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Hu W, Yang J. Effect of ambient ozone pollution on disease burden globally: A systematic analysis for the global burden of disease study 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171739. [PMID: 38508259 DOI: 10.1016/j.scitotenv.2024.171739] [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: 01/28/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Exposure to ambient ozone pollution causes health loss and even death, and both are the main risk factors for the disease burden worldwide. We comprehensively evaluated the ozone pollution-related disease burden. METHODS First, numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) were assessed globally and by sub-types in 2019. Furthermore, the temporal trend of the disease burden was explored by the linear regression model from 1990 to 2019. The cluster analysis was used to evaluate the changing pattern of related disease burden across Global Burden of Disease Study (GBD) regions. Finally, the age-period-cohort (APC) model and the Bayesian age-period-cohort (BAPC) model were used to predict the future disease burden in the next 25 years. RESULT Exposure to ozone pollution contributed to 365,222 deaths and 6,210,145 DALYs globally in 2019, which accounted for 0.65 % of deaths globally and 0.24 % of DALYs globally. The disease burden was consistently increasing with age. Males were high-risk populations and low-middle socio-demographic index (SDI) regions were high-risk areas. The disease burden of ozone pollution varied considerably across the GBD regions and the countries. In 2019, the number of deaths and DALYs cases increased by 76.11 % and 56.37 %, respectively compared to those in 1990. The predicted results showed that the number of deaths cases and DALYs cases for both genders would still increase from 2020 to 2044. CONCLUSION In conclusion, ambient ozone pollution has threatened public health globally. More proactive and effective strategic measures should be developed after considering global-specific circumstances.
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Affiliation(s)
- Wan Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Junnan Yang
- School of Public Health, BengBu Medical University, 2600 Donghai Avenue, Bengbu, Anhui 233030, China.
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Trentalange A, Renzi M, Michelozzi P, Guizzi M, Solimini AG. Association between air pollution and emergency room admission for eye diseases in Rome, Italy: A time-series analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123279. [PMID: 38160774 DOI: 10.1016/j.envpol.2023.123279] [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: 09/05/2023] [Revised: 11/27/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024]
Abstract
Eye diseases impose a significant burden on health services due to high case numbers. However, exposure to outdoor air pollution is seldom mentioned as potential harmful factor. We conducted a time-series analysis in Rome, Italy, to estimate the association between daily mean concentration of NO2, PM10 and PM2.5 and daily number of emergency room (ER) admissions for a selected cluster of eye diseases from 2006 to 2016. We used Poisson regression adjusted for time trend, population decrease during summer vacations and holidays, day of week, apparent temperature (hot and cold) and daily concentration of nine pollen species. We observed 581,868 ER admissions during the study period. 44.74% of cases were observed in subjects with less than 20 years, 19.50% in 51-65 age category and 13.4% among children (0-14 years). No differences between sexes were recorded. Mean values of pollutant concentrations were 54.75, 31.01 and 18.14 μg/m3 for NO2, PM10 and PM2.5 respectively. The air temperature ranged from -1 °C to 32.5 °C, with a mean value of 16 °C (SD = 6.88). The apparent temperature spaced from -3.58 °C to 34.08 °C (mean = 15.61 °C, SD = 8.5). The highest percent risk increases for 10 μg/m3 increases of the three pollutants were observed at lag0-1 day (1.3%, 0.63-1.98 for PM2.5; 1.03%, 0.56-1.51 for PM10 and 0.6%, 0.13-1.07 for NO2). Risk increased significantly also at lag0 and lag0-5 day for each pollutant. Secondary analyses showed higher effects in the elderly compared to younger subjects. No differences emerged between sexes. The dose response analysis suggested of possible effects on ER admission risk also at low-level concentrations of PM2.5. A strong confounding effect of pollen was not detected. RESULTS: of this study are coherent with previous analyses. Speculation can be done about the biological mechanisms that link air pollution to eye damage.
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Affiliation(s)
| | - Matteo Renzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | - Marco Guizzi
- ASL RM5, UOC Oculistica, Ospedale San Giovanni Evangelista, Tivoli, (RM), Italy
| | - Angelo Giuseppe Solimini
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
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Demoury C, Aerts R, Berete F, Lefebvre W, Pauwels A, Vanpoucke C, Van der Heyden J, De Clercq EM. Impact of short-term exposure to air pollution on natural mortality and vulnerable populations: a multi-city case-crossover analysis in Belgium. Environ Health 2024; 23:11. [PMID: 38267996 PMCID: PMC10809644 DOI: 10.1186/s12940-024-01050-w] [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: 10/04/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The adverse effect of air pollution on mortality is well documented worldwide but the identification of more vulnerable populations at higher risk of death is still limited. The aim of this study was to evaluate the association between natural mortality (overall and cause-specific) and short-term exposure to five air pollutants (PM2.5, PM10, NO2, O3 and black carbon) and identify potential vulnerable populations in Belgium. METHODS We used a time-stratified case-crossover design with conditional logistic regressions to assess the relationship between mortality and air pollution in the nine largest Belgian agglomerations. Then, we performed a random-effect meta-analysis of the pooled results and described the global air pollution-mortality association. We carried out stratified analyses by individual characteristics (sex, age, employment, hospitalization days and chronic preexisting health conditions), living environment (levels of population density, built-up areas) and season of death to identify effect modifiers of the association. RESULTS The study included 304,754 natural deaths registered between 2010 and 2015. We found percentage increases for overall natural mortality associated with 10 μg/m3 increases of air pollution levels of 0.6% (95% CI: 0.2%, 1.0%) for PM2.5, 0.4% (0.1%, 0.8%) for PM10, 0.5% (-0.2%, 1.1%) for O3, 1.0% (0.3%, 1.7%) for NO2 and 7.1% (-0.1%, 14.8%) for black carbon. There was also evidence for increases of cardiovascular and respiratory mortality. We did not find effect modification by individual characteristics (sex, age, employment, hospitalization days). However, this study suggested differences in risk of death for people with preexisting conditions (thrombosis, cardiovascular diseases, asthma, diabetes and thyroid affections), season of death (May-September vs October-April) and levels of built-up area in the neighborhood (for NO2). CONCLUSIONS This work provided evidence for the adverse health effects of air pollution and contributed to the identification of specific population groups. These findings can help to better define public-health interventions and prevention strategies.
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Affiliation(s)
- Claire Demoury
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium.
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
- Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Louvain, Belgium
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | | | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Arno Pauwels
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
- Health Information, Sciensano, Brussels, Belgium
| | | | | | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
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Tang Z, Guo J, Zhou J, Yu H, Wang Y, Lian X, Ye J, He X, Han R, Li J, Huang S. The impact of short-term exposures to ambient NO 2, O 3, and their combined oxidative potential on daily mortality. ENVIRONMENTAL RESEARCH 2024; 241:117634. [PMID: 37977272 DOI: 10.1016/j.envres.2023.117634] [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: 08/27/2023] [Revised: 10/19/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
It is widely recognized that air pollution exerts substantial detrimental effects in human health and the economy. The potential for harm is closely linked to the concentrations of pollutants like nitrogen dioxide (NO2) and ozone (O3), as well as their collective oxidative potential (OX). Yet, due to the challenges of directly monitoring OX as an independent factor and the influences of different substances' varying ability to contain or convey OX, uncertainties persist regarding its actual impact. To provide further evidence to the association between short-term exposures to NO2, O3, and OX and mortality, this study conducted multi-county time-series analyses with over-dispersed generalized additive models and random-effects meta-analyses to estimate the mortality data from 2014 to 2020 in Jiangsu, China. The findings reveal that short-term exposures to these pollutants are linked to increased risks of all-cause, cardiovascular, and respiratory mortality, where NO2 demonstrates 2.11% (95% confidence interval: 1.79%, 2.42%), 2.28% (1.91%, 2.66%), and 2.91% (2.13%, 3.69%) respectively per every 10 ppb increase in concentration, and the effect of O3 is 1.11% (0.98%, 1.24%), 1.39% (1.19%, 1.59%), and 1.82% (1.39%, 2.26%), and OX is 1.77% (1.58%, 1.97%), 2.19% (1.90%, 2.48%), and 2.90% (2.29%, 3.52%). Notably, women and individuals aged over 75 years exhibit higher susceptibility to these pollutants, with NO2 showing a greater impact, especially during the warm seasons. The elevated mortality rates associated with NO2, O3, and OX underscore the significance of addressing air pollution as a pressing public health issue, especially in controlling NO2 and O3 together. Further research is needed to explore the underlying mechanisms and possible influential factors of these effects.
