaen, Thailand
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Calciano L, Portas L, Corsico AG, Olivieri M, Degan P, Ferrari M, Fois A, Pasini AMF, Pasini A, Zanolin ME, de Marco R, Accordini S. Biomarkers related to respiratory symptoms and lung function in adults with asthma. J Breath Res 2018; 12:026012. [PMID: 29167414 DOI: 10.1088/1752-7163/aa9c86] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND There is a need for easily measurable biomarkers that are able to identify different levels of asthma severity. AIM To assess the association between peripheral blood cell counts, fractional nitric oxide in exhaled air (FeNO), urinary biomarkers of oxidative stress (8-hydroxy-2'-deoxyguanosine and 8-isoprostane), and asthma severity in adult patients from the general population. METHODS In the Gene Environment Interactions in Respiratory Diseases study, 287 subjects with asthma (aged 20-64) were identified from the general population in Verona (Italy) (2008-2010). Self-reported asthma attacks, asthma-like symptoms and the use of hospital services in the past year were synthesized in a score of respiratory symptoms (SRS). The association of biomarkers with SRS and lung function measures (pre-bronchodilator FEV1% predicted and FEV1/FVC) was assessed using quasi-Poisson and Gaussian regression models, respectively. RESULTS Eosinophils (ratio of expected scores: RES[95%CI] = 1.19[1.09,1.30]), basophils (RES[95%CI] = 1.24[1.10,1.40]), lymphocytes (RES[95%CI] = 1.27[1.12,1.45]) and FeNO (RES[95%CI] = 1.18[1.02,1.37]) were positively associated with SRS. However, only eosinophils (RES[95%CI] = 1.15[1.02,1.30]) and lymphocytes (RES[95%CI] = 1.25[1.06,1.47]) showed an independent association. Furthermore, eosinophils (change in the expected outcome for 1-SD increase: CEO[95%CI] = -1.18[-2.09, -0.27]%), basophils (CEO[95%CI] = -1.24[-2.16, -0.33]%) and lymphocytes (CEO[95%CI] = -1.07[-1.99, -0.14]%) were individually, but not independently, associated with FEV1/FVC. Finally, neutrophils were negatively associated with FEV1% predicted (CEO[95%CI] = -2.22[-4.00, -0.44]%). CONCLUSIONS We identified a pattern of association between a set of biomarkers and asthma endotypes in adult patients from the general population, which could improve understanding of the heterogeneity and severity of the disease and could be useful in defining targeted therapeutic approaches.
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Affiliation(s)
- Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Marchetti P, Pesce G, Villani S, Antonicelli L, Ariano R, Attena F, Bono R, Bellisario V, Fois A, Gibelli N, Nicolis M, Olivieri M, Pirina P, Scopano E, Siniscalco C, Verlato G, Marcon A. Pollen concentrations and prevalence of asthma and allergic rhinitis in Italy: Evidence from the GEIRD study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 584-585:1093-1099. [PMID: 28169023 DOI: 10.1016/j.scitotenv.2017.01.168] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/13/2017] [Accepted: 01/25/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Pollen exposure has acute adverse effects on sensitized individuals. Information on the prevalence of respiratory diseases in areas with different pollen concentrations is scanty. AIM We performed an ecologic analysis to assess whether the prevalence of allergic rhinitis and asthma in young adults varied across areas with different pollen concentrations in Italy. METHODS A questionnaire on respiratory diseases was delivered to random samples of 20-44year-old subjects from six centers in 2005-2010. Data on the daily air concentrations of 7 major allergologic pollens (Poaceae, Urticaceae, Oleaceae, Cupressaceae, Coryloideae, Betula and Ambrosia) were collected for 2007-2008. Center-specific pollen exposure indicators were calculated, including the average number of days per year with pollens above the low or high concentration thresholds defined by the Italian Association of Aerobiology. Associations between pollen exposure and disease prevalence, adjusted for potential confounders, were estimated using logistic regression models with center as a random-intercept. RESULTS Overall, 8834 subjects (56.8%) filled in the questionnaire. Allergic rhinitis was significantly less frequent in the centers with longer periods with high concentrations of at least one (OR per 10days=0.989, 95%CI: 0.979-0.999) or at least two pollens (OR=0.974, 95%CI: 0.951-0.998); associations with the number of days with at least one (OR=0.988, 95%CI: 0.972-1.004) or at least two (OR=0.985, 95%CI: 0.970-1.001) pollens above the low thresholds were borderline significant. Asthma prevalence was not associated with pollen concentrations. CONCLUSIONS Our study does not support that the prevalence of allergic rhinitis and asthma is greater in centers with higher pollen concentrations. It is not clear whether the observed ecologic associations hold at the individual level.
