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Zarate-Gonzalez G, Brown P, Cisneros R. Costs of Air Pollution in California's San Joaquin Valley: A Societal Perspective of the Burden of Asthma on Emergency Departments and Inpatient Care. J Asthma Allergy 2024; 17:369-382. [PMID: 38645669 PMCID: PMC11032670 DOI: 10.2147/jaa.s455745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The San Joaquin Valley (SJV) is often recognized as one of the most polluted regions in the US. Periods of pollution exposure are associated with increased health burden related to respiratory inflammation and undermined lung function, which aggravates respiratory diseases such as asthma and leads to symptoms such as coughing, wheezing, or difficulty breathing. Asthma costs US$ 82 billion annually in healthcare costs, missed work and school in the US. Methods Employing a societal perspective, a cost of illness design was combined with environmental epidemiological methods to analyze the economic impact of O3, NO2, and PM2.5-related adverse respiratory health outcomes amongst SJV residents who attended the emergency department (ED) or were hospitalized in 2016. Results Asthma exacerbations monetized value ranged from US$ 3353 to US$ 5003 per ED visit and for hospital admissions US$ 2584 per inpatient day for adults 65 years and older to US$ 3023 per child. The estimated value to society in healthcare costs, productivity losses, school absences, and opportunity costs from air pollution adverse health outcomes totaled US$ 498,014,124 in ED visits and US$ 223,552,720 in hospital admissions for the SJV population in 2016. The marginal reduction in the background concentrations of pollutants would avert 21,786 ED adverse events and 19,328 hospitalizations from the health burden on the SJV population or US$ 8,024,505 cost savings due to O3, US$ 82,482,683 from NO2 reductions, and US$ 46,214,702 from decreased concentration of PM2.5. Conclusion This study provides evidence that air pollution is a negative externality that imposes substantial social, environmental, and healthcare costs on the SJV. Furthermore, the region would avert significant adverse health outcomes realizing economic savings by reducing air pollution and exposures.
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Affiliation(s)
| | - Paul Brown
- Department of Public Health, University of California, Merced, CA, USA
| | - Ricardo Cisneros
- Department of Public Health, University of California, Merced, CA, USA
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Johnston RA, Pilkington AW, Atkins CL, Boots TE, Brown PL, Jackson WT, Spencer CY, Siddiqui SR, Haque IU. Inconsequential role for chemerin-like receptor 1 in the manifestation of ozone-induced lung pathophysiology in male mice. Physiol Rep 2024; 12:e16008. [PMID: 38631890 PMCID: PMC11023814 DOI: 10.14814/phy2.16008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
We executed this study to determine if chemerin-like receptor 1 (CMKLR1), a Gi/o protein-coupled receptor expressed by leukocytes and non-leukocytes, contributes to the development of phenotypic features of non-atopic asthma, including airway hyperresponsiveness (AHR) to acetyl-β-methylcholine chloride, lung hyperpermeability, airway epithelial cell desquamation, and lung inflammation. Accordingly, we quantified sequelae of non-atopic asthma in wild-type mice and mice incapable of expressing CMKLR1 (CMKLR1-deficient mice) following cessation of acute inhalation exposure to either filtered room air (air) or ozone (O3), a criteria pollutant and non-atopic asthma stimulus. Following exposure to air, lung elastic recoil and airway responsiveness were greater while the quantity of adiponectin, a multi-functional adipocytokine, in bronchoalveolar lavage (BAL) fluid was lower in CMKLR1-deficient as compared to wild-type mice. Regardless of genotype, exposure to O3 caused AHR, lung hyperpermeability, airway epithelial cell desquamation, and lung inflammation. Nevertheless, except for minimal genotype-related effects on lung hyperpermeability and BAL adiponectin, we observed no other genotype-related differences following O3 exposure. In summary, we demonstrate that CMKLR1 limits the severity of innate airway responsiveness and lung elastic recoil but has a nominal effect on lung pathophysiology induced by acute exposure to O3.
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Affiliation(s)
- Richard A. Johnston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and PreventionUnited States Department of Health and Human ServicesMorgantownWest VirginiaUSA
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of MedicineWest Virginia UniversityMorgantownWest VirginiaUSA
- Division of Critical Care Medicine, Department of PediatricsMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
- Department of Integrative Biology and PharmacologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Albert W. Pilkington
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and PreventionUnited States Department of Health and Human ServicesMorgantownWest VirginiaUSA
| | - Constance L. Atkins
- Division of Pulmonary Medicine, Department of PediatricsMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Theresa E. Boots
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and PreventionUnited States Department of Health and Human ServicesMorgantownWest VirginiaUSA
| | - Philip L. Brown
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and PreventionUnited States Department of Health and Human ServicesMorgantownWest VirginiaUSA
| | - William T. Jackson
- Division of Critical Care Medicine, Department of PediatricsMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Chantal Y. Spencer
- Section of Pediatric Pulmonology, Department of PediatricsBaylor College of MedicineHoustonTexasUSA
| | - Saad R. Siddiqui
- Division of Critical Care Medicine, Department of PediatricsMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Ikram U. Haque
- Division of Critical Care Medicine, Department of PediatricsMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
- Division of Critical Care, Department of PediatricsSidra MedicineDohaQatar
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3
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Stowell JD, Sun Y, Gause EL, Spangler KR, Schwartz J, Bernstein A, Wellenius GA, Nori-Sarma A. Warm season ambient ozone and children's health in the USA. Int J Epidemiol 2024; 53:dyae035. [PMID: 38553030 PMCID: PMC10980558 DOI: 10.1093/ije/dyae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/15/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Over 120 million people in the USA live in areas with unsafe ozone (O3) levels. Studies among adults have linked exposure to worse lung function and higher risk of asthma and chronic obstructive pulmonary disease (COPD). However, few studies have examined the effects of O3 in children, and existing studies are limited in terms of their geographic scope or outcomes considered. METHODS We leveraged a dataset of encounters at 42 US children's hospitals from 2004-2015. We used a one-stage case-crossover design to quantify the association between daily maximum 8-hour O3 in the county in which the hospital is located and risk of emergency department (ED) visits for any cause and for respiratory disorders, asthma, respiratory infections, allergies and ear disorders. RESULTS Approximately 28 million visits were available during this period. Per 10 ppb increase, warm-season (May through September) O3 levels over the past three days were associated with higher risk of ED visits for all causes (risk ratio [RR]: 0.3% [95% confidence interval (CI): 0.2%, 0.4%]), allergies (4.1% [2.5%, 5.7%]), ear disorders (0.8% [0.3%, 1.3%]) and asthma (1.3% [0.8%, 1.9%]). When restricting to levels below the current regulatory standard (70 ppb), O3 was still associated with risk of ED visits for all-cause, allergies, ear disorders and asthma. Stratified analyses suggest that the risk of O3-related all-cause ED visits may be higher in older children. CONCLUSIONS Results from this national study extend prior research on the impacts of daily O3 on children's health and reinforce the presence of important adverse health impacts even at levels below the current regulatory standard in the USA.