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Affiliation(s)
- Ziqi Tang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jianhui Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jinyi Zhou
- Non-communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, 210009, China
| | - Hao Yu
- Non-communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, 210009, China
| | - Yaqi Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Xinyao Lian
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jin Ye
- School of Energy and Power, Jiangsu University of Science and Technology, Jiangsu, 212100, China
| | - Xueqiong He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Renqiang Han
- Non-communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, 210009, China.
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Shaodan Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China.
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Sundar IK, Duraisamy SK, Choudhary I, Saini Y, Silveyra P. Acute and Repeated Ozone Exposures Differentially Affect Circadian Clock Gene Expression in Mice. Adv Biol (Weinh) 2023; 7:e2300045. [PMID: 37204107 PMCID: PMC10657336 DOI: 10.1002/adbi.202300045] [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: 01/30/2023] [Revised: 04/20/2023] [Indexed: 05/20/2023]
Abstract
Circadian rhythms have an established role in regulating physiological processes, such as inflammation, immunity, and metabolism. Ozone, a common environmental pollutant with strong oxidative potential, is implicated in lung inflammation/injury in asthmatics. However, whether O3 exposure affects the expression of circadian clock genes in the lungs is not known. In this study, changes in the expression of core clock genes are analyzed in the lungs of adult female and male mice exposed to filtered air (FA) or O3 using qRT-PCR. The findings are confirmed using an existing RNA-sequencing dataset from repeated FA- and O3 -exposed mouse lungs and validated by qRT-PCR. Acute O3 exposure significantly alters the expression of clock genes in the lungs of females (Per1, Cry1, and Rora) and males (Per1). RNA-seq data revealing sex-based differences in clock gene expression in the airway of males (decreased Nr1d1/Rev-erbα) and females (increased Skp1), parenchyma of females and males (decreased Nr1d1 and Fbxl3 and increased Bhlhe40 and Skp1), and alveolar macrophages of males (decreased Arntl/Bmal1, Per1, Per2, Prkab1, and Prkab2) and females (increased Cry2, Per1, Per2, Csnk1d, Csnk1e, Prkab2, and Fbxl3). These findings suggest that lung inflammation caused by O3 exposure affects clock genes which may regulate key signaling pathways.
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Affiliation(s)
- Isaac Kirubakaran Sundar
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Santhosh Kumar Duraisamy
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ishita Choudhary
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Yogesh Saini
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Patricia Silveyra
- Department of Environmental and Occupational Health, Indiana University, School of Public Health, Bloomington, IN, USA
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6
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Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell ML, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, Dszs Coelho M, Correa PM, Diaz MH, Entezari A, Forsberg B, Garland RM, Leon Guo Y, Guo Y, Hashizume M, Holobaca IH, Íñiguez C, Jaakkola JJK, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares ADL, Pan SC, Pascal M, Ragettli MS, Rao S, Raz R, Roye D, Ryti N, Hn Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, Dlc Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, De' Donato FK. Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. ENVIRONMENT INTERNATIONAL 2023; 181:108258. [PMID: 37837748 PMCID: PMC10702017 DOI: 10.1016/j.envint.2023.108258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. OBJECTIVES To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. METHODS We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. RESULTS We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. CONCLUSIONS Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | | | - Hanne Krage Carlsen
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gabriel Carrasco
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Micheline Dszs Coelho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia M Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Magali H Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Yue Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Nicolás V Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | | | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Paulo Hn Saldiva
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - César Dlc Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Francesca K De' Donato
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
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Guo X, Su W, Wang H, Li N, Song Q, Liang Q, Sun C, Liang M, Zhou Z, Song EJ, Sun Y. Short-term exposure to ambient ozone and cardiovascular mortality in China: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:958-975. [PMID: 35438585 DOI: 10.1080/09603123.2022.2066070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
Air pollution is a major public health concern in China. Notwithstanding this, there is limited evidence regarding the impact of short-term exposure to ambient ozone on cardiovascular mortality in the Chinese population. Therefore, we conducted this meta-analysis to address this important question. The random-effects model was applied to pool the results from individual studies. Finally, 32 effect estimates extracted from 19 studies were pooled in this meta-analysis. The pooled relative risk for cardiovascular mortality for each 10 µg/m3 increment in ozone concentration was 1.0068 (95% CI: 1.0049, 1.0086). Ths significant positive association between ozone exposure and cardiovascular mortality was also observed in different two-pollutant models. This meta-analysis revealed that exposure to ozone was associated with an increased risk of cardiovascular mortality in China, and more efforts on controlling the population from ozone are needed to improve cardiovascular health of Chinese population.
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Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Chenyu Sun
- Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Evelyn J Song
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
- Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, P.R. China
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Zhang F, Tang H, Zhao D, Zhu S, Ruan L, Zhu W. Short-term exposure to ozone and mortality from AIDS-related diseases: A case-crossover study in the middle Yangtze River region, China. Prev Med 2023; 175:107689. [PMID: 37652107 DOI: 10.1016/j.ypmed.2023.107689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Previous investigations have predominantly concentrated on the influence of ozone (O3) on general population mortality. However, a noticeable gap exists regarding the attention directed towards susceptible demographics, specifically individuals afflicted by human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). METHODS A dataset comprising 1467 AIDS-related fatalities from 2013 to 2020 was amassed from the Hubei Provincial Center for Disease Control and Prevention. Daily maximum 8-h average O3 levels and meteorological parameters were extracted from the ChinaHighAirPollutants dataset and the National Meteorological Science Data Center, respectively. A time-stratified case-crossover methodology was employed to scrutinize the connection between short-term exposure to O3 and AIDS-related deaths. RESULTS A rise of one interquartile (IQR) in O3 concentration, lagged by 4 days, was associated with a 15% [95% confidence intervals (CIs): 2, 31] increase in AIDS-related deaths. Notably, males demonstrated heightened susceptibility to the adverse consequences of O3, marked by an odds ratio of 1.20 (95% CIs: 1.05, 1.37) at lag 4 day. Additionally, patients aged over 65 years exhibited escalated vulnerability to brief O3 exposure. Marriage status and educational attainment emerged as influential factors modifying the interplay between O3 and AIDS-related mortality. CONCLUSIONS Our study presents novel evidence spotlighting the deleterious repercussions of O3 on mortality in the HIV/AIDS population.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Heng Tang
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Dingyuan Zhao
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lianguo Ruan
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan 430023, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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9
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Wei Y, Fei L, Wang Y, Zhang M, Chen Z, Guo H, Ge S, Zhu S, Dong P, Yang K, Xie N, Zhao G. A time-series analysis of short-term ambient ozone exposure and hospitalizations from acute myocardial infarction in Henan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:93242-93254. [PMID: 37507564 PMCID: PMC10447277 DOI: 10.1007/s11356-023-28456-2] [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: 03/15/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023]
Abstract
Epidemiological studies in recent years have identified an association between exposure to air pollutants and acute myocardial infarction (AMI); however, the association between short-term ozone (O3) exposure and AMI hospitalization remains unclear, particularly in developing countries. Therefore, this study collected information on 24,489 AMI patients, including daily air pollutant and meteorological data in Henan, China, between 2016 and 2021. A distributed lagged nonlinear model combined with a Poisson regression model was used to estimate the nonlinear lagged effect of O3 on AMI hospitalizations. We also quantified the effects of O3 on the number of AMI hospitalizations, hospitalization days, and hospitalization costs. The results showed that single- and dual-pollution models of O3 at lag0, lag1, and lag (01-07) were risk factors for AMI hospitalizations, with the most significant effect at lag03 (RR = 1.132, 95% CI:1.083-1.182). Further studies showed that males, younger people (15-64 years), warm seasons, and long sunshine duration were more susceptible to O3. Hospitalizations attributable to O3 during the study period accounted for 11.66% of the total hospitalizations, corresponding to 2856 patients, 33,492 hospital days, and 90 million RMB. Maintaining O3 at 10-130 µg/m3 can prevent hundreds of AMI hospitalizations and save millions of RMB per year in Henan, China. In conclusion, we found that short-term exposure to O3 was significantly associated with an increased risk of hospitalization for AMI in Henan, China, and that further reductions in ambient O3 levels may have substantial health and economic benefits for patients and local healthcare facilities.
