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Puci MV, Ferraro OE, Monti MC, Gnesi M, Borrelli P, Cadum E, Perotti P, Migliazza S, Dalle Carbonare S, Montomoli C, Villani S. Asthma, COPD, Respiratory, and Allergic Health Effects in an Adult Population Living near an Italian Refinery: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11071037. [PMID: 37046964 PMCID: PMC10093894 DOI: 10.3390/healthcare11071037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND AND AIM Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Globally, 545 million people suffer from chronic respiratory diseases with a wide geographical variability. Risk factors for asthma are both genetic and related to several environmental factors (internal and external pollutants); these also have an important role in the occurrence of COPD. The aim of this study was to describe the prevalence of asthma, COPD, and asthma/COPD overlap (ACO) in an adult population living in two municipalities located in the Po Valley. METHODS A standardized questionnaire on respiratory symptoms and sociodemographic characteristics was self-administered to a random sample of the adult population aged 20-64 years, living near a refinery in Northern Italy during the period between 2016 and 2019. Logistic and multinomial regression were implemented to explore factors associated with asthma, COPD, and ACO. RESULTS In total, 1108 subjects filled out the questionnaire, the mean age was 48.02 ± 12.34 years (range 21-68), and 53% of the respondents/participants were female. Half of the responders were non-smokers, but the frequency of current and former smokers was significantly greater in men than in women (p < 0.001). The likelihood of being a probable case of asthma decreased with increasing age and increased for smokers. Tobacco smoke was associated with the presence of COPD and ACO. CONCLUSION Respiratory diseases such as asthma and COPD are common in the general population, with differences among countries worldwide. Our findings show, on the basis of the main confirmed risk factor, namely smoking, that it is useful to plan target programs and actions in order to reduce smoking, thus improving the quality of life in public health.
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Affiliation(s)
- Mariangela Valentina Puci
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Ottavia Eleonora Ferraro
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Maria Cristina Monti
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Marco Gnesi
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Ennio Cadum
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Pietro Perotti
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Simona Migliazza
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | | | - Cristina Montomoli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
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Joseph SP, Borrell LN, Lovinsky-Desir S, Moroko AR, Li S. Bullying and lifetime asthma among children and adolescents in the United States. Ann Epidemiol 2022; 69:41-47. [PMID: 35202781 DOI: 10.1016/j.annepidem.2022.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/25/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the association of experiencing bullying within the past year with the prevalence of lifetime childhood asthma in US children and adolescents; and whether this associations vary with sex of the child and select socioeconomic indicators. METHODS We performed secondary analysis of data from the 2018 National Survey of Children's Health participants aged 6 to 17 years (n=19,766). We used log-binomial regression to examine the association between bullying and lifetime childhood asthma before and after controlling for select covariates. We also tested interactions of bullying with sex and select socioeconomic indicators. RESULTS Children who experience bullying have a significantly increased probability of having asthma in adjusted analyses. The probability of childhood asthma increased with the frequency of bullying with PRs starting at 1.28 (95%CI:1.06, 1.55) for children bullied 1-2 times per year to 1.59 (95%:1.22, 2.09) for those being bullied at least 4 times per month. This association did not differ with sex of the child and select socioeconomic indicators. CONCLUSION We found that children who experienced bullying had a greater probability of having asthma relative to those who never experienced bullying. These finding highlight the impact of psychosocial stressors on asthma as a nontraditional trigger in children with asthma.
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Affiliation(s)
- Sharon P Joseph
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health & Health Policy.
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health & Health Policy
| | | | - Andrew R Moroko
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health & Health Policy
| | - Sheng Li
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health & Health Policy
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Zhang L, Yi H, Sang N. Sulfur dioxide-induced exacerbation of airway inflammation via reactive oxygen species production and the toll-like receptor 4/nuclear factor-κB pathway in asthmatic mice. Toxicol Ind Health 2021; 37:564-572. [PMID: 34448417 DOI: 10.1177/07482337211033136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sulfur dioxide (SO2) is a common air pollutant that can exacerbate asthmatic airway inflammation. The mechanisms underlying these effects are not yet fully understood. In this study, we investigated the effects of SO2 exposure (10 mg/m3) on asthmatic airway inflammation in ovalbumin-induced asthmatic mice. Our results showed that SO2 exposure alone induced slight airway injury, decreased superoxide dismutase activity, and increased nuclear factor-κB (NF-κB) expression in the lungs of mice. Moreover, SO2 exposure in asthmatic mice induced marked pathological damage, significantly increased the counts of inflammatory cells (e.g., macrophages, lymphocytes, and eosinophils) in bronchoalveolar lavage fluid, and significantly enhanced malondialdehyde and glutathione levels in the lungs. Moreover, the expression of toll-like receptor 4 (TLR4), NF-κB, pro-inflammatory cytokines (e.g., tumor necrosis factor α and interleukin-6), and type II T-helper cell (Th2) cytokines was found to be elevated in the mice exposed to SO2 and ovalbumin compared to those exposed to ovalbumin alone. These results suggest that SO2 amplifies Th2-mediated inflammatory responses, which involve reactive oxygen species and TLR4/NF-κB pathway activation; these can further enhance Th2 cytokine expression and eosinophilic inflammation. Thus, our findings provide important evidence to understand a potential mechanism through which SO2 may exacerbate airway asthmatic inflammation.