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Affiliation(s)
- Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Giancarlo Pesce
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Leonardo Antonicelli
- Allergy Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - Renato Ariano
- Allergologia, Azienda Sanitaria Locale 1, Imperiese, (IM), Italy
| | - Francesco Attena
- Department of Experimental Medicine, II University of Naples, Naples, Italy
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Alessandro Fois
- Unit of Lung Disease, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Nadia Gibelli
- U.O.C. di Medicina del Lavoro, Sezione di Allergologia, Fondazione Salvatore Maugeri, Pavia, Italy
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | - Pietro Pirina
- Unit of Lung Disease, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Eugenio Scopano
- Air pollution Unit, Agenzia Regionale per la Protezione Ambientale Campania (ARPAC), Caserta, Italy
| | - Consolata Siniscalco
- Department of Life Sciences and Systems Biology, University of Turin, Turin, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Kim HK, Kook JH, Kang KR, Oh DJ, Kim TH, Lee SH. Increased expression of the aryl hydrocarbon receptor in allergic nasal mucosa, contributing to chemokine secretion in nasal epithelium. Am J Rhinol Allergy 2017; 30:107-12. [PMID: 27456584 DOI: 10.2500/ajra.2016.30.4311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pollutants produced by industrial and traffic-related activities have been linked to allergic responses. These noxious agents induce their effects through the aryl hydrocarbon receptor (AhR). OBJECTIVE We analyzed the expression and distribution pattern of AhR in normal and allergic nasal mucosa, and cytokine-driven regulation of its expression. The production levels of chemokine in cultured nasal epithelial cells were evaluated after stimulation with AhR ligand. METHODS The expression levels and distribution pattern of AhR in normal, mild, and moderate-severe persistent allergic nasal mucosa were assessed by using real-time polymerase chain reaction, Western blot, and immunohistochemistry. The expression levels of AhR were determined in cultured nasal epithelial cells treated with T-helper 2 cytokines. In cultured epithelial cells stimulated with 2-(10H-indole-30-carbonyl)-thiazole-4-carboxylic acid methyl ester, the expression levels of granulocyte macrophage colony-stimulating factor, thymus and activation regulated chemokine, macrophage inflammatory protein 1 α, monocyte chemotactic protein 1, regulated on activation normal T-cell expressed and secreted, eotaxin, and interleukin 8 were measured with real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS Expression of AhR was observed in normal and allergic nasal mucosa where it is distributed in the epithelial layer, submucosal glands, endothelial cells, and inflammatory cells. Its expression levels are increased in allergic nasal mucosa and upregulated after stimulation with T-helper 2 cytokines. The stimulation with 2-(10H-indole-30-carbonyl)-thiazole-4-carboxylic acid methyl ester resulted in increased production of chemokines in cultured epithelial cells. CONCLUSION Analysis of the study results indicated that increased expression levels of AhR may play a role in the pathogenesis of allergic rhinitis, which contributes to chemokine production in nasal mucosa.
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Affiliation(s)
- Ha Kyun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, South Korea
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The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030226. [PMID: 28241509 PMCID: PMC5369062 DOI: 10.3390/ijerph14030226] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%), 4.9% (95% CI, 0.8%–9.2%), 8.5% (95% CI, −1.8%–19.8%) and 11.1% (95% CI, 5.8%–16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs) of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to address this increasingly challenging problem.
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Jo EJ, Lee WS, Jo HY, Kim CH, Eom JS, Mok JH, Kim MH, Lee K, Kim KU, Lee MK, Park HK. Effects of particulate matter on respiratory disease and the impact of meteorological factors in Busan, Korea. Respir Med 2017; 124:79-87. [PMID: 28284326 DOI: 10.1016/j.rmed.2017.02.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/28/2017] [Accepted: 02/12/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Both air pollution and weather impact hospitalization for respiratory diseases. However, few studies have investigated the contribution of weather to hospitalization related to the adverse effects of air pollution. This study analyzed the effects of particulate matter (PM) on daily respiratory-related hospital admissions, taking into account meteorological factors. METHODS Daily hospital admissions for respiratory diseases (acute bronchitis, allergic rhinitis, and asthma) between 2007 and 2010 were extracted from the National Health Insurance Corporation, Korea. Patients were divided into three age-based groups (0-15, 16-64, and ≥65 years). PM levels were obtained from 19 monitoring stations in Busan. RESULTS The mean number of patients admitted for acute bronchitis, allergic rhinitis, and asthma was 5.8 ± 11.9, 4.4 ± 6.1, and 3.3 ± 3.3, respectively. During that time, the daily mean PM10 and PM2.5 concentrations were 49.6 ± 20.5 and 24.2 ± 10.9 μg/m3, respectively. The mean temperature anomaly was 7.0 ± 2.3 °C; the relative humidity was 62.0 ± 18.0%. Hospital admission rates for respiratory diseases increased with increasing PM and temperature, and with decreasing relative humidity. A multivariate analysis including PM, temperature anomaly, relative humidity, and age showed a significant increase in respiratory-related admissions with increasing PM levels and a decreasing relative humidity. Higher PM2.5 levels had a greater effect on respiratory-related hospital admission than did PM10 levels. Children and the elderly were the most susceptible to hospital admission for respiratory disease. CONCLUSIONS PM levels and meteorological factors impacted hospitalization for respiratory diseases, especially in children and the elderly. The effect of PM on respiratory diseases increased as the relative humidity decreased.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Woo-Seop Lee
- Climate Research Department, APEC Climate Center, Busan, South Korea
| | - Hyun-Young Jo
- Climate Research Department, APEC Climate Center, Busan, South Korea; Department of Atmospheric Sciences, Pusan National University, Busan, South Korea
| | - Chang-Hoon Kim
- Department of Preventive Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Jung-Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeong-Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ki-Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Min-Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
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Cai Y, Zijlema WL, Doiron D, Blangiardo M, Burton PR, Fortier I, Gaye A, Gulliver J, de Hoogh K, Hveem K, Mbatchou S, Morley DW, Stolk RP, Elliott P, Hansell AL, Hodgson S. Ambient air pollution, traffic noise and adult asthma prevalence: a BioSHaRE approach. Eur Respir J 2017; 49:1502127. [PMID: 27824608 DOI: 10.1183/13993003.02127-2015] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 09/01/2016] [Indexed: 11/05/2022]
Abstract
We investigated the effects of both ambient air pollution and traffic noise on adult asthma prevalence, using harmonised data from three European cohort studies established in 2006-2013 (HUNT3, Lifelines and UK Biobank).Residential exposures to ambient air pollution (particulate matter with aerodynamic diameter ≤10 µm (PM10) and nitrogen dioxide (NO2)) were estimated by a pan-European Land Use Regression model for 2007. Traffic noise for 2009 was modelled at home addresses by adapting a standardised noise assessment framework (CNOSSOS-EU). A cross-sectional analysis of 646 731 participants aged ≥20 years was undertaken using DataSHIELD to pool data for individual-level analysis via a "compute to the data" approach. Multivariate logistic regression models were fitted to assess the effects of each exposure on lifetime and current asthma prevalence.PM10 or NO2 higher by 10 µg·m-3 was associated with 12.8% (95% CI 9.5-16.3%) and 1.9% (95% CI 1.1-2.8%) higher lifetime asthma prevalence, respectively, independent of confounders. Effects were larger in those aged ≥50 years, ever-smokers and less educated. Noise exposure was not significantly associated with asthma prevalence.This study suggests that long-term ambient PM10 exposure is associated with asthma prevalence in western European adults. Traffic noise is not associated with asthma prevalence, but its potential to impact on asthma exacerbations needs further investigation.