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Affiliation(s)
- Yulong Wei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Lin Fei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Min Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
- School of Cardiovascular and Metabolic Medicine & Sciences, King's College London British Heart Foundation Centre of Research Excellence, London, SE5 9NU, UK
| | - Zhigang Chen
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Huige Guo
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Shiqi Ge
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Sen Zhu
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Pingshuan Dong
- Department of Cardiology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, China
| | - Kan Yang
- Department of Cardiovascular Surgery, Nanyang Affiliated Hospital of Zhengzhou University, Nanyang Central Hospital, Nanyang, 473009, China
| | - Na Xie
- The Cardiology Department of the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453003, China
| | - Guoan Zhao
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
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10
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Reif J, Gamero A, Flousek J, Hůnová I. Ambient ozone - New threat to birds in mountain ecosystems? THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 876:162711. [PMID: 36906038 DOI: 10.1016/j.scitotenv.2023.162711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/06/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Mountain ecosystems are inhabited by species with specific characteristics enabling survival at high altitudes, which make them at risk from various pressures. In order to study these pressures, birds represent excellent model organisms due to their high diversity and position at the top of food chains. The pressures upon mountain bird populations include climate change, human disturbance, land abandonment, and air pollution, whose impacts are little understood. Ambient ozone (O3) is one of the most important air pollutants occurring in elevated concentrations in mountain conditions. Although laboratory experiments and indirect course-scale evidence suggest its negative effects on birds, population-level impacts remain unknown. To fill this knowledge gap, we analysed a unique 25-years long time series of annual monitoring of bird populations conducted at fixed sites under constant effort in a Central European mountain range, the Giant Mountains, Czechia. We related annual population growth rates of 51 bird species to O3 concentrations measured during the breeding season and hypothesized (i) an overall negative relationship across all species, and (ii) more negative O3 effects at higher altitudes due to increasing O3 concentration along altitudinal gradient. After controlling for the influence of weather conditions on bird population growth rates, we found an indication of the overall negative effect of O3 concentration, but it was insignificant. However, the effect became stronger and significant when we performed a separate analysis of upland species occupying the alpine zone above treeline. In these species, populations growth rates were lower after the years experiencing higher O3 concentration indicating an adverse impact of O3 on bird breeding. This impact corresponds well to O3 behaviour and mountain bird ecology. Our study thus represents the first step towards mechanistic understanding of O3 impacts on animal populations in nature linking the experimental results with indirect indications at the country-level.
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Affiliation(s)
- Jiří Reif
- Institute for Environmental Studies, Faculty of Science, Charles University, Prague, Czechia; Department of Zoology, Faculty of Science, Palacký University, Olomouc, Czechia.
| | - Anna Gamero
- Czech Society for Ornithology, Prague, Czechia
| | - Jiří Flousek
- Krkonoše National Park Administration, Vrchlabí, Czechia
| | - Iva Hůnová
- Institute for Environmental Studies, Faculty of Science, Charles University, Prague, Czechia; Czech Hydrometeorological Institute, Prague, Czechia
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11
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Yang L, Zhu Y, Zhao B, Wan W, Shi S, Xuan C, Yu C, Mao W, Yan J. Long-term cardiometabolic effects of ambient ozone pollution in a large Chinese population. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 261:115115. [PMID: 37295302 DOI: 10.1016/j.ecoenv.2023.115115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
Limited studies investigated the effects of long-term ozone exposure on cardiometabolic health. We aimed to examine the association of long-term ozone exposure with a range of cardiometabolic diseases, as well as the subclinical indicators in Eastern China. The study included 202,042 adults living in 11 prefecture-level areas in Zhejiang Province between 2014 and 2021. Using a satellite-based model with a 1 × 1 km spatial resolution, we estimated residential 5-year average ozone exposures for each subject. Mixed-effects logistic and linear regression models were applied to explore the associations of ozone exposure with cardiometabolic diseases and subclinical indicators, respectively. We found that a 9% [95% confidence interval (95% CI): 7-12%] higher in odds of cardiometabolic disease per 10 μg/m3 increase in ozone exposure. Specifically, we also found higher prevalence of cardiovascular diseases (15%), stroke (19%), hypertension (7%), dyslipidemia (15%), and hypertriglyceridemia (9%) associated with ozone exposure. However, we did not find significant associations between ozone exposure and coronary heart disease, myocardial infarction, or diabetes mellitus. Long-term ozone exposures were also significantly associated with adverse changes in systolic blood pressure, diastolic blood pressure, total serum cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose concentration, and body mass index. Our results showed that people with lower education levels, those over 50 years old, and those who were overweight or obese were more susceptible to the effects of ozone on cardiometabolic diseases. Our findings demonstrated the detrimental effects of long-term ozone exposure on cardiometabolic health, emphasizing the need for ozone control strategies to reduce the burden of cardiometabolic diseases.
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Affiliation(s)
- Li Yang
- Zhejiang Provincial Research Center for Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Bowen Zhao
- The First Clinical Medical College of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Wenjing Wan
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cheng Xuan
- Chronic Disease Control Department, Zhuji Second People's Hospital, Zhuji, Zhejiang, China
| | - Caiyan Yu
- Chronic Disease Control Department, Zhuji Second People's Hospital, Zhuji, Zhejiang, China
| | - Wei Mao
- Zhejiang Provincial Research Center for Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Zhejiang Hospital, Hangzhou, Zhejiang, China.
| | - Jing Yan
- Zhejiang Provincial Research Center for Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Zhejiang Hospital, Hangzhou, Zhejiang, China.
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12
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Perryman AN, Kim HYH, Payton A, Rager JE, McNell EE, Rebuli ME, Wells H, Almond M, Antinori J, Alexis NE, Porter NA, Jaspers I. Plasma sterols and vitamin D are correlates and predictors of ozone-induced inflammation in the lung: A pilot study. PLoS One 2023; 18:e0285721. [PMID: 37186612 PMCID: PMC10184915 DOI: 10.1371/journal.pone.0285721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Ozone (O3) exposure causes respiratory effects including lung function decrements, increased lung permeability, and airway inflammation. Additionally, baseline metabolic state can predispose individuals to adverse health effects from O3. For this reason, we conducted an exploratory study to examine the effect of O3 exposure on derivatives of cholesterol biosynthesis: sterols, oxysterols, and secosteroid (25-hydroxyvitamin D) not only in the lung, but also in circulation. METHODS We obtained plasma and induced sputum samples from non-asthmatic (n = 12) and asthmatic (n = 12) adult volunteers 6 hours following exposure to 0.4ppm O3 for 2 hours. We quantified the concentrations of 24 cholesterol precursors and derivatives by UPLC-MS and 30 cytokines by ELISA. We use computational analyses including machine learning to determine whether baseline plasma sterols are predictive of O3 responsiveness. RESULTS We observed an overall decrease in the concentration of cholesterol precursors and derivatives (e.g. 27-hydroxycholesterol) and an increase in concentration of autooxidation products (e.g. secosterol-B) in sputum samples. In plasma, we saw a significant increase in the concentration of secosterol-B after O3 exposure. Machine learning algorithms showed that plasma cholesterol was a top predictor of O3 responder status based on decrease in FEV1 (>5%). Further, 25-hydroxyvitamin D was positively associated with lung function in non-asthmatic subjects and with sputum uteroglobin, whereas it was inversely associated with sputum myeloperoxidase and neutrophil counts. CONCLUSION This study highlights alterations in sterol metabolites in the airway and circulation as potential contributors to systemic health outcomes and predictors of pulmonary and inflammatory responsiveness following O3 exposure.
