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Ruggles A, Benakis C. Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut- and Lung-Brain Axis. Cells 2024; 13:803. [PMID: 38786027 PMCID: PMC11119296 DOI: 10.3390/cells13100803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Recent evidence indicates that exposure to environmental toxins, both short-term and long-term, can increase the risk of developing neurological disorders, including neurodegenerative diseases (i.e., Alzheimer's disease and other dementias) and acute brain injury (i.e., stroke). For stroke, the latest systematic analysis revealed that exposure to ambient particulate matter is the second most frequent stroke risk after high blood pressure. However, preclinical and clinical stroke investigations on the deleterious consequences of environmental pollutants are scarce. This review examines recent evidence of how environmental toxins, absorbed along the digestive tract or inhaled through the lungs, affect the host cellular response. We particularly address the consequences of environmental toxins on the immune response and the microbiome at the gut and lung barrier sites. Additionally, this review highlights findings showing the potential contribution of environmental toxins to an increased risk of stroke. A better understanding of the biological mechanisms underlying exposure to environmental toxins has the potential to mitigate stroke risk and other neurological disorders.
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Affiliation(s)
| | - Corinne Benakis
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, 81337 Munich, Germany;
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Yang K, Chen R. Association between cooking fuel exposure and respiratory health: Longitudinal evidence from the China Health and Retirement Longitudinal Study (CHARLS). ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 275:116247. [PMID: 38520808 DOI: 10.1016/j.ecoenv.2024.116247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
The epidemiological evidences for the association between cooking fuel exposure and respiratory health were inconsistent, and repeated-measures prospective evaluation of cooking fuel exposure was still lacking. We assessed the longitudinal association of chronic lung disease (CLD) and lung function with cooking fuel types among Chinese adults aged ≥ 40 years. In this prospective, nationwide representative cohort of the China Health and Retirement Longitudinal Study from 2011 to 2018, 9004 participants from 28 provinces in China were included. CLD was identified based on self-reported physician diagnosis in 2018. Lung function was assessed by peak expiratory flow (PEF) in 2011, 2013 and 2015. Multivariable logistic and linear mixed-effects repeated-measures models were conducted to measure the associations of CLD and PEF with cooking fuel types. Three-level mixed-effects model was performed as sensitivity analysis. Among the participants, 3508 and 3548 participants used persistent solid and clean cooking fuels throughout the survey, and 1948 participants who used solid cooking fuels at baseline switched to clean cooking fuels. Use of persistent clean cooking fuels (adjusted odds ratio [aOR] = 0.73, 95 % confidence interval [CI]: 0.61, 0.88) and switch of solid fuels to clean fuels (aOR = 0.81, 95 % CI: 0.67, 0.98) were associated with lower risk of CLD. The use of clean cooking fuels throughout the survey and switch of solid fuels to clean fuels in 2013 were also significantly associated with higher PEF level. Similar results were observed in stratified analyses and different statistical models. The evidence from CHARLS cohort suggested that reducing solid cooking fuel exposure was associated with lower risk of CLD and better lung function. Given the recent evidence, improving household air quality will reduce the burden of chronic lung diseases.
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Affiliation(s)
- Kai Yang
- Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, First Affiliated Hospital of Southern University of Science and Technology (Shenzhen People's Hospital, Second Clinical Medical College of Jinan University), Shenzhen 518001, China
| | - Rongchang Chen
- Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, First Affiliated Hospital of Southern University of Science and Technology (Shenzhen People's Hospital, Second Clinical Medical College of Jinan University), Shenzhen 518001, China.
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3
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Landguth EL, Knudson J, Graham J, Orr A, Coyle EA, Smith P, Semmens EO, Noonan C. Seasonal extreme temperatures and short-term fine particulate matter increases pediatric respiratory healthcare encounters in a sparsely populated region of the intermountain western United States. Environ Health 2024; 23:40. [PMID: 38622704 PMCID: PMC11017546 DOI: 10.1186/s12940-024-01082-2] [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: 10/12/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Evaluating while accounting for these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health is becoming more important. METHODS We explored short-term exposure to air pollution on children's respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated healthcare events. The main outcome measure included individual-based address located respiratory-related healthcare visits for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for ages 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis with distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 14 prior-days modified by temperature or season. RESULTS For asthma, increases of 1 µg/m3 in PM2.5 exposure 7-13 days prior a healthcare visit date was associated with increased odds that were magnified during median to colder temperatures and winter periods. For LRTIs, 1 µg/m3 increases during 12 days of cumulative PM2.5 with peak exposure periods between 6-12 days before healthcare visit date was associated with elevated LRTI events, also heightened in median to colder temperatures but no seasonal effect was observed. For URTIs, 1 unit increases during 13 days of cumulative PM2.5 with peak exposure periods between 4-10 days prior event date was associated with greater risk for URTIs visits that were intensified during median to hotter temperatures and spring to summer periods. CONCLUSIONS Delayed, short-term exposure increases of PM2.5 were associated with elevated odds of all three pediatric respiratory healthcare visit categories in a sparsely population area of the inter-Rocky Mountains, USA. PM2.5 in colder temperatures tended to increase instances of asthma and LRTIs, while PM2.5 during hotter periods increased URTIs.
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Affiliation(s)
- Erin L Landguth
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Jonathon Knudson
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Jon Graham
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Mathematical Sciences, University of Montana, Missoula, USA
| | - Ava Orr
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Emily A Coyle
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Paul Smith
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
- Pediatric Pulmonology, Community Medical Center, Missoula, MT, USA
| | - Erin O Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Curtis Noonan
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Baek MS, Shin H, Gu KM, Jung HI, Kim WY, Jung JW, Shin JW, Jung SY, Kim JY. Sex differences in chronic obstructive pulmonary disease characteristics: the Korea National Health and Nutrition Examination Survey 2007-2018. Korean J Intern Med 2024; 39:137-147. [PMID: 38092558 PMCID: PMC10790036 DOI: 10.3904/kjim.2023.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/14/2023] [Accepted: 10/19/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND/AIMS Chronic obstructive pulmonary disease (COPD) is less prevalent in females than males, but it affects mortality in females. There may be sex differences in the clinical characteristics of COPD. METHODS We analyzed the Korea National Health and Nutrition Examination Survey dataset from 2007 to 2018. We compared the clinical characteristics and comorbidities in subjects with COPD according to sex. We adjusted the multivariate logistic regression of lung cancer prevalence according to COPD and sex by age and smoking amount. RESULTS Females with COPD tended to be older than males with COPD (64.1 ± 0.4 yr vs. 62.3 ± 0.2 yr, respectively, p < 0.001). Approximately 89% of males with COPD had a smoking history, while 86% of females with COPD were non-smokers (p < 0.001). Household income was lower (p < 0.001) and asthma and overall malignancy were more prevalent in females with COPD than males with COPD (25.5 vs. 11.6%, respectively, p < 0.001; (6.3 vs. 5.4%, respectively, p < 0.001). However, lung cancer was more common in males with COPD than females with COPD (0.9 vs. 0.1%, respectively, p < 0.001). Lung cancer prevalence increased in males with moderate COPD compared to subjects without COPD (OR, 4.409; 95% CI, 1.741-9.419). CONCLUSION Females with COPD had a lower smoking rate, household income, and lung cancer prevalence than males with COPD. More active COPD screening is needed for women of low socioeconomic status, even if they do not smoke.
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Affiliation(s)
- Moon Seong Baek
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Haegwang Shin
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Kang-Mo Gu
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Hae In Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Won Young Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jong-Wook Shin
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | | | - Jae-Yeol Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
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Victoria S, Trine L, Hystad P, Roper C. Indoor and Personal PM 2.5 Samples Differ in Chemical Composition and Alter Zebrafish Behavior Based on Primary Fuel Source. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:21260-21271. [PMID: 38060427 DOI: 10.1021/acs.est.3c03585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Fine particulate matter (PM2.5) exposure has been linked to diverse human health impacts. Little is known about the potential heterogeneous impacts of PM2.5 generated from different indoor fuel sources and how exposure differs between personal and indoor environments. Therefore, we used PM2.5 collected by one stationary sampler in a kitchen and personal samplers (female and male participants), in homes (n = 24) in Kheri, India, that used either biomass or liquified petroleum gas (LPG) as primary fuel sources. PM2.5 samples (pooled by fuel type and monitor placement) were analyzed for oxidative potential and chemical composition, including elements and 125 organic compounds. Zebrafish (Danio rerio) embryos were acutely exposed to varying concentrations of PM2.5 and behavioral analyses were conducted. We found relatively high PM2.5 concentrations (5-15 times above World Health Organization daily exposure guidelines) and varied human health-related chemical composition based on fuel type and monitor placement (up to 15% carcinogenic polycyclic aromatic hydrocarbon composition). Altered biological responses, including changes to mortality, morphology, and behavior, were elicited by exposure to all sample types. These findings reveal that although LPG is generally ranked the least harmful compared to biomass fuels, chemical characteristics and biological impacts were still present, highlighting the need for further research in determining the safety of indoor fuel sources.
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Affiliation(s)
- Shayla Victoria
- Department of BioMolecular Sciences, University of Mississippi, University, Mississippi 38677, United States
| | - Lisandra Trine
- Department of Chemistry, Oregon State University, Corvallis, Oregon 97331, United States
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon 97331, United States
| | - Courtney Roper
- Department of BioMolecular Sciences, University of Mississippi, University, Mississippi 38677, United States
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Twinamasiko B, Mutekanga A, Ogueri O, Kisakye NI, North CM, Muzoora C, Muyanja D. Factors Associated with Chronic Obstructive Pulmonary Disease: A Hospital-Based Case-Control Study. Int J Chron Obstruct Pulmon Dis 2023; 18:2521-2529. [PMID: 38022824 PMCID: PMC10644879 DOI: 10.2147/copd.s426928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. In this paper, we determined risk factors for COPD among patients presenting to pulmonology and medical outpatients' clinics of Mbarara Regional Referral Hospital (MRRH). Methods In this case-control study, cases were patients with COPD confirmed by spirometry and controls were those with normal spirometry. The two groups were matched by age and gender. Results We enrolled 123 participants, of whom 41 were cases and 82 controls. A total of 51 women (41.5%) and 72 men (58.5%), of whom 25 were male cases (61%) and 47 were male controls (57%), were included. The results of our study suggest that the variables associated with the presence of COPD among participants attending MRRH were a history of having ever smoked and a prior history of atopy. This brings to our attention the fact that smoking remains a major risk factor for COPD in this setting, just as it is in developed countries. Conclusion Our study has shown that the factors associated with COPD are smoking and a history of atopy. Patients with a history of asthma and tuberculosis are also probably more likely to develop COPD than those without similar disease conditions.
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Affiliation(s)
- Bruce Twinamasiko
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew Mutekanga
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Crystal M North
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Conrad Muzoora
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Daniel Muyanja
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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van Nijnatten J, Faiz A, Timens W, Guryev V, Slebos DJ, Klooster K, Hartman JE, Kole T, Choy DF, Chakrabarti A, Grimbaldeston M, Rosenberger CM, Kerstjens H, Brandsma CA, van den Berge M. A bronchial gene signature specific for severe COPD that is retained in the nose. ERJ Open Res 2023; 9:00354-2023. [PMID: 38020574 PMCID: PMC10680034 DOI: 10.1183/23120541.00354-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction A subset of COPD patients develops advanced disease with severe airflow obstruction, hyperinflation and extensive emphysema. We propose that the pathogenesis in these patients differs from mild-moderate COPD and is reflected by bronchial gene expression. The aim of the present study was to identify a unique bronchial epithelial gene signature for severe COPD patients. Methods We obtained RNA sequencing data from bronchial brushes from 123 ex-smokers with severe COPD, 23 with mild-moderate COPD and 23 non-COPD controls. We identified genes specific to severe COPD by comparing severe COPD to non-COPD controls, followed by removing genes that were also differentially expressed between mild-moderate COPD and non-COPD controls. Next, we performed a pathway analysis on these genes and evaluated whether this signature is retained in matched nasal brushings. Results We identified 219 genes uniquely differentially expressed in severe COPD. Interaction network analysis identified VEGFA and FN1 as the key genes with the most interactions. Genes were involved in extracellular matrix regulation, collagen binding and the immune response. Of interest were 10 genes (VEGFA, DCN, SPARC, COL6A2, MGP, CYR61, ANXA6, LGALS1, C1QA and C1QB) directly connected to fibronectin 1 (FN1). Most of these genes were lower expressed in severe COPD and showed the same effect in nasal brushings. Conclusions We found a unique severe COPD bronchial gene signature with key roles for VEGFA and FN1, which was retained in the upper airways. This supports the hypothesis that severe COPD, at least partly, comprises a different pathology and supports the potential for biomarker development based on nasal brushes in COPD.