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Affiliation(s)
- Jennifer D Stowell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Emma L Gause
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Keith R Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health Boston, MA, USA
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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Tyris J, Keller S, Parikh K, Gourishankar A. Population-level SDOH and Pediatric Asthma Health Care Utilization: A Systematic Review. Hosp Pediatr 2023; 13:e218-e237. [PMID: 37455665 DOI: 10.1542/hpeds.2022-007005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
CONTEXT Spatial analysis is a population health methodology that can determine geographic distributions of asthma outcomes and examine their relationship to place-based social determinants of health (SDOH). OBJECTIVES To systematically review US-based studies analyzing associations between SDOH and asthma health care utilization by geographic entities. DATA SOURCES Pubmed, Medline, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION Empirical, observational US-based studies were included if (1) outcomes included asthma-related emergency department visits or revisits, and hospitalizations or rehospitalizations; (2) exposures were ≥1 SDOH described by the Healthy People (HP) SDOH framework; (3) analysis occurred at the population-level using a geographic entity (eg, census-tract); (4) results were reported separately for children ≤18 years. DATA EXTRACTION Two reviewers collected data on study information, demographics, geographic entities, SDOH exposures, and asthma outcomes. We used the HP SDOH framework's 5 domains to organize and synthesize study findings. RESULTS The initial search identified 815 studies; 40 met inclusion criteria. Zip-code tabulation areas (n = 16) and census-tracts (n = 9) were frequently used geographic entities. Ten SDOH were evaluated across all HP domains. Most studies (n = 37) found significant associations between ≥1 SDOH and asthma health care utilization. Poverty and environmental conditions were the most often studied SDOH. Eight SDOH-poverty, higher education enrollment, health care access, primary care access, discrimination, environmental conditions, housing quality, and crime - had consistent significant associations with asthma health care utilization. CONCLUSIONS Population-level SDOH are associated with asthma health care utilization when evaluated by geographic entities. Future work using similar methodology may improve this research's quality and utility.
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Affiliation(s)
- Jordan Tyris
- Children's National Hospital, Washington, District of Columbia; and Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Susan Keller
- Children's National Hospital, Washington, District of Columbia; and Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Kavita Parikh
- Children's National Hospital, Washington, District of Columbia; and Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Anand Gourishankar
- Children's National Hospital, Washington, District of Columbia; and Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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5
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Bi J, D’Souza RR, Moss S, Senthilkumar N, Russell AG, Scovronick NC, Chang HH, Ebelt S. Acute Effects of Ambient Air Pollution on Asthma Emergency Department Visits in Ten U.S. States. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47003. [PMID: 37011135 PMCID: PMC10069759 DOI: 10.1289/ehp11661] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/05/2023] [Accepted: 03/02/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Previous studies of short-term ambient air pollution exposure and asthma morbidity in the United States have been limited to a small number of cities and/or pollutants and with limited consideration of effects across ages. OBJECTIVES To estimate acute age group-specific effects of fine and coarse particulate matter (PM), major PM components, and gaseous pollutants on emergency department (ED) visits for asthma during 2005-2014 across the United States. METHODS We acquired ED visit and air quality data in regions surrounding 53 speciation sites in 10 states. We used quasi-Poisson log-linear time-series models with unconstrained distributed exposure lags to estimate site-specific acute effects of air pollution on asthma ED visits overall and by age group (1-4, 5-17, 18-49, 50-64, and 65+ y), controlling for meteorology, time trends, and influenza activity. We then used a Bayesian hierarchical model to estimate pooled associations from site-specific associations. RESULTS Our analysis included 3.19 million asthma ED visits. We observed positive associations for multiday cumulative exposure to all air pollutants examined [e.g., 8-d exposure to PM2.5: rate ratio of 1.016 with 95% credible interval (CI) of (1.008, 1.025) per 6.3-μg/m3 increase, PM10-2.5: 1.014 (95% CI: 1.007, 1.020) per 9.6-μg/m3 increase, organic carbon: 1.016 (95% CI: 1.009, 1.024) per 2.8-μg/m3 increase, and ozone: 1.008 (95% CI: 0.995, 1.022) per 0.02-ppm increase]. PM2.5 and ozone showed stronger effects at shorter lags, whereas associations of traffic-related pollutants (e.g., elemental carbon and oxides of nitrogen) were generally stronger at longer lags. Most pollutants had more pronounced effects on children (<18 y old) than adults; PM2.5 had strong effects on both children and the elderly (>64 y old); and ozone had stronger effects on adults than children. CONCLUSIONS We reported positive associations between short-term air pollution exposure and increased rates of asthma ED visits. We found that air pollution exposure posed a higher risk for children and older populations. https://doi.org/10.1289/EHP11661.