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Affiliation(s)
- Alexia N. Perryman
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Hye-Young H. Kim
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States of America
| | - Alexis Payton
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Julia E. Rager
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Erin E. McNell
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Meghan E. Rebuli
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Heather Wells
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Martha Almond
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jamie Antinori
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Neil E. Alexis
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Ned A. Porter
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States of America
| | - Ilona Jaspers
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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13
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Rosser F, Balmes J. Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard. Pediatr Pulmonol 2023; 58:1355-1366. [PMID: 36815617 PMCID: PMC10121852 DOI: 10.1002/ppul.26368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.
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Affiliation(s)
- Franziska Rosser
- Department of Pediatrics, Division of Pulmonary Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - John Balmes
- Department of Medicine, University of California, San Francisco, San Francisco, CA
- School of Public Health, University of California, Berkeley, CA
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14
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Rai M, Stafoggia M, de'Donato F, Scortichini M, Zafeiratou S, Vazquez Fernandez L, Zhang S, Katsouyanni K, Samoli E, Rao S, Lavigne E, Guo Y, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Maasikmets M, Jaakkola JJK, Ryti N, Pascal M, Hashizume M, Fook Sheng Ng C, Alahmad B, Hurtado Diaz M, De la Cruz Valencia C, Nunes B, Madureira J, Scovronick N, Garland RM, Kim H, Lee W, Tobias A, Íñiguez C, Forsberg B, Åström C, Maria Vicedo-Cabrera A, Ragettli MS, Leon Guo YL, Pan SC, Li S, Gasparrini A, Sera F, Masselot P, Schwartz J, Zanobetti A, Bell ML, Schneider A, Breitner S. Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries. ENVIRONMENT INTERNATIONAL 2023; 174:107825. [PMID: 36934570 DOI: 10.1016/j.envint.2023.107825] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. OBJECTIVES We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. METHODS Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. RESULTS Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. DISCUSSION We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | | | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Baltazar Nunes
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, València, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | | | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, and Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Pierre Masselot
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven CT, USA
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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15
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Kim H, Samet JM, Bell ML. Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:117006. [PMID: 36367781 PMCID: PMC9651183 DOI: 10.1289/ehp10836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35 μg/m3); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7 μg/m3 or 70 parts per billion). An interquartile range (IQR) increase (5.2 μg/m3) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2 μg/m3) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. https://doi.org/10.1289/EHP10836.
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Affiliation(s)
- Honghyok Kim
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
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16
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Zhang Y, Ma Y, Shen J, Li H, Wang H, Cheng B, Ma L. Effect of ambient O 3 on mortality due to circulatory and respiratory diseases in a high latitude city of northeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:67776-67786. [PMID: 35522413 DOI: 10.1007/s11356-022-20585-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/29/2022] [Indexed: 06/14/2023]
Abstract
In recent years, O3 pollution had been worsening in China and became a major challenge for human health. To evaluate the O3 effects on circulatory and respiratory mortality in Harbin, a high latitude city of northeast China, we applied a time-series study from 2014 to 2016. After collecting data and adjusting for the effects of confounders, we built the generalized additive model to assess the associations between O3 and mortality at different lag days. The results showed that an interquartile-range (IQR) increase in O3 concentration corresponded to excess risk (ER) of 2.00% (95%CI: - 0.25-4.30%) for circulatory mortality at lag 0 and 8.02% (95%CI: 4.18-12.01%) for respiratory mortality at lag 2 days in the single-pollutant model. Stratified analysis showed that O3 had a greater effect on females than on males. The effect of O3 exposure on circulatory mortality was stronger during the warm period, while the opposite trend was founded for respiratory mortality. The sensitivity analysis showed that the effects of O3 were relatively independent and the major results were robust.
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Affiliation(s)
- Yifan Zhang
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China.
| | - Jiahui Shen
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Heping Li
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Liya Ma
- Lanzhou Petrochemical Company, Lanzhou, 730060, China
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17
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Wen B, Wu Y, Ye T, Xu R, Yu W, Yu P, Guo Y, Li S. Short-term exposure to ozone and economic burden of premature mortality in Italy: A nationwide observation study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 241:113781. [PMID: 35772358 DOI: 10.1016/j.ecoenv.2022.113781] [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: 02/27/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
Italy is among the countries with the highest ozone concentration in Europe. However, the mortality burden of ozone and related economic loss has not been fully characterized. This study aimed to estimate the ozone-mortality association in Italy and evaluate attributable mortality burden and related economic loss in 2015-2019. We collected daily all-cause mortality data stratified by age and sex from 2015 to 2019 in 107 provinces of Italy. A two-stage time-series framework was applied to estimate the association between daily maximum eight-hour average ozone and mortality as well as economic loss. An overall increase in the risk of mortality (RR=1.0043, 95% CI: 1.0029, 1.0057) was associated with every 10 µg/m3 increase in ozone. Generally, a total of 70,060 deaths and $65 billion economic loss were attributed to ozone exposure, corresponding to 3.11% of mortality and about 0.5% of the national GDP during the study period, respectively. The highest ozone-related mortality burden (30,910 deaths) and economic loss ($29.24 billion) were observed in the hot season. This nationwide study suggested considerable mortality burden and economic loss were associated with exposure to ozone. More actions and policies should be proposed to reduce ozone levels and help the public protect their health.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Wenhua Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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18
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Adebayo-Ojo TC, Wichmann J, Arowosegbe OO, Probst-Hensch N, Schindler C, Künzli N. Short-Term Effects of PM10, NO2, SO2 and O3 on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006–2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138078. [PMID: 35805737 PMCID: PMC9265394 DOI: 10.3390/ijerph19138078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023]
Abstract
Background: The health effect of air pollution is rarely quantified in Africa, and this is evident in global systematic reviews and multi-city studies which only includes South Africa. Methods: A time-series analysis was conducted on daily mortality (cardiovascular (CVD) and respiratory diseases (RD)) and air pollution from 2006–2015 for the city of Cape Town. We fitted single- and multi-pollutant models to test the independent effects of particulate matter (PM10), nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3) from co-pollutants. Results: daily average concentrations per interquartile range (IQR) increase of 16.4 µg/m3 PM10, 10.7 µg/m3 NO2, 6 µg/m3 SO2 and 15.6 µg/m3 O3 lag 0–1 were positively associated with CVD, with an increased risk of 2.4% (95% CI: 0.9–3.9%), 2.2 (95% CI: 0.4–4.1%), 1.4% (95% CI: 0–2.8%) and 2.5% (95% CI: 0.2–4.8%), respectively. For RD, only NO2 showed a significant positive association with a 4.5% (95% CI: 1.4–7.6%) increase per IQR. In multi-pollutant models, associations of NO2 with RD remained unchanged when adjusted for PM10 and SO2 but was weakened for O3. In CVD, O3 estimates were insensitive to other pollutants showing an increased risk. Interestingly, CVD and RD lag structures of PM10, showed significant acute effect with evidence of mortality displacement. Conclusion: The findings suggest that air pollution is associated with mortality, and exposure to PM10 advances the death of frail population.