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Affiliation(s)
- Jos van Nijnatten
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Technology Sydney, Respiratory Bioinformatics and Molecular Biology, Sydney, NSW, Australia
| | - Alen Faiz
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Technology Sydney, Respiratory Bioinformatics and Molecular Biology, Sydney, NSW, Australia
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Wim Timens
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
| | - Victor Guryev
- University of Groningen University Medical Center Groningen, European Research Institute for the Biology of Ageing, Groningen, the Netherlands
| | - Dirk-Jan Slebos
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Karin Klooster
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Jorine E. Hartman
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Tessa Kole
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | | | | | | | | | - Huib Kerstjens
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Corry-Anke Brandsma
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- These authors contributed equally
| | - Maarten van den Berge
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
- These authors contributed equally
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Landguth EL, Knudson J, Graham J, Orr A, Coyle EA, Smith P, Semmens EO, Noonan C. Seasonal extreme temperatures and short-term fine particulate matter increases child respiratory hospitalizations in a sparsely populated region of the intermountain western United States. RESEARCH SQUARE 2023:rs.3.rs-3438033. [PMID: 37886498 PMCID: PMC10602161 DOI: 10.21203/rs.3.rs-3438033/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Few studies have evaluated these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health. Methods We explored short-term exposure to air pollution on childhood respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated hospitalizations. The main outcome measure included all respiratory-related hospital admissions for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for all individuals aged 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis and distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 15 prior-days modified by temperature or season. Results Short-term exposure increases of 1 μg/m3 in PM2.5 were associated with elevated odds of all three respiratory hospital admission categories. PM2.5 was associated with the largest increased odds of hospitalizations for asthma at lag 7-13 days [1.87(1.17-2.97)], for LRTI at lag 6-12 days [2.18(1.20-3.97)], and for URTI at a cumulative lag of 13 days [1.29(1.07-1.57)]. The impact of PM2.5 varied by temperature and season for each respiratory outcome scenario. For asthma, PM2.5 was associated most strongly during colder temperatures [3.11(1.40-6.89)] and the winter season [3.26(1.07-9.95)]. Also in colder temperatures, PM2.5 was associated with increased odds of LRTI hospitalization [2.61(1.15-5.94)], but no seasonal effect was observed. Finally, 13 days of cumulative PM2.5 prior to admissions date was associated with the greatest increased odds of URTI hospitalization during summer days [3.35(1.85-6.04)] and hotter temperatures [1.71(1.31-2.22)]. Conclusions Children's respiratory-related hospital admissions were associated with short-term exposure to PM2.5. PM2.5 associations with asthma and LRTI hospitalizations were strongest during cold periods, whereas associations with URTI were largest during hot periods. Classification environmental public health, fine particulate matter air pollution, respiratory infections.
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Holtjer JCS, Bloemsma LD, Beijers RJHCG, Cornelissen MEB, Hilvering B, Houweling L, Vermeulen RCH, Downward GS, Maitland-Van der Zee AH. Identifying risk factors for COPD and adult-onset asthma: an umbrella review. Eur Respir Rev 2023; 32:32/168/230009. [PMID: 37137510 PMCID: PMC10155046 DOI: 10.1183/16000617.0009-2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/27/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND COPD and adult-onset asthma (AOA) are the most common noncommunicable respiratory diseases. To improve early identification and prevention, an overview of risk factors is needed. We therefore aimed to systematically summarise the nongenetic (exposome) risk factors for AOA and COPD. Additionally, we aimed to compare the risk factors for COPD and AOA. METHODS In this umbrella review, we searched PubMed for articles from inception until 1 February 2023 and screened the references of relevant articles. We included systematic reviews and meta-analyses of observational epidemiological studies in humans that assessed a minimum of one lifestyle or environmental risk factor for AOA or COPD. RESULTS In total, 75 reviews were included, of which 45 focused on risk factors for COPD, 28 on AOA and two examined both. For asthma, 43 different risk factors were identified while 45 were identified for COPD. For AOA, smoking, a high body mass index (BMI), wood dust exposure and residential chemical exposures, such as formaldehyde exposure or exposure to volatile organic compounds, were amongst the risk factors found. For COPD, smoking, ambient air pollution including nitrogen dioxide, a low BMI, indoor biomass burning, childhood asthma, occupational dust exposure and diet were amongst the risk factors found. CONCLUSIONS Many different factors for COPD and asthma have been found, highlighting the differences and similarities. The results of this systematic review can be used to target and identify people at high risk for COPD or AOA.
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Affiliation(s)
- Judith C S Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Lizan D Bloemsma
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Merel E B Cornelissen
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Bart Hilvering
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Laura Houweling
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Roel C H Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - George S Downward
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anke-Hilse Maitland-Van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
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Bessa MJ, Sarmento B, Oliveira M, Rodrigues F. In vitro data for fire pollutants: contribution of studies using human cell models towards firefighters' occupational. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2023; 26:238-255. [PMID: 36883725 DOI: 10.1080/10937404.2023.2187909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Firefighters are the principal line of defense against fires, being at elevated risk of exposure to health-relevant pollutants released during fires and burning processes. Although many biomonitoring studies exist, only a limited number of human in vitro investigations in fire risk assessment are currently available. In vitro studies stand out as valuable tools to assess the toxicity mechanisms involved following exposure to fire pollutants at a cellular level. The aim of the present review was to contextualize existing in vitro studies using human cell models exposed to chemicals emitted from fire emissions and wood smoke and discuss the implications of the observed toxic outcomes on adverse health effects detected in firefighters. Most of the reported in vitro investigations focused on monocultures respiratory models and exposure to particulate matter (PM) extracts collected from fire effluents. Overall, (1) a decrease in cellular viability, (2) enhanced oxidative stress, (3) increased pro-inflammatory cytokines levels and (4) elevated cell death frequencies were noted. However, limited information remains regarding the toxicity mechanisms initiated by firefighting activities. Hence, more studies employing advanced in vitro models and exposure systems using human cell lines are urgently needed taking into consideration different routes of exposure and health-related pollutants released from fires. Data are needed to establish and define firefighters' occupational exposure limits and to propose mitigation strategies to promote beneficial human health.
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Affiliation(s)
- Maria João Bessa
- UNIPRO - Unidade de Investigação em Patologia e Reabilitação Oral, Instituto Universitário de Ciências da Saúde (IUCS), CESPU, Gandra, Portugal
| | - Bruno Sarmento
- UNIPRO - Unidade de Investigação em Patologia e Reabilitação Oral, Instituto Universitário de Ciências da Saúde (IUCS), CESPU, Gandra, Portugal
- i3S - Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- INEB - Institute of Biomedical Engineering, University of Porto, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, ISEP, Polytechnique of Porto, Porto, Portugal
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Sin DD, Doiron D, Agusti A, Anzueto A, Barnes PJ, Celli BR, Criner GJ, Halpin D, Han MK, Martinez FJ, Montes de Oca M, Papi A, Pavord I, Roche N, Singh D, Stockley R, Lopez Varlera MV, Wedzicha J, Vogelmeier C, Bourbeau J. Air pollution and COPD: GOLD 2023 committee report. Eur Respir J 2023; 61:2202469. [PMID: 36958741 DOI: 10.1183/13993003.02469-2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/04/2023] [Indexed: 03/25/2023]
Abstract
Exposure to air pollution is a major contributor to the pathogenesis of COPD worldwide. Indeed, most recent estimates suggest that 50% of the total attributable risk of COPD may be related to air pollution. In response, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Scientific Committee performed a comprehensive review on this topic, qualitatively synthesised the evidence to date and proffered recommendations to mitigate the risk. The review found that both gaseous and particulate components of air pollution are likely contributors to COPD. There are no absolutely safe levels of ambient air pollution and the relationship between air pollution levels and respiratory events is supra-linear. Wildfires and extreme weather events such as heat waves, which are becoming more common owing to climate change, are major threats to COPD patients and acutely increase their risk of morbidity and mortality. Exposure to air pollution also impairs lung growth in children and as such may lead to developmental COPD. GOLD recommends strong public health policies around the world to reduce ambient air pollution and for implementation of public warning systems and advisories, including where possible the use of personalised apps, to alert patients when ambient air pollution levels exceed acceptable minimal thresholds. When household particulate content exceeds acceptable thresholds, patients should consider using air cleaners and filters where feasible. Air pollution is a major health threat to patients living with COPD and actions are urgently required to reduce the morbidity and mortality related to poor air quality around the world.
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Affiliation(s)
- Don D Sin
- Centre for Heart Lung Innovation, St Paul's Hospital and University of British Columbia Division of Respiratory Medicine, Vancouver, BC, Canada
| | - Dany Doiron
- McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBERES, Barcelona, Spain
| | - Antonio Anzueto
- South Texas Veterans Health Care System, University of Texas, San Antonio, TX, USA
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - David Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Fernando J Martinez
- Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, USA
| | - Maria Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico de Caracas, Caracas, Venezuela
| | - Alberto Papi
- Respiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nicolas Roche
- Service de Pneumologie, Hôpital Cochin, AP-HP, Université Paris Cité, UMR 1016, Institut Cochin, Paris, France
| | - Dave Singh
- University of Manchester, Manchester, UK
| | | | | | - Jadwiga Wedzicha
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Claus Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Hospital Giessen and Marburg, German Center for Lung Research (DZL), University of Marburg, Marburg, Germany
| | - Jean Bourbeau
- McGill University Health Centre, McGill University, Montreal, QC, Canada
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12
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Wang Y, Duong M, Brauer M, Rangarajan S, Dans A, Lanas F, Lopez-Jaramillo P, Puoane T, Yeates K, Chifamba J, Yusuf R, Liu Z, Li Y, Tse LA, Mohan D, Gupta R, Nair S, Lakshmi P, Iqbal R, Anto T, Yusuf S, Hystad P. Household Air Pollution and Adult Lung Function Change, Respiratory Disease, and Mortality across Eleven Low- and Middle-Income Countries from the PURE Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47015. [PMID: 37126654 PMCID: PMC10132780 DOI: 10.1289/ehp11179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Globally, household air pollution (HAP) is a major environmental hazard that affects respiratory health. However, few studies have examined associations between HAP and lung function decline and respiratory disease and mortality. METHODS We used data from the Prospective Urban and Rural Epidemiology study and examined adults residing in 240 rural communities in 11 low- and middle-income countries where HAP from cooking with solid fuels is common. Spirometry was conducted for 28,574 individuals at baseline and 12,489 individuals during follow-up (mean of 8 y between spirometry measures). In cross-sectional analyses, we compared lung function measurements [forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio] in those who used solid fuels for cooking in comparison with clean fuels. Using repeated measurements of lung function, we examined the percent change in lung function measures per year, comparing individuals by baseline fuel type and individuals who used solid fuels at baseline but switched to clean fuels during follow-up. We also examined associations with prospective health events (any respiratory diseases, respiratory disease hospitalizations, and all-cause mortality). RESULTS In adjusted cross-sectional models, use of solid fuel in comparison with clean fuels was associated with lower FEV1 of -17.5mL (95% CI: -32.7, -2.3) and FVC of -14.4mL (95% CI: -32.0, 3.2), but not FEV1/FVC. In longitudinal analyses, individuals who switched from solid fuels to clean cooking fuels during follow-up (n=3,901, 46% of those using solid fuel at baseline), showed no differences in the annual rate of change in FEV1 or FVC, but had small improvements in FEV1/FVC change (0.2% per year, 95% CI: 0.03, 0.3). Individuals who switched from solid to clean fuels had a decreased hazard ratio for respiratory events of 0.76 (95% CI: 0.57, 1.00) in comparison with persistent solid fuel users, which was not attenuated by lung function measures. CONCLUSION We observed modest associations between HAP exposure and lung function, lung function change, and respiratory disease and mortality. https://doi.org/10.1289/EHP11179.
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Affiliation(s)
- Ying Wang
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - MyLinh Duong
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Antonio Dans
- University of the Philippines, Ermita, Manila, Philippines
| | - Fernando Lanas
- Universidad de La Frontera, Francisco Salazar, Temuco, Chile
| | | | - Thandi Puoane
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Karen Yeates
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Jephat Chifamba
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Zhiguang Liu
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yang Li
- Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | - Sanjeev Nair
- Health Action By People, Government Medical College, Trivandrum, India
| | - Pvm Lakshmi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Romaina Iqbal
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Taniya Anto
- Department of Physiology, St. John's Medical College, Bangalore, India
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
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13
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Egere U, Shayo EH, Chinouya M, Taegtmeyer M, Ardrey J, Mpagama S, Ntinginya NE, Ahmed R, Hussein EH, Sony AE, Wingfield T, Obasi A, Tolhurst R. "Honestly, this problem has affected me a lot": a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania. BMC Public Health 2023; 23:485. [PMID: 36915117 PMCID: PMC10010645 DOI: 10.1186/s12889-023-15368-6] [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: 01/29/2022] [Accepted: 03/02/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Over 500 million people live with chronic respiratory diseases globally and approximately 4 million of these, mostly from the low- and middle-income countries including sub-Saharan Africa, die prematurely every year. Despite high CRD morbidity and mortality, only very few studies describe CRDs and little is known about the economic, social and psychological dimensions of living with CRDs in sub-Saharan Africa. We aimed to gain an in-depth understanding of the social, livelihood and psychological dimensions of living with CRD to inform management of CRDs in Sudan and Tanzania. METHOD We conducted 12 in-depth interviews in 2019 with people with known or suspected CRD and 14 focus group discussions with community members in Gezira state, Sudan and Dodoma region, Tanzania, to share their understanding and experience with CRD. The data was analysed using thematic framework analysis. RESULTS People with CRD in both contexts reported experiences under two broad themes: impact on economic wellbeing and impact on social and psychological wellbeing. Capacity to do hard physical work was significantly diminished, resulting in direct and indirect economic impacts for them and their families. Direct costs were incurred while seeking healthcare, including expenditures on transportation to health facility and procurement of diagnostic tests and treatments, whilst loss of working hours and jobs resulted in substantial indirect costs. Enacted and internalised stigma leading to withdrawal and social exclusion was described by participants and resulted partly from association of chronic cough with tuberculosis and HIV/AIDS. In Sudan, asthma was described as having negative impact on marital prospects for young women and non-disclosure related to stigma was a particular issue for young people. Impaired community participation and restrictions on social activity led to psychological stress for both people with CRD and their families. CONCLUSION Chronic respiratory diseases have substantial social and economic impacts among people with CRD and their families in Sudan and Tanzania. Stigma is particularly strong and appears to be driven partly by association of chronic cough with infectiousness. Context-appropriate measures to address economic impacts and chronic cough stigma are urgently needed as part of interventions for chronic respiratory diseases in these sub-Saharan African contexts.