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Affiliation(s)
- Yutong Cai
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Wilma L Zijlema
- Dept of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dany Doiron
- Research Institute of the McGill University Health Centre and Dept of Medicine, McGill University, Montreal, QC, Canada
| | - Marta Blangiardo
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paul R Burton
- Data to Knowledge (D2K) Research Group, University of Bristol, Bristol, UK
- Public Population Project in Genomics and Society (P3G), Montreal, QC, Canada
| | - Isabel Fortier
- Research Institute of the McGill University Health Centre and Dept of Medicine, McGill University, Montreal, QC, Canada
| | - Amadou Gaye
- Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - John Gulliver
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kees de Hoogh
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristian Hveem
- Dept of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stéphane Mbatchou
- Research Institute of the McGill University Health Centre and Dept of Medicine, McGill University, Montreal, QC, Canada
| | - David W Morley
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ronald P Stolk
- Dept of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Anna L Hansell
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London, UK
| | - Susan Hodgson
- MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Wang W. Progress in the impact of polluted meteorological conditions on the incidence of asthma. J Thorac Dis 2016; 8:E57-61. [PMID: 26904253 DOI: 10.3978/j.issn.2072-1439.2015.12.64] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
It has been revealed by many studies that air pollution is one of the important inducements of asthma exacerbations. In addition, meteorological conditions such as high atmospheric pressure, low temperature, low humidity and large diurnal amplitude can directly induce asthma. Meanwhile, meteorological conditions play an important role in the diffusion, dilution and accumulation of air pollution. This article reviewed research progress in the impact of polluted meteorological conditions on the incidence of asthma.
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Affiliation(s)
- Wen Wang
- 1 Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China ; 2 Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing 100020, China
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Pesce G, Bugiani M, Marcon A, Marchetti P, Carosso A, Accordini S, Antonicelli L, Cogliani E, Pirina P, Pocetta G, Spinelli F, Villani S, de Marco R. Geo-climatic heterogeneity in self-reported asthma, allergic rhinitis and chronic bronchitis in Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 544:645-652. [PMID: 26674694 DOI: 10.1016/j.scitotenv.2015.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/29/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Several studies highlighted a great variability, both between and within countries, in the prevalence of asthma and chronic airways diseases. AIM To evaluate if geo-climatic variations can explain the heterogeneity in the prevalence of asthma and respiratory diseases in Italy. METHODS Between 2006 and 2010, a postal screening questionnaire on respiratory health was administered to 18,357 randomly selected subjects, aged 20-44, living in 7 centers in northern, central, and southern Italy. A random-effects meta-analysis was fitted to evaluate the between-centers heterogeneity in the prevalence of asthma, asthma-like symptoms, allergic rhinitis, and chronic bronchitis (CB). A principal component analysis (PCA) was performed to synthetize the geo-climatic information (annual mean temperature, range of temperature, annual rainfalls, global solar radiations, altitude, distance from the sea) of all the 110 Italian province capital towns. The associations between these geo-climatic components obtained with PCA and the prevalence of respiratory diseases were analyzed through meta-regression models. RESULTS 10,464 (57%) subjects responded to the questionnaire. There was a significant between-centers heterogeneity in the prevalence of asthma (I(2)=59.5%, p=0.022) and CB (I(2)=60.5%, p=0.019), but not in that of asthma-like symptoms or allergic rhinitis. Two independent geo-climatic components explaining together about 80% of the overall geo-climatic variability were identified: the first principally summarized the climatic variables; the second the topographic ones. Variations in the prevalence of asthma across centers were significantly associated with differences in the climatic component (p=0.017), but not with differences in the topographic one. CONCLUSIONS Our findings suggest that climate play a role in determining the between-center heterogeneity in the prevalence of asthma in Italy, with higher prevalence in dry-hot Mediterranean climates, and lower in rainy-cold northern climates.