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Affiliation(s)
- Lingxiu Zhang
- School of Life Science, 12441Shanxi University, Taiyuan, China.,College of Environment and Resource Sciences, 12441Shanxi University, Taiyuan, China.,Department of Biology, 66353Xinzhou Teachers University, Xinzhou, China
| | - Huilan Yi
- School of Life Science, 12441Shanxi University, Taiyuan, China
| | - Nan Sang
- College of Environment and Resource Sciences, 12441Shanxi University, Taiyuan, China
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Willis M, Hystad P, Denham A, Hill E. Natural gas development, flaring practices and paediatric asthma hospitalizations in Texas. Int J Epidemiol 2021; 49:1883-1896. [PMID: 32879945 DOI: 10.1093/ije/dyaa115] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent advancements in drilling technology led to a rapid increase in natural gas development (NGD). Air pollution may be elevated in these areas and may vary by drilling type (conventional and unconventional), production volume and gas flaring. Impacts of NGD on paediatric asthma are largely unknown. This study quantifies associations between specific NGD activities and paediatric asthma hospitalizations in Texas. METHODS We leveraged a database of Texas inpatient hospitalizations between 2000 and 2010 at the zip code level by quarter to examine associations between NGD and paediatric asthma hospitalizations, where our primary outcome is 0 vs ≥1 hospitalization. We used quarterly production reports to assess additional drilling-specific exposures at the zip code-level including drilling type, production and gas flaring. We developed logistic regression models to assess paediatric asthma hospitalizations by zip code-quarter-year observations, thus capturing spatiotemporal exposure patterns. RESULTS We observed increased odds of ≥1 paediatric asthma hospitalization in a zip code per quarter associated with increasing tertiles of NGD exposure and show that spatiotemporal variation impacts results. Conventional drilling, compared with no drilling, is associated with odds ratios up to 1.23 [95% confidence interval (CI): 1.13, 1.34], whereas unconventional drilling is associated with odds ratios up to 1.59 (95% CI: 1.46, 1.73). Increasing production volumes are associated with increased paediatric asthma hospitalizations in an exposure-response relationship, whereas associations with flaring volumes are inconsistent. CONCLUSIONS We found evidence of associations between paediatric asthma hospitalizations and NGD, regardless of drilling type. Practices related to production volume may be driving these positive associations.
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Affiliation(s)
- Mary Willis
- School of Biological & Population Health, College of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Perry Hystad
- School of Biological & Population Health, College of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Alina Denham
- Department of Public Health Sciences, School of Medicine & Dentistry, University of Rochester, Rochester, NY, USA
| | - Elaine Hill
- School of Biological & Population Health, College of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USA.,Department of Public Health Sciences, School of Medicine & Dentistry, University of Rochester, Rochester, NY, USA
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Khatatbeh M, Alzoubi K, Khabour O, Al-Delaimy W. Adverse Health Impacts of Living Near an Oil Refinery in Jordan. ENVIRONMENTAL HEALTH INSIGHTS 2020; 14:1178630220985794. [PMID: 33488089 PMCID: PMC7768879 DOI: 10.1177/1178630220985794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Air pollution can adversely affect the health of communities and manifest as a variety of symptoms. OBJECTIVE This study aimed at assessing health symptoms among populations living near an oil refinery in Jordan. METHODS A cross-sectional survey study was conducted utilizing convenient random sampling at Al-Hashimeya town (where the refinery is located) and Bal'ma town (about 12 km further away from refinery). A total of 486 participants were recruited for the study. The data were checked, coded, and entered to excel sheet and exported to the Statistical Package for Social Science (SPSS) Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽ 0.25 were fitted to multivariate logistic regression so as to assess the presence and strength of associations between socio-demographic characteristics and health symptoms and outcomes. A P value < 0.05 was considered for statistical significance. RESULTS In the cross tabulation analysis, there were significant differences in the reported respiratory health problems and history of abortions in the family between residents in the 2 towns (P < 0.05). Only 4.7% of Al-Hashimeya residents were extremely enjoying their town compared to 32.9% among Bal'ma residents (P < 0.001). In addition, residents of Al-Hashimeya were at several folds higher risk to have phlegm and about 3 times more likely to have skin problems compared to participants from Bal'ma (P < 0.001). Furthermore, reporting asthma was substantially higher among Al-Hashimeya residents (odds ratio [OR] = 5.20; 95% confidence interval [CI]: 2.11-12.84), and they were more likely to perceive the neighboring oil refinery industry as the leading cause of their health problems than Bal'ma residents (OR = 86.40; 95%CI: 45.95-162.44). CONCLUSION Residents living close to the oil refinery industry in Jordan report adverse impacts on their health, including respiratory problems, skin diseases, and perception of poor health.