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Affiliation(s)
- Uzochukwu Egere
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK.
| | - Elizabeth H Shayo
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Martha Chinouya
- Faculty of Education, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Tropical Infectious Diseases Unit, Royal Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, UK
| | - Jane Ardrey
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
| | - Stellah Mpagama
- Kibong'oto Infectious Diseases Hospital, Mae Street, Kilimanjaro, Tanzania
- Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | | | - Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | | | | | - Tom Wingfield
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Tropical Infectious Diseases Unit, Royal Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Global Public Health, WHO Collaborating Centre on Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden
| | - Angela Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Honorary Consultant in HIV and Genitourinary Medicine, AXESS Clinic, The Royal Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rachel Tolhurst
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
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14
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Montuori P, Gioia M, Sorrentino M, Di Duca F, Pennino F, Messineo G, Maccauro ML, Riello S, Trama U, Triassi M, Nardone A. Determinants Analysis Regarding Household Chemical Indoor Pollution. TOXICS 2023; 11:264. [PMID: 36977029 PMCID: PMC10059753 DOI: 10.3390/toxics11030264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Indoor household pollution is not yet sufficiently studied in the general population. Over 4 million people die prematurely every year due to air pollution in households. This study aimed to propose quantitative data research through the administration of a KAP (Knowledge, Attitudes, and Practices) Survey Questionnaire. This cross-sectional study administered questionnaires to adults from the metropolitan city of Naples (Italy). Three Multiple Linear Regression Analyses (MLRA) were developed, including Knowledge, Attitudes, and Behavior regarding household chemical air pollution and the related risks. One thousand six hundred seventy subjects received a questionnaire to be filled out and collected anonymously. The mean age of the sample was 44.68 years, ranging from 21-78 years. Most of the people interviewed (76.13%) had good attitudes toward house cleaning, and 56.69% stated paying attention to cleaning products. Results of the regression analysis indicated that positive attitudes were significantly higher among subjects who graduated, with older age, male and non-smokers, but they were correlated with lower knowledge. In conclusion, a behavioral and attitudinal program targeted those with knowledge, such as younger subjects with high educational levels, but do not engage in correct practices towards household indoor chemical pollution.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Mariagiovanna Gioia
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Giuseppe Messineo
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Maria Luisa Maccauro
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Simonetta Riello
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale Is. C3, 80143 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
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15
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Khaltaev N, Axelrod S, Cui Y. Countrywide "best buy" interventions for noncommunicable diseases prevention and control in countries with different level of socioeconomic development. Chronic Dis Transl Med 2023; 9:44-53. [PMID: 36926253 PMCID: PMC10011669 DOI: 10.1002/cdt3.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/18/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, on lower-income countries (LIC). WHO identified a package of 16 "best buy" lifestyle and management interventions that are cost-effective and applicable in all settings. The purpose of this study was to evaluate and compare NCD risk factors in all WHO countries and make preliminary assessment of "best buy" interventions. Methods Risk factors estimation was made in 188 countries. NCD attributable "best buys" concern tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Management issues are based on the availability of the national NCD guidelines and provision of drug therapy. Results Every fourth adult in high-income countries (HIC) has raised blood pressure (RBP). Prevalence of RBP in lower-middle-income countries (LMIC) and LIC is 22%-23% (HIC/LMIC: t = 3.12, p < 0.01). Prevalence of diabetes in LIC is less than half of that in HIC and upper-middle-income countries (UMIC) UMIC/LIC: t = 8.37, p < 0.001. Obesity prevalence is gradually decreasing from HIC to LIC (HIC/LIC: t = 11.48, p < 0.001). Highest level of physical inactivity is seen in HIC, which then gradually declines to LIC (17%). Tobacco prevalence in LIC is almost less than half of that in HIC and UMIC (HIC/LIC: t = 7.2, p < 0.0001). There is a gradual decline in the implementation of "best buys" from HIC to LIC. Conclusion Wealthier countries have better implementation of the WHO NCD prevention strategy.
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Affiliation(s)
- Nikolai Khaltaev
- Global Alliance against Chronic Respiratory Diseases Geneva Switzerland
| | - Svetlana Axelrod
- Institute for Leadership and Health Management I.M. Sechenov First Moscow State University (Sechenov University) Moscow Russia
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16
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Kizhakke Puliyakote AS, Stapleton EM, Durairaj K, Karuppusamy K, Kathiresan GB, Shanmugam K, Abdul Rahim S, Navaneethakrishnan S, Bilas M, Huang R, Metwali N, Jeronimo M, Chan KS, Guo J, Nagpal P, Peters TM, Thorne PS, Comellas AP, Hoffman EA. Imaging-based assessment of lung function in a population cooking indoors with biomass fuel: a pilot study. J Appl Physiol (1985) 2023; 134:710-721. [PMID: 36759166 PMCID: PMC10027118 DOI: 10.1152/japplphysiol.00286.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Biomass fuels (wood) are commonly used indoors in underventilated environments for cooking in the developing world, but the impact on lung physiology is poorly understood. Quantitative computed tomography (qCT) can provide sensitive metrics to compare the lungs of women cooking with wood vs. liquified petroleum gas (LPG). We prospectively assessed (qCT and spirometry) 23 primary female cooks (18 biomass, 5 LPG) with no history of cardiopulmonary disease in Thanjavur, India. CT was obtained at coached total lung capacity (TLC) and residual volume (RV). qCT assessment included texture-derived ground glass opacity [GGO: Adaptive Multiple Feature Method (AMFM)], air-trapping (expiratory voxels ≤ -856HU) and image registration-based assessment [Disease Probability Measure (DPM)] of emphysema, functional small airways disease (%AirTrapDPM), and regional lung mechanics. In addition, within-kitchen exposure assessments included particulate matter <2.5 μm(PM2.5), black carbon, β-(1, 3)-d-glucan (surrogate for fungi), and endotoxin. Air-trapping went undetected at RV via the threshold-based measure (voxels ≤ -856HU), possibly due to density shifts in the presence of inflammation. However, DPM, utilizing image-matching, demonstrated significant air-trapping in biomass vs. LPG cooks (P = 0.049). A subset of biomass cooks (6/18), identified using k-means clustering, had markedly altered DPM-metrics: greater air-trapping (P < 0.001), lower TLC-RV volume change (P < 0.001), a lower mean anisotropic deformation index (ADI; P < 0.001), and elevated % GGO (P < 0.02). Across all subjects, a texture measure of bronchovascular bundles was correlated to the log-transformed β-(1, 3)-d-glucan concentration (P = 0.026, R = 0.46), and black carbon (P = 0.04, R = 0.44). This pilot study identified environmental links with qCT-based lung pathologies and a cluster of biomass cooks (33%) with significant small airways disease.NEW & NOTEWORTHY Quantitative computed tomography has identified a cluster of women (33%) cooking with biomass fuels (wood) with image-based markers of functional small airways disease and associated alterations in regional lung mechanics. Texture and image registration-based metrics of lung function may allow for early detection of potential inflammatory processes that may arise in response to inhaled biomass smoke, and help identify phenotypes of chronic lung disease prevalent in nonsmoking women in the developing world.
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Affiliation(s)
- Abhilash S Kizhakke Puliyakote
- Department of Radiology, University of California, San Diego, La Jolla, California, United States
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States
| | - Emma M Stapleton
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Kumar Durairaj
- Department of Physics, Periyar Maniammai Institute of Science and Technology, Thanjavur, India
| | - Kesavan Karuppusamy
- Department of Physics, Periyar Maniammai Institute of Science and Technology, Thanjavur, India
| | - Geetha B Kathiresan
- Department of Electronics and Communication Engineering, Periyar Maniammai Institute of Science and Technology, Thanjavur, India
| | - Kumaran Shanmugam
- Department of Biotechnology, Periyar Maniammai Institute of Science and Technology, Thanjavur, India
| | | | | | - Monalisa Bilas
- Department of Radiology, University of Iowa, Iowa City, Iowa, United States
| | - Rui Huang
- School of Economics, Nanjing University, Nanjing, People's Republic of China
| | - Nervana Metwali
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, United States
| | - Matthew Jeronimo
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kung-Sik Chan
- Department of Statistics and Actuarial Science, University of Iowa, Iowa City, Iowa, United States
| | - Junfeng Guo
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States
- Department of Radiology, University of Iowa, Iowa City, Iowa, United States
| | - Prashant Nagpal
- Department of Radiology, University of Iowa, Iowa City, Iowa, United States
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Thomas M Peters
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, United States
| | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, United States
| | - Alejandro P Comellas
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Eric A Hoffman
- Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
- Department of Radiology, University of Iowa, Iowa City, Iowa, United States
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17
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Mechanisms of Lung Damage and Development of COPD Due to Household Biomass-Smoke Exposure: Inflammation, Oxidative Stress, MicroRNAs, and Gene Polymorphisms. Cells 2022; 12:cells12010067. [PMID: 36611860 PMCID: PMC9818405 DOI: 10.3390/cells12010067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022] Open
Abstract
Chronic exposure to indoor biomass smoke from the combustion of solid organic fuels is a major cause of disease burden worldwide. Almost 3 billion people use solid fuels such as wood, charcoal, and crop residues for indoor cooking and heating, accounting for approximately 50% of all households and 90% of rural households globally. Biomass smoke contains many hazardous pollutants, resulting in household air pollution (HAP) exposure that often exceeds international standards. Long-term biomass-smoke exposure is associated with Chronic Obstructive Pulmonary Disease (COPD) in adults, a leading cause of morbidity and mortality worldwide, chronic bronchitis, and other lung conditions. Biomass smoke-associated COPD differs from the best-known cigarette smoke-induced COPD in several aspects, such as a slower decline in lung function, greater airway involvement, and less emphysema, which suggests a different phenotype and pathophysiology. Despite the high burden of biomass-associated COPD, the molecular, genetic, and epigenetic mechanisms underlying its pathogenesis are poorly understood. This review describes the pathogenic mechanisms potentially involved in lung damage, the development of COPD associated with wood-derived smoke exposure, and the influence of genetic and epigenetic factors on the development of this disease.
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18
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Exposure to indoor air pollution and the cognitive functioning of elderly rural women: a cross-sectional study using LASI data, India. BMC Public Health 2022; 22:2272. [PMID: 36471286 PMCID: PMC9724350 DOI: 10.1186/s12889-022-14749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The majority of people in rural developing counties still rely on unclean and solid fuels for cooking, putting their health at risk. Adult and elderly women are most vulnerable due to prolonged exposure in cooking areas, and Indoor Air Pollution (IAP) may negatively impact their health and cognitive function. This study examines the effect of IAP on the cognitive function of middle-aged and elderly rural women in India. METHODS The study utilized the data from the Longitudinal Ageing Study in India (LASI 2017-18, Wave-1). Bivariate analysis and multilevel linear regression models were applied to show the association between IAP and the cognitive abilities of rural women and results from regression were presented by beta coefficient (β) with 95% confidence interval (CI). Confounding factors such as age, education, health risk behaviours, marital status, monthly per capita consumption expenditure (MPCE), religion etc. were adjusted in the final model. RESULTS The study found that 18.71 percent of the rural women (n = 3,740) lived in Indoor Air Pollution exposed households. IAP was significantly found to be associated with the cognitive functional abilities among the middle and older aged rural women. Middle and older aged rural women exposed to IAP had lower cognitive functional abilities than non-exposed women. Comparing to the non-exposed group, the cognitive score was worse for those exposed to IAP in both the unadjusted (β = -1.96; 95%CI: -2.22 to -1.71) and the adjusted (β = -0.72; 95%CI: -0.92 to -0.51) models. Elderly rural women from lower socioeconomic backgrounds were more likely to have cognitive impairment as a result of IAP. CONCLUSION Findings revealed that IAP from solid fuels could significantly affect the cognitive health of elderly rural women in India, indicating the need for immediate intervention efforts to reduce the use of solid fuels, IAP and associated health problems.
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19
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Floss M, Zandavalli RB, Leão JRB, Lima CV, Vianna N, Barros EF, Saldiva PHN. Poluição do ar. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: As mortes atribuíveis à poluição do ar em longo prazo chegam a 9 milhões ao ano, concentrando-se principalmente em países de baixa e média renda como o Brasil. Classifica-se a poluição do ar em: domiciliar (indoor) ou ambiente (outdoor). A inalação de poluentes está relacionada com o aumento da incidência e desenvolvimento de condições clínicas, como doenças cardiovasculares, respiratórias e outras, que fazem parte da prática da medicina de família e comunidade. Objetivo: Verificar as evidências clínicas para a abordagem da poluição do ar relacionada à saúde humana no contexto da prática na Atenção Primária à Saúde. Métodos: Revisão de escopo do papel clínico da medicina de família e comunidade em relação à poluição do ar e saúde, voltada para questões clínicas associadas com a poluição do ar. Incluíram-se 35 artigos nesta revisão. Recomendações clínicas: Em nível individual, destacam-se a redução do uso de fogões a lenha, o uso de estratégias de proteção de fontes poluidoras (como queimadas, vias de trânsito e indústria), a filtragem do ar, o estímulo ao transporte ativo, a cessação do tabagismo. Essas recomendações devem ser complementares às políticas governamentais relacionadas à poluição do ar. Propõem-se perguntas para a entrevista clínica. Exploram-se recomendações específicas sobre uso de máscaras, atividade física e COVID-19. Sugerem-se temas de pesquisa que podem ser realizadas na Atenção Primária à Saúde e o papel da medicina de família e comunidade nesse contexto. Considerações: A inclusão na classificação internacional de atenção primária e no Código internacional de Doenças poderia melhorar a notificação e os estudos epidemiológicos sobre o assunto.
