Loss of life expectancy from air pollution compared to other risk factors: a worldwide perspective

Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality

BACKGROUND

The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important.

OBJECTIVE

In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality.

RESULTS

Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74-3.66) and 1.29% (95% CI: 0.51-2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [-3.81% (95% CI: -14.82, 8.63)]; [-0.45% (95% CI: -2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [-3.00% (95% CI: -20.80, 18.79)]; [-0.30% (95% CI: -3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves.

CONCLUSIONS

Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent.

Effects of ambient air pollution on the risk of small- and large-for-gestational-age births: an analysis using national birth data in Japan

OBJECTIVES

Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) births are major adverse birth outcomes related to newborn health. In contrast, the association between ambient air pollution levels and SGA or LGA births has not been investigated in Japan; hence, the purpose of our study is to investigate this association.

METHODS

We used birth data from Vital Statistics in Japan from 2017 to 2021 and municipality-level data on air pollutants, including nitrogen dioxide (NO2), sulfur dioxide (SO2), photochemical oxidants, and particulate matter 2.5 (PM2.5). Ambient air pollution levels throughout the first, second, and third trimesters, as well as the whole pregnancy, were calculated for each birth. The association between SGA/LGA and ambient levels of the air pollutants was investigated using crude and adjusted log-binomial regression models. In addition, a regression model with spline functions was also used to detect the non-linear association.

RESULTS

We analyzed data from 2,434,217 births. Adjusted regression analyses revealed statistically significant and positive associations between SGA birth and SO2 level, regardless of the exposure period. Specifically, the risk ratio for average SO2 values throughout the whole pregnancy was 1.014 (95% confidence interval [CI] 1.009, 1.019) per 1 ppb increase. In addition, regression analysis with spline functions indicated that an increase in risk ratio for SGA birth depending on SO2 level was linear. Furthermore, statistically significant and negative associations were observed between LGA birth and SO2 except for the third trimester.

CONCLUSIONS

It was suggested that ambient level of SO2 during the pregnancy term is a risk factor for SGA birth in Japan.

Air pollution and skin diseases: A comprehensive evaluation of the associated mechanism

Air pollutants deteriorate the survival environment and endanger human health around the world. A large number of studies have confirmed that air pollution jeopardizes multiple organs, such as the cardiovascular, respiratory, and central nervous systems. Skin is the largest organ and the first barrier that protects us from the outside world. Air pollutants such as particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs) will affect the structure and function of the skin and bring about the development of inflammatory skin diseases (atopic dermatitis (AD), psoriasis), skin accessory diseases (acne, alopecia), auto-immune skin diseases (cutaneous lupus erythematosus(CLE) scleroderma), and even skin tumors (melanoma, basal cell carcinoma (BCC), squamous-cell carcinoma (SCC)). Oxidative stress, skin barrier damage, microbiome dysbiosis, and skin inflammation are the pathogenesis of air pollution stimulation. In this review, we summarize the current evidence on the effects of air pollution on skin diseases and possible mechanisms to provide strategies for future research.

Organic Emissions of Volatile Chemical Products in Canada: Emission Inventories, Indoor-to-Outdoor Transfer, and Regional Impacts

The contribution of volatile chemical products (VCPs) to ambient air pollution has increased following decades of regulating combustion sources. There is a research gap concerning the impact of indoor physicochemical phenomena on VCP emissions. In this work, a bottom-up speciated VCP emission inventory with indoor-outdoor resolution was developed for Canada, an industrialized country with low air pollution levels, whose major cities are among the largest urban areas in North America. VCPs were estimated to account for about 290 kilotons of gaseous organic emissions for a typical year in the 2010s, with more than 60% of emissions occurring indoors. Coatings and cleaners were the most emissive VCP categories. Oxygenated species and saturated aliphatics dominated the chemical profiles of most emissions. Less than 5% of VCP emissions were impacted by indoor physicochemical phenomena. VCP emissions were predicted to account for 0.8-3.2 s-1 of OH reactivity and 0.22-0.52 μg/m3 of secondary organic aerosol formation potential in major urban areas in Canada. Our predictions aligned with previous measurements concerning indoor and outdoor organic pollutant levels, underscoring the important air quality impacts of VCPs relative to other sources. Our results provide helpful insights for future research regarding VCP emissions, especially from indoor spaces.

Environmentally Not So Friendly: Global Warming, Air Pollution, and Wildfires: JACC Focus Seminar, Part 1

Environmental stresses are increasingly recognized as significant risk factors for adverse health outcomes. In particular, various forms of pollution and climate change are playing a growing role in promoting noncommunicable diseases, especially cardiovascular disease. Given recent trends, global warming and air pollution are now associated with substantial cardiovascular morbidity and mortality. As a vicious cycle, global warming increases the occurrence, size, and severity of wildfires, which are significant sources of airborne particulate matter. Exposure to wildfire smoke is associated with cardiovascular disease, and these effects are underpinned by mechanisms that include oxidative stress, inflammation, impaired cardiac function, and proatherosclerotic effects in the circulation. In the first part of a 2-part series on pollution and cardiovascular disease, this review provides an overview of the impact of global warming and air pollution, and because of recent events and emerging trends specific attention is paid to air pollution caused by wildfires.

Prevalence and outcomes of patients with SMuRF-less acute coronary syndrome undergoing percutaneous coronary intervention

BACKGROUND

There is increasing awareness that patients without standard modifiable risk factors (SMuRFs; diabetes, hypercholesterolaemia, hypertension and smoking) may represent a unique subset of patients with acute coronary syndrome (ACS). We aimed to investigate the prevalence and outcomes of patients with SMuRF-less ACS undergoing percutaneous coronary intervention (PCI) compared with those with SMuRFs.

METHODS

We analysed data from the Melbourne Interventional Group PCI Registry. Patients with coronary artery disease were excluded. The primary outcome was 30-day mortality. Secondary outcomes included in-hospital and 30-day events. Long-term mortality was investigated using Cox-proportional hazards regression.

RESULTS

From 1 January 2005 to 31 December 2020, 2727/18 988 (14.4%) patients were SMuRF less, with the proportion increasing over time. Mean age was similar for patients with and without SMuRFs (63 years), and fewer females were SMuRF-less (19.8% vs 25.4%, p<0.001). SMuRF-less patients were more likely to present with cardiac arrest (6.6% vs 3.9%, p<0.001) and ST-elevation myocardial infarction (59.1% vs 50.8%, p<0.001) and were more likely to experience postprocedural cardiogenic shock (4.5% vs 3.6%, p=0.019) and arrhythmia (11.2% vs 9.9%, p=0.029). At 30 days, mortality, myocardial infarction, revascularisation and major adverse cardiac and cerebrovascular events did not differ between the groups. During median follow-up of 7 years, SMuRF-less patients had an adjusted 13% decreased rate of mortality (HR 0.87 (95% CI 0.78 to 0.97)).

CONCLUSIONS

The proportion of SMuRF-less patients increased over time. Presentation was more often a devastating cardiac event compared with those with SMuRFs. No difference in 30-day outcomes was observed and SMuRF-less patients had lower hazard for long-term mortality.

Associations between long-term exposure to air pollution, diabetes, and hypertension in metropolitan Iran: an ecologic study

Epidemiological studies on air pollution, diabetes, and hypertension conflict. This study examined air pollution, diabetes, and hypertension in adults in 11 metropolitan areas of Iran (2012-2016). Local environment departments and the Tehran Air Quality Control Company provided air quality data. The VIZIT website and Stepwise Approach to Chronic Disease Risk Factor Surveillance study delivered chronic disease data. Multiple logistic regression and generalized estimating equations evaluated air pollution-related diabetes and hypertension. In Isfahan, Ahvaz, and Tehran, PM2.5 was linked to diabetes. In all cities except Urmia, Yasuj, and Yazd, PM2.5 was statistically related to hypertension. O3 was connected to hypertension in Ahvaz, Tehran, and Shiraz, whereas NO2 was not. BMI and gender predict hypertension and diabetes. Diabetes, SBP, and total cholesterol were correlated. Iran's largest cities' poor air quality may promote diabetes and hypertension. PM2.5 impacts many cities' outcomes. Therefore, politicians and specialists have to control air pollution.