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Affiliation(s)
- Moawiah Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Karem Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Wael Al-Delaimy
- Department of Family Medicine and Public Health, School of Medicine, University of California at San Diego, La Jolla, CA, USA
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Yang F, Zhang W, Zhao Y, Ji Y, Liu B, Zhou K. Optimization of Working Conditions by Response Surface Methodology of Sulfur Dioxide Gas Sensors Based on Au/CoO‐2La
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Nanoparticles. ChemistrySelect 2020. [DOI: 10.1002/slct.202001415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Fuxiu Yang
- Biochemical Engineering College Beijing Union University Beijing 100023 China
| | - Wenjuan Zhang
- Biochemical Engineering College Beijing Union University Beijing 100023 China
| | - Youxi Zhao
- Biochemical Engineering College Beijing Union University Beijing 100023 China
- Beijing Key Laboratory of Biomass Waste Resource Utilization Beijing 100023 China
| | - Yizhi Ji
- Biochemical Engineering College Beijing Union University Beijing 100023 China
- Beijing Key Laboratory of Biomass Waste Resource Utilization Beijing 100023 China
| | - Baining Liu
- Biochemical Engineering College Beijing Union University Beijing 100023 China
- Beijing Key Laboratory of Biomass Waste Resource Utilization Beijing 100023 China
| | - Kaowen Zhou
- Biochemical Engineering College Beijing Union University Beijing 100023 China
- Beijing Key Laboratory of Biomass Waste Resource Utilization Beijing 100023 China
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Marquès M, Domingo JL, Nadal M, Schuhmacher M. Health risks for the population living near petrochemical industrial complexes. 2. Adverse health outcomes other than cancer. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 730:139122. [PMID: 32388111 DOI: 10.1016/j.scitotenv.2020.139122] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 05/12/2023]
Affiliation(s)
- Montse Marquès
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - José L Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia, Spain.
| | - Martí Nadal
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - Marta Schuhmacher
- Departament d'Enginyeria Química, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia, Spain
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Casey JA, Su JG, Henneman LR, Zigler C, Neophytou AM, Catalano R, Gondalia R, Chen YT, Kaye L, Moyer SS, Combs V, Simrall G, Smith T, Sublett J, Barrett MA. Improved asthma outcomes observed in the vicinity of coal power plant retirement, retrofit, and conversion to natural gas. NATURE ENERGY 2020; 5:398-408. [PMID: 32483491 PMCID: PMC7263319 DOI: 10.1038/s41560-020-0600-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 03/06/2020] [Indexed: 05/25/2023]
Abstract
Coal-fired power plants release substantial air pollution, including over 60% of U.S. sulfur dioxide (SO2) emissions in 2014. Such air pollution may exacerbate asthma however direct studies of health impacts linked to power plant air pollution are rare. Here, we take advantage of a natural experiment in Louisville, Kentucky, where one coal-fired power plant retired and converted to natural gas, and three others installed SO2 emission control systems between 2013 and 2016. Dispersion modeling indicated exposure to SO2 emissions from these power plants decreased after the energy transitions. We used several analysis strategies, including difference-in-differences, first-difference, and interrupted time-series modeling to show that the emissions control installations and plant retirements were associated with reduced asthma disease burden related to ZIP code-level hospitalizations and emergency room visits, and individual-level medication use as measured by digital medication sensors.