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Rahman M, Petersen H, Irshad H, Liu C, McDonald J, Sood A, Meek PM, Tesfaigzi Y. Cleaning the Flue in Wood-Burning Stoves Is a Key Factor in Reducing Household Air Pollution. TOXICS 2022; 10:615. [PMID: 36287895 PMCID: PMC9609584 DOI: 10.3390/toxics10100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
In experimental settings, replacing old wood stoves with new wood stoves results in reduced personal exposure to household air pollution. We tested this assumption by measuring PM2.5 and levoglucosan concentrations inside homes and correlated them with wood stove age. Methods: Thirty homes in the Albuquerque, NM area were monitored over a seven-day period using in-home particulate monitors placed in a common living area during the winter months. Real-time aerosol monitoring was performed, and filter samples were analyzed gravimetrically to calculate PM2.5 concentrations and chemically to determine concentrations of levoglucosan. A linear regression model with backward stepwise elimination was performed to determine the factors that would predict household air pollution measures. Results: In this sample, 73.3% of the households used wood as their primary source of heating, and 60% burned daily or almost daily. The mean burn time over the test week was 50 ± 38 h, and only one household burned wood 24/day (168 h). The average PM2.5 concentration (standard deviation) for the 30 homes during the seven-day period was 34.6 µg/m3 (41.3 µg/m3), and median (min, max) values were 15.5 µg/m3 (7.3 µg/m3, 193 µg/m3). Average PM2.5 concentrations in 30 homes ranged from 0−15 μg/m3 to >100 μg/m3. Maximum PM2.5 concentrations ranged from 100−200 μg/m3 to >3000 μg/m3. The levoglucosan levels showed a linear correlation with the total PM2.5 collected by the filters (R2 = 0.92). However, neither mean nor peak PM2.5 nor levoglucosan levels were correlated with the age (10.85 ± 8.54 years) of the wood stove (R2 ≤ 0.07, p > 0.23). The final adjusted linear regression model showed that average PM2.5 was associated with reports of cleaning the flue with a beta estimate of 35.56 (3.47−67.65) and R2 = 0.16 (p = 0.04). Discussion: Cleaning the flue and not the wood stove age was associated with household air pollution indices. Education on wood stove maintenance and safe burning practices may be more important in reducing household air pollution than the purchase of new stoves.
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Affiliation(s)
- Mizanur Rahman
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Hans Petersen
- Chronic Obstructive Pulmonary Disease Program, Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA
| | - Hammad Irshad
- Applied Sciences, Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA
| | - Congjian Liu
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jacob McDonald
- Applied Sciences, Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA
| | - Akshay Sood
- Department of Internal Medicine, University of New Mexico School of Medicine and Miners Colfax Medical Center, Raton, NM 87740, USA
| | - Paula M. Meek
- Department of Internal Medicine, University of New Mexico School of Medicine and Miners Colfax Medical Center, Raton, NM 87740, USA
- College of Nursing, University of Utah, Salt Lake City, UT 84102, USA
| | - Yohannes Tesfaigzi
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Dhital S, Rupakheti D, Rupakheti M, Yin X, Liu Y, Mafiana JJ, Alareqi MM, Mohamednour H, Zhang B. A scientometric analysis of indoor air pollution research during 1990-2019. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 320:115736. [PMID: 35932736 DOI: 10.1016/j.jenvman.2022.115736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 01/26/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Indoor air pollution (IAP) is one of the leading risk factors for various adverse health outcomes including premature deaths globally. Even though research related to IAP has been carried out, bibliometric studies with particular emphasis on this topic have been lacking. Here, we investigated IAP research from 1990 to 2019 retrieved from the Web of Science database through a comprehensive and systematic scientometric analysis using the CiteSpace 5.7.R2, a powerful tool for visualizing structural, temporal patterns and trends of a scientific field. There was an exponential increase in publications, however, with a stark difference between developed and developing countries. The journals publishing IAP related research had multiple disciplines; 'Indoor Air' journal that focuses solely on IAP issues ranked fifth among top-cited journals. The terms like 'global burden', 'comparative risk assessment,' 'household air pollution (HAP)', 'ventilation', 'respiratory health', 'emission factor', 'impact,' 'energy', 'household', 'India' were the current topical subject where author Kirk R. Smith was identified with a significant contribution. Research related to rural, fossil-fuel toxicity, IAP, and exposure-assessment had the highest citation burst signifying the particular attention of scientific communities to these subjects. Overall, this study examined the evolution of IAP research, identified the gaps and provided future research directions.
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Affiliation(s)
- Sushma Dhital
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Dipesh Rupakheti
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing 210044, China
| | | | - Xiufeng Yin
- State Key Laboratory of Cryospheric Science, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Yanli Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | | | | | | | - Benzhong Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
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22
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Banaganapalli B, Mallah B, Alghamdi KS, Albaqami WF, Alshaer DS, Alrayes N, Elango R, Shaik NA. Integrative weighted molecular network construction from transcriptomics and genome wide association data to identify shared genetic biomarkers for COPD and lung cancer. PLoS One 2022; 17:e0274629. [PMID: 36194576 PMCID: PMC9531836 DOI: 10.1371/journal.pone.0274629] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/01/2022] [Indexed: 11/05/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a multifactorial progressive airflow obstruction in the lungs, accounting for high morbidity and mortality across the world. This study aims to identify potential COPD blood-based biomarkers by analyzing the dysregulated gene expression patterns in blood and lung tissues with the help of robust computational approaches. The microarray gene expression datasets from blood (136 COPD and 6 controls) and lung tissues (16 COPD and 19 controls) were analyzed to detect shared differentially expressed genes (DEGs). Then these DEGs were used to construct COPD protein network-clusters and functionally enrich them against gene ontology annotation terms. The hub genes in the COPD network clusters were then queried in GWAS catalog and in several cancer expression databases to explore their pathogenic roles in lung cancers. The comparison of blood and lung tissue datasets revealed 63 shared DEGs. Of these DEGs, 12 COPD hub gene-network clusters (SREK1, TMEM67, IRAK2, MECOM, ASB4, C1QTNF2, CDC42BPA, DPF3, DET1, CCDC74B, KHK, and DDX3Y) connected to dysregulations of protein degradation, inflammatory cytokine production, airway remodeling, and immune cell activity were prioritized with the help of protein interactome and functional enrichment analysis. Interestingly, IRAK2 and MECOM hub genes from these COPD network clusters are known for their involvement in different pulmonary diseases. Additional COPD hub genes like SREK1, TMEM67, CDC42BPA, DPF3, and ASB4 were identified as prognostic markers in lung cancer, which is reported in 1% of COPD patients. This study identified 12 gene network- clusters as potential blood based genetic biomarkers for COPD diagnosis and prognosis.
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Affiliation(s)
- Babajan Banaganapalli
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail: (BB); (NAS)
| | - Bayan Mallah
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kawthar Saad Alghamdi
- Department of Biology, Faculty of Science, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia
| | - Walaa F. Albaqami
- Department of Science, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Dalal Sameer Alshaer
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nuha Alrayes
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ramu Elango
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor A. Shaik
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail: (BB); (NAS)
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Orysiak J, Młynarczyk M, Piec R, Jakubiak A. Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73741-73768. [PMID: 36094704 PMCID: PMC9465149 DOI: 10.1007/s11356-022-22479-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
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Affiliation(s)
- Joanna Orysiak
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland.
| | - Magdalena Młynarczyk
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland
| | - Robert Piec
- Institute of Internal Security, The Main School of Fire Service, Słowackiego St. 52/54, 01-629, Warsaw, Poland
| | - Agnieszka Jakubiak
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Żwirki and Wigury St. 61, 02-091, Warsaw, Poland
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24
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Chen J, Yin Y, Zhang Y, Lin X, Chen T, Yang Z, Wang D, Zhong W. Chronic Obstructive Pulmonary Disease Prevalence and Associated Risk Factors in Adults Aged 40 Years and Older in Southeast China: A Cross-Sectional Study During 2019-2020. Int J Chron Obstruct Pulmon Dis 2022; 17:2317-2328. [PMID: 36159656 PMCID: PMC9491879 DOI: 10.2147/copd.s377857] [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: 06/14/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is one of many major public health problems in China, and its prevalence and associated risk factors in the southeast of China need to be determined to facilitate disease control and prevention. Methods A multistage stratified cluster sampling method was used to select 5486 participants aged ≥ 40 years from nine COPD monitoring districts in Fujian Province during 2019–2020. Participants were interviewed using a laptop-based questionnaire and underwent pulmonary function tests. COPD was diagnosed according to the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Results Final analysis was conducted using data from 4999 participants with qualified post-bronchodilator results. The prevalence of COPD was 11.6% (95% confidence interval [CI]: 10.5–12.7). Risk factors for COPD in the logistic regression model were being male (odds ratio [OR] = 2.83, 95% CI: 2.01–3.98), > 70 years old (OR = 16.16, 95% CI: 8.14–32.08), having a low body mass index (BMI) (OR = 1.81, 95% CI: 1.13–2.89), parental history of respiratory disease (OR = 1.78, 95% CI: 1.50–2.10), being a current (OR = 2.82, 95% CI: 1.83–4.36) or former (OR = 2.47, 95% CI: 1.45–4.19) smoker, and indoor exposure to biomass (OR = 1.28, 95% CI: 1.05–1.58). Conclusion The estimated prevalence of COPD in southeast China is high. COPD was strongly associated with sex, aging, a low BMI, parental history of respiratory diseases, smoking, and indoor exposure to biomass in adults aged ≥ 40 years. The government should urgently implement comprehensive measures to reduce the risk factors for COPD.
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Affiliation(s)
- Jingyu Chen
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Yanrong Yin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Yefa Zhang
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Xiuquan Lin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Tiehui Chen
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Ze Yang
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Dengwei Wang
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
| | - Wenling Zhong
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, People's Republic of China
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25
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Sun Z, Guo W, Chan CK, Jin L, Griffith SM, Yu JZ, Chan W. Polyurethane Foam Face Masks as a Dosimeter for Quantifying Personal Exposure to Airborne Volatile and Semi-Volatile Organic Compounds. Chem Res Toxicol 2022; 35:1604-1613. [PMID: 35972223 DOI: 10.1021/acs.chemrestox.2c00205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Airborne volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are commonly quantitated by collecting the analytes on solid sorbent tubes or passive air samplers, followed by solvent extraction and instrumental analysis, or by grab bag/canister measurements. We report herein a user-friendly sampling method by breathing through polyurethane foam (PUF) face masks to collect airborne VOCs and SVOCs for chemical analysis. Specifically, dibasic esters, phthalate esters, polycyclic aromatic hydrocarbons, linalool, and nicotine trapped on PUF masks were quantitated by gas chromatography-mass spectrometry analysis as model VOCs and SVOCs. Results showed that the amount of these model VOCs and SVOCs trapped on PUF masks is proportional to the exposure duration. After cross-validation by parallel sampling using XAD-2 packed sorbent tubes, the method was used to quantitate VOCs and SVOCs in a variety of indoor and outdoor environments with varying air concentrations of analytes, temperature, humidity, and wind speed. Because air pollution is considered a major cause of many human diseases and premature deaths and the developed PUF mask sampling method showed high trapping efficiencies for both VOCs and SVOCs, it is believed that the developed sampling method will find wide application in assessing air pollution-associated disease risks with possible extension to more classes of VOCs and SVOCs when coupled with suitable instrumental detection methods.
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Affiliation(s)
- Zhihan Sun
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
| | - Wanlin Guo
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
| | - Chi-Kong Chan
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
| | - Long Jin
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
| | - Stephen M Griffith
- Department of Atmospheric Sciences, National Central University, Taoyuan 32001, Taiwan
| | - Jian Zhen Yu
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
| | - Wan Chan
- Department of Chemistry and Division of Environment, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon 999077, Hong Kong
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Kamal R, Srivastava AK, Kesavachandran CN, Bihari V, Singh A. Chronic obstructive pulmonary disease (COPD) in women due to indoor biomass burning: a meta analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1403-1417. [PMID: 33573386 DOI: 10.1080/09603123.2021.1887460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is attributable to household air pollution and is known to increase the Disability Adjusted Life Years (DALYs), morbidity and mortality and women are most susceptible groups for the exposure. In order to understand the global risk among women with COPD due to exposure of household air pollutants, an evidence-based systematic review and meta-analysis was conducted. Meta regression analysis was carried out to identify potential sources of heterogeneity. The summary estimates of the included studies showed higher prevalence of COPD due to biomass fuel exposure in women. Clinical diagnosis has shown more risk of COPD prevalence compared to diagnosis based on spirometer test alone. However, the data between included studies for both clinical and spirometry-based studies showed higher heterogeneity. The present meta-data analysis has shown that household air pollutants may be a factor associated with increased risk of COPD in women.