Impact of indoor air pollution on DNA damage and chromosome stability: a systematic review

Indoor air pollution is becoming a rising public health problem and is largely resulting from the burning of solid fuels and heating in households. Burning these fuels produces harmful compounds, such as particulate matter regarded as a major health risk, particularly affecting the onset and exacerbation of respiratory diseases. As exposure to polluted indoor air can cause DNA damage including DNA sd breaks as well as chromosomal damage, in this paper, we aim to provide an overview of the impact of indoor air pollution on DNA damage and genome stability by reviewing the scientific papers that have used the comet, micronucleus, and γ-H2AX assays. These methods are valuable tools in human biomonitoring and for studying the mechanisms of action of various pollutants, and are readily used for the assessment of primary DNA damage and genome instability induced by air pollutants by measuring different aspects of DNA and chromosomal damage. Based on our search, in selected studies (in vitro, animal models, and human biomonitoring), we found generally higher levels of DNA strand breaks and chromosomal damage due to indoor air pollutants compared to matched control or unexposed groups. In summary, our systematic review reveals the importance of the comet, micronucleus, and γ-H2AX assays as sensitive tools for the evaluation of DNA and genome damaging potential of different indoor air pollutants. Additionally, research in this particular direction is warranted since little is still known about the level of indoor air pollution in households or public buildings and its impact on genetic material. Future studies should focus on research investigating the possible impact of indoor air pollutants in complex mixtures on the genome and relate pollutants to possible health outcomes.

Exposure-Response to High PM 2.5 Levels for Cardiovascular Events in High-risk Older Adults in Taiwan

Background

Multiple studies from countries with relatively lower PM 2.5 level demonstrated that acute and chronic exposure even at lower than recommended level, e.g., 9 μg/m 3 in the US increased the risk of cardiovascular (CV) events. However, limited studies using individual level data exist from countries with a wider range of PM levels to illustrate shape of the exposure-response curve throughout the range including > 20 μg/m 3 PM 2·5 concentrations. Taiwan with its policies reduced PM 2.5 over time provide opportunities to illustrate the dose response curves and how reductions of PM 2.5 over time correlated with CV events incidence in a nationwide sample.

Methods

Using data from the 2009-2019 Taiwan National Health Insurance Database linked to nationwide PM2.5 data. We examined the shape and magnitude of the exposure-response curve between seasonal average PM 2·5 level and CV events-related hospitalizations among older adults at high-risk for CV events. We used history-adjusted marginal structural models including potential confounding by individual demographic factors, baseline comorbidities, and health service measures. To quantify the risk below and above 20 μg/m 3 we conducted stratified Cox regression. We also plotted PM 2.5 and CV events from 2009-2019 as well as average temperature as a comparison.

Findings

Using the PM 2.5 concentration <15 μg/m 3 (Taiwan regulatory standard) as a reference, the seasonal average PM 2.5 concentration (15-23.5μg/m 3 and > 23.5 μg/m 3 ) were associated with hazard ration of 1.13 (95%CI 1.09-1.18) and 1.19 (95%CI 1.14-1.24), 1.07 (95%CI 1.03-1.11) and 1.14 (95%CI 1.10-1.18), 1.22 (95%CI 1.08-1.38) and 1.31 (95%CI 1.16-1.48), 1.04 (95%CI 0.98-1.10) and 1.10 (95%CI 1.04-1.16) respectively for HF, IS/TIA,PE/DVT and MI/ACS. A nonlinear relationship between PM 2·5 and CV events outcomes was observed at PM 2·5 levels above 20 μg/m 3 .

Interpretation

A nonlinear exposure-response relationship between PM2·5 concentration and the incidence of cardiovascular events exists when PM2.5 is higher than the levels recommended by WHO Air Quality Guidelines. Further lowering PM2·5 levels beyond current regulatory standards may effectively reduce the incidence of cardiovascular events, particularly HF and DVT, and can lead to tangible health benefits in high-risk elderly population.

Unveiling the health consequences of air pollution in the world's most polluted nations

Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Environmental Impacts on Cardiovascular Health and Biology: An Overview

Environmental stressors associated with human activities (eg, air and noise pollution, light disturbance at night) and climate change (eg, heat, wildfires, extreme weather events) are increasingly recognized as contributing to cardiovascular morbidity and mortality. These harmful exposures have been shown to elicit changes in stress responses, circadian rhythms, immune cell activation, and oxidative stress, as well as traditional cardiovascular risk factors (eg, hypertension, diabetes, obesity) that promote cardiovascular diseases. In this overview, we summarize evidence from human and animal studies of the impacts of environmental exposures and climate change on cardiovascular health. In addition, we discuss strategies to reduce the impact of environmental risk factors on current and future cardiovascular disease burden, including urban planning, personal monitoring, and mitigation measures.

Local incomplete combustion emissions define the PM2.5 oxidative potential in Northern India

The oxidative potential (OP) of particulate matter (PM) is a major driver of PM-associated health effects. In India, the emission sources defining PM-OP, and their local/regional nature, are yet to be established. Here, to address this gap we determine the geographical origin, sources of PM, and its OP at five Indo-Gangetic Plain sites inside and outside Delhi. Our findings reveal that although uniformly high PM concentrations are recorded across the entire region, local emission sources and formation processes dominate PM pollution. Specifically, ammonium chloride, and organic aerosols (OA) from traffic exhaust, residential heating, and oxidation of unsaturated vapors from fossil fuels are the dominant PM sources inside Delhi. Ammonium sulfate and nitrate, and secondary OA from biomass burning vapors, are produced outside Delhi. Nevertheless, PM-OP is overwhelmingly driven by OA from incomplete combustion of biomass and fossil fuels, including traffic. These findings suggest that addressing local inefficient combustion processes can effectively mitigate PM health exposure in northern India.

Assessment of the health impacts of air pollution exposure in East African countries

The health effects of air pollution remain a public concern worldwide. Using data from the Global Burden of Disease 2019 report, we statistically analyzed total mortality, disability-adjusted life years (DALY), and years of life lost (YLL) attributable to air pollution in eight East African countries between 1990 and 2019. We acquired ambient ozone (O3), PM2.5 concentrations and household air pollution (HAP) from the solid fuel from the State of Global Air report. The multilinear regression model was used to evaluate the predictability of YLLs by the air pollutants. We estimated the ratio rate for each health burden attributable to air pollution to compare the country's efforts in the reduction of air pollution health burden. This study found that the total number of deaths attributable to air pollution decreased by 14.26% for 30 years. The drop came from the reduction of 43.09% in mortality related to Lower Respiratory tract Infection (LRI). However, only five out of eight countries managed to decrease the total number of deaths attributable to air pollution with the highest decrease observed in Ethiopia (40.90%) and the highest increase in Somalia (67.49%). The linear regression model showed that HAP is the pollutant of the most concern in the region, with a 1% increase in HAP resulting in a 31.06% increase in regional YLL (R2 = 0.93; p < 0.05). With the increasing ground-level ozone, accompanied by the lack of adequate measures to reduce particulate pollutants, the health burdens attributable to air pollution are still a threat in the region.

24-hour average PM2.5 concentration caused by aircraft in Chinese airports from Jan. 2006 to Dec. 2023

Since 2006, the rapid development of China's aviation industry has been accompanied by a significant increase in one of its emissions, namely, PM2.5, which poses a substantial threat to human health. However, little data is describing the PM2.5 concentration caused by aircraft activities. This study addresses this gap by initially computing the monthly PM2.5 emissions of the landing-take-off (LTO) stage from Jan. 2006 to Dec. 2023 for 175 Chinese airports, employing the modified BFFM2-FOA-FPM method. Subsequently, the study uses the Gaussian diffusion model to measure the 24-hour average PM2.5 concentration resulting from flight activities at each airport. This study mainly draws the following conclusions: Between 2006 and 2023, the highest recorded PM2.5 concentration data at all airports was observed in 2018, reaching 5.7985 micrograms per cubic meter, while the lowest point was recorded in 2022, at 2.0574 micrograms per cubic meter. Moreover, airports with higher emissions are predominantly located in densely populated and economically vibrant regions such as Beijing, Shanghai, Guangzhou, Chengdu, and Shenzhen.