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Affiliation(s)
- G Pesce
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - M Bugiani
- Unit of Respiratory Medicine and Allergology, CPA-ASL TO-2, Turin, Italy
| | - A Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - P Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Carosso
- Unit of Respiratory Medicine and Allergology, CPA-ASL TO-2, Turin, Italy
| | - S Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - L Antonicelli
- Dept of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona, Italy
| | - E Cogliani
- Casaccia Research Centre, Italian National Agency for New Technologies, Energy, and Substainable Economic Development (ENEA), Rome, Italy
| | - P Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - G Pocetta
- Dept of Experimental Medicine, University of Perugia, Perugia, Italy
| | - F Spinelli
- Casaccia Research Centre, Italian National Agency for New Technologies, Energy, and Substainable Economic Development (ENEA), Rome, Italy
| | - S Villani
- Dept of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - R de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Chen CC, Chiu HF, Yang CY. Air pollution exposure and daily clinical visits for allergic rhinitis in a subtropical city: Taipei, Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2016; 79:494-501. [PMID: 27294298 DOI: 10.1080/15287394.2016.1182002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study was undertaken to determine whether there was an association between air pollutant level exposure and daily clinic visits for allergic rhinitis (AR) in Taipei, Taiwan. Daily clinic visits for AR and ambient air pollution data for Taipei were obtained for the period of 2006-2011. The relative risk for clinic visits for AR was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days (>23ºC) significant positive associations were found for increased rate of AR occurrence and ambient levels of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). On cool days (<23ºC), all air pollutants were significantly associated with elevated number of AR visits except SO2. For the two-pollutant models, PM10, O3, and NO2 were significantly associated with higher rate of AR visits in combination with each of the other four pollutants on cool days. On warm days, CO levels remained significantly related with increased AR visits in all two-pollutant models. This study provides evidence that higher levels of ambient air contaminants enhance the risk of elevated frequency of clinic visits for AR.
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Affiliation(s)
- Chih-Cheng Chen
- a Department of Pediatrics , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan
- b Chang-Gung University, College of Medicine , Kaohsiung , Taiwan
| | - Hui-Fen Chiu
- c Department of Pharmacology , College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Chun-Yuh Yang
- d Faculty of Public Health , College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- e Division of Environmental Health and Occupational Medicine , National Health Research Institute , Miaoli , Taiwan
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Zhang J, Dai J, Yan L, Fu W, Yi J, Chen Y, Liu C, Xu D, Wang Q. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2935163. [PMID: 27556031 PMCID: PMC4983328 DOI: 10.1155/2016/2935163] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/13/2022]
Abstract
Background. Prevalence of childhood asthma varies significantly among regions, while its reasons are not clear yet with only a few studies reporting relevant causes for this variation. Objective. To investigate the potential role of city-average levels of air pollutants and climatic factors in order to distinguish differences in asthma prevalence in China and explain their reasons. Methods. Data pertaining to 10,777 asthmatic patients were obtained from the third nationwide survey of childhood asthma in China's urban areas. Annual mean concentrations of air pollutants and other climatic factors were obtained for the same period from several government departments. Data analysis was implemented with descriptive statistics, Pearson correlation coefficient, and multiple regression analysis. Results. Pearson correlation analysis showed that the situation of childhood asthma was strongly linked with SO2, relative humidity, and hours of sunshine (p < 0.05). Multiple regression analysis indicated that, among the predictor variables in the final step, SO2 was found to be the most powerful predictor variable amongst all (β = -19.572, p < 0.05). Furthermore, results had shown that hours of sunshine (β = -0.014, p < 0.05) was a significant component summary predictor variable. Conclusion. The findings of this study do not suggest that air pollutants or climate, at least in terms of children, plays a major role in explaining regional differences in asthma prevalence in China.
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Affiliation(s)
- Juanjuan Zhang
- Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China
| | - Jihong Dai
- Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- *Jihong Dai:
| | - Li Yan
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Wenlong Fu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Jing Yi
- Department of Medical Statistics, Chongqing Medical University, Chongqing 400046, China
| | - Yuzhi Chen
- Center for Asthma Prevalence and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Chuanhe Liu
- Center for Asthma Prevalence and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Dongqun Xu
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qiang Wang
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Cazzoletti L, Ferrari M, Olivieri M, Verlato G, Antonicelli L, Bono R, Casali L, Cerveri I, Marchetti P, Pirina P, Rossi A, Villani S, de Marco R. The gender, age and risk factor distribution differs in self-reported allergic and non-allergic rhinitis: a cross-sectional population-based study. Allergy Asthma Clin Immunol 2015; 11:36. [PMID: 26640494 PMCID: PMC4669616 DOI: 10.1186/s13223-015-0101-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/21/2015] [Indexed: 11/10/2022] Open
Abstract
Background Few population-based studies have assessed the prevalence and the risk factors of non-allergic rhinitis (NAR) in comparison to allergic rhinitis (AR). Moreover, epidemiologic data on rhinitis in the elderly subjects and in southern Europe are scarce. Objective This study aimed at estimating the prevalence and at comparing the risk factor distribution of AR and NAR in a general population sample aged 20–84 years in Italy. Methods A questionnaire on respiratory symptoms and risk factors was administered to random samples of the Italian population aged 20–44 (n = 10,494) 45–64 (n = 2167) and 65–84 (n = 1030) in the frame of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study. Current AR and NAR were defined according to the self-reported presence of nasal allergies or of nasal symptoms without a cold or the flu. Results NAR showed a significant descending pattern in females from 12.0 % (95 % CI 11.1, 13.1) in the 20–44 year age class, to 7.5 % (5.4, 10.3) in the 65–84 year age class (p = 0.0009), and a roughly stable pattern in males, from 10.2 % (9.3, 11.2) to 11.1 % (8.4, 13.9) (p = 0.5261). AR decreased from 26.6 % (25.7, 27.6) in 20–44 years age class to 15.6 % (13.3, 18.0) in the 65–84 years age class (p < 0.0001), without gender difference. Subjects living near industrial plants and ex- and current smokers had a higher risk of NAR. Current smokers had a lower risk and subjects living in a Mediterranean climate a higher risk of AR. Conclusion AR and NAR are fairly distinct conditions, as they have a different age, gender and risk factor distribution.