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Affiliation(s)
- Ritul Kamal
- Epidemiology Lab, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research, Lucknow, India
- Department of Statistics, University of Lucknow, Lucknow, India
| | - Anup Kumar Srivastava
- Epidemiology Lab, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research, Lucknow, India
| | | | - Vipin Bihari
- Epidemiology Lab, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research, Lucknow, India
| | - Amarnath Singh
- Epidemiology Lab, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research, Lucknow, India
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27
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Kumar P, Hama S, Abbass RA, Nogueira T, Brand VS, Wu HW, Abulude FO, Adelodun AA, Anand P, Andrade MDF, Apondo W, Asfaw A, Aziz KH, Cao SJ, El-Gendy A, Indu G, Kehbila AG, Ketzel M, Khare M, Kota SH, Mamo T, Manyozo S, Martinez J, McNabola A, Morawska L, Mustafa F, Muula AS, Nahian S, Nardocci AC, Nelson W, Ngowi AV, Njoroge G, Olaya Y, Omer K, Osano P, Sarkar Pavel MR, Salam A, Santos ELC, Sitati C, Shiva Nagendra SM. In-kitchen aerosol exposure in twelve cities across the globe. ENVIRONMENT INTERNATIONAL 2022; 162:107155. [PMID: 35278800 DOI: 10.1016/j.envint.2022.107155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Poor ventilation and polluting cooking fuels in low-income homes cause high exposure, yet relevant global studies are limited. We assessed exposure to in-kitchen particulate matter (PM2.5 and PM10) employing similar instrumentation in 60 low-income homes across 12 cities: Dhaka (Bangladesh); Chennai (India); Nanjing (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Akure (Nigeria); Blantyre (Malawi); Dar-es-Salaam (Tanzania) and Nairobi (Kenya). Exposure profiles of kitchen occupants showed that fuel, kitchen volume, cooking type and ventilation were the most prominent factors affecting in-kitchen exposure. Different cuisines resulted in varying cooking durations and disproportional exposures. Occupants in Dhaka, Nanjing, Dar-es-Salaam and Nairobi spent > 40% of their cooking time frying (the highest particle emitting cooking activity) compared with ∼ 68% of time spent boiling/stewing in Cairo, Sulaymaniyah and Akure. The highest average PM2.5 (PM10) concentrations were in Dhaka 185 ± 48 (220 ± 58) μg m-3 owing to small kitchen volume, extensive frying and prolonged cooking compared with the lowest in Medellín 10 ± 3 (14 ± 2) μg m-3. Dual ventilation (mechanical and natural) in Chennai, Cairo and Sulaymaniyah reduced average in-kitchen PM2.5 and PM10 by 2.3- and 1.8-times compared with natural ventilation (open doors) in Addis Ababa, Dar-es-Salam and Nairobi. Using charcoal during cooking (Addis Ababa, Blantyre and Nairobi) increased PM2.5 levels by 1.3- and 3.1-times compared with using natural gas (Nanjing, Medellin and Cairo) and LPG (Chennai, Sao Paulo and Sulaymaniyah), respectively. Smaller-volume kitchens (<15 m3; Dhaka and Nanjing) increased cooking exposure compared with their larger-volume counterparts (Medellin, Cairo and Sulaymaniyah). Potential exposure doses were highest for Asian, followed by African, Middle-eastern and South American homes. We recommend increased cooking exhaust extraction, cleaner fuels, awareness on improved cooking practices and minimising passive occupancy in kitchens to mitigate harmful cooking emissions.
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Affiliation(s)
- Prashant Kumar
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Dublin, Ireland; School of Architecture, Southeast University, Nanjing, China.
| | - Sarkawt Hama
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom
| | - Rana Alaa Abbass
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom
| | - Thiago Nogueira
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | - Veronika S Brand
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | - Huai-Wen Wu
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; School of Architecture, Southeast University, Nanjing, China
| | | | - Adedeji A Adelodun
- Department of Marine Science and Technology, The Federal University of Technology Akure, 340001, Nigeria
| | - Partibha Anand
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Maria de Fatima Andrade
- Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | | | - Araya Asfaw
- Physics Department, Addis Ababa University, Ethiopia
| | - Kosar Hama Aziz
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | - Shi-Jie Cao
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; School of Architecture, Southeast University, Nanjing, China
| | - Ahmed El-Gendy
- Department of Construction Engineering, School of Sciences and Engineering, The American University in Cairo, New Cairo 11835, Egypt
| | - Gopika Indu
- Department of Civil Engineering, Indian Institute of Technology Madras, Chennai, India
| | | | - Matthias Ketzel
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Mukesh Khare
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Sri Harsha Kota
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Tesfaye Mamo
- Physics Department, Addis Ababa University, Ethiopia
| | | | | | - Aonghus McNabola
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Dublin, Ireland
| | - Lidia Morawska
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
| | - Fryad Mustafa
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | | | - Samiha Nahian
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | | | - William Nelson
- Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Aiwerasia V Ngowi
- Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | | | - Yris Olaya
- Universidad Nacional de Colombia, Colombia
| | - Khalid Omer
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | | | - Md Riad Sarkar Pavel
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | - Abdus Salam
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | - Erik Luan Costa Santos
- Department of Environmental Health - School of Public Health - University of São Paulo, Brazil
| | | | - S M Shiva Nagendra
- Department of Civil Engineering, Indian Institute of Technology Madras, Chennai, India
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Shillito LM, Namdeo A, Bapat AV, Mackay H, Haddow SD. Analysis of fine particulates from fuel burning in a reconstructed building at Çatalhöyük World Heritage Site, Turkey: assessing air pollution in prehistoric settled communities. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:1033-1048. [PMID: 34155558 PMCID: PMC8863713 DOI: 10.1007/s10653-021-01000-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
The use of wood, dung and other biomass fuels can be traced back to early prehistory. While the study of prehistoric fuel use and its environmental impacts is well established, there has been little investigation of the health impacts this would have had, particularly in the Neolithic period, when people went from living in relatively small groups, to living in dense settlements. The UNESCO World Heritage Site of Çatalhöyük, Turkey, is one of the earliest large 'pre-urban' settlements in the world. In 2017, a series of experiments were conducted to measure fine particulate (PM2.5) concentrations during typical fuel burning activities, using wood and dung fuel. The results indicate that emissions from both fuels surpassed the WHO and EU standard limits for indoor air quality, with dung fuel being the highest contributor for PM2.5 pollution inside the house, producing maximum values > 150,000 µg m-3. Maximum levels from wood burning were 36,000 µg m-3. Average values over a 2-3 h period were 13-60,000 µg m-3 for dung and 10-45,000 µg m-3 for wood. The structure of the house, lack of ventilation and design of the oven and hearth influenced the air quality inside the house. These observations have implications for understanding the relationship between health and the built environment in the past.
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Affiliation(s)
- Lisa-Marie Shillito
- School of History, Classics and Archaeology, Newcastle University, Newcastle upon Tyne, UK.
| | - Anil Namdeo
- Department of Geography and Environmental Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Helen Mackay
- Department of Geography, Durham University, Durham, UK
| | - Scott D Haddow
- Department of Cross-Cultural and Regional Studies, Copenhagen University, Copenhagen, Denmark
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29
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Younger A, Alkon A, Harknett K, Jean Louis R, Thompson LM. Adverse birth outcomes associated with household air pollution from unclean cooking fuels in low- and middle-income countries: A systematic review. ENVIRONMENTAL RESEARCH 2022; 204:112274. [PMID: 34710435 DOI: 10.1016/j.envres.2021.112274] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
Approximately 3.8 billion people in low- and middle-income countries use unclean fuels as a source of primary cooking fuel as well as for heating. For pregnant women, the toxic chemicals produced by combustion of unclean fuels not only affect women's health directly, but particulate matter and carbon monoxide are absorbed in maternal blood and cross the placental barrier impairing fetal tissue growth. PRISMA 2009 guidelines were used for this systematic review. The inclusion criteria were quantitative, peer reviewed journal articles published within a date range of May 1, 2013-June 12, 2021 examining birth outcomes related to household air pollution from type of cooking fuel in low- and middle-income countries. The quality of available evidence was evaluated using the Office of Health Assessment and Translation (OHAT) risk of bias rating tool. Of the 553 studies screened, 23 satisfied the inclusion criteria. Of the studies that met the inclusion criteria, 14 were cross-sectional, 5 cohort, 1 case-control and 3 randomized control trials conducted across 15 different countries. A range of birth outcomes are reported across studies including birthweight (19), small for gestational age (6), spontaneous abortion (3), preterm birth (6), stillbirth (7) and neonatal mortality (6). The reviewed studies presented evidence for an increased risk of low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), stillbirth, neonatal mortality and reduction in birthweight with solid fuel and kerosene use compared to cleaner fuels like gas and LPG. Systematically reviewing the evidence and risk of bias ratings illuminated several gaps in the current literature related to exposure assessment, outcome measurement and adequacy of adjustment for confounding.
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Affiliation(s)
- Ashley Younger
- University of California, San Francisco (UCSF), School of Nursing, United States.
| | - Abbey Alkon
- University of California, San Francisco (UCSF), School of Nursing, United States
| | - Kristen Harknett
- University of California, San Francisco (UCSF), Department of Social and Behavioral Sciences, United States
| | | | - Lisa M Thompson
- Emory University Nell Hodgson Woodruff School of Nursing, United States
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30
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Guercio V, Doutsi A, Exley KS. A systematic review on solid fuel combustion exposure and respiratory health in adults in Europe, USA, Canada, Australia and New Zealand. Int J Hyg Environ Health 2022; 241:113926. [PMID: 35149281 DOI: 10.1016/j.ijheh.2022.113926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/22/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
Epidemiological studies performed in low- and middle-income countries have shown a positive association between solid fuel burning exposure and adverse health effects, including respiratory effects in adults. However, the evidence is less clear in other countries. We performed a systematic review of epidemiological studies conducted in Europe, North America (Canada and USA only), Australia and New Zealand on the association between outdoor and indoor exposure to solid fuel (biomass and coal) combustion and respiratory outcomes in adults. We identified 34 articles. The epidemiological evidence is still limited. Positive associations were found between indoor coal, wood and combined solid fuel combustion exposure and lung cancer risk, although based on a limited number of studies. A significant association was found between indoor solid fuel exposure and COPD risk. Inconsistent results were found considering indoor coal, wood and mixed solid fuel burning exposure and other respiratory outcomes (i.e. lower respiratory infections, upper respiratory infections and other upper respiratory tract diseases, asthma and respiratory symptoms). Inconsistent results were found considering the relationship between the exposure to outdoor wood burning exposure and overall respiratory mortality, asthma, COPD and respiratory symptoms in adults. The available epidemiological evidence between outdoor exposure to residential coal burning and respiratory outcomes suggests an increased risk of adverse respiratory effects. The studies considering the impact of the introduction of measures in order to reduce solid fuel burning on air quality and health showed an improvement in air quality resulting in a reduction of adverse respiratory effects. The identified epidemiological studies have several limitations. Additional and better conducted epidemiological studies are needed to establish whether exposure occurring indoors and outdoors to solid fuel combustion pollutants is associated with adverse respiratory outcomes in adults.
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Affiliation(s)
- Valentina Guercio
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Radiation, Chemical and Environmental Hazards, UK Health Security Agency, United Kingdom.
| | - Artemis Doutsi
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Radiation, Chemical and Environmental Hazards, UK Health Security Agency, United Kingdom
| | - Karen S Exley
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Radiation, Chemical and Environmental Hazards, UK Health Security Agency, United Kingdom; Department of Health Sciences, University of Leicester, United Kingdom
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31
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Women’s Perceptions and Attitudes to Household Air Pollution Exposure and Capability to Change Cooking Behaviours in Urban Rwanda. SUSTAINABILITY 2022. [DOI: 10.3390/su14031608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Household air pollution (HAP) from cooking on biomass fuel presents significant health, environmental and socioeconomic consequences worldwide. However, there is a lack of understanding of the factors influencing cooking behaviours that affect HAP exposure in Rwanda (e.g., cooking location, removing children from the cooking area). Sixteen qualitative in-depth interviews were undertaken with women living in an underprivileged neighbourhood in Kigali, Rwanda. Deductive thematic analysis was carried out using the Behaviour Change Wheel (Capability—ability to engage with chosen activity, Opportunity—factors which are beyond the individual’s control and Motivation—brain processes which direct behaviour: COM-B) to determine the thoughts and perceptions around cooking location and removing children from the cooking area. Facilitators and barriers were subsequently identified within the COM-B framework for the following HAP mitigation interventions: outdoor cooking, removing children from the cooking area and Liquid Petroleum Gas (LPG) use. Of the 16 interviewed, 12 cooked outdoors (75%), two (12.5%) cooked indoors (in the main home) and two (12.5%) in a separate kitchen. Despite the majority cooking outdoors, this was reported not to be a favourable cooking location. Levels of awareness of HAP sources and knowledge of the health effects of air pollution were observed to be limited, reducing women’s capability to change, along with stated barriers of cost, housing constraints and safety. Factors out of the individuals’ control (opportunities) included weather, socio-economic and educational factors. Preconceived beliefs, experiencing smoke reduction and the briefly described short-term health effects, directed motivation. Furthermore, participants identified a need for community-based education as a facilitator to changing their behaviour. Despite a high level of observed motivation towards reducing HAP exposure, many women lacked the capability and opportunity to change their behaviour. There are research and policy implications concerning development of community-based interventions which involved end-users and relevant stakeholders in the development process.
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32
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Saini J, Dutta M, Marques G. ADFIST: Adaptive Dynamic Fuzzy Inference System Tree Driven by Optimized Knowledge Base for Indoor Air Quality Assessment. SENSORS 2022; 22:s22031008. [PMID: 35161754 PMCID: PMC8838659 DOI: 10.3390/s22031008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 01/27/2023]
Abstract
Air quality levels do not just affect climate change; rather, it leaves a significant impact on public health and wellbeing. Indoor air pollution is the major contributor to increased mortality and morbidity rates. This paper is focused on the assessment of indoor air quality based on several important pollutants (PM10, PM2.5, CO2, CO, tVOC, and NO2). These pollutants are responsible for potential health issues, including respiratory disease, central nervous system dysfunction, cardiovascular disease, and cancer. The pollutant concentrations were measured from a rural site in India using an Internet of Things-based sensor system. An Adaptive Dynamic Fuzzy Inference System Tree was implemented to process the field variables. The knowledge base for the proposed model was designed using a global optimization algorithm. However, the model was tuned using a local search algorithm to achieve enhanced prediction performance. The proposed model gives normalized root mean square error of 0.6679, 0.6218, 0.1077, 0.2585, 0.0667 and 0.0635 for PM10, PM2.5, CO2, CO, tVOC, and NO2, respectively. This approach was compared with the existing studies in the literature, and the approach was also validated against the online benchmark dataset.