Surface Hydroxyl and Oxygen Vacancies Engineering in ZnSnAl LDH: Synergistic Promotion of Photocatalytic Oxidation of Aromatic VOCs

Photocatalytic oxidation has gained great interest in environmental remediation, but it is still limited by its low efficiency and catalytic deactivation in the degradation of aromatic VOCs. In this study, we concurrently regulated the surface hydroxyl and oxygen vacancies by introducing Al into ZnSn layered double hydroxide (LDH). The presence of distorted Al species induced local charge redistribution, leading to the remarkable formation of oxygen vacancies. These oxygen vacancies subsequently increased the amount of surface hydroxyl and elongated its bond length. The synergistic effects of surface hydroxyl and oxygen vacancies greatly enhanced reactant adsorption-activation and facilitated charge transfer to generate •OH, •O2-, and 1O2, resulting in highly efficient oxidation and ring-opening of various aromatic VOCs. Compared with commercial TiO2, the optimized ZnSnAl-50 catalyst exhibited about 2-fold activity for the toluene and styrene degradation and 10-fold activity for the chlorobenzene degradation. Moreover, ZnSnAl-50 demonstrated exceptional stability in the photocatalytic oxidation of toluene under a wide humidity range of 0-75%. This work marvelously improves the photocatalytic efficiency, stability, and adaptability through a novel strategy of surface hydroxyl and oxygen vacancies engineering.

Satellite or ground-based measurements for air pollutants (PM2.5, PM10, SO2, NO2, O3) data and their health hazards: which is most accurate and why?

Air pollution is growing at alarming rates on regional and global levels, with significant consequences for human health, ecosystems, and change in climatic conditions. The present 12 weeks (4 October 2021, to 26 December 2021) study revealed the different ambient air quality parameters, i.e., PM2.5, PM10, SO2, NO2, and O3 over four different sampling stations of Delhi-NCR region (Dwarka, Knowledge park III, Sector 125, and Vivek Vihar), India, by using satellite remote sensing data (MERRA-2, OMI, and Aura Satellite) and different ground-based instruments. The ground-based observation revealed the mean concentration of PM2.5 in Dwarka, Knowledge park III, Sector 125, and Vivek Vihar as 279 µg m-3, 274 µg m-3, 294 µg m-3, and 365 µg m-3, respectively. The ground-based instrumental concentration of PM2.5 was greater than that of satellite observations, while as for SO2 and NO2, the mean concentration of satellite-based monitoring was higher as compared to other contaminants. Negative and positive correlations were observed among particulate matter, trace gases, and various meteorological parameters. The wind direction proved to be one of the prominent parameter to alter the variation of these pollutants. The current study provides a perception into an observable behavior of particulate matter, trace gases, their variation with meteorological parameters, their health hazards, and the gap between the measurements of satellite remote sensing and ground-based measurements.

[Air pollution, noise and hypertension : Partners in crime]

Air pollution and traffic noise are two important environmental risk factors that endanger health in urban societies and often act together as "partners in crime". Although air pollution and noise often co-occur in urban environments, they have typically been studied separately, with numerous studies documenting consistent effects of individual exposure on blood pressure. In the following review article, we examine the epidemiology of air pollution and noise, especially regarding the cardiovascular risk factor arterial hypertension and the underlying pathophysiology. Both environmental stressors have been shown to lead to endothelial dysfunction, oxidative stress, pronounced vascular inflammation, disruption of circadian rhythms and activation of the autonomic nervous system, all of which promote the development of hypertension and cardiovascular diseases. From a societal and political perspective, there is an urgent need to point out the potential dangers of air pollution and traffic noise in the American Heart Association (AHA)/American College of Cardiology (ACC) prevention guidelines and the European Society of Cardiology (ESC) guidelines on prevention. Therefore, an essential goal for the future is to raise awareness of environmental risk factors as important and, in particular, preventable risk factors for cardiovascular diseases.

The impact of COVID-19 pandemic on air particulate matter exposure and heart attacks: a 5-year retrospective cohort study in Taiwan (2017-2021)

Background

Heart attacks including acute ST-segment elevation myocardial infarction (STEMI) and acute decompensated heart failure (ADHF) caused from the particulate matter (PM) and air pollutant exposures are positively associated with regional air pollution severity and individual exposure. The exceptional coronavirus disease epidemic of 2019 (COVID-19) may enhance the air conditions in areas under COVID-19 pandemic. We sought to study the impact of COVID-19 pandemic on air particulate matter (PM) exposure and heart attacks in Taiwan.

Methods

This retrospective cohort study was conducted in one teaching hospital in Taichung, Taiwan. We examined emergency patients diagnosed with acute STEMI and ADHF from January 1, 2017, to March 31, 2020, (i.e., before the COVID-19 pandemic) and from April 1, 2020, to December 31, 2021, (after the COVID-19 pandemic). The effects of particulate matter with a diameter of less than 2.5 micrometers (PM2.5) and PM10 as well as temperature and humidity on environmental air pollutants were recorded. The analysis was performed with a unidirectional case-crossover research design and a conditional logistic regression model.

Results

Both PM2.5 and PM10 levels had a positive association with the risk of acute STEMI before the COVID-19 pandemic (PM2.5 adjusted odds ratio (OR): 1.016, 95% confidence interval (CI): 1.003-1.032 and PM10 adjusted OR: 1.009, 95% CI: 1.001-1.018) and ADHF (PM2.5 adjusted OR: 1.046, 95% CI: 1.034-1.067 and PM10 adjusted OR: 1.023, 95% CI: 1.027-1.047). Moreover, the results demonstrated that PM2.5 and PM10 were not associated with the risk of acute STEMI or ADHF after the COVID-19 pandemic. Reduction in PM2.5 and PM10 levels after the COVID-19 pandemic were noted. Hospital admissions for acute STEMI (7.4 and 5.8/per month) and ADHF (9.7 and 8.2/per month) also decreased (21.6 and 15.5%) after the COVID-19 pandemic.

Conclusion

In Taiwan, paradoxical reductions in PM2.5 and PM10 levels during the COVID-19 pandemic may decrease the number of hospital admissions for acute STEMI and ADHF. As the COVID-19 pandemic eases, the condition of air pollution may gradually become worse again. The governments should formulate better policies to improve the health of the public and the quality of the air.

Pollution risk and life insurance decisions: Microgeographic evidence from the United Kingdom

Recent research documents that exposure to air pollution can trigger various behavioral reactions. This article presents novel empirical evidence on the causal effect of pollution risk on life insurance decisions. We create a unique dataset by linking microgeographic air quality information to the confidential UK Wealth and Assets Survey. We identify an inverse N-shape relationship between pollution risk and life insurance adoption by exploiting the orthogonal variations in meteorological conditions. Over a given range above a threshold of exposure, rising pollution is associated with rising demand for life insurance, whereas at lower than the threshold levels of pollution, higher exposure risk reduces demand for insurance. Our findings indicate-for the first time-a nonlinear relationship between local pollution risk and life insurance demand.

Burden of Disease Due to Air Pollution in Afghanistan-Results from the Global Burden of Disease Study 2019

INTRODUCTION

Air pollution is a significant risk factor for a range of diseases and leads to substantial disease burden and deaths worldwide. This study aimed to investigate the burden of disease in Afghanistan attributed to air pollution in 2019.

METHODS

Data from the Global Burden of Disease (GBD) Study 2019 were used to investigate disability-adjusted life-years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to air pollution in Afghanistan.

RESULTS

In 2019, air pollution in Afghanistan was associated with significant health impacts, and contributed to 37,033 deaths (14.72% of total deaths), 1,849,170 DALYs (10.80% of total DALYs), 76,858 YLDs (2.07% of total YLDs), and 1,772,311 YLLs (13.23% of total YLLs). The analysis further revealed that lower respiratory infections, neonatal disorders, ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus were the leading causes of mortality and disease burden associated with air pollution in Afghanistan from 1990 to 2019. Comparative assessments between 1990 and 2019 underscored air pollution as a consistent prominent risk factor that ranked closely with other risk factors, like malnutrition, high blood pressure, and dietary risks, in contributing to deaths, DALYs, YLDs, and YLLs. In a comparative country analysis for the year 2019, Afghanistan emerged as having a substantial burden of disease due to air pollution, closely mirroring other high-burden nations like China, India, Pakistan, and Bangladesh.