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Affiliation(s)
- Joan A. Casey
- School of Public Health, University of California, Berkeley, California, USA 94720
- Columbia University Mailman School of Public Health, New York, New York, USA 10032
| | - Jason G. Su
- School of Public Health, University of California, Berkeley, California, USA 94720
| | - Lucas R.F. Henneman
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA 02115
| | - Corwin Zigler
- Department of Statistics and Data Sciences and Department of Women's Health, University of Texas, Austin, Texas, USA
| | - Andreas M. Neophytou
- School of Public Health, University of California, Berkeley, California, USA 94720
- Department of Environmental and Radiological Sciences, Colorado State University, Fort Collins, Colorado, USA 80523
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, California, USA 94720
| | | | - Yu-Ting Chen
- Louisville Metro Department of Public Health and Wellness, Louisville, Kentucky, USA 40202
| | - Leanne Kaye
- Propeller Health, San Francisco, California, USA 94108
| | - Sarah S. Moyer
- Louisville Metro Department of Public Health and Wellness, Louisville, Kentucky, USA 40202
| | - Veronica Combs
- Christina Lee Brown Environment Institute, University of Louisville, Louisville, Kentucky, USA 40202
| | - Grace Simrall
- Louisville Metro Office of Civic Innovation, Louisville, Kentucky, USA 40202
| | - Ted Smith
- Christina Lee Brown Environment Institute, University of Louisville, Louisville, Kentucky, USA 40202
| | - James Sublett
- Family Allergy & Asthma, Louisville, Kentucky, USA 40223
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Rosser F, Forno E, Kurland KS, Han YY, Mair C, Acosta-Pérez E, Canino G, Celedón JC. Annual SO 2 exposure, asthma, atopy, and lung function in Puerto Rican children. Pediatr Pulmonol 2020; 55:330-337. [PMID: 31805225 PMCID: PMC7122992 DOI: 10.1002/ppul.24595] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/20/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Long-term effects of sulfur dioxide (SO2 ) exposure on children, a vulnerable population, are largely unknown. Further, how long-term SO2 affects Puerto Rican children living in the island of Puerto Rico, a group with high asthma prevalence, is unclear. We evaluated the effects of annual average 1-hour daily maximum SO2 average on asthma, atopy, total immunoglobulin E (IgE), and lung function in Puerto Rican children. METHODS A cohort of 678 children (351 with asthma, 327 without asthma) was recruited in Puerto Rico from 2009 to 2010. Annual average 1-hour daily maximum SO2 exposure was interpolated utilizing publicly available monitoring data. Multivariable logistic and linear regression was used for the analysis of asthma, atopy (defined as an IgE ≥0.35 IU/mL to at least one of five common aero-allergens), total IgE, and lung function measures (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], and FEV1/FVC ratio). RESULTS Annual SO2 exposure (per 1 ppb) was significantly associated with asthma (odds ratio [OR] = 1.42; 95% confidence interval [CI] = 1.05-1.91) and atopy (OR = 1.35; 95% CI = 1.02-1.78). Such exposure was also significantly associated with lower FEV1/FVC in all children (β = -1.42; 95% CI = -2.78 to -0.08) and in children with asthma (β = -2.39; 95% CI= -4.31 to -0.46). Annual SO2 exposure was not significantly associated with total IgE, FEV1, or FVC. CONCLUSIONS Among Puerto Rican children in Puerto Rico, long-term SO2 exposure is linked to asthma and atopy. In these children, long-term SO2 exposure is also associated with reduced FEV1/FVC, particularly in those with asthma.