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Affiliation(s)
- Jagriti Saini
- National Institute of Technical Teacher’s Training and Research, Chandigarh 160019, India;
- Correspondence: (J.S.); (G.M.)
| | - Maitreyee Dutta
- National Institute of Technical Teacher’s Training and Research, Chandigarh 160019, India;
| | - Gonçalo Marques
- ESTGOH, Polytechnic of Coimbra, Rua General Santos Costa, 3400-124 Oliveira do Hospital, Portugal
- Correspondence: (J.S.); (G.M.)
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Liu YH, Lu YK, Liu XT, Li YL, Hu LK, Gao HY, Yang K, Yan YX. Association of household solid fuel use and long-term exposure to PM 2.5 with arthritis in middle-aged and older population in China: A cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113104. [PMID: 34953276 DOI: 10.1016/j.ecoenv.2021.113104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/02/2021] [Accepted: 12/15/2021] [Indexed: 05/26/2023]
Abstract
Air pollutants are common modifiable risk factors for arthritis. To explore the longitudinal effects of air pollution on arthritis based on a cohort study in middle-aged and elder people of China. Data was obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. A total of 7449 participants aged 45 years and older were involved in our study. The generalized linear mixed models were conducted to examine the separate and joint effects of household air pollution and outdoor air pollution on arthritis, respectively. We found a strong significant association between air pollution and arthritis incidence. Individuals cooking primarily with solid fuel were more likely in higher risk of arthritis compared with cleaner fuel (OR= 1.15; 95% CI: 1.08-1.23). The group-based trajectory model identified four trajectory groups, compared with group "High-Decreasing rapidly", adjusted ORs of incident arthritis for group "Middle-Decreasing moderately", "Low-Decreasing slowly" and "Low-Stably" were 1.36 (95% CI, 1.03-1.79), 1.36 (95% CI, 1.01-1.83) and 1.81 (95% CI, 1.30-2.52), respectively. These associations were generally higher in participants younger than 65 years. In addition, solid fuel use and PM2.5 exposure had additive and multiplicative effects on arthritis. The results suggested that solid fuel use and long-term PM2.5 exposure were associated with a higher incidence of arthritis. Therefore, it is necessary to restrict solid fuel use to reduce household air pollution and make stronger environmental protection policies to reduce PM2.5 concentration.
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Affiliation(s)
- Yu-Hong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Ya-Ke Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xiang-Tong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yan-Ling Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Li-Kun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Hao-Yu Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Kun Yang
- Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100069, China.
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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34
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Shupler M, Hystad P, Birch A, Chu YL, Jeronimo M, Miller-Lionberg D, Gustafson P, Rangarajan S, Mustaha M, Heenan L, Seron P, Lanas F, Cazor F, Jose Oliveros M, Lopez-Jaramillo P, Camacho PA, Otero J, Perez M, Yeates K, West N, Ncube T, Ncube B, Chifamba J, Yusuf R, Khan A, Liu Z, Wu S, Wei L, Tse LA, Mohan D, Kumar P, Gupta R, Mohan I, Jayachitra KG, Mony PK, Rammohan K, Nair S, Lakshmi PVM, Sagar V, Khawaja R, Iqbal R, Kazmi K, Yusuf S, Brauer M. Multinational prediction of household and personal exposure to fine particulate matter (PM 2.5) in the PURE cohort study. ENVIRONMENT INTERNATIONAL 2022; 159:107021. [PMID: 34915352 DOI: 10.1016/j.envint.2021.107021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Use of polluting cooking fuels generates household air pollution (HAP) containing health-damaging levels of fine particulate matter (PM2.5). Many global epidemiological studies rely on categorical HAP exposure indicators, which are poor surrogates of measured PM2.5 levels. To quantitatively characterize HAP levels on a large scale, a multinational measurement campaign was leveraged to develop household and personal PM2.5 exposure models. METHODS The Prospective Urban and Rural Epidemiology (PURE)-AIR study included 48-hour monitoring of PM2.5 kitchen concentrations (n = 2,365) and male and/or female PM2.5 exposure monitoring (n = 910) in a subset of households in Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania and Zimbabwe. PURE-AIR measurements were combined with survey data on cooking environment characteristics in hierarchical Bayesian log-linear regression models. Model performance was evaluated using leave-one-out cross validation. Predictive models were applied to survey data from the larger PURE cohort (22,480 households; 33,554 individuals) to quantitatively estimate PM2.5 exposures. RESULTS The final models explained half (R2 = 54%) of the variation in kitchen PM2.5 measurements (root mean square error (RMSE) (log scale):2.22) and personal measurements (R2 = 48%; RMSE (log scale):2.08). Primary cooking fuel type, heating fuel type, country and season were highly predictive of PM2.5 kitchen concentrations. Average national PM2.5 kitchen concentrations varied nearly 3-fold among households primarily cooking with gas (20 μg/m3 (Chile); 55 μg/m3 (China)) and 12-fold among households primarily cooking with wood (36 μg/m3 (Chile)); 427 μg/m3 (Pakistan)). Average PM2.5 kitchen concentration, heating fuel type, season and secondhand smoke exposure were significant predictors of personal exposures. Modeled average PM2.5 female exposures were lower than male exposures in upper-middle/high-income countries (India, China, Colombia, Chile). CONCLUSION Using survey data to estimate PM2.5 exposures on a multinational scale can cost-effectively scale up quantitative HAP measurements for disease burden assessments. The modeled PM2.5 exposures can be used in future epidemiological studies and inform policies targeting HAP reduction.
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Affiliation(s)
- Matthew Shupler
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Aaron Birch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yen Li Chu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Jeronimo
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Paul Gustafson
- Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maha Mustaha
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Heenan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Pamela Seron
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Paul A Camacho
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
| | - Johnna Otero
- Universidad Militar Nueva Granada, Bogota, Colombia
| | | | - Karen Yeates
- Department of Medicine, Queen's University, Kingston, Ontario, Canada; Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nicola West
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
| | - Tatenda Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Brian Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jephat Chifamba
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Afreen Khan
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Zhiguang Liu
- Beijing An Zhen Hospital of the Capital University of Medical Sciences, China
| | - Shutong Wu
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - Li Wei
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | - Indu Mohan
- Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India
| | - K G Jayachitra
- St. John's Medical College & Research Institute, Bangalore, India
| | - Prem K Mony
- St. John's Medical College & Research Institute, Bangalore, India
| | - Kamala Rammohan
- Health Action By People, Government Medical College, Trivandrum, India
| | - Sanjeev Nair
- Health Action By People, Government Medical College, Trivandrum, India
| | - P V M Lakshmi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Sagar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rehman Khawaja
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Khawar Kazmi
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Krishnamoorthy Y, Rajaa S, Ramasubramani P, Saya GK. Association between indoor air pollution and cognitive function among nationally representative sample of middle-aged and older adults in India-A multilevel modelling approach. INDOOR AIR 2022; 32:e12929. [PMID: 34510562 DOI: 10.1111/ina.12929] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/05/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
We have used a nationally representative sample of middle-aged and older adults in India to study the association between indoor air pollution and cognitive function. Longitudinal aging study in India (LASI) Wave-I data was utilized for this study. A two-level mixed-effects linear regression model was used to study the association between indoor air pollution and cognitive function and interpreted as adjusted beta coefficient (ꞵ) with 95% confidence interval (CI). In total, 56,179 participants aged ≥45 years were included in the analysis. The proportion of participants living in households with indoor air pollution were 30.6% (95%CI: 30.0%-31.3%). After adjusting for all the potential confounders (age, gender, education, region, religion, separate kitchen, socioeconomic status, marital status, residence, smoking, alcohol consumption, body mass index, self-rated health, and sleep problems), participants living in households with indoor air pollution had significant decline in the cognitive function when compared to those living in households without indoor air pollution (ꞵ = -0.57; 95%CI: -0.69 to -0.45). Since the LASI survey is being conducted as a biennial panel survey, assessing the impact of indoor air pollution on cognitive decline using the follow-up data can provide further insights into the pathogenesis of condition.
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Affiliation(s)
| | - Sathish Rajaa
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| | | | - Ganesh Kumar Saya
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
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36
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Tassew D, Fort S, Mebratu Y, McDonald J, Chu HW, Petersen H, Tesfaigzi Y. Effects of Wood Smoke Constituents on Mucin Gene Expression in Mice and Human Airway Epithelial Cells and on Nasal Epithelia of Subjects with a Susceptibility Gene Variant in Tp53. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:17010. [PMID: 35072516 PMCID: PMC8785869 DOI: 10.1289/ehp9446] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Exposure to wood smoke (WS) increases the risk for chronic bronchitis more than exposure to cigarette smoke (CS), but the underlying mechanisms are unclear. OBJECTIVE The effect of WS and CS on mucous cell hyperplasia in mice and in human primary airway epithelial cells (AECs) was compared with replicate the findings in human cohorts. Responsible WS constituents were identified to better delineate the pathway involved, and the role of a tumor protein p53 (Tp53) gene polymorphism was investigated. METHODS Mice and primary human AECs were exposed to WS or CS and the signaling receptor and pathway were identified using short hairpin structures, small molecule inhibitors, and Western analyses. Mass spectrometric analysis was used to identify active WS constituents. The role of a gene variant in Tp53 that modifies proline to arginine was examined using nasal brushings from study participants in the Lovelace Smokers Cohort, primary human AECs, and mice with a modified Tp53 gene. RESULTS WS at 25-fold lower concentration than CS increased mucin expression more efficiently in mice and in human AECs in a p53 pathway-dependent manner. Study participants who were homozygous for p53 arginine compared with the proline variant showed higher mucin 5AC (MUC5AC) mRNA levels in nasal brushings if they reported WS exposure. The WS constituent, oxalate, increased MUC5AC levels similar to the whole WS extract, especially in primary human AECs homozygous for p53 arginine, and in mice with a modified Tp53 gene. Further, the anion exchange protein, SLC26A9, when reduced, enhanced WS- and oxalate-induced mucin expression. DISCUSSION The potency of WS compared with CS in inducing mucin expression may explain the increased risk for chronic bronchitis in participants exposed to WS. Identification of the responsible compounds could help estimate the risk of pollutants in causing chronic bronchitis in susceptible individuals and provide strategies to improve management of lung diseases. https://doi.org/10.1289/EHP9446.
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Affiliation(s)
- Dereje Tassew
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Fort
- Chronic Obstructive Pulmonary Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA
| | - Yohannes Mebratu
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jacob McDonald
- Applied Sciences, Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA
| | - Hong Wei Chu
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Hans Petersen
- Chronic Obstructive Pulmonary Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA
| | - Yohannes Tesfaigzi
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Kang J, Jung JY, Huh JY, Ji HW, Kim HC, Lee SW. Behavioral interventions to reduce particulate matter exposure in patients with COPD. Medicine (Baltimore) 2021; 100:e28119. [PMID: 34889270 PMCID: PMC8663843 DOI: 10.1097/md.0000000000028119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is commonly affected by particulate matter (PM) exposure. In this study, we aimed to evaluate whether behavioral interventions to reduce PM exposure improve clinical outcomes in patients with COPD. METHODS A multicenter randomized controlled trial will be conducted involving 120 participants recruited from 3 hospitals in the capital region of the Republic of Korea. Patients aged 40 to 80 years with a diagnosis of COPD and a forced expiratory volume at 1 s <80% of the predicted value are eligible for inclusion. The participants will be randomized to either the intervention group or the usual care group (2:1). The behavioral interventions will comprise the following activities: checking air quality forecast; operating indoor air cleaners and regular check-ups of filters; ventilating the home regularly by opening windows; adhering to inhaler treatment; and refraining from going out on high air pollution days. "Internet-of-things"-based, gravimetric, and light-scattering methods will be used to measure indoor and outdoor PM concentrations. To estimate the degree of individual PM exposure, a time-activity diary and land use regression modeling will be used. The efficacy of the behavioral interventions on the following outcomes will be analyzed: amount of PM exposure, changes in forced expiratory volume at 1 s from the baseline, changes in respiratory symptoms and quality of life, risks of exacerbation, hospitalization, and death. DISCUSSION Given the harmful effect of air pollutants, individual-level interventions to reduce exposure may be significant. However, there is a lack of evidence on how effective such interventions are to date. This study will be able to provide physicians and patients with evidence-based strategies to reduce PM exposure in daily life. TRIAL REGISTRATION NUMBER NCT04878367.