DISCUSSION

Air pollution is one of the major health risk factors that significantly contribute to the burden of disease in Afghanistan, which emphasizes the urgent need for targeted interventions to address this substantial public health threat.

Exposome in ischaemic heart disease: beyond traditional risk factors

Ischaemic heart disease represents the leading cause of morbidity and mortality, typically induced by the detrimental effects of risk factors on the cardiovascular system. Although preventive interventions tackling conventional risk factors have helped to reduce the incidence of ischaemic heart disease, it remains a major cause of death worldwide. Thus, attention is now shifting to non-traditional risk factors in the built, natural, and social environments that collectively contribute substantially to the disease burden and perpetuate residual risk. Of importance, these complex factors interact non-linearly and in unpredictable ways to often enhance the detrimental effects attributable to a single or collection of these factors. For this reason, a new paradigm called the 'exposome' has recently been introduced by epidemiologists in order to define the totality of exposure to these new risk factors. The purpose of this review is to outline how these emerging risk factors may interact and contribute to the occurrence of ischaemic heart disease, with a particular attention on the impact of long-term exposure to different environmental pollutants, socioeconomic and psychological factors, along with infectious diseases such as influenza and COVID-19. Moreover, potential mitigation strategies for both individuals and communities will be discussed.

Reassessing the role of urban green space in air pollution control

The assumption that vegetation improves air quality is prevalent in scientific, popular, and political discourse. However, experimental and modeling studies show the effect of green space on air pollutant concentrations in urban settings is highly variable and context specific. We revisited the link between vegetation and air quality using satellite-derived changes of urban green space and air pollutant concentrations from 2,615 established monitoring stations over Europe and the United States. Between 2010 and 2019, stations recorded declines in ambient NO2, (particulate matter) PM10, and PM2.5 (average of -3.14% y-1), but not O3 (+0.5% y-1), pointing to the general success of recent policy interventions to restrict anthropogenic emissions. The effect size of total green space on air pollution was weak and highly variable, particularly at the street scale (15 to 60 m radius) where vegetation can restrict ventilation. However, when isolating changes in tree cover, we found a negative association with air pollution at borough to city scales (120 to 16,000 m) particularly for O3 and PM. The effect of green space was smaller than the pollutant deposition and dispersion effects of meteorological drivers including precipitation, humidity, and wind speed. When averaged across spatial scales, a one SD increase in green space resulted in a 0.8% (95% CI: -3.5 to 2%) decline in air pollution. Our findings suggest that while urban greening may improve air quality at the borough-to-city scale, the impact is moderate and may have detrimental street-level effects depending on aerodynamic factors like vegetation type and urban form.

Health benefits from the rapid reduction in ambient exposure to air pollutants after China's clean air actions: progress in efficacy and geographic equality

Clean air actions (CAAs) in China have been linked to considerable benefits in public health. However, whether the beneficial effects of CAAs are equally distributed geographically is unknown. Using high-resolution maps of the distributions of major air pollutants (fine particulate matter [PM2.5] and ozone [O3]) and population, we aimed to track spatiotemporal changes in health impacts from, and geographic inequality embedded in, the reduced exposures to PM2.5 and O3 from 2013 to 2020. We used a method established by the Global Burden of Diseases Study. By analyzing the changes in loss of life expectancy (LLE) attributable to PM2.5 and O3, we calculated the gain of life expectancy (GLE) to quantify the health benefits of the air-quality improvement. Finally, we assessed the geographic inequality embedded in the GLE using the Gini index (GI). Based on risk assessments of PM2.5 and O3, during the first stage of CAAs (2013 to 2017), the mean GLE was 1.87 months. Half of the sum of the GLE was disproportionally distributed in about one quarter of the population exposed (GI 0.44). During the second stage of CAAs (2017 to 2020), the mean GLE increased to 3.94 months and geographic inequality decreased (GI 0.18). According to our assessments, CAAs were enhanced, from the first to second stages, in terms of not only preventing premature mortality but also ameliorating health inequalities. The enhancements were related to increased sensitivity to the health effects of air pollution and synergic control of PM2.5 and O3 levels. Our findings will contribute to optimizing future CAAs.

The impact of air quality on cardiovascular health: A state of the art review

Air pollution is a global health challenge, increasing the risk of cardiovascular diseases such as heart disease, stroke, and arrhythmias. Particulate matter (PM), particularly PM2.5 and ultrafine particles (UFP), is a key contributor to the adverse effects of air pollution on cardiovascular health. PM exposure can lead to oxidative stress, inflammation, atherosclerosis, vascular dysfunction, cardiac arrhythmias, and myocardial injury. Reactive oxygen species (ROS) play a key role in mediating these effects. PM exposure can also lead to hypertension, a significant risk factor for cardiovascular disease. The COVID-19 pandemic resulted in a significant reduction of air pollutants, leading to a decline in the incidence of heart attacks and premature deaths caused by cardiovascular diseases. This review highlights the relationship between environmental air quality and cardiovascular health, elucidating the pathways through which air pollutants affect the cardiovascular system. It also emphasizes the need for increased awareness, collective efforts to mitigate the adverse effects of air pollution, and strategic policies for long-term air quality improvement to prevent the devastating effects of air pollution on global cardiovascular health.

Atmospheric particulate matter retention capacity of bark and leaves of urban tree species

Urban vegetation can effectively filter and adsorb particulate matter (PM). However, limited studies have been conducted on the PM retention capacity of tree barks. This study investigated the ability of five common urban tree species in the Yangtze River Delta region to retain PM through their barks and leaves by conducting a 14-day tree PM retention experiment on the five tree species during autumn and winter. The results showed that (1) the PM retention per unit area of bark was 6.9 times and 11.8 times higher than that of leaves during autumn and winter, respectively; (2) when considering total surface area, bark and leaves exhibited comparable PM retention capacities at the whole-plant scale; (3) the ability of bark to retain PM is species-specific, which can be attributed to different bark morphology among different tree species; and (4) bark and leaves exhibited distinct preferences for retaining PM of different particle sizes, even when exposed to similar environmental conditions. This study highlights the remarkable ability of tree bark to PM removal and provides valuable insights into the role of urban trees in mitigating PM pollution. Furthermore, these findings can provide valuable insights into studies on dry deposition modelling, urban planning, and green space management strategies.

Data-Driven Compound Identification in Atmospheric Mass Spectrometry

Aerosol particles found in the atmosphere affect the climate and worsen air quality. To mitigate these adverse impacts, aerosol particle formation and aerosol chemistry in the atmosphere need to be better mapped out and understood. Currently, mass spectrometry is the single most important analytical technique in atmospheric chemistry and is used to track and identify compounds and processes. Large amounts of data are collected in each measurement of current time-of-flight and orbitrap mass spectrometers using modern rapid data acquisition practices. However, compound identification remains a major bottleneck during data analysis due to lacking reference libraries and analysis tools. Data-driven compound identification approaches could alleviate the problem, yet remain rare to non-existent in atmospheric science. In this perspective, the authors review the current state of data-driven compound identification with mass spectrometry in atmospheric science and discuss current challenges and possible future steps toward a digital era for atmospheric mass spectrometry.

Nonlinear proinflammatory effect of short-term PM2.5 exposure: A potential role of lipopolysaccharide

The association between PM2.5 (particulate matter ≤ 2.5 µm) short-term exposure and its health effect is non-linear from the epidemiological studies. And this nonlinearity is suggested to be related with the PM2.5 heterogeneity, however, the underlying biological mechanism is still unclear. Here, a total of 38 PM2.5 filters were collected continuously for three weeks in winter Beijing, with the ambient PM2.5 varying between 10 and 270 µg/m3. Human monocytes-derived macrophages (THP-1) were treated with PM2.5 water-soluble elutes at 10 µg/mL to investigate the PM2.5 short-term exposure effect from a proinflammatory perspective. The proinflammatory cytokine tumor necrosis factor (TNF) induced by the PM2.5 elutes at equal concentrations were unequal, showing the heterogeneity of PM2.5 proinflammatory potentials. Of the various chemical and biological components, lipopolysaccharide (LPS) showed a strong positive association with the TNF heterogeneity. However, some outliers were observed among the TNF-LPS association. Specifically, for PM2.5 from relatively clean air episodes, the higher LPS amount corresponded to relatively low TNF levels. And this phenomenon was also observed in the promotion tests by treating macrophages with PM2.5 elutes dosed with additional trace LPS. Gene expression analysis indicated the involvement of oxidative-stress related genes in the LPS signaling pathway. Therefore, a potential oxidative-stress-mediated suppression on the PM2.5-borne LPS proinflammatory effect was proposed to be accounted for the outliers. Overall, the results showed the differential role of LPS in the heterogeneity of PM2.5 proinflammatory effects from a component-based perspective. Future experimental studies are needed to elucidate the signaling pathway of LPS attached on PM2.5 from different air quality episodes.