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Affiliation(s)
- Franziska Rosser
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kristen S Kurland
- H John Heinz III College and School of Architecture, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute of Puerto Rico, University of Puerto Rico, San Juan, Puerto Rico
| | - Glorisa Canino
- Behavioral Sciences Research Institute of Puerto Rico, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
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Review of the effect of air pollution exposure from industrial point sources on asthma-related effects in childhood. Environ Epidemiol 2019; 3:e077. [PMID: 33778345 PMCID: PMC7939412 DOI: 10.1097/ee9.0000000000000077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/10/2019] [Indexed: 01/01/2023] Open
Abstract
We reviewed epidemiologic studies of the association between exposure to air pollution from industries and asthma-related outcomes in childhood. We searched bibliographic databases and reference lists of relevant articles to identify studies examining the association between children's exposure to air pollution from industrial point-sources and asthma-related outcomes, including asthma, asthma-like symptoms, wheezing, and bronchiolitis. We extracted key characteristics of each study and when appropriate we performed a random-effects meta-analysis of results and quantified heterogeneity (I 2). Thirty-six studies were included in this review. Meta-analysis was generally not possible and limited to a few studies because of substantial variation across design characteristics and methodologies. In case-crossover studies using administrative health data, pooled odds ratio (OR) of hospitalization for asthma and bronchiolitis in children <5 years were 1.02 [95% confidence intervals (CI): 0.96, 1.08; I 2 = 56%] and 1.01 (95% CI: 0.97, 1.05; I 2 = 64%) per 10 ppb increase in the daily mean and hourly maximum concentration of sulfur dioxide (SO2), respectively. For PM2.5, pooled ORs were 1.02 (95% CI: 0.93, 1.10; I 2 = 56%) and 1.01 (95% CI: 0.98, 1.03 I 2 = 33%) per 10 μg/m3 increment in the daily mean and hourly maximum concentration. In cross-sectional studies using questionnaires, pooled ORs for the prevalence of asthma and wheezing in relation to residential proximity to industry were 1.98 (95% CI: 0.87, 3.09; I 2 =71%) and 1.33 (95% CI: 0.86, 1.79; I 2= 65%), respectively. In conclusion, this review showed substantial heterogeneity across study designs and methods. Meta-analysis results suggested no evidence of an association for short-term asthma-related effects and an indication for long-term effects, but heterogeneity between results and limitations in terms of design and exposure assessment preclude drawing definite conclusions. Further well-conducted studies making use of a longitudinal design and of refined exposure assessment methods are needed to improve risk estimates.
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Kuo CY, Chan CK, Wu CY, Phan DV, Chan CL. The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020203. [PMID: 30642061 PMCID: PMC6351918 DOI: 10.3390/ijerph16020203] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
- Department of Biotechnology, Ming Chuan University, 5 De Ming Road, Gui Shan Dist., Taoyuan 333, Taiwan.
| | - Chiung-Yi Wu
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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Krishnan S, Panacherry S. Asthma, Environment and Pollution: Where the Rubber Hits the Road. Indian J Pediatr 2018; 85:893-898. [PMID: 29845404 DOI: 10.1007/s12098-018-2691-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
The detrimental effects of environmental pollution on one's health are undeniable and have been demonstrated time and time again. Breathing in pollutants in ambient air often has consequences throughout the body, including cardiovascular disease, effects on the reproductive system, and oncologic implications. In the respiratory system, chronic exposure yields a number of outcomes, including chronic obstructive pulmonary disease (COPD) and asthma exacerbations, increased rates of hospitalizations, and increased severity of acute illnesses. On a macro-level, this morbidity and mortality then leads to vast and far-reaching public health consequences the world over, including the loss of billions of dollars' worth of labor. This is especially applicable in developing countries, which often undergo rapid growth, industrialization and urbanization with a resultant increase in vehicular traffic, coal combustion, and fuel emissions as a whole. For this reason, environmental pollutants have been studied extensively, and countries around the globe have established laws that regulate ambient air levels of so-called criteria pollutants. This article will explore several of these criteria pollutants, including particulate matter, nitrogen dioxide, sulfur dioxide, and ozone, and their individual relationships to asthma pathophysiology. However, it is also emphasized that though each one of these toxins yields its own effects, the group of them often works together to have cumulative consequences. For these reasons and many more, it is important to remain aware and educated about these omnipresent environmental pollutants.
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Affiliation(s)
- Sankaran Krishnan
- New York Medical College and Maria Fareri Children's Hospital at Westchester Medical Center, 40 Sunshine Cottage Road - Skyline 1N-D29, Valhalla, NY, 10595, USA.