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Affiliation(s)
- Jieun Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ji Ye Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Huh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Woo Ji
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Gruß I, McCreary GM, Ivlev I, Houlihan ME, Yawn BP, Pasquale C, Clark W, Mularski RA. Developing a patient-driven chronic obstructive pulmonary disease (COPD) research agenda in the U.S. J Patient Rep Outcomes 2021; 5:126. [PMID: 34865193 PMCID: PMC8643383 DOI: 10.1186/s41687-021-00399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To document a generalizable process for developing a patient-prioritized chronic obstructive pulmonary disease (COPD) research agenda and to provide an overview of domains that were developed in response to people living with COPD and caregivers' suggestions for research. METHODS Adults with COPD and caregivers who are members of the COPD Patient-Powered Research Network (PPRN) provided suggestions for COPD-related research through a self-administered, online survey. These responses were analyzed with a content analysis approach: domains for categorizing all survey responses were created, then all responses were categorized independently by a group of researchers, then these categorizations were adjudicated, and finally a density map was created that represented the number of responses in each of the domains. RESULTS At the time of analysis, 6157 adults had fully completed the baseline survey. Survey responses were categorized across seven domains as follows: 22.5% of all responses fell into the domain family/social/community research, 20.8% of all responses fell into the domain well-being, 15% of all responses fell into the domain curative research, 14.6% of all responses fell into the domain biomedical therapies, 10.5% of all responses fell into the domain policy concerns, 6% of all responses fell into the domain holistic therapies and 10.7% of all responses fell into the domain ambiguous comments that could not be translated into concrete research topics. CONCLUSION Using qualitative open-ended survey responses from the COPD PPRN registrants, we were able to identify six key domains of research about COPD that are considered most important by patients. These domains differ in content from prior scientist-led efforts to develop priorities for COPD research, demonstrating the ongoing importance of involving patients and their caregivers in determining research priorities. The results suggest the field can more closely align research efforts to patient priorities by considering the identified domains.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA.
| | | | - Ilya Ivlev
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | | | - Barbara P Yawn
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
- University of Minnesota, 6500 Delaware, Minneapolis, MN, 55449, USA
| | - Cara Pasquale
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
| | - William Clark
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
| | - Richard A Mularski
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
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Abdo M, Kanyomse E, Alirigia R, Coffey ER, Piedrahita R, Diaz-Sanchez D, Hagar Y, Naumenko DJ, Wiedinmyer C, Hannigan MP, Oduro AR, Dickinson KL. Health impacts of a randomized biomass cookstove intervention in northern Ghana. BMC Public Health 2021; 21:2211. [PMID: 34863138 PMCID: PMC8642932 DOI: 10.1186/s12889-021-12164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Household air pollution (HAP) from cooking with solid fuels has adverse health effects. REACCTING (Research on Emissions, Air quality, Climate, and Cooking Technologies in Northern Ghana) was a randomized cookstove intervention study that aimed to determine the effects of two types of "improved" biomass cookstoves on health using self-reported health symptoms and biomarkers of systemic inflammation from dried blood spots for female adult cooks and children, and anthropometric growth measures for children only. METHODS Two hundred rural households were randomized into four different cookstove groups. Surveys and health measurements were conducted at four time points over a two-year period. Chi-square tests were conducted to determine differences in self-reported health outcomes. Linear mixed models were used to assess the effect of the stoves on inflammation biomarkers in adults and children, and to assess the z-score deviance for the anthropometric data for children. RESULTS We find some evidence that two biomarkers of oxidative stress and inflammation, serum amyloid A and C-reactive protein, decreased among adult primary cooks in the intervention groups relative to the control group. We do not find detectable impacts for any of the anthropometry variables or self-reported health. CONCLUSIONS Overall, we conclude that the REACCTING intervention did not substantially improve the health outcomes examined here, likely due to continued use of traditional stoves, lack of evidence of particulate matter emissions reductions from "improved" stoves, and mixed results for HAP exposure reductions. CLINICAL TRIAL REGISTRY ClinicalTrials.gov (National Institutes of Health); Trial Registration Number: NCT04633135 ; Date of Registration: 11 November 2020 - Retrospectively registered. URL: https://clinicaltrials.gov/ct2/show/NCT04633135?term=NCT04633135&draw=2&rank=1.
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Affiliation(s)
- Mona Abdo
- Colorado School of Public Health, Aurora, USA
| | | | - Rex Alirigia
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, USA
| | - Evan R. Coffey
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, USA
| | | | - David Diaz-Sanchez
- Environmental Protection Agency Human Studies Facility, Chapel Hill, USA
| | - Yolanda Hagar
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, USA
| | - Daniel J. Naumenko
- Department of Anthropology, University of Colorado Boulder, Boulder, USA
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Christine Wiedinmyer
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, USA
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, USA
| | - Michael P. Hannigan
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, USA
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Ahmadi Y, Bhardwaj N, Kim KH, Kumar S. Recent advances in photocatalytic removal of airborne pathogens in air. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 794:148477. [PMID: 34198079 DOI: 10.1016/j.scitotenv.2021.148477] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/31/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
The abatement of airborne pathogens such as bacteria, viruses, and fungi has become an important goal of air-quality management. Efficient and effective treatment techniques such as photocatalysis are essential for disinfection of airborne microorganisms. This review focuses on recent advances in the formulation and development of photocatalytic disinfection, design of efficient photocatalysts, choice of photocatalytic reactor, removal and/or disinfection mechanisms, and the role of reactive ion species. Data from recent studies are analyzed to accurately assess the efficacy of such disinfection approaches. This review also highlights the application of innovative materials in individual and combined abatement systems against airborne bacterial, viral, and fungal pathogens. We discuss the efficiency and benefits presented by such systems, address the challenges, and provide a perspective for future research.
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Affiliation(s)
- Younes Ahmadi
- Department of Analytical Chemistry, Kabul University, Kabul 1001, Afghanistan
| | - Neha Bhardwaj
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul 04763, Republic of Korea.
| | - Sandeep Kumar
- Department of Bio and Nano Technology, Guru Jambheshwar University of Science and Technology, Hisar, Haryana 125001, India.
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Liang Z, Wang W, Wang Y, Ma L, Liang C, Li P, Yang C, Wei F, Li S, Zhang L. Urbanization, ambient air pollution, and prevalence of chronic kidney disease: A nationwide cross-sectional study. ENVIRONMENT INTERNATIONAL 2021; 156:106752. [PMID: 34256301 DOI: 10.1016/j.envint.2021.106752] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/23/2021] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
An increasing number of studies have linked ambient air pollution to chronic kidney disease (CKD) prevalence. However, its potential effect modification by urbanization has not been investigated. Based on data of 47,204 adults from the China National Survey of Chronic Kidney Disease (CKSCKD) dataset, night light satellite remote sensing data and high-resolution air pollution inversion products, the present cross-sectional study investigated the association between fine particulate matter <2.5 mm in diameter (PM2.5), nitrogen dioxide (NO2), night light index (NLI) and CKD prevalence in China, and the effect modification by urbanization characterized by administrative classification and NLI on the pollutant-health associations. Our results showed that a 10-μg/m3 increase in PM2.5 at 3-year moving average, a 10-μg/m3 increase in NO2 at 5-year moving average, and a 10-U increase in NLI at 5-year moving average were significantly associated with increased odds of CKD prevalence [OR = 1.24 (95 %CI:1.14, 1.35); OR = 1.12 (95 %CI:1.09, 1.15); OR = 1.05 (95 %CI:1.02, 1.07)]. Meanwhile, the pollutant-health associations were more apparent in medium-urbanized areas compared to low- and high-urbanized areas. For instance, a 10-μg/m3 increase in PM2.5 concentration at 2-year moving average was associated with increased odds of CKD in the areas with NLI level in the second [OR = 2.78 (95 %CI:1.77, 4.36)] and third quartiles [OR = 1.49 (95 %CI:1.14, 1.95)], compared to the lowest [OR = 0.96 (95% CI: 0.73, 1.26)] and highest [OR = 0.63 (95% CI: 0.39-1.02)] quartiles. PM2.5 and NO2 were associated with increased odds of CKD prevalence, especially in areas with medium NLI levels, suggesting the necessity of strengthening environmental management in medium-urbanized regions.
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Affiliation(s)
- Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wanzhou Wang
- School of Public Health, Peking University, Beijing 100191, China
| | - Yueyao Wang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Lin Ma
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Chenyu Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China
| | - Feili Wei
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Shuangcheng Li
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; National Institutes of Health Data Science at Peking University, Beijing 100191, China.
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Fuller DT, Kedar E, Lovelett CR, Mondal S, Sur S. Prevalence of Common Comorbidities in Rheumatoid Arthritis in Rural New York Compared With National Data. Cureus 2021; 13:e19432. [PMID: 34909337 PMCID: PMC8663125 DOI: 10.7759/cureus.19432] [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] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a systemic autoimmune disease with multiple known comorbidities and risk factors. The rate and severity of different comorbidities among RA patients are influenced by various demographic, behavioral, and socioeconomic factors, which can vary widely between urban and rural areas. However, limited information is currently available regarding the association of comorbidities with RA in rural settings. In this study, we investigated the prevalence of common comorbidities and risk factors of RA among RA patients from a rural hospital located in rural northern New York and compared them against national patient records obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Methodology We compared de-identified patient records of 153 RA patients obtained from St. Lawrence Health (SLH) to 198 RA patients from the NHAMCS. After performing the descriptive analyses and removing outliers, two-sample tests of proportions were used for comparing the binary categories of sex, age, obesity, hypertension, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) between the two datasets. These analyses were applied to both weighted and unweighted sets of national data, and a p-value of <0.05 was considered statistically significant. The differences were then explored at a greater resolution by binning body mass index, blood pressure (BP), COPD prevalence, and tobacco usage data across different age groups. Results A significantly higher rate of diastolic hypertension (χ2 = 17.942, w = 0.232, p < 0.001) and over two times higher prevalence of COPD (χ2 = 7.635, w = 0.147, p = 0.006) were observed among RA patients in the rural group. The rates of CHF were significantly different only when sample weighting was applied. When categorized by age groups, diastolic BP showed a peak at 40-49 years, coinciding with the age group for high tobacco smoking and peak disease activity in rural RA patients. Conclusions A higher prevalence of comorbidities of RA such as hypertension (diastolic) and COPD are observed in patients from northern rural New York compared to the national average. Our findings indicate that rural RA patients might have a distinct comorbidity burden, suggesting the need for larger-scale studies.
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Affiliation(s)
- Daniel T Fuller
- Department of Mathematics, Clarkson University, Potsdam, USA
| | - Eyal Kedar
- Clinical and Rural Health Research, St. Lawrence Health, Potsdam, USA
| | - Carly R Lovelett
- Clinical and Rural Health Research, St. Lawrence Health, Potsdam, USA
| | - Sumona Mondal
- Department of Mathematics, Clarkson University, Potsdam, USA
| | - Shantanu Sur
- Department of Biology, Clarkson University, Potsdam, USA
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Piracón JAB, Vallejo LAM, Cortés MAQ, Vasquez YA, Achury NJM, Cerón LCB, Hernández MA. Spirometry parameter alterations due to exposure to indoor air pollutants in rural homes in Bogotá, Colombia. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:57275-57287. [PMID: 34086176 DOI: 10.1007/s11356-021-14717-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to determine the association between the concentrations of intradomiciliary PM2.5, CO, and BC and alterations in respiratory function parameters in a population living in rural dwellings in Bogotá, Colombia. For this cross-sectional study, people were recruited from the rural areas of the localities of Usme and Sumapaz in Bogotá. In total, 68 participants were recruited by means of nonrandom sampling. Indoor air monitoring of PM2.5, BC, and CO was carried out. Additionally, evaluations of pulmonary function were performed using spirometry. The variables of pulmonary function were included in a multiple linear regression by successive steps and adjusted by the main variables described as modifiers of spirometry parameters, which are age, height, sex, disability, and a history of tobacco use. Assumptions of multicollinearity and the randomization of variances in the residuals were evaluated. Negative associations were found between spirometry parameters and the concentrations of indoor air pollutants. For FEV1/FVC and theoretical FEV1, there was a statistically significant association with the concentration of carbon monoxide (p = 0.003 and 0.019, respectively). The environmental concentrations were higher in homes where biomass was used for cooking, but these differences were statistically significant only for BC and CO (p = 0.008 and 0.03, respectively). The concentrations of carbon monoxide in rural homes were associated with alterations in respiratory function parameters.
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Yan M, Gong J, Liu Q, Li W, Duan X, Cao S, Li S, He L, Yin Z, Lin W, Zhang JJ. The effects of indoor and outdoor air pollution on the prevalence of adults' respiratory diseases in four Chinese cities: a comparison between 2017-2018 and 1993-1996. J Thorac Dis 2021; 13:4560-4573. [PMID: 34422382 PMCID: PMC8339734 DOI: 10.21037/jtd-20-2121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 04/25/2021] [Indexed: 11/24/2022]
Abstract
Background Over the past decades, both ambient and household air pollution have changed in several aspects, including the emission sources and the concentrations of pollutants, in many Chinese cities. It is unknown whether these changes are associated with changes in health conditions, especially given changes in other factors due to rapid economic growth. Methods Two cross-sectional surveys were conducted in two periods spanning more than twenty years (1993–1996 vs. 2017–2018) in four Chinese cities of Chongqing, Wuhan, Lanzhou, and Guangzhou. Data were collected regarding adults’ respiratory disease, smoking status, education, occupation, and household characteristics. Ambient air pollution data were obtained for each study. We first used logistic regression models to construct the district-specific adjusted disease prevalences. In the second stage, first-difference regression models were employed to examine whether the change in respiratory diseases prevalences was associated with the change in outdoor air pollution and indoor air pollution surrogates. Results A total of 7,557 and 9,974 households were participating in Period 1 (1993–1996) and Period 2 (2017–2018), respectively. Compared to Period 1, we found substantial reductions in the ambient air pollution concentrations, and a suggestive improvement in cooking-related indoor air pollution in Period 2. We observed decreases in the district-specific covariate-adjusted prevalences of both asthma and chronic bronchitis among participants, with an average reduction of 3.6% (range: 0.0% to 24.3%). From Period 1 to Period 2, one percent decrease in the proportion of cooking with coal was associated with a 19.0% (95% CI, 0.96–37.04%) decrease in the prevalence of males’ chronic bronchitis and a 1.86% (0.69–3.04%) increase in the prevalence of females’ asthma. Little evidence was observed regarding the potential health benefits associated with the decreases in ambient air pollution levels. Conclusions The substantial reduction in household use of coal for cooking might be an important contributor to the decrease in adults’ respiratory disease prevalence from 1993–1996 to 2017–2019 in four Chinese cities. Changes in this indoor air pollution source, along with other risk factors for respiratory diseases, may have masked respiratory health benefits associated with reductions in outdoor air pollution levels.