Residential Wood Combustion in Germany: A Twin-Site Study of Local Village Contributions to Particulate Pollutants and Their Potential Health Effects

Residential wood combustion contributing to airborne particulate matter (PM10) was studied for 1 year at two sites in the village of Melpitz. Significant excess pollution was observed at the Melpitz center compared to that at the TROPOS research station Melpitz reference site, situated only 700 m away. Local concentration increments at the village site for the combustion PM constituents organic carbon, elemental carbon, levoglucosan, and benzo[a]pyrene were determined under appropriate wind directions, and their winter mean values were 0.7 μg m-3, 0.3 μg m-3, 0.1 μg m-3, and 0.4 ng m-3, representing relative increases over the regional background concentration of 24, 70, 61, and 107%, respectively. Yearly, weekly, and diurnal profiles of village increments suggest residential heating as the dominant source of this excess pollution, mainly originating from wood combustion. Receptor modeling using positive matrix factorization quantified 4.5 μg m-3 wood combustion PM at the village site, representing an increment of 1.9 μg m-3 and an increase of ∼75% over the 2.6 μg m-3 regional background wood combustion PM. This increment varied with season, temperature, and boundary layer height and reached daily mean values of 4-6 μg m-3 during unfavorable meteorological conditions. Potential health effects were estimated and resulted in an all-cause mortality from short-term exposure to wood combustion PM of 2.1 cases per 100,000 inhabitants and year for areas with similar wood smoke levels as observed in Melpitz. The excess cancer risk from the concentrations of polycyclic aromatic hydrocarbons was 6.4 per 100,000. For both health metrics, the very local contributions from the village itself were about 40-50%, indicating a strong potential for mitigation through local-scale policies. A compilation of literature data demonstrates wood combustion to represent a major source of PM pollution in Germany, with average winter-time contributions of 10-20%. The present study quantifies the negative impacts of heating with wood in rural residential areas, where the continuous monitoring of air quality is typically lacking. Further regulation of this PM source is warranted in order to protect human health.

Influence of aerosol acidity and organic ligands on transition metal solubility and oxidative potential of fine particulate matter in urban environments

The adverse health effects of air pollution around the world have been associated with the inhalation of fine particulate matter (PM2.5). Such outcomes are thought to be related to the induction of oxidative stress due to the excess formation of reactive oxygen species (ROS) in the respiratory and cardiovascular systems. The ability of airborne chemicals to deplete antioxidants and to form ROS is known as oxidative potential (OP). Here we studied the influence of aerosol acidity and organic ligands on the solubility of transition metals, in particular iron (Fe) and copper (Cu), and on the OP of PM2.5 from Canadian National Air Pollution Surveillance urban sites in Toronto, Vancouver, and Hamilton. Using chemical assays and model simulations of the lung redox chemistry, we quantified ROS formation in the lung lining fluid, targeting superoxide anion (O2•-), hydrogen peroxide (H2O2), and hydroxyl radical (•OH), as well as the PM2.5 redox potential (RP). Experimental •OH formation (OPOH) showed high correlations with RP and model-predicted ROS metrics. Both aerosol acidity and oxalate content enhanced the solubility of transition metals, with oxalate showing a stronger association. While experimental OP metrics were primarily associated with species of primary origin such as elemental carbon, Fe, and Cu, model-predicted ROS were associated with secondary processes including proton- and ligand-mediated dissolution of Fe. Model simulations showed that water-soluble Cu was the main contributor to O2•- formation, while water-soluble Fe dominated the formation of highly reactive •OH radical, particularly at study sites with highly acidic aerosol and elevated levels of oxalate. This study underscores the importance of reducing transition metal emissions in urban environments to improve population health.

Molecular insights into microbial transformation of bioaerosol-derived dissolved organic matter discharged from wastewater treatment plant

Wastewater treatment plants (WWTP) are important sources of aerosol-derived dissolved organic matter (ADOM) which may threaten human health via the respiratory system. In this study, aerosols were sampled from a typical WWTP to explore the chemical molecular diversity, molecular ecological network, and potential toxicities of the ADOM in the aerosols. The high fluorescence index (>1.9) and biological index (0.66-1.17) indicated the strong autogenous microbial source characteristics of the ADOM in the WWTP. DOM and microbes in the wastewater were aerosolized due to strong agitation and bubbling in the treatment processes, and contributed to 74 % and 75 %, respectively, of the ADOM and microbes in the aerosols. The ADOM was mainly composed of CHO and CHOS accounting for 35 % and 29 % of the total number of molecules, respectively, with lignin-like (69 %) as the major constituent. 49 % of the ADOM transformations were thermodynamically limited, and intragroup transformations were easier than intergroup transformations. Bacteria in the aerosols involved in ADOM transformations exhibited both cooperative and divergent behaviors and tended to transform carbohydrate-like and amino sugar/protein-like into recalcitrant lignin-like. The microbial compositions were affected by atmosphere temperature and humidity indirectly by modulating the properties of ADOM. Tannin-like, lignin-like, and unsaturated hydrocarbon-like molecules in the ADOM were primary toxicity contributors, facilitating the expression of inflammatory factors IL-β (2.2-5.4 folds), TNF-α (3.5-7.0 folds), and IL-6 (3.5-11.2 folds), respectively.

Monitoring gaseous pollutants using passive sampling in the Philadelphia region

Air pollution can have deleterious impacts on human health and the environment. Historically, air pollution studies have focused more on cities. However, it is also important to consider the impact on large suburban populations living closer to the major cities. In this study, nitrogen oxides (nitrogen dioxide and nitric oxide), sulfur dioxide, ozone, and ammonia concentrations were measured from fifteen sites in the Greater Philadelphia area, Pennsylvania, USA using Ogawa passive samplers from September 2021 to May 2022. The fall season had the highest mean NOx concentrations (11.03 ± 4.51 ppb), and spring had the highest mean O3 concentration (18.65 ± 6.71 ppb) compared to other seasons. NOx concentrations were higher at suburban (30.43 ± 33.79 ppb) and urban sites (22.49 ± 12.54 ppb) compared to semi-rural sites (11.08 ± 9.20 ppb). SO2 was not detected in most of the measurements. The positive statistically significant correlation between NO and NH3 in urban (R2 = 0.33, p-value <0.05) and suburban sites (R2 = 0.37, p-value <0.05) during winter and spring, respectively, suggests a high attribution of traffic emissions to NH3 at urban and suburban sites. Influence of traffic emissions on air pollutant values for the study region is also supported by similar NOx concentrations between suburban and urban sites as well as decreasing NO2/NOx ratios with increased distance from expressways. This study shows that passive sampling can be effectively used for assessing spatial and seasonal variations in air pollutants within an area of diverse land use.Implications: This study presents the findings of temporal and seasonal patterns for nitrogen dioxide, nitric oxide, tropospheric ozone, and ammonia at urban, suburban, and semi-rural areas of the greater Philadelphia region. The main objective of the study is to monitor air pollution in suburban and semi-rural areas which are not monitored for air pollution. We monitored from a total of fifteen sites in three seasons to assess air pollution in suburban and semi-rural areas near the major city in the United States - Philadelphia. The findings are important to learn how air quality is affected in suburban and semi-rural areas near the major city. The study also shows the useful application of inexpensive passive sampling technique for measuring air pollution.