| | - Sherin Panacherry
- New York Medical College and Maria Fareri Children's Hospital at Westchester Medical Center, 40 Sunshine Cottage Road - Skyline 1N-D29, Valhalla, NY, 10595, USA
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Li X, Huang L, Wang N, Yi H, Wang H. Sulfur dioxide exposure enhances Th2 inflammatory responses via activating STAT6 pathway in asthmatic mice. Toxicol Lett 2017; 285:43-50. [PMID: 29288730 DOI: 10.1016/j.toxlet.2017.12.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/12/2017] [Accepted: 12/27/2017] [Indexed: 01/13/2023]
Abstract
Sulfur dioxide (SO2) is one of potential risk factors for induction and/or exacerbation of asthma, but the underlying mechanisms are not well understood. In this study, we investigate the role of SO2 in asthma using a classical asthmatic model with allergic airway inflammation by treating C57BL/6 mice with ovalbumin (OVA) and/or 10 mg/m3 SO2. Our results showed that SO2 exposure alone induced slight pathological changes but did not significantly increase inflammatory cell counts, pro-inflammatory cytokine expression, and mucus production in the airway of mice, whereas SO2 exposure in OVA-induced asthmatic mice caused marked pulmonary pathological changes and significantly increased the counts of eosinophil-rich leukocytes compared with OVA alone asthmatic mice. The expression of MUC5AC, TNF-α, Th2 cytokines (IL-4, IL-5, and IL-13) and STAT6 was further up-regulated in OVA plus SO2 treated mice compared with OVA alone treated mice. In addition, exposure to SO2 alone markedly elevated STAT6 mRNA levels and hydrogen peroxide (H2O2) content in the lung. These findings suggest that SO2 amplifies Th2 inflammatory responses in OVA-induced asthmatic mice by activating STAT6, which can further induce Th2 cytokine expression. Induction of STAT6 expression might be an important mechanism underlying the increased risk for asthma after environmental exposure.
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Affiliation(s)
- Xiujuan Li
- School of Life Science, Shanxi University, Taiyuan 030006, China; College of Environment and Resource, Shanxi University, Taiyuan 030006, China
| | - Liqun Huang
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Na Wang
- School of Life Science, Shanxi University, Taiyuan 030006, China
| | - Huilan Yi
- School of Life Science, Shanxi University, Taiyuan 030006, China.
| | - Hong Wang
- School of Life Science, Shanxi University, Taiyuan 030006, China; Monell Chemical Senses Center, Philadelphia, PA, USA
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Chiang TY, Yuan TH, Shie RH, Chen CF, Chan CC. Increased incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO 2 pollution. ENVIRONMENT INTERNATIONAL 2016; 96:1-7. [PMID: 27585759 DOI: 10.1016/j.envint.2016.08.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/25/2016] [Accepted: 08/17/2016] [Indexed: 06/06/2023]
Abstract
This study aims to investigate incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO2 pollution obtained by air monitoring stations. A total of 587 children aged 11 to 14 were recruited and classified into high and low exposure groups based on a radius of 10km from the complex. To study the influence of health on children since the operation of complex in 1999 and observe the difference of these diseases' short-term and long-term impact, we obtained the incidence rates of allergic rhinitis (ICD-9: 477), bronchitis (490-491) and asthma (493) from the Taiwan Health Insurance Database for three periods: 1999-2002, 1999-2006, and 1999-2010. Since 2001, the mean and 99th percentile of SO2 concentrations in the high exposure area have been significantly higher than those in low exposure area. There were significant differences between the high and low exposure groups in the percentage of smoking, alcohol consumption, passive smoking exposure and incense burning habits. The incidence rates of three intervals were 26.9%, 35.7%, 41.7%; 8.3%, 8.8%, 10.2%; 18.5%, 25.0%, 26.9% for allergic rhinitis, bronchitis and asthma in high exposure group. Significant differences were found between groups for allergic rhinitis in all periods, bronchitis in the first two periods, and asthma in the first period using Student's t-test. After we adjusted age, gender, group, living near roads, incense burning and passive smoking exposure, the hazard ratios between exposure groups were 3.05, 2.74, and 1.93 for allergic rhinitis with significant difference in three periods, and 2.53, 1.92 and 1.72 for bronchitis with significant difference in first period and 1.60, 1.28 and 1.29 for asthma with significant difference in first period by Cox regression. The higher incidence of allergic rhinitis was related to boys and living near roads and the higher incidence of asthma was also related to younger children, boys, and passive smoking exposure.