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Affiliation(s)
- Jianzhao Bi
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Rohan R. D’Souza
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Shannon Moss
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Niru Senthilkumar
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Armistead G. Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Noah C. Scovronick
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
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6
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Alcala E, Capitman JA, Cisneros R. The Moderating Role of Housing Quality on Concentrated Poverty and Asthma-Related Emergency Department Visits Among Hispanics/Latinos. J Asthma 2023:1-8. [PMID: 36927232 DOI: 10.1080/02770903.2023.2188567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background. Rates of asthma-related emergency department visits have been shown to vary significantly by place (i.e., neighborhood) and race/ethnicity. The moderating factors of asthmatic events among Hispanic/Latino-specific populations are known to a much lesser degree. Objective. To assess the extent to which housing moderates the effect of poverty on Hispanic/Latino-specific asthma-related emergency department (ED) visits at an ecological level. Methods. Using data from the Office of Statewide Health Planning and Development (OSHPD) and the 2016-2017 U.S. Census, a cross-sectional ecological analysis at the census tract-level was conducted. Crosswalk files from the U.S. Department of Housing and Urban Development were used to associate zip codes to census tracts. Negative binomial regression was used to estimate rate ratios. Results. The effect of poverty on asthma-related ED visits was significantly moderated by the median year of housing structures built. The effect of mid-level poverty (RR= 1.57, 95% CI 1.27, 1.95) and high-level poverty (RR= 1.47, 95% CI 1.22, 1.78) in comparison to low-level poverty, was significantly greater among census tracts with housing built prior to 1965 in comparison to census tract with housing built between 1965-2020. Conclusion. Communities with older housing structures tend to be associated with increased Hispanic/Latino ED visits apart from affluent communities.
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Affiliation(s)
- Emanuel Alcala
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA.,Central Valley Health Policy Institute, College of Health and Human Services, California State University, Fresno, CA 93740, USA
| | - John A Capitman
- Central Valley Health Policy Institute, College of Health and Human Services, California State University, Fresno, CA 93740, USA
| | - Ricardo Cisneros
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
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7
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Akdis CA, Akdis M, Boyd SD, Sampath V, Galli SJ, Nadeau KC. Allergy: Mechanistic insights into new methods of prevention and therapy. Sci Transl Med 2023; 15:eadd2563. [PMID: 36652536 DOI: 10.1126/scitranslmed.add2563] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In the past few decades, the prevalence of allergic diseases has increased worldwide. Here, we review the etiology and pathophysiology of allergic diseases, including the role of the epithelial barrier, the immune system, climate change, and pollutants. Our current understanding of the roles of early life and infancy; diverse diet; skin, respiratory, and gut barriers; and microbiome in building immune tolerance to common environmental allergens has led to changes in prevention guidelines. Recent developments on the mechanisms involved in allergic diseases have been translated to effective treatments, particularly in the past 5 years, with additional treatments now in advanced clinical trials.
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Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos CH-7265, Switzerland.,Christine Kühne-Center for Allergy Research and Education, Davos CH-7265, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos CH-7265, Switzerland
| | - Scott D Boyd
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305, USA
| | - Stephen J Galli
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94305, USA
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Abstract
Asthma is a chronic illness of the airways that affects approximately 300 million individuals worldwide. While it is commonly accepted that high ozone levels exacerbate asthma symptoms, the impact of low to moderate ozone levels on asthma symptoms has received little attention. The purpose of this research was to determine the relationship between hospital visits by asthma patients showing the severity of their symptoms and moderate ozone levels. Statistical analyses were performed on hospital visit big data for asthma patients in Seoul, Korea, collected between 2013 and 2017. The data set includes outpatient hospital visits (n = 17,787,982), hospital admissions (n = 215,696), and emergency department visits (n = 85,482). The frequency of hospital visits by asthma patients was evaluated in relation to low ozone levels (< 0.03 ppm) and moderate ozone levels (0.03-0.06 ppm) in the Seoul environment. In comparison to low ozone levels, moderate ozone levels resulted in a reduction in outpatient hospital visits (t = 7.052, P < .001). When ozone levels were low to moderate, there was a negative correlation between ozone levels and outpatient visits (r = -0.281, 95% CI: -0.331 to -0.228). Negative associations were also identified between ozone levels and new hospital admissions (t = 2.909, P < .01; r = -0.125, 95% CI: -0.179 to -0.070) and emergency treatments (t = 2.679, P < .01; r = -0.132, 95% CI: -0.186 to -0.076). Additionally, it was verified that moderate ozone levels one day before the visits resulted in a reduction in outpatient visits (t = 5.614, P < .001; r = -0.207, 95% CI: -0.259 to -0.153). A strong relationship was identified between moderate atmospheric ozone levels and a reduction in asthma patient hospital visits.