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Affiliation(s)
- Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Marcello Ferrari
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Leonardo Antonicelli
- Allergy Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Lucio Casali
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Perugia, Perugia, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
| | - Pietro Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Andrea Rossi
- Unit of Respiratory Diseases, Department of Internal Medicine, University of Verona, Verona, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134 Verona, Italy
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Lundbäck B, Backman H, Lötvall J, Rönmark E. Is asthma prevalence still increasing? Expert Rev Respir Med 2015; 10:39-51. [DOI: 10.1586/17476348.2016.1114417] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wang J, Engvall K, Smedje G, Norbäck D. Rhinitis, asthma and respiratory infections among adults in relation to the home environment in multi-family buildings in Sweden. PLoS One 2014; 9:e105125. [PMID: 25136984 PMCID: PMC4138153 DOI: 10.1371/journal.pone.0105125] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/21/2014] [Indexed: 11/18/2022] Open
Abstract
Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (≥ 18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960-1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03-2.29). And those constructed during 1976-1985 had more current rhinitis (OR = 1.43, 95%CI 1.12-1.84) and respiratory infections (OR = 1.46, 95%CI 1.21-1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (p<0.001). Rented apartments had more current rhinitis (OR = 1.23, 95%CI 1.07-1.40), wheeze (OR = 1.20, 95%CI 1.02-1.41), day time breathlessness (OR = 1.31, 95%CI 1.04-1.66) and respiratory infections (OR = 1.13, 95%CI 1.01-1.26). Living in colder parts of the country was a risk factor for wheeze (p = 0.03) and night time breathlessness (p = 0.002). Building dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08-1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09-2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08-2.06) and current asthma (OR = 1.52, 95%CI 1.03-2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09-2.16). Window panel condensation was a risk factor for antibiotic medication for respiratory infections (OR = 1.41, 95%CI 1.10-1.82). In conclusion, rhinitis, asthma and respiratory infections were related to a number of factors in the home environment. Certain building years (1961-1985), building dampness, window panel condensation and odor in the dwelling may be risk factors.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
- * E-mail:
| | - Karin Engvall
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Greta Smedje
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
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Li S, Baker PJ, Jalaludin BB, Guo Y, Marks GB, Denison LS, Williams GM. Are children׳s asthmatic symptoms related to ambient temperature? A panel study in Australia. ENVIRONMENTAL RESEARCH 2014; 133:239-245. [PMID: 24981821 DOI: 10.1016/j.envres.2014.05.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/12/2014] [Accepted: 05/15/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To examine the short-term effects of ambient temperature on respiratory symptoms for school children with asthma across Australia. METHODS A panel of 270 children (7-12 years) with asthma was recruited from six Australian cities. They were asked to record their respiratory symptoms every day in the morning (for night-time symptoms) and evening (for daytime symptoms) for four weeks. Daily ambient temperature, relative humidity and air pollution data were obtained from fixed monitors nearby. A mixed logistic regression model was used to examine the effects of ambient temperature on respiratory symptoms adjusted for children's sex, age, standing height, weight and air pollution. Subjects were specified as random effects. RESULTS The relationships between ambient temperature and respiratory symptoms were linear. Increasing temperatures induced the risks of children's asthmatic symptoms, especially for "wheeze/chest tightness" and to a lesser extent for "cough/phlegm". The effects were acute and lasted for four days (lag 0-3) in general. With increasing ambient temperature, boys were more at risk than girls. CONCLUSIONS High ambient temperature is a risk factor for respiratory symptoms in children with asthma. As ambient temperature increases, policies and strategies for rising temperatures will be necessary to protect asthmatic children.
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Affiliation(s)
- Shanshan Li
- School of Population Health, University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia.
| | - Peter J Baker
- School of Population Health, University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia
| | - Bin B Jalaludin
- Centre for Research, Evidence Management and Surveillance, Sydney and South Western Sydney Local Health District, Liverpool, New South Wales 1871, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Yuming Guo
- School of Population Health, University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia
| | - Guy B Marks
- Department of Respiratory Medicine, Liverpool Hospital, Elizabeth Street, Liverpool, New South Wales 2170, Australia; Woolcock Institute of Medical Research, University of Sydney, 431 Glebe Point Road, Glebe, Sydney, New South Wales 2037, Australia
| | - Lyn S Denison
- Pacific Environment ‒Toxikos, Suite G62, 63 Turner Street, Port Melbourne, Victoria 3207, Australia
| | - Gail M Williams
- School of Population Health, University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia
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Fuertes E, Butland BK, Ross Anderson H, Carlsten C, Strachan DP, Brauer M. Childhood intermittent and persistent rhinitis prevalence and climate and vegetation: a global ecologic analysis. Ann Allergy Asthma Immunol 2014; 113:386-92.e9. [PMID: 25065574 DOI: 10.1016/j.anai.2014.06.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/17/2014] [Accepted: 06/25/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND The effect of climate change and its effects on vegetation growth, and consequently on rhinitis, are uncertain. OBJECTIVE To examine between- and within-country associations of climate measures and the normalized difference vegetation index with intermittent and persistent rhinitis symptoms in a global context. METHODS Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of the International Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom report but not for 2 consecutive months) and persistent (symptoms for ≥2 consecutive months) rhinitis symptom prevalences with temperature, precipitation, vapor pressure, and the normalized difference vegetation index were assessed in linear mixed-effects regression models adjusted for gross national income and population density. The mean difference in prevalence per 100 children (with 95% confidence intervals [CIs]) per interquartile range increase of exposure is reported. RESULTS The country-level intermittent symptom prevalence was associated with several country-level climatic measures, including the country-level mean monthly temperature (6.09 °C; 95% CI, 2.06-10.11°C per 10.4 °C), precipitation (3.10 mm; 95% CI, 0.46-5.73 mm; per 67.0 mm), and vapor pressure (6.21 hPa; 95% CI, 2.17-10.24 hPa; per 10.4 hPa) among 13- to 14-year-olds (222 center in 94 countries). The center-level persistent symptom prevalence was positively associated with several center-level climatic measures. Associations with climate were also found for the 6- to 7-year-olds (132 center in 57 countries). CONCLUSION Several between- and within-country spatial associations between climatic factors and intermittent and persistent rhinitis symptom prevalences were observed. These results provide suggestive evidence that climate (and future changes in climate) may influence rhinitis symptom prevalence.