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Affiliation(s)
- Meilin Yan
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qin Liu
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Wenyan Li
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Lingyan He
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Zixuan Yin
- Key Laboratory for Urban Habitat Environmental Science and Technology, School of Environment and Energy, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Checkley W, Williams KN, Kephart JL, Fandiño-Del-Rio M, Steenland NK, Gonzales GF, Naeher LP, Harvey SA, Moulton LH, Davila-Roman VG, Goodman D, Tarazona-Meza C, Miele CH, Simkovich S, Chiang M, Chartier RT, Koehler K. Effects of a Household Air Pollution Intervention with Liquefied Petroleum Gas on Cardiopulmonary Outcomes in Peru. A Randomized Controlled Trial. Am J Respir Crit Care Med 2021; 203:1386-1397. [PMID: 33306939 DOI: 10.1164/rccm.202006-2319oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Rationale: Approximately 40% of people worldwide are exposed to household air pollution (HAP) from the burning of biomass fuels. Previous efforts to document health benefits of HAP mitigation have been stymied by an inability to lower emissions to target levels. Objectives: We sought to determine if a household air pollution intervention with liquefied petroleum gas (LPG) improved cardiopulmonary health outcomes in adult women living in a resource-poor setting in Peru. Methods: We conducted a randomized controlled field trial in 180 women aged 25-64 years living in rural Puno, Peru. Intervention women received an LPG stove, continuous fuel delivery for 1 year, education, and behavioral messaging, whereas control women were asked to continue their usual cooking practices. We assessed for stove use adherence using temperature loggers installed in both LPG and biomass stoves of intervention households. Measurements and Main Results: We measured blood pressure, peak expiratory flow (PEF), and respiratory symptoms using the St. George's Respiratory Questionnaire at baseline and at 3-4 visits after randomization. Intervention women used their LPG stove exclusively for 98% of days. We did not find differences in average postrandomization systolic blood pressure (intervention - control 0.7 mm Hg; 95% confidence interval, -2.1 to 3.4), diastolic blood pressure (0.3 mm Hg; -1.5 to 2.0), prebronchodilator peak expiratory flow/height2 (0.14 L/s/m2; -0.02 to 0.29), postbronchodilator peak expiratory flow/height2 (0.11 L/s/m2; -0.05 to 0.27), or St. George's Respiratory Questionnaire total score (-1.4; -3.9 to 1.2) over 1 year in intention-to-treat analysis. There were no reported harms related to the intervention. Conclusions: We did not find evidence of a difference in blood pressure, lung function, or respiratory symptoms during the year-long intervention with LPG. Clinical trial registered with www.clinicaltrials.gov (NCT02994680).
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Affiliation(s)
- William Checkley
- Division of Pulmonary and Critical Care, Department of Medicine, and.,Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Kendra N Williams
- Division of Pulmonary and Critical Care, Department of Medicine, and.,Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Josiah L Kephart
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Department of Environmental Health and Engineering
| | - Magdalena Fandiño-Del-Rio
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Department of Environmental Health and Engineering
| | - N Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Gustavo F Gonzales
- Department of Biological and Physiological Sciences and.,Laboratory for Research and Development, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia
| | - Steven A Harvey
- Department of International Health, Program in Social Behavioral Interventions, and
| | - Lawrence H Moulton
- Department of International Health, Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Victor G Davila-Roman
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, Cardiovascular Imaging and Clinical Research Core Lab, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Dina Goodman
- Division of Pulmonary and Critical Care, Department of Medicine, and.,Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Carla Tarazona-Meza
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Biomedical Research Unit, PRISMA, Lima, Peru; and
| | - Catherine H Miele
- Division of Pulmonary and Critical Care, Department of Medicine, and.,Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Suzanne Simkovich
- Division of Pulmonary and Critical Care, Department of Medicine, and.,Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Kirsten Koehler
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Department of Environmental Health and Engineering
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Shupler M, O'Keefe M, Puzzolo E, Nix E, Anderson de Cuevas R, Mwitari J, Gohole A, Sang E, Čukić I, Menya D, Pope D. Pay-as-you-go liquefied petroleum gas supports sustainable clean cooking in Kenyan informal urban settlement during COVID-19 lockdown. APPLIED ENERGY 2021; 292:116769. [PMID: 34140750 PMCID: PMC8121759 DOI: 10.1016/j.apenergy.2021.116769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Approximately 2.8 billion people rely on polluting fuels (e.g. wood, kerosene) for cooking. With affordability being a key access barrier to clean cooking fuels, such as liquefied petroleum gas (LPG), pay-as-you-go (PAYG) LPG smart meter technology may help resource-poor households adopt LPG by allowing incremental fuel payments. To understand the potential for PAYG LPG to facilitate clean cooking, objective evaluations of customers' cooking and spending patterns are needed. This study uses novel smart meter data collected between January 2018-June 2020, spanning COVID-19 lockdown, from 426 PAYG LPG customers living in an informal settlement in Nairobi, Kenya to evaluate stove usage (e.g. cooking events/day, cooking event length). Seven semi-structured interviews were conducted in August 2020 to provide context for potential changes in cooking behaviours during lockdown. Using stove monitoring data, objective comparisons of cooking patterns are made with households using purchased 6 kg cylinder LPG in peri-urban Eldoret, Kenya. In Nairobi, 95% of study households continued using PAYG LPG during COVID-19 lockdown, with consumption increasing from 0.97 to 1.22 kg/capita/month. Daily cooking event frequency also increased by 60% (1.07 to 1.72 events/day). In contrast, average days/month using LPG declined by 75% during lockdown (17 to four days) among seven households purchasing 6 kg cylinder LPG in Eldoret. Interviewed customers reported benefits of PAYG LPG beyond fuel affordability, including safety, time savings and cylinder delivery. In the first study assessing PAYG LPG cooking patterns, LPG use was sustained despite a COVID-19 lockdown, illustrating how PAYG smart meter technology may help foster clean cooking access.
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Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Corresponding author at: Department of Public Health, Policy and Systems, 3rd Floor, Whelan Building, Brownlow Hill, Liverpool L69 3GB, United Kingdom.
| | | | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Global LPG Partnership (GLPGP), 654 Madison Avenue, New York, United States
| | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | | | - James Mwitari
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Arthur Gohole
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Edna Sang
- School of Public Health, Moi University, Eldoret, Kenya
| | - Iva Čukić
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Diana Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
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The Awareness of Pulmonologists and Patients with Respiratory Diseases about the Impact of Air Pollution on Health in Poland. J Clin Med 2021; 10:jcm10122606. [PMID: 34204758 PMCID: PMC8231647 DOI: 10.3390/jcm10122606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 01/19/2023] Open
Abstract
Within the European Union, air pollution is highest in Poland. The aim of this study was to compare the awareness of Polish pulmonologists and that of patients with respiratory diseases about the impact of air pollution on health. It was a crossover study with voluntary and anonymous participation. The study included 309 pulmonologists and 262 patients with respiratory diseases. The majority of the patients declared good knowledge about the impact of air pollution on health, and only 16% of the pulmonologists declared sufficient knowledge on this topic. The main sources of information on air pollution were radio and television for patients and the medical press for doctors. Doctors rarely informed patients about the impact of air pollution on their disease. Patients followed information on the quality of air in their areas more often than doctors. Polish patients’ knowledge about the main sources of air pollution in their areas was higher than the knowledge of pulmonologists. Patients declared knowledge of air pollution standards twice as often as doctors. Patients with respiratory diseases are interested in the effects of air pollution on their health. Polish patients’ knowledge about air pollution and its health effects is higher than that of the specialists treating them. Professional education of Polish pulmonologists in this field is needed.
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Deng Y, Gao Q, Yang T, Wu B, Liu Y, Liu R. Indoor solid fuel use and incident arthritis among middle-aged and older adults in rural China: A nationwide population-based cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145395. [PMID: 33578144 DOI: 10.1016/j.scitotenv.2021.145395] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Many households in developing countries, including China, rely on the traditional use of solid fuels for cooking and heating. Arthritis is highly prevalent in middle-aged and older adults and is a major cause of disability. However, evidence linking indoor solid fuel use with arthritis is scarce in this age group (≥45 years) in developing countries. OBJECTIVES To investigate whether exposure to indoor solid fuel for cooking and heating is associated with arthritis in middle-aged and older adults in rural China. METHODS Data for the present study were extracted from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal national prospective study of adults aged 45 years and older enrolled in 2010 and followed up through 2015. We included 7807 rural participants without arthritis at baseline, of whom 1548 living in a central heating area in winter were included in the heating analysis (taking the Qinling-Huaihe line as the heating boundary). Cox proportional hazards models were used to examine the association between indoor solid fuel use and arthritis, controlling for age, sex, education, marital status, smoking status, drinking status, self-reported socioeconomic status, BMI, sleep time, napping time, independent cooking, hypertension, diabetes, dyslipidemia, heart problems and stroke. We also investigated the effect of switching primary fuels and using solid fuels for both cooking and heating on arthritis risk. RESULTS The mean (SD) age of the study participants was 59.2 (10.0) years old, and 48.0% of participants were women. A total of 64.8% and 63.0% of the participants reported primarily using solid fuel for cooking and heating, respectively. Arthritis incidence rates were lower among clean fuel users than solid fuel users. Compared to those using clean fuels, cooking and heating solid fuel users had a higher risk of arthritis, with hazard ratios (HRs) of 1.22 (95% confidence interval (CI): 1.01, 1.49) and 1.76 (95% CI: 1.07, 2.89), respectively. Switching from clean fuels to solid fuels for heating (HR: 3.28, 95% CI: 1.21, 7.91) and using solid fuels for both cooking and heating (HR, 1.71, 95% CI, 1.01-2.79) increased the risk of arthritis. CONCLUSIONS Long-term solid fuel use for indoor cooking and heating is associated with an increased risk of arthritis events among adults aged 45 years and older in rural China. The potential benefits of reducing indoor solid fuel use in groups at high risk for arthritis merit further exploration.
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Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tianyao Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Bo Wu
- Department of Anal and Rectal Diseases, First Hospital, China Medical University, Shenyang 110001, China
| | - Yang Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Ruxi Liu
- Department of Immunology and Rheumatology, First Hospital, China Medical University, Shenyang 110001, China.
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Neighborhood level chronic respiratory disease prevalence estimation using search query data. PLoS One 2021; 16:e0252383. [PMID: 34106982 PMCID: PMC8189491 DOI: 10.1371/journal.pone.0252383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Estimation of disease prevalence at sub-city neighborhood scale allows early and targeted interventions that can help save lives and reduce public health burdens. However, the cost-prohibitive nature of highly localized data collection and sparsity of representative signals, has made it challenging to identify neighborhood scale prevalence of disease. To overcome this challenge, we utilize alternative data sources, which are both less sparse and representative of localized disease prevalence: using query data from a large commercial search engine, we identify the prevalence of respiratory illness in the United States, localized to census tract geographic granularity. Focusing on asthma and Chronic Obstructive Pulmonary Disease (COPD), we construct a set of features based on searches for symptoms, medications, and disease-related information, and use these to identify illness rates in more than 23 thousand tracts in 500 cities across the United States. Out of sample model estimates from search data alone correlate with ground truth illness rate estimates from the CDC at 0.69 to 0.76, with simple additions to these models raising those correlations to as high as 0.84. We then show that in practice search query data can be added to other relevant data such as census or land cover data to boost results, with models that incorporate all data sources correlating with ground truth data at 0.91 for asthma and 0.88 for COPD.
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Campbell CA, Bartington SE, Woolley KE, Pope FD, Thomas GN, Singh A, Avis WR, Tumwizere PR, Uwanyirigira C, Abimana P, Kabera T. Investigating Cooking Activity Patterns and Perceptions of Air Quality Interventions among Women in Urban Rwanda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5984. [PMID: 34199593 PMCID: PMC8199661 DOI: 10.3390/ijerph18115984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/03/2022]
Abstract
Household air pollution (HAP) from biomass cooking with traditional stoves is a major cause of morbidity and mortality in low-and-middle-income countries (LMICs) worldwide. Air quality interventions such as improved cookstoves (ICS) may mitigate HAP-related impacts; however, poor understanding of contextual socio-cultural factors such as local cooking practices have limited their widespread adoption. Policymakers and stakeholders require an understanding of local cooking practices to inform effective HAP interventions which meet end-user needs. A semi-structured questionnaire was administered to 36 women residing in biomass-cooking fuel households in Kigali, Rwanda to identify cooking activity patterns, awareness of HAP-related health risks and ICS intervention preferences. Overall, 94% of respondents exclusively used charcoal cooking fuel and 53% cooked one meal each day (range = 1-3 meals). Women were significantly more likely to cook outdoors compared to indoors (64% vs. 36%; p < 0.05). Over half of respondents (53%) were unaware of HAP-related health risks and 64% had no prior awareness of ICS. Participants expressed preferences for stove mobility (89%) and facility for multiple pans (53%) within an ICS intervention. Our findings highlight the need for HAP interventions to be flexible to suit a range of cooking patterns and preferred features for end-users in this context.
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Affiliation(s)
- Catherine A. Campbell
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
- NHS Lothian, Waverly Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, UK
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (G.N.T.)
| | - Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (G.N.T.)
| | - Francis D. Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (F.D.P.); (A.S.)
| | - Graham Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (G.N.T.)
| | - Ajit Singh
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (F.D.P.); (A.S.)
| | - William R. Avis
- International Development, School of Government, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
| | - Patrick R. Tumwizere
- College of Science and Technology, University of Rwanda, Avenue de l’Armee, Kigali P.O. Box 3900, Rwanda; (P.R.T.); (C.U.); (P.A.); (T.K.)
| | - Clement Uwanyirigira
- College of Science and Technology, University of Rwanda, Avenue de l’Armee, Kigali P.O. Box 3900, Rwanda; (P.R.T.); (C.U.); (P.A.); (T.K.)
| | - Pacifique Abimana
- College of Science and Technology, University of Rwanda, Avenue de l’Armee, Kigali P.O. Box 3900, Rwanda; (P.R.T.); (C.U.); (P.A.); (T.K.)
| | - Telesphore Kabera
- College of Science and Technology, University of Rwanda, Avenue de l’Armee, Kigali P.O. Box 3900, Rwanda; (P.R.T.); (C.U.); (P.A.); (T.K.)
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