A Gender Differentiated Analysis of Healthy Life Expectancy in South Asia: The Role of Greenhouse Gas Emission

The sluggish progress concerning SDG-9 and SDG 13 has made South Asia an epicentre of household and ambient greenhouse gases emissions. Furthermore, the regional progress concerning attainment of SDG-3 is considerably low. The major research objectives are twofold. First, to explore the impact of GHGs emissions from agriculture, transportation, and manufacturing sector on disaggregated life expectancy. Second, to examine the mitigating impact of renewable energy use, trade integration, and human capital development for practice policy recommendations. These research objectives are realized by employing recently advanced cross-sectional auto regressive distributed lag (CS-ARDL) model on panel data of five South Asian countries such as Bangladesh, India, Pakistan, Nepal, and Sri Lanka from 1990 to 2019. The estimation outcome reveals that the emissions from transportation, manufacturing, and agricultural sectors significantly deteriorate healthy life expectancy of male and female healthy life expectancy in South Asia with different intensity. Especially, we find that long-run impact of GHG is more profound on male healthy life expectancy than female life expectancy. The result further shows that renewable energy and human capital substantially improve healthy life expectancy, whereas the effects of trade integration are insignificant. The finding of moderating variables shows that renewable energy, human capital development, and trade integration have high potential to reduce GHGs emissions. The findings of this study urge South Asia for investments in human capital development and renewable energy along with fostering regional integration to decrease GHG and improve healthy life expectancy.

[Climate Crisis: What Gastrointestinal Complications of this Medical Emergency Should We Be Aware Of?]

INTRODUCTION

The climate crisis has serious consequences for many areas of life. This applies in particular to human health - also in Europe. While cardiovascular, pneumological and dermatological diseases related to the climate crisis are often discussed, the crisis' significant gastroenterological consequences for health must also be considered.

METHODS

A literature search (Pubmed, Cochrane Library) was used to identify papers with relevance particularly to the field of gastroenterology in (Central) Europe. Findings were supplemented and discussed by an interdisciplinary team.

RESULTS

The climate crisis impacts the frequency and severity of gastrointestinal diseases in Europe due to more frequent and severe heat waves, flooding and air pollution. While patients with intestinal diseases are particularly vulnerable to acute weather events, the main long-term consequences of climate change are gastrointestinal cancer and liver disease. In addition to gastroenteritis, other infectious diseases such as vector-borne diseases and parasites are important in the context of global warming, heat waves and floods.

DISCUSSION

Adaptation strategies must be consistently developed and implemented for vulnerable groups. Patients at risk should be informed about measures that can be implemented individually, such as avoiding heat, ensuring appropriate hydration and following hygiene instructions. Recommendations for physical activity and a healthy and sustainable diet are essential for the prevention of liver diseases and carcinomas. Measures for prevention and the promotion of resilience can be supported by the physicians at various levels. In addition to efforts fostering sustainability in the immediate working environment, a system-oriented commitment to climate protection is important.

Subchronic exposure to 1,2-naphthoquinone induces adipose tissue inflammation and changes the energy homeostasis of mice, partially due to TNFR1 and TLR4

Air pollution affects energy homeostasis detrimentally. Yet, knowledge of how each isolated pollutant can impact energy metabolism remains incomplete. The present study was designed to investigate the distinct effects of 1,2-naphthoquinone (1,2-NQ) on energy metabolism since this pollutant increases at the same rate as diesel combustion. In particular, we aimed to determine in vivo effects of subchronic exposure to 1,2-NQ on metabolic and inflammatory parameters of wild-type mice (WT) and to explore the involvement of tumor necrosis factor receptor 1 (TNFR1) and toll-like receptor 4 (TLR4) in this process. Males WT, TNFR1KO, and TLR4KO mice at eight weeks of age received 1,2-NQ or vehicle via nebulization five days a week for 17 weeks. In WT mice, 1,2-NQ slightly decreased the body mass compared to vehicle-WT. This effect was likely due to a mild food intake reduction and increased energy expenditure (EE) observed after six weeks of exposure. After nine weeks of exposure, we observed higher fasting blood glucose and impaired glucose tolerance, whereas insulin sensitivity was slightly improved compared to vehicle-WT. After 17 weeks of 1,2-NQ exposure, WT mice displayed an increased percentage of M1 and a decreased (p = 0.057) percentage of M2 macrophages in adipose tissue. The deletion of TNFR1 and TLR4 abolished most of the metabolic impacts caused by 1,2-NQ exposure, except for the EE and insulin sensitivity, which remained high in these mice under 1,2-NQ exposure. Our study demonstrates for the first time that subchronic exposure to 1,2-NQ affects energy metabolism in vivo. Although 1,2-NQ increased EE and slightly reduced feeding and body mass, the WT mice displayed higher inflammation in adipose tissue and impaired fasting blood glucose and glucose tolerance. Thus, in vivo subchronic exposure to 1,2-NQ is harmful, and TNFR1 and TLR4 are partially involved in these outcomes.

Air pollution deaths attributable to fossil fuels: observational and modelling study

OBJECTIVES

To estimate all cause and cause specific deaths that are attributable to fossil fuel related air pollution and to assess potential health benefits from policies that replace fossil fuels with clean, renewable energy sources.

DESIGN

Observational and modelling study.

METHODS

An updated atmospheric composition model, a newly developed relative risk model, and satellite based data were used to determine exposure to ambient air pollution, estimate all cause and disease specific mortality, and attribute them to emission categories.

DATA SOURCES

Data from the global burden of disease 2019 study, observational fine particulate matter and population data from National Aeronautics and Space Administration (NASA) satellites, and atmospheric chemistry, aerosol, and relative risk modelling for 2019.

RESULTS

Globally, all cause excess deaths due to fine particulate and ozone air pollution are estimated at 8.34 million (95% confidence interval 5.63 to 11.19) deaths per year. Most (52%) of the mortality burden is related to cardiometabolic conditions, particularly ischaemic heart disease (30%). Stroke and chronic obstructive pulmonary disease both account for 16% of mortality burden. About 20% of all cause mortality is undefined, with arterial hypertension and neurodegenerative diseases possibly implicated. An estimated 5.13 million (3.63 to 6.32) excess deaths per year globally are attributable to ambient air pollution from fossil fuel use and therefore could potentially be avoided by phasing out fossil fuels. This figure corresponds to 82% of the maximum number of air pollution deaths that could be averted by controlling all anthropogenic emissions. Smaller reductions, rather than a complete phase-out, indicate that the responses are not strongly non-linear. Reductions in emission related to fossil fuels at all levels of air pollution can decrease the number of attributable deaths substantially. Estimates of avoidable excess deaths are markedly higher in this study than most previous studies for these reasons: the new relative risk model has implications for high income (largely fossil fuel intensive) countries and for low and middle income countries where the use of fossil fuels is increasing; this study accounts for all cause mortality in addition to disease specific mortality; and the large reduction in air pollution from a fossil fuel phase-out can greatly reduce exposure.

CONCLUSION

Phasing out fossil fuels is deemed to be an effective intervention to improve health and save lives as part the United Nations' goal of climate neutrality by 2050. Ambient air pollution would no longer be a leading, environmental health risk factor if the use of fossil fuels were superseded by equitable access to clean sources of renewable energy.

Redox and inflammatory mechanisms linking air pollution particulate matter with cardiometabolic derangements

Air pollution is the largest environmental risk factor for disease and premature death. Among the different components that are present in polluted air, fine particulate matter below 2.5 μm in diameter (PM2.5) has been identified as the main hazardous constituent. PM2.5 mainly arises from fossil fuel combustion during power generation, industrial processes, and transportation. Exposure to PM2.5 correlates with enhanced mortality risk from cardiovascular diseases (CVD), such as myocardial infarction and stroke. Over the last decade, it has been increasingly suggested that PM2.5 affects CVD already at the stage of risk factor development. Among the multiple biological mechanisms that have been described, the interplay between oxidative stress and inflammation has been consistently highlighted as one of the main drivers of pulmonary, systemic, and cardiovascular effects of PM2.5 exposure. In this context, PM2.5 uptake by tissue-resident immune cells in the lung promotes oxidative and inflammatory mediators release that alter tissue homeostasis at remote locations. This pathway is central for PM2.5 pathogenesis and might account for the accelerated development of risk factors for CVD, including obesity and diabetes. However, transmission and end-organ mechanisms that explain PM2.5-induced impaired function in metabolic active organs are not completely understood. In this review, the main features of PM2.5 physicochemical characteristics related to PM2.5 ability to induce oxidative stress and inflammation will be presented. Hallmark and recent epidemiological and interventional studies will be summarized and discussed in the context of current air quality guidelines and legislation, knowledge gaps, and inequities. Lastly, mechanistic studies at the intersection between redox metabolism, inflammation, and function will be discussed, with focus on heart and adipose tissue alterations. By offering an integrated analysis of PM2.5-induced effects on cardiometabolic derangements, this review aims to contribute to a better understanding of the pathogenesis and potential interventions of air pollution-related CVD.