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Affiliation(s)
- Elaine Fuertes
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Institute of Epidemiology I, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany.
| | - Barbara K Butland
- MRC-PHE Centre for Environment and Health, St Georges, University of London, London, United Kingdom
| | - H Ross Anderson
- MRC-PHE Centre for Environment and Health, St Georges, University of London, London, United Kingdom; MRC-PHE Centre for Environment and Health, King's College London, London, United Kingdom
| | - Chris Carlsten
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David P Strachan
- MRC-PHE Centre for Environment and Health, St Georges, University of London, London, United Kingdom
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Johannessen A, Verlato G, Benediktsdottir B, Forsberg B, Franklin K, Gislason T, Holm M, Janson C, Jögi R, Lindberg E, Macsali F, Omenaas E, Real FG, Saure EW, Schlünssen V, Sigsgaard T, Skorge TD, Svanes C, Torén K, Waatevik M, Nilsen RM, de Marco R. Longterm follow-up in European respiratory health studies - patterns and implications. BMC Pulm Med 2014; 14:63. [PMID: 24739530 PMCID: PMC4021078 DOI: 10.1186/1471-2466-14-63] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/03/2014] [Indexed: 11/25/2022] Open
Abstract
Background Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in their material and what characterizes the bias in their material. In the present study we examined long-term participation and consequences of loss to follow-up in the studies Respiratory Health in Northern Europe (RHINE), Italian centers of European Community Respiratory Health Survey (I-ECRHS), and the Italian Study on Asthma in Young Adults (ISAYA). Methods Logistic regression identified predictors for follow-up participation. Baseline prevalence of 9 respiratory symptoms (asthma attack, asthma medication, combined variable with asthma attack and/or asthma medication, wheeze, rhinitis, wheeze with dyspnea, wheeze without cold, waking with chest tightness, waking with dyspnea) and 9 exposure-outcome associations (predictors sex, age and smoking; outcomes wheeze, asthma and rhinitis) were compared between all baseline participants and long-term participants. Bias was measured as ratios of relative frequencies and ratios of odds ratios (ROR). Results Follow-up response rates after 10 years were 75% in RHINE, 64% in I-ECRHS and 53% in ISAYA. After 20 years of follow-up, response was 53% in RHINE and 49% in I-ECRHS. Female sex predicted long-term participation (in RHINE OR (95% CI) 1.30(1.22, 1.38); in I-ECRHS 1.29 (1.11, 1.50); and in ISAYA 1.42 (1.25, 1.61)), as did increasing age. Baseline prevalence of respiratory symptoms were lower among long-term participants (relative deviations compared to total baseline population 0-15% (RHINE), 0-48% (I-ECRHS), 3-20% (ISAYA)), except rhinitis which had a slightly higher prevalence. Most exposure-outcome associations did not differ between long-term participants and all baseline participants, except lower OR for rhinitis among ISAYA long-term participating smokers (relative deviation 17% (smokers) and 44% (10–20 pack years)). Conclusions We found comparable patterns of long-term participation and loss to follow-up in RHINE, I-ECRHS and ISAYA. Baseline prevalence estimates for long-term participants were slightly lower than for the total baseline population, while exposure-outcome associations were mainly unchanged by loss to follow-up.
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Affiliation(s)
- Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen 5021, Norway.
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Wang J, Li B, Yu W, Yang Q, Wang H, Huang D, Sundell J, Norbäck D. Rhinitis symptoms and asthma among parents of preschool children in relation to the home environment in Chongqing, China. PLoS One 2014; 9:e94731. [PMID: 24733290 PMCID: PMC3986232 DOI: 10.1371/journal.pone.0094731] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/18/2014] [Indexed: 11/18/2022] Open
Abstract
Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1-8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95%CI): 1.31(1.13,1.52)) and AR (OR(95%CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95%CI): 1.43(1.10,1.85)), new furniture (OR(95%CI): 1.28(1.11,1.49)), water damage (OR(95%CI): 1.68(1.29,2.18)), cockroaches (OR(95%CI): 1.46(1.23,1.73)), and keeping pets (OR(95%CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95%CI): 2.14(1.34,3.41)), mold spots (OR(95%CI): 2.23(1.06,4.68)), window pane condensation (OR(95%CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95%CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95%CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
- * E-mail:
| | - Wei Yu
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Qin Yang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Han Wang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Duchai Huang
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
| | - Jan Sundell
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Ministry of Education, Chongqing University, Chongqing, China
- Department of Building Science, Tsinghua University, Beijing, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
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Cazzoletti L, Corsico AG, Albicini F, Di Vincenzo EMG, Gini E, Grosso A, Ronzoni V, Bugiani M, Pirina P, Cerveri I. The course of asthma in young adults: a population-based nine-year follow-up on asthma remission and control. PLoS One 2014; 9:e86956. [PMID: 24489813 PMCID: PMC3906087 DOI: 10.1371/journal.pone.0086956] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022] Open
Abstract
Background Only few longitudinal studies on the course of asthma among adults have been carried out. Objective The aim of the present prospective study, carried out between 2000 and 2009 in Italy, is to assess asthma remission and control in adults with asthma, as well as their determinants. Methods All the subjects with current asthma (21–47 years) identified in 2000 in the Italian Study on Asthma in Young Adults in 6 Italian centres were followed up. Asthma remission was assessed at follow-up in 2008–2009 (n = 214), asthma control at baseline and follow-up. Asthma remission and control were related to potential determinants by a binomial logistic and a multinomial logistic model. Separate models for remission were used for men and women. Results The estimate of the proportion of subjects who were in remission was 29.7% (95%CI: 14.4%;44.9%). Men who were not under control at baseline had a very low probability of being in remission at follow-up (OR = 0.06; 95%CI:0.01;0.33) when compared to women (OR = 0.40; 95%CI:0.17;0.94). The estimates of the proportion of subjects who were under control, partial control or who were not under control in our sample were 26.3% (95%CI: 21.2;31.3%), 51.6% (95%CI: 44.6;58.7%) and 22.1% (95%CI: 16.6;27.6%), respectively. Female gender, increasing age, the presence of chronic cough and phlegm and partial or absent asthma control at baseline increased the risk of uncontrolled asthma at follow-up. Conclusion Asthma remission was achieved in nearly 1/3 of the subjects with active asthma in the Italian adult population, whereas the proportion of the subjects with controlled asthma among the remaining subjects was still low.