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Affiliation(s)
- Soyeon Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea
| | - Minhyeok Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea
- * Correspondence: School of Electrical and Electronics Engineering, Chung-Ang University, Seoul, Korea (e-mail: )
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de Camargo Matos J, Botelho MLDA, Pamplona YDAP, Pereira LAA, Braga ALF, Martins LC. Self-reported prevalence of asthma symptoms in adults living in a port city. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73519-73527. [PMID: 35619017 DOI: 10.1007/s11356-022-21066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
Air pollution is a worldwide health problem, and exposure to the pollution can cause damage to the human body, especially to the respiratory and cardiovascular systems. Asthma is the third most common chronic disease in Brazil, presenting high prevalence in some areas. The aim of this study was to evaluate the self-report the prevalence of asthma symptoms in Santos city, Brazil, and its associated factors in the adult population (between 18 and 59 years old). A cross-sectional study was applied in two different areas of the city. The participants of this study were selected by zip code estimated on a random sample. The ECHRS and a demographic questionnaire were used to collect data. Associations between categorical variables were tested using Pearson's chi-square test or Fisher's exact test. Single and multiple logistic regression models were applied to evaluate the risk factors for asthma. Georeferencing was implemented to distribute the cases. The highest prevalence of asthma was found in Ponta da Praia neighborhood (16.4%; p=0.019), as well as waking up with a coughing crisis in the last 12 months (26.4%; p <0.001). The risk factors for asthma were the following: living next Santos Port area (OR: 2.90; 95%CI 1.13-7.44); and the presence of O3 (OR = 2.63; 95%CI 0.86-7.96). This pioneering study demonstrated that living near the port area increases the chances of adults having self-reported asthma symptoms.
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Affiliation(s)
- Janara de Camargo Matos
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil.
| | - Mônica Luiza De Arruda Botelho
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil
| | - Ysabely De Aguiar Pontes Pamplona
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil
| | - Luiz Alberto Amador Pereira
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil
| | - Alfésio Luís Ferreira Braga
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 450, CEP: 01246-903, São Paulo, Brazil
| | - Lourdes Conceição Martins
- Exposure and Environmental Risk Assessment Group-Postgraduate Program in Collective Health, Catholic University of Santos, Av. Conselheiro Nebias, 300; CEP: 11045-003, Santos, São Paulo, Brazil
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 450, CEP: 01246-903, São Paulo, Brazil
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Ibrahim MF, Hod R, Ahmad Tajudin MAB, Wan Mahiyuddin WR, Mohammed Nawi A, Sahani M. Children's exposure to air pollution in a natural gas industrial area and their risk of hospital admission for respiratory diseases. ENVIRONMENTAL RESEARCH 2022; 210:112966. [PMID: 35202623 DOI: 10.1016/j.envres.2022.112966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/27/2022] [Accepted: 02/13/2022] [Indexed: 06/14/2023]
Abstract
The rapid expansion of the natural gas industry to meet the global demand have raised environmental health concerns. Few studies have found that areas with natural gas industrial activity have poor air quality. However, the negative health impacts of ambient air pollution in a natural gas industrial area remain unclear. This study aimed to explore the relationship between short-term exposure to air pollution and hospital admissions for respiratory diseases among children in a natural gas industrial area in Bintulu, Malaysia. Daily hospital admissions for respiratory diseases among children were collected from a hospital in Bintulu from 2010 to 2019. Data on six air pollutants (PM10, PM2.5, SO2, NO2, O3, and CO) in the study area were obtained from the Department of Environment Malaysia. Quasi-Poisson time series regressions with distributed lag non-linear models (DLNM) were applied to explore the associations between ambient air pollution and childhood hospitalisations for respiratory diseases. Stratification analyses were performed by gender and age group to identify the vulnerable populations. A 10 μg/m3 increased PM2.5 and SO2 was associated with hospital admissions for respiratory diseases among children with the greatest relative risk of RR 1.089 (95% CI 1.001-1.183) at cumulative lag 0-2 days and RR 1.229 (95% CI 1.073-1.409) at cumulative lag 0-6 days, respectively. There was no significant association between short-term exposure of PM10, NO2, CO, and O3 with childhood respiratory hospitalisation. The association between PM2.5 and SO2 exposure and hospital admissions for childhood respiratory diseases in the two pollutants model remained statistically significant. There were stronger associations in younger children aged 0-4 years and girls. This study reveals that short-term exposure to SO2 was associated with a higher risk of respiratory hospitalisations among children in Bintulu than PM2.5. Better air quality control is necessary for children's health living in the natural gas industrial area.
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Affiliation(s)
- Mohd Faiz Ibrahim
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia.
| | | | - Wan Rozita Wan Mahiyuddin
- Institute for Medical Research, National Institutes of Health, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selango, Shah Alam, Selangor, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mazrura Sahani
- Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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11
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Review of Ground-Level Ozone Impact in Respiratory Health Deterioration for the Past Two Decades. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Ground-level ozone has been gaining notoriety with increasing evidence of its nefarious effects on health, especially respiratory diseases. Where do we stand on the solidity of this data and is there room for improvement? Objectives: Evaluate this evidence for incongruities or heterogeneity in this field of research. How is the exposure assessment conducted, where does Portugal stand in this field, and what can be improved? Health deterioration concerning asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) are analysed. Methods: A review of 1735 studies was conducted through PubMed and Google Scholar engines for the past two decades. We identified 59 eligible studies and included an array of variables, including O3 measurements, number of air-quality monitoring stations used, relative risks, odds ratios, hazard ratios, number of hospital admissions, visits, or mortality, and size of population dataset used. Results: Approximately 83% of data in this review presents significant correlations of ozone with asthma, COPD, and ARDS. Studies that report negative or not significant associations mention a lack of data or topographic differences as the main issue with these divergent results. Studies consistently report summer as a period of particular concern. Portuguese data in this field is lacking. Conclusions: This research field is growing in interest and there is evidence that ozone plays a non-negligible role in health deterioration. The few Portuguese studies in this field seem aligned with the literature reviewed but more research is needed. Suggested improvements are more and better data through denser air-quality networks to accurately depict personal exposure to ozone. Homogenization of the exposure assessment concerning averaging times of ozone to daily maximum 8 h averages whenever possible. Risk increments based on 10 ppb instead of interquartile ranges. Lastly, contrary to some studies in this review, the topographic effect on concentrations and health deterioration should not be underestimated and seasonality should always be checked.