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Affiliation(s)
- Temitope Christina Adebayo-Ojo
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
- Correspondence:
| | - Janine Wichmann
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa;
| | - Oluwaseyi Olalekan Arowosegbe
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
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19
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Liu X, Li Z, Zhang J, Guo M, Lu F, Xu X, Deginet A, Liu M, Dong Z, Hu Y, Liu M, Li Y, Wu M, Luo Y, Tao L, Lin H, Guo X. The association between ozone and ischemic stroke morbidity among patients with type 2 diabetes in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 818:151733. [PMID: 34800453 DOI: 10.1016/j.scitotenv.2021.151733] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The association between ozone and ischemic stroke has been widely reported; however, the association among patients with type 2 diabetes (T2D) has remained largely unknown. METHODS The time series data of daily morbidity and concentrations of ozone from 2014 to 2018 were collected in Beijing, China. A time-stratified case-crossover study combined with a distributed lag nonlinear model was used to estimate the ozone effect on stroke morbidity among T2D patients. Based on principal diagnosis, ischemic stroke cases were identified according to the International Classification of Diseases (I63), and a history of T2D was coded as E12. RESULTS A total of 149,757 hospital admissions for ischemic stroke among T2D patients were recorded in Beijing. Approximately U-shaped exposure-response curves were observed for ozone and ischemic stroke morbidity among T2D patients. With a reference at 54.91 μg/m3, extreme-low (5th: 9.59 μg/m3) ozone was significantly associated with a decreased risk for ischemic stroke [RR = 0.88, 95% confidence interval (CI): 0.80-0.98]. Subgroup analysis showed that extremely low-ozone (5th) level only had a significant protective effect in males and elderly population, with a RR value of 0.86 (95% CI: 0.76-0.97) and 0.85 (95% CI: 0.75-0.96), respectively. Extreme-high ozone (99th: 157.06 μg/m3) was significantly associated with an increased risk for ischemic stroke (RR = 1.33, 95% CI: 1.12-1.57). The effect size was 1.34 (95% CI: 1.10-1.63) for males and 1.32 (95% CI: 1.07-1.63) for females, and the difference was not significant (Z = -0.29, P = 0.77). The effect size in younger adults was significantly higher than that in participants aged ≥65 years [1.52 (95% CI: 1.21-1.91) vs. 1.22 (95% CI: 1.01-1.47), Z = -1.62, P < 0.05]. CONCLUSIONS U-shaped associations were observed between ozone and ischemic stroke morbidity in T2D patients. Men and elderly population are vulnerable to low-ozone level, and the younger adults are more susceptible to extremely high-ozone level than the elderly.
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Affiliation(s)
- Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Jie Zhang
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Moning Guo
- Beijing Municipal Health Commission Information Center, Beijing 100034, China.
| | - Feng Lu
- Beijing Municipal Health Commission Information Center, Beijing 100034, China.
| | - Xiaolin Xu
- The University of Queensland, Brisbane, Australia; School of Public Health, Zhejiang University, Hangzhou 310058, China.
| | - Aklilu Deginet
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Mengmeng Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Zhaomin Dong
- School of Space and Environment, Beihang University, Beijing 100191, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China.
| | - Yaoyu Hu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Mengyang Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Yutong Li
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Mengqiu Wu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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20
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Tovar A, Crouse WL, Smith GJ, Thomas JM, Keith BP, McFadden KM, Moran TP, Furey TS, Kelada SNP. Integrative analysis reveals mouse strain-dependent responses to acute ozone exposure associated with airway macrophage transcriptional activity. Am J Physiol Lung Cell Mol Physiol 2022; 322:L33-L49. [PMID: 34755540 PMCID: PMC8721896 DOI: 10.1152/ajplung.00237.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 01/03/2023] Open
Abstract
Acute ozone (O3) exposure is associated with multiple adverse cardiorespiratory outcomes, the severity of which varies across individuals in human populations and inbred mouse strains. However, molecular determinants of response, including susceptibility biomarkers that distinguish who will develop severe injury and inflammation, are not well characterized. We and others have demonstrated that airway macrophages (AMs) are an important resident immune cell type that are functionally and transcriptionally responsive to O3 inhalation. Here, we sought to explore influences of strain, exposure, and strain-by-O3 exposure interactions on AM gene expression and identify transcriptional correlates of O3-induced inflammation and injury across six mouse strains, including five Collaborative Cross (CC) strains. We exposed adult mice of both sexes to filtered air (FA) or 2 ppm O3 for 3 h and measured inflammatory and injury parameters 21 h later. Mice exposed to O3 developed airway neutrophilia and lung injury with strain-dependent severity. In AMs, we identified a common core O3 transcriptional response signature across all strains, as well as a set of genes exhibiting strain-by-O3 exposure interactions. In particular, a prominent gene expression contrast emerged between a low- (CC017/Unc) and high-responding (CC003/Unc) strain, as reflected by cellular inflammation and injury. Further inspection indicated that differences in their baseline gene expression and chromatin accessibility profiles likely contribute to their divergent post-O3 exposure transcriptional responses. Together, these results suggest that aspects of O3-induced respiratory responses are mediated through altered AM transcriptional signatures and further confirm the importance of gene-environment interactions in mediating differential responsiveness to environmental agents.
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Affiliation(s)
- Adelaide Tovar
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Genetics & Molecular Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wesley L Crouse
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Bioinformatics & Computational Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gregory J Smith
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joseph M Thomas
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Benjamin P Keith
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Bioinformatics & Computational Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn M McFadden
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Timothy P Moran
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Terrence S Furey
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Genetics & Molecular Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Bioinformatics & Computational Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Samir N P Kelada
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Genetics & Molecular Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Bioinformatics & Computational Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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21
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Kim H, Lee JT. Inter-mortality displacement hypothesis and short-term effect of ambient air pollution on mortality in seven major cities of South Korea: a time-series analysis. Int J Epidemiol 2021; 49:1802-1812. [PMID: 33211858 DOI: 10.1093/ije/dyaa181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inter-mortality displacement (IMD) between cause-specific mortalities has not been introduced in air pollution epidemiology. Investigation into IMD would provide insights on the actual health burden of air pollution and interpretation of associations. We aimed to investigate IMD regarding short-term effect of air pollution on mortality. METHODS We illustrated manifestations and interpretations of lag-mortality associations. If IMD exists, a net increase of one cause-specific death can be offset by a net decrease of other cause-specific deaths. We conducted a time-series analysis to estimate associations of ambient particulate matter smaller than 10 µm (PM10), ozone (O3), sulphur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) with mortality, considering lags up to the previous 45 days, for seven major cities of South Korea from 2006 to 2013. Attributable mortality cases were identified. RESULTS For O3, respiratory mortality [11 929 cases, 95% empirical confidence interval (eCI), 5358, 17 688 cases] was counterbalanced by cardiovascular mortality (-11 272 cases, 95% eCI: -22 444, -629 cases). All-cause mortality was 37 148 cases (95% eCI: 4448, 68 782 cases). For PM10, respiratory deaths were 9167 cases (95% eCI: 563, 16 521 cases), and cardiovascular deaths were 6929 cases (95% eCI: -11 793, 24 138 cases). Estimates for SO2 were comparable to those for PM10. All-cause mortality attributable to NO2 was explained by short-term mortality displacement. No associations with mortality were found for CO. CONCLUSIONS IMD may exist in the relationship between air pollution and mortality. The actual relationship between air pollution and cause-specific mortality may be masked by IMD.