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Affiliation(s)
- Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
- * E-mail:
| | | | - Federica Albicini
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
| | - Eti Maria Giulia Di Vincenzo
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
| | - Erica Gini
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
| | - Amelia Grosso
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
| | - Vanessa Ronzoni
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
| | | | - Pietro Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico “San Matteo” Hospital Foundation, University of Pavia, Pavia, Italy
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Abstract
The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.
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Vernon MK, Wiklund I, Bell JA, Dale P, Chapman KR. What do we know about asthma triggers? a review of the literature. J Asthma 2013; 49:991-8. [PMID: 23574397 DOI: 10.3109/02770903.2012.738268] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE For patients with asthma, exacerbations and poor control can result from exposure to environmental triggers, such as allergens and air particulates. This study reviewed the international literature to determine whether a global checklist of common asthma triggers might be feasible for use as a research or management tool in clinical practice. METHODS Literature published from 2002 to 2012 was identified through PubMed and EMBASE using the following search terms: asthma, asthma triggers, prevalence, among others. A total of 1046 abstracts were found; 85 articles were reviewed covering six continents (number of articles): Africa (1), Asia (22), Australia (1), Europe (27), North America (22), and South America (4). RESULTS The literature consistently pointed to asthma triggers as one contributor to poor asthma control. Frequently cited triggers were similar across countries/regions and included allergens (particularly pollens, molds, dust, and pet dander), tobacco smoke, exercise, air pollutants/particulates, weather patterns/changes, and respiratory infections. Definitions of asthma triggers, how triggers are taken into account in definitions of asthma control, and scientific inquiry into optimal management techniques for triggers were inconsistent and sparse. CONCLUSIONS Given the apparent importance of triggers in attaining and maintaining asthma control, empirical research concerning optimal trigger management is needed. Results demonstrate that asthma triggers are similar across continents, suggesting a global checklist of triggers for use in research and clinical practice would be feasible.
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Aschan-Leygonie C, Baudet-Michel S, Mathian H, Sanders L. Gaining a better understanding of respiratory health inequalities among cities: an ecological case study on elderly males in the larger French cities. Int J Health Geogr 2013; 12:19. [PMID: 23575258 PMCID: PMC3735046 DOI: 10.1186/1476-072x-12-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 04/02/2013] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, there have been a growing number of studies on spatial inequalities in health covering a variety of scales, from small areas to metropolitan areas or regions, and for various health outcomes. However, few investigations have compared health status between cities with a view to gaining a better understanding of the relationships between such inequalities and the social, economic and physical characteristics. This paper focuses on disparities in respiratory health among the 55 largest French cities. The aim is to explore the relationships between inter-urban health patterns, city characteristics and regional context, and to determine how far a city’s health status relates to the features observed on different geographical scales. Methods We used health data describing hospitalizations for Chronic Obstructive Pulmonary Disease (COPD) as a proxy for respiratory health, and the total number of hospitalizations (overall) as a proxy for general health. This last indicator was used as a benchmark. A large set of indicators relating to socioeconomic, physical and amenity aspects of the cities (urban units) was also constructed. Data were analyzed using linear correlations and multiple linear regression models. Results The results suggest that socioeconomic characteristics are major discriminators for inequalities in respiratory health status among urban units. Indeed, once combined to socioeconomic characteristics, only a climate indicator remained significant among the physical indicators. It appeared that the pollution indicators which were significantly correlated with COPD hospitalization rates loosed significance when associated to the socio-economic indicators in a multiple regression. The analysis showed that among the socio-economic indicators, an employment indicator derived at the regional scale, and two indicators reflecting the unequal intra-urban spatial distribution of population according to their education, were the most efficient to describe differences in the respiratory health status of urban units. Conclusion In order to design effective urban policies, it is essential to gain a better understanding of the differences among cities in their entirety, rather than solely differences across small urban areas or individuals.