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Guo M, Du C, Li B, Yao R, Tang Y, Jiang Y, Liu H, Su H, Zhou Y, Wang L, Yang X, Zhou M, Yu W. Reducing particulates in indoor air can improve the circulation and cardiorespiratory health of old people: A randomized, double-blind crossover trial of air filtration. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 798:149248. [PMID: 34325134 DOI: 10.1016/j.scitotenv.2021.149248] [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: 04/11/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
Exposure to indoor air particulate pollution increases respiratory and cardiovascular morbidity and mortality, especially in the elderly. To assess a short-term, indoor air filtration's potential benefit on circulatory and cardiopulmonary health among healthy older people, a randomized, double-blind crossover trial was conducted with 24 healthy residents of an aged-care center in Chongqing, China in 2020. Each room received a high-efficiency particulate air filter air purifier and a placebo air purifier for two days. Fifteen circulatory system biomarkers of inflammation, coagulation, and oxidative stress; lung function; blood pressure (BP); heart rate (HR) and fractional exhaled nitric oxide (FeNO) were measured end of each two days. Indoor air particulate pollution was monitored throughout the study period. Linear mixed-effect models were used to associate health outcome variables with indoor particles. This intervention study demonstrated that air filtration was associated with significantly decreased concentrations of inflammatory and coagulation biomarkers, but not of biomarkers of oxidative stress and lung function. Just 48 h of air filtration can improve the cardiopulmonary health of the elderly. Air purifiers may be a public health measure that can be taken to improve circulatory and cardiopulmonary health among older people.
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Affiliation(s)
- Miao Guo
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Runming Yao
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yuping Tang
- Department of Geriatrics, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Yi Jiang
- Department of Geriatrics, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Hong Liu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Hongjie Su
- Department of Physical Examination Center, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
| | - Yixi Zhou
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Lexiang Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Xu Yang
- Lab of Environmental Biomedicine, School of Life Sciences, Central China Normal University, Wuhan 430079, China; Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China
| | - Min Zhou
- Department of Geriatrics, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
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Cook Q, Argenio K, Lovinsky-Desir S. The impact of environmental injustice and social determinants of health on the role of air pollution in asthma and allergic disease in the United States. J Allergy Clin Immunol 2021; 148:1089-1101.e5. [PMID: 34743831 DOI: 10.1016/j.jaci.2021.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
There is clear evidence that exposure to environmental air pollution is associated with immune dysregulation, asthma, and other allergic diseases. However, the burden of air pollution exposure is not equally distributed across the United States. Many social and environmental factors place communities of color and people who are in poverty at increased risk of exposure to pollution and morbidity from asthma and allergies. Here, we review the evidence that supports the relationship between air pollution and asthma, while considering the social determinants of health that contribute to disparities in exposures and outcomes.
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Affiliation(s)
- Quindelyn Cook
- Division of Pediatric Pulmonary and Allergy, Department of Pediatrics, Boston University School of Medicine, Boston, Mass
| | - Kira Argenio
- Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Stephanie Lovinsky-Desir
- Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY.
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Duan R, Niu H, Yu T, Huang K, Cui H, Chen C, Yang T, Wang C. Adverse effects of short-term personal exposure to fine particulate matter on the lung function of patients with chronic obstructive pulmonary disease and asthma: a longitudinal panel study in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:47463-47473. [PMID: 33893585 DOI: 10.1007/s11356-021-13811-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5) is an important environmental factor affecting human health. However, most studies on PM2.5 and health have used data from fixed monitoring sites to assess PM2.5 exposure, which may have introduced misleading information on the exposure-response relationship. We aimed to assess the effect of short-term personal PM2.5 exposure on lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma. To achieve this, we conducted a longitudinal panel study among 37 COPD patients and 45 asthma patients from Beijing, China. The COPD group and the asthma group completed 148 and 180 lung function tests, respectively. We found that in COPD patients, for every 10-μg/m3 increase in PM2.5 exposure at lag2, the FEV1, FVC and DLco decreased by -0.014 L (95% CI -0.025, -0.003), -0.025 L (95% CI -0.050, -0.003) and -0.089 mmol/min/kPa (95% CI -0.156, -0.023), respectively. There was also a decrease of -0.023 L/s (95% CI -0.042, -0.003) and -0.017 L/s (95% CI -0.032, -0.002) in MMEF at lag3 and lag03, respectively. In the asthma group, every 10-μg/m3 increase in PM2.5 exposure led to a reduction of -0.012 L (95% CI -0.023, -0.001), -0.042 L (95% CI -0.081, -0.003) and -0.061 L/s (95% CI -0.116, -0.004) in the FEV1, FVC and PEF at lag3, respectively. Our findings suggest that PM2.5 exposure may primarily affect both airway function and lung diffusion function in COPD patients, and airway function in asthma patients.
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Affiliation(s)
- Ruirui Duan
- Peking University China-Japan Friendship School of Clinical Medicine, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Hongtao Niu
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
- National Respiratory Center, Beijing, China
| | - Tao Yu
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
- National Respiratory Center, Beijing, China
| | - Han Cui
- National Respiratory Center, Beijing, China
| | - Chen Chen
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ting Yang
- Peking University China-Japan Friendship School of Clinical Medicine, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
- National Respiratory Center, Beijing, China.