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Affiliation(s)
- Tzu-Ying Chiang
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tzu-Hsuen Yuan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ruei-Hao Shie
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Chen-Fang Chen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Brand A, McLean KE, Henderson SB, Fournier M, Liu L, Kosatsky T, Smargiassi A. Respiratory hospital admissions in young children living near metal smelters, pulp mills and oil refineries in two Canadian provinces. ENVIRONMENT INTERNATIONAL 2016; 94:24-32. [PMID: 27203781 DOI: 10.1016/j.envint.2016.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/02/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Industrial plants emit air pollutants like fine particles (PM2.5), sulfur dioxide (SO2) and nitrogen dioxide (NO2) that may affect the health of individuals living nearby. OBJECTIVE To assess the effects of community exposure to air emissions of PM2.5, SO2, and NO2 from pulp mills, oil refineries, metal smelters, on respiratory hospital admissions in young children in Quebec (QC) and British Columbia (BC), Canada. METHODS We assessed QC, BC and pooled associations between the following estimates of exposure and hospital admissions for asthma and bronchiolitis in children aged 2-4years for the years 2002-2010: i) Crude emission exposures at the residential postal codes of children, calculated by multiplying estimated daily emissions of PM2.5, SO2, or NO2 from all nearby (<7.5km) pulp mills, oil refineries, metal smelters emitting yearly ≥50t and their total emissions, by the percent of the day each postal code was downwind; ii) Daily levels of these pollutants at central ambient monitoring stations nearby the industries and the children's residences. RESULTS Seventy-one major industries were selected between QC and BC, with a total of 2868 cases included in our analyses. More cases were exposed to emissions from major industries in QC than in BC (e.g. 2505 admissions near SO2 industrial emitters in QC vs 334 in BC), although air pollutant levels were similar. Odds ratios (ORs) for crude refinery and smelter emissions were positive in QC but more variable in BC. For example with PM2.5 in QC, ORs were 1.13 per 0.15t/day (95% CI: 1.00-1.27) and 1.03 (95% CI: 0.99-1.07) for refinery and smelter emissions, respectively. Pooled results of QC and BC for crude total SO2 emissions from all sources indicated a 1% increase (0-3%) in odds of hospital admissions per 1.50t/day increase in exposure. Associations with measured pollutant levels were only seen in BC, with SO2 and NO2. CONCLUSION Hospital admissions for wheezing diseases in young children were associated with community exposure to industrial air pollutant emissions. Future work is needed to better assess the risk of exposure to complex mixture of air pollutants from multiple industrial sources.
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Affiliation(s)
- Allan Brand
- Quebec Institute of Public Health, Québec, Canada
| | - Kathleen E McLean
- British Columbia Center for Disease Control, British Columbia, Canada
| | - Sarah B Henderson
- British Columbia Center for Disease Control, British Columbia, Canada
| | | | - Ling Liu
- Healthy Environments & Consumer Safety Branch, Health Canada, Canada
| | - Tom Kosatsky
- British Columbia Center for Disease Control, British Columbia, Canada
| | - Audrey Smargiassi
- Quebec Institute of Public Health, Québec, Canada; Department of Environmental Health and Occupational Health, School of Public Health, University of Montreal, Montreal, QC H3C 3J7, Canada; Public Health Research Institute, University of Montreal, Canada.
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The effects of outdoor air pollution on the respiratory health of Canadian children: A systematic review of epidemiological studies. Can Respir J 2015; 22:282-92. [PMID: 25961280 DOI: 10.1155/2015/263427] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Outdoor air pollution is a global problem with serious effects on human health, and children are considered to be highly susceptible to the effects of air pollution. OBJECTIVE To conduct a comprehensive and updated systematic review of the literature reporting the effects of outdoor air pollution on the respiratory health of children in Canada. METHODS Searches of four electronic databases between January 2004 and November 2014 were conducted to identify epidemiological studies evaluating the effect of exposure to outdoor air pollutants on respiratory symptoms, lung function measurements and the use of health services due to respiratory conditions in Canadian children. The selection process and quality assessment, using the Newcastle-Ottawa Scale, were conducted independently by two reviewers. RESULTS Twenty-seven studies that were heterogeneous with regard to study design, population, respiratory outcome and air pollution exposure were identified. Overall, the included studies reported adverse effects of outdoor air pollution at concentrations that were below Canadian and United States standards. Heterogeneous effects of air pollutants were reported according to city, sex, socioeconomic status and seasonality. The present review also describes trends in research related to the effect of air pollution on Canadian children over the past 25 years. CONCLUSION The present study reconfirms the adverse effects of outdoor air pollution on the respiratory health of children in Canada. It will help researchers, clinicians and environmental health authorities identify the available evidence of the adverse effect of outdoor air pollution, research gaps and the limitations for further research.