General Public Knowledge, Attitude, and Practice Regarding the Impact of Air Pollution and Cardiopulmonary Diseases in Jeddah, Saudi Arabia

Introduction Air pollution is a critical public health issue associated with various respiratory and cardiovascular diseases. The lungs and heart are the organs most affected by air pollution, and damage to these organs is strongly associated with inhaled particulate matter produced by burning fossil fuels. Household and ambient air pollution have been closely linked to lower respiratory infections, with ambient air pollution alone estimated to be responsible for millions of deaths globally each year. Therefore, this study aimed to assess the general public knowledge attitude and practice regarding air pollution and cardiopulmonary morbidity in Jeddah, Saudi Arabia. Methods The study was conducted in Saudi Arabia using a self-administered questionnaire distributed through popular social media apps. A snowball sampling technique was used, including only Saudi citizens aged 18 or older. The questionnaire consisted of 30 questions derived from a comprehensive literature review on the subject matter. Questions were validated through face validity, pilot testing, and Cronbach's alpha reliability measurement. The questionnaire included questions on demographic data, knowledge of air pollution, the relationship between air pollution and cardiopulmonary diseases, and attitudes and practices toward lowering exposure to air pollution. Results The study included 649 participants, with a mean age of 32.11 ± 13.47 years, and over half were females (54.7%). Most participants were aware of outdoor and indoor air pollution, but only a tiny percentage recognized cooking as a primary indoor source of pollution. However, the majority believed that indoor pollution could contribute to outdoor pollution. Participants associated air pollution with cardiopulmonary diseases, mainly secondhand tobacco smoke and outdoor air pollution caused by factories and industrial facilities. Knowledge and practice levels varied, with older individuals, females, and those in non-health-related occupations having higher levels of knowledge. Positive attitudes, particularly believing that moving to a less polluted area improves health, were associated with better knowledge. Females exhibited better air pollution-related practices, and there was a positive correlation between knowledge and practice scores. Conclusion The study highlighted the need for targeted public health campaigns to improve awareness and promote healthier practices, particularly among young adults, to mitigate the potential health impacts of air pollution, especially cardiopulmonary health.

Highly Breathable, Stretchable, and Tailorable TPU Foam for Flexible Gas Sensors

Continuous real-time monitoring of air quality is of great significance in the realms of environmental monitoring, personal safety, and healthcare. Recently, flexible gas sensors have gained great popularity for their potential to be integrated into various smart wearable electronics and display devices. However, the development of gas sensors with superior sensitivity, breathability, and stretchability remains a challenge. Here, a new high porosity thermoplastic polyurethane (HP-TPU) foam was reported for gas sensors, which exhibited large three-dimensional network structures and excellent mechanical properties. The HP-TPU foam was achieved by using a simple steam-induced method, which was suitable for mass production. The unique structure endowed this foam with 77.5% porosity, 260% strain ability, and 0.45 MPa Young's modulus, which improved 35, 31, and 80%, respectively, compared to previously reported traditional TPU foam (T-TPU) prepared by the drying method. In addition, the foam presented high gas permeability (312 g/m-2, 24 h) and excellent stability, and it remained undamaged even after 2000 cycles at 70% strain. The sensing material was coated on a PET flexible interdigital electrode and sandwiched between two HP-TPU foam layers for a gas sensitivity test. Due to the easy diffusion of gas between the pores and contact with the sensing materials, the HP-TPU foam exhibited a significant reduction of 85% in average response time and 46% in average recovery time, compared to the T-TPU foam. A wearable sensing device, comprising sensing, data processing, and wireless transmission modules, was successfully developed to enable outdoor testing and achieved a detection range at the ppb level. Finally, the cytotoxicity test results confirmed that this flexible gas sensor did not harm human health. These results proved that this HP-TPU foam was an ideal matrix for the flexible gas sensor, exhibiting great application potential in the fields of seamless human-machine integration.

The global and regional air quality impacts of dietary change

Air pollution increases cardiovascular and respiratory-disease risk, and reduces cognitive and physical performance. Food production, especially of animal products, is a major source of methane and ammonia emissions which contribute to air pollution through the formation of particulate matter and ground-level ozone. Here we show that dietary changes towards more plant-based flexitarian, vegetarian, and vegan diets could lead to meaningful reductions in air pollution with health and economic benefits. Using systems models, we estimated reductions in premature mortality of 108,000-236,000 (3-6%) globally, including 20,000-44,000 (9-21%) in Europe, 14,000-21,000 (12-18%) in North America, and 49,000-121,000 (4-10%) in Eastern Asia. We also estimated greater productivity, increasing economic output by USD 0.6-1.3 trillion (0.5-1.1%). Our findings suggest that incentivising dietary changes towards more plant-based diets could be a valuable mitigation strategy for reducing ambient air pollution and the associated health and economic impacts, especially in regions with intensive agriculture and high population density.

The contribution of the exposome to the burden of cardiovascular disease

Large epidemiological and health impact assessment studies at the global scale, such as the Global Burden of Disease project, indicate that chronic non-communicable diseases, such as atherosclerosis and diabetes mellitus, caused almost two-thirds of the annual global deaths in 2020. By 2030, 77% of all deaths are expected to be caused by non-communicable diseases. Although this increase is mainly due to the ageing of the general population in Western societies, other reasons include the increasing effects of soil, water, air and noise pollution on health, together with the effects of other environmental risk factors such as climate change, unhealthy city designs (including lack of green spaces), unhealthy lifestyle habits and psychosocial stress. The exposome concept was established in 2005 as a new strategy to study the effect of the environment on health. The exposome describes the harmful biochemical and metabolic changes that occur in our body owing to the totality of different environmental exposures throughout the life course, which ultimately lead to adverse health effects and premature deaths. In this Review, we describe the exposome concept with a focus on environmental physical and chemical exposures and their effects on the burden of cardiovascular disease. We discuss selected exposome studies and highlight the relevance of the exposome concept for future health research as well as preventive medicine. We also discuss the challenges and limitations of exposome studies.

Sex Associations Between Air Pollution and Estimated Atherosclerotic Cardiovascular Disease Risk Determination

Objective: The purpose of this study was to investigate the sex correlations of particulate matters (PM2.5, PM10, PM2.5-10), NO2 and NOx with ASCVD risk in the UK Biobank population. Methods: Among 285,045 participants, pollutants were assessed and correlations between ASCVD risk were stratified by sex and estimated using multiple linear and logistic regressions adjusted for length of time at residence, education, income, physical activity, Townsend deprivation, alcohol, smocking pack years, BMI and rural/urban zone. Results: Males presented higher ASCVD risk than females (8.63% vs. 2.65%, p < 0.001). In males PM2.5, PM10, NO2, and NOx each were associated with an increased ASCVD risk >7.5% in the adjusted logistic models, with ORs [95% CI] for a 10 μg/m3 increase were 2.17 [1.87-2.52], 1.15 [1.06-1.24], 1.06 [1.04-1.08] and 1.05 [1.04-1.06], respectively. In females, the ORs for a 10 μg/m3 increase were 1.55 [1.19-2.05], 1.22 [1.06-1.42], 1.07 [1.03-1.10], and 1.04 [1.02-1.05], respectively. No association was observed in both sexes between ASCVD risk and PM2.5-10. Conclusion: Our findings may suggest the possible actions of air pollutants on ASCVD risk.