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Chen Wang
- Peking University China-Japan Friendship School of Clinical Medicine, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China.
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
- National Respiratory Center, Beijing, China.
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Ecotypic Morphological and Physio-Biochemical Responses of Two Differentially Adapted Forage Grasses, Cenchrus ciliaris L. and Cyperus arenarius Retz. to Drought Stress. SUSTAINABILITY 2021. [DOI: 10.3390/su13148069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Crop performance and yield are the results of genotypic expression as modulated by continuous interaction with the environment. Among the environmental aspects, drought and salinity are the most important factors, which limit the forages, including grasses, on a global basis. Grass species have the ability to grow under low water conditions and can produce high dry yield, proteins, and energy in areas exposed to drought stress. For this purpose, we conducted the present study to understand the response of forage grasses under drought stress from two different regions (Salt Range and Faisalabad) of Punjab, Pakistan. Two ecotypes of each grass species (Cenchrus ciliaris L. and Cyperus arenarius Retz.) were grown in pots at the botanical research area, Government College University Faisalabad, Pakistan. A group of plants were subjected to drought stress (60% field capacity) and controlled (100% field capacity) after three weeks of seed germination. The results from the present study depicted that the fresh and dry weights of root and shoot were decreased significantly under drought conditions. Moreover, C. ciliaris of the Salt Range area showed more resistance and higher growth production under drought stress. The chlorophyll (a and b) contents were also decreased significantly, while MDA, total soluble sugars, and proline levels were increased significantly under water-limited environments in the C. arenarius of Salt Range area. Enzymatic antioxidants (superoxidase dismutase (SOD) and peroxidase (POD)) and leaf Na+ were significantly raised in C. arenarius under drought stress collected from the Faisalabad region. Cenchrus ciliaris showed higher level of H2O2, total soluble proteins, glycinebetaine, catalase (CAT) and POD compared to C. arenarius. It also retained more leaf and root Ca2+, and root K+ under drought stress. It was concluded from the study that C. ciliaris is more resistant to drought in biomass production collected from the Salt Range area. The results suggested that C. ciliaris can be more widely used as a forage grass under water-scarce conditions as compared to C. arenarius.
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Jaafari J, Naddafi K, Yunesian M, Nabizadeh R, Hassanvand MS, Shamsipour M, Ghanbari Ghozikali M, Nazmara S, Shamsollahi HR, Yaghmaeian K. Associations between short term exposure to ambient particulate matter from dust storm and anthropogenic sources and inflammatory biomarkers in healthy young adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:144503. [PMID: 33352344 DOI: 10.1016/j.scitotenv.2020.144503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/18/2020] [Accepted: 12/10/2020] [Indexed: 05/13/2023]
Abstract
This study examined the association between particulate matter from anthropogenic and natural sources and inflammatory biomarkers, including hs-CRP, IL-6, sTNF-RII, and WBCs, in two groups of healthy young subjects. We followed up subjects of two panels (16 to 22 years old), including 22 subjects selected from the urban area (Tehran city) with high-level pollution background and 22 subjects selected from the rural area (Ahmadabad) with low-level pollution background. In each group, we collected 4 times blood samples in various air pollution conditions, In the subjects of the urban group, there was a substantial difference (p < 0.05) between inversion days and cold season control days, and between dust storm days and warm season control days for concentrations of hs-CRP, IL-6, and WBCs biomarkers. In the subjects of the rural group, a significant difference could be detected in the concentration of hs-CRP, IL-6, and WBCs biomarkers (p < 0.05) between inversion days and cold season control days, and between dust storm and warm control days. We found that the difference in concentrations of hs-CRP, IL-6, and WBCs biomarkers between dust storm days and warm control conditions in the rural group were higher than the difference in inversion and cold control conditions, which can be attributed to low background air pollution in the rural area. In the urban area, the health effect of anthropogenic sources of PM is higher than the dust storm condition, which can be attributed to the stronger effect of anthropogenic pollution effect.
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Affiliation(s)
- Jalil Jaafari
- Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Nabizadeh
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Shamsollahi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Byrwa-Hill BM, Venkat A, Presto AA, Rager JR, Gentile D, Talbott E. Lagged Association of Ambient Outdoor Air Pollutants with Asthma-Related Emergency Department Visits within the Pittsburgh Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8619. [PMID: 33233547 PMCID: PMC7699695 DOI: 10.3390/ijerph17228619] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/07/2020] [Accepted: 11/11/2020] [Indexed: 01/23/2023]
Abstract
Asthma affects millions of people globally and is especially concerning in populations living with poor air quality. This study examines the association of ambient outdoor air pollutants on asthma-related emergency department (ED) visits in children and adults throughout the Pittsburgh region. A time-stratified case-crossover design is used to analyze the lagged effects of fine particulate matter (PM2.5) and gaseous pollutants, e.g., ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) on asthma-related ED visits (n = 6682). Single-, double-, and multi-pollutant models are adjusted for temperature and analyzed using conditional logistic regression. In children, all models show an association between O3 and increased ED visits at lag day 1 (OR: 1.12, 95% CI, 1.03-1.22, p < 0.05) for the double-pollutant model (OR: 1.10, 95% CI: 1.01-1.20, p < 0.01). In adults, the single-pollutant model shows associations between CO and increased ED visits at lag day 5 (OR: 1.13, 95% CI, 1.00-1.28, p < 0.05) and average lag days 0-5 (OR: 1.22, 95% CI: 1.00-1.49, p < 0.05), and for NO2 at lag day 5 (OR: 1.04, 95% CI: 1.00-1.07, p < 0.05). These results show an association between air pollution and asthma morbidity in the Pittsburgh region and underscore the need for mitigation efforts to improve public health outcomes.