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Reno AL, Brooks EG, Ameredes BT. Mechanisms of Heightened Airway Sensitivity and Responses to Inhaled SO2 in Asthmatics. ENVIRONMENTAL HEALTH INSIGHTS 2015; 9:13-25. [PMID: 25922579 PMCID: PMC4384764 DOI: 10.4137/ehi.s15671] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 05/29/2023]
Abstract
Sulfur dioxide (SO2) is a problematic inhalable air pollutant in areas of widespread industrialization, not only in the United States but also in countries undergoing rapid industrialization, such as China, and it can be a potential trigger factor for asthma exacerbations. It is known that asthmatics are sensitive to the effects of SO2; however, the basis of this enhanced sensitivity remains incompletely understood. A PubMed search was performed over the course of 2014, encompassing the following terms: asthma, airway inflammation, sulfur dioxide, IL-10, mouse studies, and human studies. This search indicated that biomarkers of SO2 exposure, SO2 effects on airway epithelial cell function, and animal model data are useful in our understanding of the body's response to SO2, as are SO2-associated amplification of allergic inflammation, and potential promotion of neurogenic inflammation due to chemical irritant properties. While definitive answers are still being sought, these areas comprise important foci of consideration regarding asthmatic responses to inhaled SO2. Furthermore, IL-10 deficiency associated with asthma may be another important factor associated with an inability to resolve inflammation and mitigate oxidative stress resulting from SO2 inhalation, supporting the idea that asthmatics are predisposed to SO2 sensitivity, leading to asthma exacerbations and airway dysfunction.
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Affiliation(s)
| | - Edward G Brooks
- University of Texas Health Science Center at San Antonio, Texas, USA
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Li R, Kou X, Tian J, Meng Z, Cai Z, Cheng F, Dong C. Effect of sulfur dioxide on inflammatory and immune regulation in asthmatic rats. CHEMOSPHERE 2014; 112:296-304. [PMID: 25048919 DOI: 10.1016/j.chemosphere.2014.04.065] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/17/2014] [Accepted: 04/22/2014] [Indexed: 05/28/2023]
Abstract
BACKGROUND Exposure to sulfur dioxide (SO2) increases asthma risk. Inflammatory and immune responses are typical in asthma disease. The exact effect of SO2 on modulation of the inflammatory and immune responses in asthmatic rats remains unclear. OBJECTIVES Here we sought to investigate the molecular mechanisms underlying the NF-κB inflammatory pathway and the Th1/Th2 imbalance in asthmatic rats exposed to SO2. METHODS Male Wistar rats were challenged by ovalbumin (OVA) or SO2 alone or together, and then mRNA and protein levels of some inflammatory and immune genes were measured. NF-κB nuclear translocation was analyzed. Bronchoalveolar lavage (BAL), inflammatory cell counts and histopathologic examination were performed. RESULTS (1) OVA plus SO2 induced abnormal pathological changes and inflammatory responses in lung relative to exposure to OVA alone; (2) showing NF-κB nuclear translocation and activation through up-regulating IKKβ mRNA and protein expression and down-regulating IκBα expression in the presence of OVA or OVA plus SO2; (3) OVA plus SO2 significantly raised TNF-α and IL-6 levels in BALF compared with the OVA group; (4) SO2 markedly elevated IL-4 levels and decreased IFN-γ levels in BALF in the asthmatic rats, stimulating IgE generation which was closely related to inhibiting the expression of Foxp3, a specific marker of regulatory T cells. CONCLUSIONS SO2 affects the airway inflammatory and immune responses of the asthmatic rats and enhances the susceptibility to OVA by aggravating inflammatory responses in lungs, up-regulating pro-inflammatory cytokine expression, and causing the Th1/Th2 imbalance, which might contribute to the increased risk of asthma disease.
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Affiliation(s)
- Ruijin Li
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China; State Environmental Protection Key Laboratory of Efficient Utilization of Coal Waste Resources, Shanxi University, Taiyuan, PR China
| | - Xiaojing Kou
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China
| | - Jingjing Tian
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China
| | - Ziqiang Meng
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China
| | - Zongwei Cai
- Department of Chemistry, Hong Kong Baptist University, Hong Kong Special Administrative Region
| | - Fangqin Cheng
- State Environmental Protection Key Laboratory of Efficient Utilization of Coal Waste Resources, Shanxi University, Taiyuan, PR China.
| | - Chuan Dong
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China.
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Abstract
OBJECTIVE Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. METHODS We reviewed the literature on health effects, community exposure data, and dose-response relationships of the principal hazardous agents emitted. RESULTS On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. CONCLUSIONS It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data.
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Affiliation(s)
- Stephen Claude Martin
- From the Department of Epidemiology, Biostatistics and Occupational Health (Dr Martin), McGill University, Montreal; and Expertise Industrial Hygiene Inc (Mr Larivière), Otterburn Park, Quebec, Canada
| | - Claude Larivière
- From the Department of Epidemiology, Biostatistics and Occupational Health (Dr Martin), McGill University, Montreal; and Expertise Industrial Hygiene Inc (Mr Larivière), Otterburn Park, Quebec, Canada
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