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Affiliation(s)
- Christina Aschan-Leygonie
- UMR Environnement Ville Société, Université de Lyon, Faculté GHHAT, 5 Avenue Pierre Mendès-France, Bron Cedex 69676, France
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Bielory L, Lyons K, Goldberg R. Climate change and allergic disease. Curr Allergy Asthma Rep 2013; 12:485-94. [PMID: 23065327 DOI: 10.1007/s11882-012-0314-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Allergies are prevalent throughout the United States and impose a substantial quality of life and economic burden. The potential effect of climate change has an impact on allergic disorders through variability of aeroallergens, food allergens and insect-based allergic venoms. Data suggest allergies (ocular and nasal allergies, allergic asthma and sinusitis) have increased in the United States and that there are changes in allergies to stinging insect populations (vespids, apids and fire ants). The cause of this upward trend is unknown, but any climate change may induce augmentation of this trend; the subspecialty of allergy and immunology needs to be keenly aware of potential issues that are projected for the near and not so distant future.
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Affiliation(s)
- Leonard Bielory
- Robert Wood Johnson University Hospital, Rutgers University, New Brunswick, NJ, USA.
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Accordini S, Corsico AG, Cerveri I, Antonicelli L, Attena F, Bono R, Casali L, Ferrari M, Fois A, Marchetti P, Pirina P, Tassinari R, Verlato G, de Marco R. Diverging trends of chronic bronchitis and smoking habits between 1998 and 2010. Respir Res 2013; 14:16. [PMID: 23394461 PMCID: PMC3574861 DOI: 10.1186/1465-9921-14-16] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No study has been carried out on the time trend in the prevalence of chronic bronchitis (CB) in recent years, despite its clinical and epidemiological relevance. We evaluated the trend in CB prevalence during the past decade among young Italian adults. METHODS A screening questionnaire was mailed to general population samples of 20-44 year-old subjects in two cross-sectional surveys: the Italian Study on Asthma in Young Adults (ISAYA) (1998/2000; n = 18,873, 9 centres) and the screening stage of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007/2010; n = 10,494, 7 centres). CB was defined as having cough and phlegm on most days for a minimum of 3 months a year and for at least 2 successive years. The prevalence rates and the risk ratios (RRs) for the association between CB and each potential predictor were adjusted for gender, age, season of response, type of contact, cumulative response rate, and centre. RESULTS CB prevalence was 12.5% (95% CI: 12.1-12.9%) in 1998/2000 and 12.6% (95% CI: 11.7-13.7%) in 2007/2010; it increased among never smokers (from 7.6 to 9.1%, p = 0.003), current light smokers (<15 pack-years; from 15.1 to 18.6%, p < 0.001), and unemployed/retired subjects (from 14.3 to 19.1%, p = 0.001). In this decade, the prevalence of current smoking decreased (from 33.6 to 26.9%, p < 0.001), whereas the prevalence of unemployment/premature retirement (from 5.3 to 6.0%, p = 0.005), asthma (from 5.0 to 6.2%, p = 0.003), and allergic rhinitis (from 19.5 to 24.5%, p < 0.001) increased. In both 1998/2000 and 2007/2010, the likelihood of having CB was significantly higher for women, current smokers, asthmatic patients, and subjects with allergic rhinitis. During this period, the strength of the association between CB and current heavy smoking (≥15 pack-years) decreased (RR: from 4.82 to 3.57, p = 0.018), whereas it increased for unemployment/premature retirement (from 1.11 to 1.53, p = 0.019); no change was observed for gender, asthma, and allergic rhinitis. CONCLUSIONS Despite the significant reduction in current smoking, CB prevalence did not vary among young Italian adults. The temporal pattern of CB prevalence can only be partly explained by the increase of unemployment/premature retirement, asthma and allergic rhinitis, and suggests that other factors could have played a role.
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Affiliation(s)
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, c/o Istituti Biologici II, Strada Le Grazie 8, 37134, Verona, Italy.
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Climate change and its impact on allergic rhinitis and other allergic respiratory diseases. Curr Opin Otolaryngol Head Neck Surg 2013; 20:188-93. [PMID: 22569402 DOI: 10.1097/moo.0b013e3283524b14] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To discuss current evidence of global climate change and its implications for allergic rhinitis and other allergic respiratory diseases. RECENT FINDINGS Global climate change is evidenced by increasing average earth temperature, increasing anthropogenic greenhouse gas levels, and elevated pollen levels. Pollutants of interest include carbon dioxide (CO2), ozone (O3), and nitrous oxide (NO2) because they can enhance the allergic response and lead to increased symptoms of allergic respiratory diseases. Heightened CO2 levels stimulate pollen production via photosynthesis and increased growth in multiple plant species investigated. Although worsened air quality appears to increase prevalence of allergic rhinitis, the effects of increased temperature are less certain. The findings of increased aeroallergen levels likely contribute to increases in presentation of allergic diseases, although more healthcare impact studies are necessary. SUMMARY Although recent literature indicates and strongly supports changes in temperature, pollution levels, and aeroallergen levels, more longitudinal epidemiologic surveillance of allergic diseases in relation to climate change as well as pathophysiologic studies on changing aeroallergen effects on allergic diseases are needed.
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Jie Y, Isa ZM, Jie X, Ju ZL, Ismail NH. Urban vs. rural factors that affect adult asthma. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2013; 226:33-63. [PMID: 23625129 DOI: 10.1007/978-1-4614-6898-1_2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.
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Affiliation(s)
- Yu Jie
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
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Dapul-Hidalgo G, Bielory L. Climate change and allergic diseases. Ann Allergy Asthma Immunol 2012; 109:166-72. [PMID: 22920070 DOI: 10.1016/j.anai.2012.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/04/2012] [Accepted: 02/14/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Gina Dapul-Hidalgo
- Center for Allergy and Asthma Research, Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, USA
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