Tension as a key factor in skin responses to pollution

Being the more apparent organ exposed to the outdoor stressors, the effect of pollution on the skin has been widely studied in the last few decades. Although UV light is known as the most aggressive stressor to which our cutaneous tissue is daily exposed, other components of the tropospheric pollution have also shown to affect skin health and functionality. Among them, ozone has been proven to be one of the most toxic due to its high reactivity with the epidermal lipids. Studying the cutaneous effect of pollution in a laboratory setting presents challenges, therefore it becomes critical to employ appropriate and tailored models that aim to answer specific questions. Several skin models are available nowadays: in vitro models (2D cell lines and 3D cutaneous tissues), ex vivo skin explants and in vivo approaches (animals and humans). Although in the last 20 years researchers developed skin models that closely resemble human skin (3D cutaneous tissues), ex vivo skin explants still remain one of the best models to study cutaneous responses. Unfortunately, one important cutaneous property that is not present in the traditional ex vivo human skin explants is the physiological tension, which has been shown to be a cardinal player in skin structure, homeostasis, functional properties and responses to external stimuli. For this reason, in this study, to confirm and further comprehend the harmful mechanism of ozone exposure on the integumentary system, we have performed experiments using the state of art in cutaneous models: the innovative TenSkin™ model in which ex vivo human skin explants are cultured under physiologically relevant tension during the whole experimental procedure. Specifically, we were interested in corroborating previous findings showing that ozone exposure modulates the expression of cutaneous antimicrobial peptides (AMPs). The present work demonstrates that cutaneous exposure to ozone induces AMPs gene and protein levels (CAMP/LL-37, hBD2, hBD3) and that the presence of tension can further modulate their expression. In addition, different responses between tension and non-tension cultured skin were also observed during the evaluation of OxInflammatory markers [cyclooxygenase-2 (COX2), aryl hydrocarbon receptor (AhR), matrix-metallo-proteinase 9 (MMP9) and 4-hydroxy-nonenal (4HNE)]. This current study supports our previous findings confirming the ability of pollution to induce the cutaneous expression of AMPs via redox signaling and corroborates the principle that skin explants are a good and reliable model to study skin responses even though it underlines the need to holistically consider the role of skin tension before extrapolating the data to real life.

Research trends on the relationship between air pollution and cardiovascular diseases in 2013-2022 - A scientometric analysis

Exposure to air pollution is linked with an elevated risk of cardiovascular diseases (CVDs) and CVDs-related mortality. However, there is a shortage of scientometric analysis on this topic. Therefore, we propose a scientometric study to explore research hotspots and directions in this topical field over the past decade. We used the core collection of Web of Science (WoS) to obtain relevant publications and analyzed them using Excel, the Bibliometix R-package, CiteSpace, and VOSviewer. The study covered various aspects such as annual publications, highly cited papers, co-cited references, journals, authors, countries, organizations, and keywords. Research on air pollution and CVDs has remarkable increase over the past decade, with notable researchers including Kan H, Brook RD, Peters A, and Schwartz J. The 3144 articles were published by 4448 institutions in 131 countries/regions. The leading countries were the USA and China, and the most published journal was Environmental Research. Mortality, hospital admissions, oxidative stress, inflammation, long-term exposure, fine particulate matter, and PM2.5 are the top areas that merit further investigation and hold significant potential for advancing our understanding of the complex relationship between air pollution and CVDs.

Spatiotemporal evolution and characteristics of worldwide life expectancy

Exploring global differences in life expectancy can facilitate the development of strategies to narrow regional disparities. However, few researchers have systematically examined patterns in the evolution of worldwide life expectancy over a long time period. Spatial differences among 181 countries in 4 types of worldwide life expectancy patterns from 1990 to 2019 were investigated via geographic information system (GIS) analysis. The aggregation characteristics of the spatiotemporal evolution of life expectancy were revealed by local indicators of spatial association. The analysis employed spatiotemporal sequence-based kernel density estimation and explored the differences in life expectancy among regions with the Theil index. We found that the global life expectancy progress rate shows upward then downward patterns over the last 30 years. Female have higher rates of spatiotemporal progression in life expectancy than male, with less internal variation and a wider spatial aggregation. The global spatial and temporal autocorrelation of life expectancy shows a weakening trend. The difference in life expectancy between male and female is reflected in both intrinsic causes of biological differences and extrinsic causes such as environment and lifestyle habits. Investment in education pulls apart differences in life expectancy over long time series. These results provide scientific guidelines for obtaining the highest possible level of health in countries around the world.

Air mapping during COVID-19 and association between air pollutants and physiochemical parameters of the plants using structural equal modeling: a case study

In urban areas around the world, air pollution introduced by vehicular movement is a key concern. However, restricting vehicular traffic during the COVID-19 shutdown improved air quality to some extent. This study was conducted out in the smart city of Bhubaneswar, which is also the state capital of Odisha, India. The study has tried to map Bhubaneswar by collecting the air quality data before, during, and after the COVID lockdown of six air quality monitoring stations present in Bhubaneswar established under "National Ambient Air Monitoring Program" (NAMP). Furthermore, plants, which are the most vulnerable to air pollution, can show a variety of visible changes depending on their level of sensitivity. Moreover, leaves of Mangifera indica, Monoon longifolium, Azadirachta indica, Millettia pinnata, Aegle marmelos were collected from nearby of six air monitoring stations to assess the "Air Pollution Tolerance Index." M. indica was found to be intermediately tolerant, and all of the other species were found to be sensitive. The structural equation modeling results also revealed a significant relationship between total chlorophyll content, relative water content, ascorbic acid content, leaf extract pH, APTI with species, air quality index, and PM10.

Global air pollution exposure and poverty

Air pollution is one of the leading causes of health complications and mortality worldwide, especially affecting lower-income groups, who tend to be more exposed and vulnerable. This study documents the relationship between ambient air pollution exposure and poverty in 211 countries and territories. Using the World Health Organization's (WHO) 2021 revised fine particulate matter (PM2.5) thresholds, we show that globally, 7.3 billion people are directly exposed to unsafe average annual PM2.5 concentrations, 80 percent of whom live in low- and middle-income countries. Moreover, 716 million of the world's lowest income people (living on less than $1.90 per day) live in areas with unsafe levels of air pollution, especially in Sub-Saharan Africa. Air pollution levels are particularly high in lower-middle-income countries, where economies tend to rely more heavily on polluting industries and technologies. These findings are based on high-resolution air pollution and population maps with global coverage, as well as subnational poverty estimates based on harmonized household surveys.

Wildfire smoke exposure and early childhood respiratory health: a study of prescription claims data

Wildfire smoke is associated with short-term respiratory outcomes including asthma exacerbation in children. As investigations into developmental wildfire smoke exposure on children's longer-term respiratory health are sparse, we investigated associations between developmental wildfire smoke exposure and first use of respiratory medications. Prescription claims from IBM MarketScan Commercial Claims and Encounters database were linked with wildfire smoke plume data from NASA satellites based on Metropolitan Statistical Area (MSA). A retrospective cohort of live infants (2010-2016) born into MSAs in six western states (U.S.A.), having prescription insurance, and whose birthdate was estimable from claims data was constructed (N = 184,703); of these, gestational age was estimated for 113,154 infants. The residential MSA, gestational age, and birthdate were used to estimate average weekly smoke exposure days (smoke-day) for each developmental period: three trimesters, and two sequential 12-week periods post-birth. Medications treating respiratory tract inflammation were classified using active ingredient and mode of administration into three categories:: 'upper respiratory', 'lower respiratory', 'systemic anti-inflammatory'. To evaluate associations between wildfire smoke exposure and medication usage, Cox models associating smoke-days with first observed prescription of each medication category were adjusted for infant sex, birth-season, and birthyear with a random intercept for MSA. Smoke exposure during postnatal periods was associated with earlier first use of upper respiratory medications (1-12 weeks: hazard ratio (HR) = 1.094 per 1-day increase in average weekly smoke-day, 95%CI: (1.005,1.191); 13-24 weeks: HR = 1.108, 95%CI: (1.016,1.209)). Protective associations were observed during gestational windows for both lower respiratory and systemic anti-inflammatory medications; it is possible that these associations may be a consequence of live-birth bias. These findings suggest wildfire smoke exposure during early postnatal developmental periods impact subsequent early life respiratory health.