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Affiliation(s)
- Brandy M. Byrwa-Hill
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA
| | - Arvind Venkat
- Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA;
| | - Albert A. Presto
- Center for Atmospheric Particle Studies and Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - Judith R. Rager
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA; (J.R.R.); (E.T.)
| | | | - Evelyn Talbott
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA; (J.R.R.); (E.T.)
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Baek J, Kash BA, Xu X, Benden M, Roberts J, Carrillo G. Pediatric asthma hospitalization: individual and environmental characteristics of high utilizers in South Texas. J Asthma 2020; 59:94-104. [PMID: 32962451 DOI: 10.1080/02770903.2020.1827424] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Few studies have examined factors affecting the high frequency of hospitalization for pediatric asthma. This study identifies individual and environmental characteristics of children with asthma from a low-income community with a high number of hospitalizations. METHODS The study population included 902 children admitted at least once to a children's hospital in South Texas because of asthma from 2010 to 2016. The population was divided into three groups by utilization frequency (high: ≥4 times, medium: 2-3 times, or low: 1 time). Individual-level factors at index admission and environmental factors were included for the analysis. Unadjusted and adjusted multivariate ordered logistic regression models were applied to identify significant characteristics of high hospital utilizers. RESULTS The high utilization group comprised 2.4% of total patients and accounted for substantial hospital resource utilization: 10.8% of all admissions and 13.5% of days stayed in the hospital. Patients in the high utilization group showed longer length of stay (LOS) and shorter time between admissions on average than the other two groups. The multivariate ordered logistic regression models revealed that age of 5-11 years (OR = 0.57, 95%CI = 0.35-0.93), longer LOS (2 days: OR = 1.80, 95%CI = 1.15-2.84; ≥3 days: OR = 3.38, 95%CI = 2.10-5.46), warm season at index admission (OR = 1.49, 95%CI = 1.01-2.20), and higher average ozone level in children's residential neighborhoods (OR = 1.78, 95%CI = 1.01-3.14) were significantly associated with a higher number of asthma hospitalizations. CONCLUSIONS The findings suggest the importance of monitoring high hospital utilizers and establishing strategies for such patients based on their characteristics to reduce repeated hospitalizations and to increase optimal use of hospital resources.
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Affiliation(s)
- Juha Baek
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA.,Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Bita A Kash
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, USA.,Center for Health & Nature, Houston Methodist Research Institute, Houston, TX, USA.,Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Xiaohui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mark Benden
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Jon Roberts
- Department of Pediatric Pulmonology, Driscoll Children's Hospital, Corpus Christi, TX, USA
| | - Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
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Jaafari J, Naddafi K, Yunesian M, Nabizadeh R, Hassanvand MS, Shamsipour M, Ghozikali MG, Shamsollahi HR, Nazmara S, Yaghmaeian K. The acute effects of short term exposure to particulate matter from natural and anthropogenic sources on inflammation and coagulation markers in healthy young adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 735:139417. [PMID: 32498012 DOI: 10.1016/j.scitotenv.2020.139417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/24/2020] [Accepted: 05/11/2020] [Indexed: 05/13/2023]
Abstract
Airborne particulate matter is associated with increasing the risk of cardiovascular diseases. The purpose of this study was to investigate the association between air pollution conditions and MDA, vWF, and fibrinogen markers in the blood of two panels of healthy young individuals in an urban area in Tehran city with a high air pollution background and another group was living in a rural area (Ahmad Abad Mostofi), with a low air pollution background. In each group, 4 blood samples were taken as follows: one in inversion days, the second in winter, but during the existence of normal condition in terms of air pollution, the third sample in the spring during the normal condition in terms of air pollution and the fourth sample during the dust storm conditions. In the urban and rural groups, there was a significant difference between the concentration of MDA, vWF, fibrinogen between inversion and cold season control conditions, and between dust storm conditions and warm season control conditions (p < 0.05). The results showed that the association of dust storm condition on the measured biomarkers was stronger than the inversion condition, which health consideration in the dust conditions be taken into account similar to the inversion conditions.
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Affiliation(s)
- Jalil Jaafari
- Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamid Reza Shamsollahi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
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Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134846. [PMID: 32640508 PMCID: PMC7370127 DOI: 10.3390/ijerph17134846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/16/2022]
Abstract
Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities. This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas. A time-stratified case-crossover study was conducted using the hospitalization data from a children’s hospital and the air pollution data, including particulate matter 2.5 (PM2.5) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014. A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature. We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014. The single-pollutant models showed that PM2.5 concentration had a significant positive effect on risk for hospital readmissions (OR = 1.082, 95% CI = 1.008–1.162, p = 0.030). In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1.023, 95% CI = 1.001–1.045, p = 0.042) and PM2.5 concentrations (OR = 1.080, 95% CI = 1.005–1.161, p = 0.036). The effects of ambient air pollutants on hospital readmissions varied by age and season. Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients.
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Trumble BC, Finch CE. THE EXPOSOME IN HUMAN EVOLUTION: FROM DUST TO DIESEL. THE QUARTERLY REVIEW OF BIOLOGY 2019; 94:333-394. [PMID: 32269391 PMCID: PMC7141577 DOI: 10.1086/706768] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Global exposures to air pollution and cigarette smoke are novel in human evolutionary history and are associated with about 16 million premature deaths per year. We investigate the history of the human exposome for relationships between novel environmental toxins and genetic changes during human evolution in six phases. Phase I: With increased walking on savannas, early human ancestors inhaled crustal dust, fecal aerosols, and spores; carrion scavenging introduced new infectious pathogens. Phase II: Domestic fire exposed early Homo to novel toxins from smoke and cooking. Phases III and IV: Neolithic to preindustrial Homo sapiens incurred infectious pathogens from domestic animals and dense communities with limited sanitation. Phase V: Industrialization introduced novel toxins from fossil fuels, industrial chemicals, and tobacco at the same time infectious pathogens were diminishing. Thereby, pathogen-driven causes of mortality were replaced by chronic diseases driven by sterile inflammogens, exogenous and endogenous. Phase VI: Considers future health during global warming with increased air pollution and infections. We hypothesize that adaptation to some ancient toxins persists in genetic variations associated with inflammation and longevity.