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Affiliation(s)
- Honghyok Kim
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.,School of the Environment, Yale University, New Haven, CT, USA
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.,Department of Environmental Health, Korea University, Seoul, Republic of Korea.,School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
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22
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Smith A, Laribi O. Environmental Justice in the American Public Health Context: Trends in the Scientific Literature at the Intersection Between Health, Environment, and Social Status. J Racial Ethn Health Disparities 2021; 9:247-256. [PMID: 33420608 DOI: 10.1007/s40615-020-00949-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022]
Abstract
Although various governmental entities in the USA are required to consider environmental justice (EJ) impacts of their actions during decision-making, socially vulnerable groups continue to be disproportionately exposed to environmental hazards. Tools and programs to quantify and mitigate environmental injustices are limited by existing data, which may not capture the full range of health disparities exacerbated by the complex interactions between environmental exposures and social stressors. In this study, we analyzed how the scientific literature approaches EJ issues in the USA. We searched PubMed for journal articles discussing at least one sociodemographic or environmental variable in the context of cumulative impacts and analyzed the relative frequency with which various EJ topics were studied. Our findings indicate that demographic variables are commonly used in epidemiologic studies, though some areas (e.g., age) are better studied than others. Similarly, occupational exposure and ambient air pollution were more studied than other types of exposures. Word frequency analyses revealed which toxicants and health outcomes are the most frequently studied. In addition, temporality analyses showed that the rate of occupational publications rose rapidly in the 1970-1980s and has since plateaued, while other publication rates increased two decades later and are still on the rise. Cumulative impacts are considered in a relatively small portion of journal articles across all topics; nevertheless, they have seen an exponential climb in the last decade. A more equitable distribution of scientific efforts might be needed for a better distribution of funding, policy-making efforts, and other resources to socially and environmentally vulnerable communities.
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Affiliation(s)
| | - Ouahiba Laribi
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
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23
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Renzi M, Stafoggia M, Michelozzi P, Davoli M, Forastiere F, Solimini AG. Short-term exposure to PM 2.5 and risk of venous thromboembolism: A case-crossover study. Thromb Res 2020; 190:52-57. [PMID: 32302781 DOI: 10.1016/j.thromres.2020.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/10/2020] [Accepted: 03/09/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Short-term exposure to air pollution increases the risk of cardiovascular mortality and morbidity but little evidence is available on pollution effects on venous thromboembolism (VTE), a common vascular disease. METHODS We conducted a case-crossover analysis of all urgent hospitalizations for deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients >35 years during the period 2006 to 2017 in Rome (Italy). We examined whether 1) short-term exposure to particulate matter with aerodynamic diameter <2.5 μg (PM2.5) increases the risk of hospitalization for DVT or PE, and 2) if the associations are modified by the period of the year (warm and cold seasons), sex, age and comorbidity. RESULTS We found that short-term exposure to PM2.5 was associated with an increase of PE hospitalization risk of during the warm season (April to September) of 19.6% (95% confidence intervals: 8.3, 31%) per 10 μg/m3, while no statistically significant effects were displayed during the cold season or the whole year or for DVT hospitalizations. The effect of PM2.5 remained significant (%change: 21.3; 95%CI: 5.4, 39.5) after adjustment for nitrogen dioxide (NO2) co-exposure (a marker of traffic sources) and when limiting to primary diagnosis of PE (%change: 19.1; 95%CI: 4.2, 36.1). Age, sex and comorbid conditions did not modify the association. CONCLUSIONS Our results suggested a positive association between short-term exposure to PM2.5 and pulmonary embolism during the warm period of the year while no evidence emerged for deep vein thrombosis.
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Affiliation(s)
- Matteo Renzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy; Institute of Environmental Medicine, Karonlinska Instituet, Stockholm, Sweden
| | - Paola Michelozzi
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Health Authority Service, ASL Rome 1, Rome, Italy
| | | | - Angelo G Solimini
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
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The Impact of Ambient Fine Particulate Matter on Consumer Expenditures. SUSTAINABILITY 2020. [DOI: 10.3390/su12051855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Airborne particulate matter suspended from industrial facilities, power plants, and automobiles is detrimental to health. Growing concerns about the increasing level of airborne particulate matter have led many industrialized nations to advocate for the transformation of the energy market and investment in sustainable energy products. At the other end, consumers have made individual adjustments and attempted to reduce the exposure to the particulate matter. In this paper, we focus on the effect of ambient air pollution on consumer expenditures based on scanner panel data on consumers’ debit and credit card transactions. A series of empirical analyses found robust evidence that the increased level of particulate matter led to considerable disruption in total consumer expenditures with significant heterogeneity across categories. Our findings suggest that consumers alter their spending behaviors in an attempt to reduce the risk of exposures to particulate matter. Such an estimated effect of air pollution is qualitatively different from those of other macroeconomic factors and provides important guidance for policy interventions and practical decisions aimed at sustaining economic growth.
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A Random Forest Approach to Estimate Daily Particulate Matter, Nitrogen Dioxide, and Ozone at Fine Spatial Resolution in Sweden. ATMOSPHERE 2020. [DOI: 10.3390/atmos11030239] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Air pollution is one of the leading causes of mortality worldwide. An accurate assessment of its spatial and temporal distribution is mandatory to conduct epidemiological studies able to estimate long-term (e.g., annual) and short-term (e.g., daily) health effects. While spatiotemporal models for particulate matter (PM) have been developed in several countries, estimates of daily nitrogen dioxide (NO2) and ozone (O3) concentrations at high spatial resolution are lacking, and no such models have been developed in Sweden. We collected data on daily air pollutant concentrations from routine monitoring networks over the period 2005–2016 and matched them with satellite data, dispersion models, meteorological parameters, and land-use variables. We developed a machine-learning approach, the random forest (RF), to estimate daily concentrations of PM10 (PM<10 microns), PM2.5 (PM<2.5 microns), PM2.5–10 (PM between 2.5 and 10 microns), NO2, and O3 for each squared kilometer of Sweden over the period 2005–2016. Our models were able to describe between 64% (PM10) and 78% (O3) of air pollutant variability in held-out observations, and between 37% (NO2) and 61% (O3) in held-out monitors, with no major differences across years and seasons and better performance in larger cities such as Stockholm. These estimates will allow to investigate air pollution effects across the whole of Sweden, including suburban and rural areas, previously neglected by epidemiological investigations.
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Michaudel C, Bataille F, Maillet I, Fauconnier L, Colas C, Sokol H, Straube M, Couturier-Maillard A, Dumoutier L, van Snick J, Quesniaux VF, Togbe D, Ryffel B. Ozone-Induced Aryl Hydrocarbon Receptor Activation Controls Lung Inflammation via Interleukin-22 Modulation. Front Immunol 2020; 11:144. [PMID: 32161582 PMCID: PMC7053361 DOI: 10.3389/fimmu.2020.00144] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/20/2020] [Indexed: 01/09/2023] Open
Abstract
Airborne ozone exposure causes severe lung injury and inflammation. The aryl hydrocarbon Receptor (AhR) (1), activated in pollutant-induced inflammation, is critical for cytokine production, especially IL-22 and IL-17A. The role of AhR in ozone-induced lung inflammation is unknown. We report here that chronic ozone exposure activates AhR with increased tryptophan and lipoxin A4 production in mice. AhR-/- mice show increased lung inflammation, airway hyperresponsiveness, and tissue remodeling with an increased recruitment of IL-17A and IL-22-expressing cells in comparison to control mice. IL-17A- and IL-22-neutralizing antibodies attenuate lung inflammation in AhR-/- and control mice. Enhanced lung inflammation and recruitment of ILC3, ILC2, and T cells were observed after T cell-specific AhR depletion using the AhRCD4cre-deficient mice. Together, the data demonstrate that ozone exposure activates AhR, which controls lung inflammation, airway hyperresponsiveness, and tissue remodeling via the reduction of IL-22 expression.
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Affiliation(s)
- Chloé Michaudel
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Florent Bataille
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Isabelle Maillet
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
| | | | - Cyril Colas
- University of Orléans, CNRS ICOA, UMR7311, F-45067, Orléans, France
- CNRS, CBM, UPR4301, University Orléans, Orléans, France
| | - Harry Sokol
- Avenir Team Gut Microbiota and Immunity, Equipe de Recherche Labélisée 1157, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Marjolène Straube
- Avenir Team Gut Microbiota and Immunity, Equipe de Recherche Labélisée 1157, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Aurélie Couturier-Maillard
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Laure Dumoutier
- Institut de Duve, Université Catholique de Louvain, Brussels, Belgium
| | - Jacques van Snick
- Ludwig Institute for Cancer Research, Université Catholique de Louvain, Brussels, Belgium
| | - Valérie F. Quesniaux
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Dieudonnée Togbe
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
- ArtImmune SAS, Orléans, France
| | - Bernhard Ryffel
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orléans, France
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Vicedo-Cabrera AM, Sera F, Liu C, Armstrong B, Milojevic A, Guo Y, Tong S, Lavigne E, Kyselý J, Urban A, Orru H, Indermitte E, Pascal M, Huber V, Schneider A, Katsouyanni K, Samoli E, Stafoggia M, Scortichini M, Hashizume M, Honda Y, Ng CFS, Hurtado-Diaz M, Cruz J, Silva S, Madureira J, Scovronick N, Garland RM, Kim H, Tobias A, Íñiguez C, Forsberg B, Åström C, Ragettli MS, Röösli M, Guo YLL, Chen BY, Zanobetti A, Schwartz J, Bell ML, Kan H, Gasparrini A. Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries. BMJ 2020; 368:m108. [PMID: 32041707 PMCID: PMC7190035 DOI: 10.1136/bmj.m108] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. DESIGN Two stage time series analysis. SETTING 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. POPULATION Deaths for all causes or for external causes only registered in each city within the study period. MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only). RESULTS A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. CONCLUSIONS Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.
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Affiliation(s)
- Ana M Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Ai Milojevic
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mathilde Pascal
- Santé Publique France, French National Public Health Agency, Saint Maurice, France
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Masahiro Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Magali Hurtado-Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Julio Cruz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Susana Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Joana Madureira
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Natural Resources and the Environment Unit, Council for Scientific and Industrial Research, Pretoria 0001, South Africa
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
- Department of Geography, Geo-informatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, University of Valencia, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taiwan
| | - Bing-Yu Chen
- Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taiwan
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Haidong Kan
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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28
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Nuvolone D, Petri D, Biggeri A, Barbone F, Voller F. Health effects associated with short-term exposure to hydrogen sulfide from geothermal power plants: a case-crossover study in the geothermal areas in Tuscany. Int Arch Occup Environ Health 2020; 93:669-682. [PMID: 32034472 DOI: 10.1007/s00420-020-01522-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Thirty-four geothermal power plants for the production of electricity are currently active in the geothermal areas in Tuscany. The present study aimed to investigate the association between short-term exposure to hydrogen sulfide (H2S) and acute health outcomes. METHODS This study used individual data on non-accidental, cardiovascular and respiratory mortality, urgent hospital admissions (HA) and emergency department (ED) visits for cardiorespiratory diseases occurring from 2000 to 2017. All cases were georeferenced and matched to daily H2S data, derived from 18 monitoring sites. A case-crossover design following the matched pair interval approach was applied and conditional logistic regression models were fitted to estimate odds ratios and their 90% confidence intervals, adjusting for a set of time-dependent variables, such as influenza epidemics, holidays and temperature. RESULTS A total of 8054 deaths, 30,527 HA and 15,263 ED visits occurred. Mortality for non-accidental (OR = 1.11, 90% CI 1.02-1.22) and cardiovascular causes (OR = 1.22, 90% CI 1.03-1.44) were associated with an increase of 10 µg/m3 of H2S daily levels only among men. Hospital admissions for respiratory diseases were positively associated with H2S exposure: OR = 1.11 (90% CI 1.00-1.22) among women. No associations were observed in ED visits analyses. CONCLUSIONS In this case-crossover study in the Tuscan geothermal areas, short-term exposure to H2S was weakly associated with some mortality and morbidity outcomes. Our findings did not show a clear pattern as the results were not homogeneous between mortality and morbidity data or between men and women.
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Affiliation(s)
- Daniela Nuvolone
- Epidemiology Unit, Regional Health Agency of Tuscany, Via Pietro Dazzi 1, 50124, Florence, Italy.
| | - Davide Petri
- Epidemiology Unit, Regional Health Agency of Tuscany, Via Pietro Dazzi 1, 50124, Florence, Italy
| | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Viale Morgagni 59, 50134, Florence, Italy
| | - Fabio Barbone
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, via dell'Istria 65/1, 34137, Trieste, Italy
| | - Fabio Voller
- Epidemiology Unit, Regional Health Agency of Tuscany, Via Pietro Dazzi 1, 50124, Florence, Italy
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29
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Yang BY, Fan S, Thiering E, Seissler J, Nowak D, Dong GH, Heinrich J. Ambient air pollution and diabetes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2020; 180:108817. [PMID: 31627156 DOI: 10.1016/j.envres.2019.108817] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/10/2019] [Accepted: 10/08/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Air pollutants are suggested to be related to type 2 diabetes (T2D). Since several high quality papers on air pollutants and T2D have been published beyond the last reviews, an extended systematic review is highly warranted. We review epidemiological studies to quantify the association between air pollutants and T2D, and to answer if diabetes patients are more vulnerable to air pollutants. METHODS We systematically reviewed the databases of PubMed and Web of Science based on the guidelines of the Preferred Reporting Items for Systematic review and Meta-analysis (PRISMA). We calculated odds ratios (OR) or hazard ratios (HR) and their 95% confidence intervals (CI) to assess the strength of the associations between air pollutants [e.g., particulate matter with diameter ≤ 2.5 μm (PM2.5), particulate matter with diameter ≤ 10 μm (PM10), and nitrogen dioxide (NO2)] and T2D. We evaluated the quality and risk of bias of the included studies and graded the credibility of the pooled evidence using several recommended tools. We also performed sensitivity analysis, meta-regression analysis, and publication bias test. RESULTS Out of 716 articles identified, 86 were used for this review and meta-analysis. Meta-analyses showed significant associations of PM2.5 with T2D incidence (11 studies; HR = 1.10, 95% CI = 1.04-1.17 per 10 μg/m3 increment; I2 = 74.4%) and prevalence (11 studies; OR = 1.08; 95% CI = 1.04-1.12 per 10 μg/m3 increment; I2 = 84.3%), of PM10 with T2D prevalence (6 studies; OR = 1.10; 95% CI = 1.03-1.17 per 10 μg/m3 increment; I2 = 89.5%) and incidence (6 studies; HR = 1.11; 95% CI = 1.00-1.22 per μg/m3 increment; I2 = 70.6%), and of NO2 with T2D prevalence (11 studies; OR = 1.07; 95% CI = 1.04-1.11 per 10 μg/m3 increment; I2 = 91.1%). The majority of studies on glucose-homoeostasis markers also showed increased risks with higher air pollutants levels, but the studies were too heterogeneous for meta-analysis. Overall, patients with diabetes might be more vulnerable to PM. CONCLUSIONS Recent publications strengthened the evidence for adverse effects of ambient air pollutants exposure (especially for PM) on T2D and that diabetic patients might be more vulnerable to air pollutants exposure.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Institute and Clinic for Occupational, Social and Environmental Medicine, Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Member, German Center for Lung Research (DZL Munich), CPC (Comprehensive Pneumology Center Munich), Germany; Institute of Epidemiology, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - Shujun Fan
- Guangzhou Center for Disease Control and Prevention, Guangzhu, 510440, China
| | - Elisabeth Thiering
- Institute of Epidemiology, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Jochen Seissler
- Diabetes Center, Medizinische Klinik und Poliklinik IV - Campus Innenstadt, Ludwig-Maximilians-University, Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Member, German Center for Lung Research (DZL Munich), CPC (Comprehensive Pneumology Center Munich), Germany
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Member, German Center for Lung Research (DZL Munich), CPC (Comprehensive Pneumology Center Munich), Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
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30
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Liang S, Li X, Teng Y, Fu H, Chen L, Mao J, Zhang H, Gao S, Sun Y, Ma Z, Azzi M. Estimation of health and economic benefits based on ozone exposure level with high spatial-temporal resolution by fusing satellite and station observations. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113267. [PMID: 31574391 DOI: 10.1016/j.envpol.2019.113267] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/29/2019] [Accepted: 09/16/2019] [Indexed: 06/10/2023]
Abstract
In recent years, ozone pollution has become more and more serious in China. Several epidemiological studies have demonstrated the correlation between short-term ozone exposure and several health risks including all-cause mortality, cardiovascular mortality, and respiratory mortality. In this study, the daily ozone exposure levels with 10 km × 10 km resolution were estimated based on satellite data derived from Ozone Monitoring Instrument (OMI) and the monitoring data. The health impacts for potential decrease in the daily ozone concentration and the corresponding economic benefits in 2016 were estimated by applying the environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. By reducing the daily maximum 8-h average concentration of ozone to 100 μg/m3, the estimated avoided all-cause mortalities were 120 × 103 (95% confidence interval (CI): 67 × 103, 160 × 103) cases and the correspondingly economic benefits ranged from 36 to 64 billion CNY using amended human capital (AHC) and willingness to pay (WTP) method in 2016. If the daily maximum 8-h average concentration of ozone were rolled back to 70 μg/m3, the estimated avoided all-cause mortalities were 160 × 103 (95% CI: 98 × 103, 230 × 103) cases and economic benefits ranged from 54 to 95 billion CNY based on AHC and WTP methods.