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Affiliation(s)
- Benjamin C Trumble
- School of Human Evolution & Social Change and Center for Evolution and Medicine, Arizona State University Tempe, Arizona 85287 USA
| | - Caleb E Finch
- Leonard Davis School of Gerontology and Dornsife College, University of Southern California Los Angeles, California 90089-0191 USA
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Gharibi H, Entwistle MR, Schweizer D, Tavallali P, Thao C, Cisneros R. Methyl-bromide and asthma emergency department visits in California, USA from 2005 to 2011. J Asthma 2019; 57:1227-1236. [PMID: 31311358 DOI: 10.1080/02770903.2019.1645167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Urban monitors of Methyl bromide (MBr), not typically near application sites, are used to investigate the impact of ambient concentrations on asthma Emergency Department (ED) visits.Methods: 4262 ED visits from August to February of 2005 to 2011 in Central and Southern California were selected from California's Office of Statewide Health Planning and Development (OSHPD). A bidirectional-symmetric case-crossover study design using conditional logistic regression model was used to obtain the odds ratio (OR) and 95% confidence interval associated with a 0.01 ppb (interquartile range) increase in MBr.Results: The population sample was comprised of 46.0% male and 53.9% females. Ethnic groups included 32.0% Non-Hispanic White, 23.5% Non-Hispanic Black, and 44.4% Hispanic. Age distribution was between 2 and 5 years old (11.6%), 6 and 18 years old (23.5%), 19 and 40 years old (29.3%), 41 and 64 years old (24.1%), and 65 or older (6.9%). There was a positive association between MBr and asthma ED visits among Non-Hispanic Blacks [OR: 1.065 (95% confidence intervals: 1.019, 1.108)] and Hispanics [OR: 1.107 (95% confidence intervals: 1.043, 1.173)], while Non-Hispanic Whites did not have an association with asthma ED visits. Positive association between MBr and asthma ED visits was found only among 6 to 18 [OR: 1.071 (95% confidence intervals: 1.016, 1.125)] years old.Conclusion: An increase in MBr concentration was found to be associated with an increase of the odds of having asthma ED visits in California among 6 to 18 years old and disproportionately affects Non-Hispanic Blacks and Hispanics over Non-Hispanic Whites.
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Affiliation(s)
- Hamed Gharibi
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Marcela R Entwistle
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA.,USDA Forest Service, Pacific Southwest Region, Clovis, CA, USA
| | - Pooya Tavallali
- Electrical Engineering and Computer Science, University of California, Merced, Merced, CA, USA
| | - Chia Thao
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA.,Public Health, University of California, Merced, Merced, CA, USA
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Gharibi H, Entwistle MR, Schweizer D, Tavallali P, Cisneros R. The association between 1,3-dichloropropene and asthma emergency department visits in California, USA from 2005 to 2011: a bidirectional-symmetric case crossover study. J Asthma 2019; 57:601-609. [PMID: 30938205 DOI: 10.1080/02770903.2019.1590596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The ever-increasing rate of pesticide use in California farmlands is of great concern due to its potential toxicity on human health. In this study, the association between short term exposure to 1,3-dichloropropene (1,3-D) and asthma emergency department (ED) visits in central and southern California from 2005 to 2011 is investigated.Methods: 3878 ED visits were identified from 2005 to 2011 (1064 days). Conditional logistic regression models were used to obtain the odds ratio (OR) associated with 0.01 ppb increase in 1,3-D. Potential effect modification by sex, race/ethnicity (Non-Hispanic White, Non-Hispanic Black, or Hispanic), and age (2-5, 6-18, 19-40, 41-64 or ≥ 65) are investigated.Results: It was found that a 0.01 ppb increase in 1,3-D at the event day is associated with 13.5% [OR = 1.135, 95% CI: 1.123, 1.149] increase in the odds of having asthma ED visits in central and southern California during October to February of 2005 to 2011. Race had a positive association between 1,3-D and asthma ED visits among Non-Hispanic Black [OR= 1.095 95% CI: 1.035, 1.155] and Hispanic [OR= 1.121 95% CI: 1.064, 1.179]; while Non-Hispanic Whites had no association. Positive association for age was found between 1,3-D and asthma ED visits among patients 2 to 5 [OR= 1.065 95% CI: 1.020, 1.133], 6 to 18 [OR= 1.142 95% CI: 1.086, 1.196], and 19 to 40 [OR= 1.023 95% CI: 1.015, 1.073] years old.Conclusion: These findings suggest a 0.01 ppb increase in 1,3-D concentration increases the odds of having asthma ED visits.
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Affiliation(s)
- Hamed Gharibi
- Health Sciences Research Institute, University of California, Merced, California, USA
| | - Marcela R Entwistle
- Health Sciences Research Institute, University of California, Merced, California, USA
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, California, USA.,USDA Forest Service, Pacific Southwest Region, California, USA
| | - Pooya Tavallali
- Electrical Engineering and Computer Science, University of California, Merced, USA
| | - Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, California, USA.,Public Health, University of California, Merced, California, USA
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