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Affiliation(s)
- Shuang Liang
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Xiaoli Li
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Yu Teng
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Hongchen Fu
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Li Chen
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China.
| | - Jian Mao
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Hui Zhang
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Shuang Gao
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Yanling Sun
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Zhenxing Ma
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, 300387, China
| | - Merched Azzi
- Commonwealth Scientific and Industrial Research Organization (CSIRO) Energy, North Ryde, Australia
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31
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Assessing the Impact of Ozone and Particulate Matter on Mortality Rate from Respiratory Disease in Seoul, Korea. ATMOSPHERE 2019. [DOI: 10.3390/atmos10110685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The evidence linking ozone and particulate matter with adverse health impacts is increasing. The goal of this study was to assess the impact of air pollution on the mortality rate from respiratory disease in Seoul, Korea, between 2008 and 2017. The analysis was conducted using a decision tree model in two ways: using 24-hour average concentrations and using 1-hour maximum values to compare any health impacts from the different times of exposure to pollution. Results show that in spring an elevated level of ozone is one of the most important factors, but in summer temperature has a greater impact than air pollution. Nitrogen dioxide is one of the most important factors in fall, while high levels of particles less than 2.5 μm (PM2.5) and 10 μm in size (PM10) and cooler temperatures are key factors in winter. We checked the accuracy of our results through a 10-fold cross validation method. Error rates using 24-hour average and 1-hour maximum concentrations were in the ranges of 24.9%–42% and 27.6%–42%, respectively, indicating that 24-hour average concentrations are slightly more directly related with mortality rate. These results could be useful for policy makers in determining the temporal scale of predicted pollutant concentrations for an air quality warning system to help minimize the adverse impacts of air pollution.
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32
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Sicard P, Khaniabadi YO, Perez S, Gualtieri M, De Marco A. Effect of O 3, PM 10 and PM 2.5 on cardiovascular and respiratory diseases in cities of France, Iran and Italy. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:32645-32665. [PMID: 31576506 DOI: 10.1007/s11356-019-06445-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/05/2019] [Indexed: 05/22/2023]
Abstract
At present, both tropospheric ozone (O3) and particulate matters (PM) are among the most threatening air pollutants for human health in cities. The air pollution effects over public health include increased risk of hospital admissions and mortality for respiratory and cardiovascular diseases even when air pollutant concentrations are below European and international standards. The aim of this study was to (i) estimate the burden of mortality and morbidity for cardiovascular and respiratory diseases attributed to PM2.5, PM10 and O3 in nine selected cities in France, Iran and Italy in 2015 and 2016 and to (ii) compare estimated burdens at current O3 and PM levels with pre-industrial levels. The selected Mediterranean cities are among the most affected by the air pollution in Europe, in particular by rising O3 while the selected Iranian cities rank as the most polluted by PM in the world. The software AirQ+ was used to estimate the short-term health effects, in terms of mortality and morbidity by using in situ air quality data, city-specific relative risk values and baseline incidence. Compared to pre-industrial levels, long-term exposures to ambient PM2.5, PM10 and O3 have substantially contributed to mortality and hospital admissions in selected cities: about 8200 deaths for non-accidental causes, 2400 deaths for cardiovascular diseases, 540 deaths for respiratory diseases, 220 deaths for chronic obstructive pulmonary diseases as well as 18,800 hospital admissions for cardiovascular diseases and 3400 for respiratory diseases were reported in 2015. The study supports the need of city-specific epidemiological data and urgent strategies to mitigate the health burden of air pollution.
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Affiliation(s)
| | - Yusef Omidi Khaniabadi
- Health Care System of Karoon, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sandra Perez
- University Côte d'Azur, UMR 7300 ESPACE, Nice, France
| | - Maurizio Gualtieri
- ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, SSPT, Rome, Italy
| | - Alessandra De Marco
- ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, SSPT, Rome, Italy
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Michael R, O'Lenick CR, Monaghan A, Wilhelmi O, Wiedinmyer C, Hayden M, Estes M. Application of geostatistical approaches to predict the spatio-temporal distribution of summer ozone in Houston, Texas. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:806-820. [PMID: 30451934 DOI: 10.1038/s41370-018-0091-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 09/09/2018] [Accepted: 09/17/2018] [Indexed: 06/09/2023]
Abstract
Mitigation of adverse effects of air pollution requires understanding underlying exposures, such as ambient ozone concentrations. Geostatistical approaches were employed to analyze temporal trends and estimate spatial patterns of summertime ozone concentrations for Houston, Texas, based on hourly ozone observations obtained from the Texas Commission on Environmental Quality. We systematically assess the accuracy of several spatial interpolation methods, comparing inverse distance weighting, simple kriging, ordinary kriging, and universal kriging methods utilizing the hourly ozone observations and meteorological measurements from monitoring sites. Model uncertainty was assessed by leave-one-out cross-validation. Kriging methods performed better, showing greater consistency in the generated surfaces, fewer interpolation errors, and lower biases. Universal kriging did not significantly improve the interpolation results compared to ordinary kriging, and thus ordinary kriging was determined to be the optimal method, striking a balance between accuracy and simplicity. The resulting spatial patterns indicate that the more industrialized areas east and northeast of Houston exhibit the highest summertime ozone concentrations. Estimated daily maximum 8 h ozone concentration fields generated will be used to inform research on population health risks from exposure to surface ozone in Houston.
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Affiliation(s)
- Ryan Michael
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA.
| | - Cassandra R O'Lenick
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Andrew Monaghan
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Olga Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Christine Wiedinmyer
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Mary Hayden
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Mark Estes
- Air Modeling and Data Analysis Section, Texas Commission on Environmental Quality, Austin, TX, USA
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Cheng H, Zhu F, Lei R, Shen C, Liu J, Yang M, Ding R, Cao J. Associations of ambient PM 2.5 and O 3 with cardiovascular mortality: a time-series study in Hefei, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1437-1447. [PMID: 31385092 DOI: 10.1007/s00484-019-01766-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 04/04/2019] [Accepted: 07/16/2019] [Indexed: 06/10/2023]
Abstract
China is among the countries with the worst air quality throughout the world. As PM2.5 was not included in the national air quality monitoring network before January 2013 in China, no study has investigated the associations of ambient PM2.5 and O3 with cardiovascular mortality in Hefei, China. In this time-series analysis, Poisson regression in generalized additive model was adopted to assess the associations between the air pollutants and cardiovascular mortality during the 2013-2015 in Hefei, China. The findings showed that the daily average level of PM2.5 and O3 was 77.8 μg/m3 and 60.1 μg/m3 in the study period, respectively. PM2.5 and O3 exposure tended to increase cardiovascular mortality, but the associations were statistically insignificant. Further stratified analyses by seasons showed that with every 10 μg/m3 increase of PM2.5 in the cold season (October-March), the risk of cardiovascular death increased by 0.22% (95% CI 0.05%, 0.39%); while every 10 μg/m3 increase of O3 in the warm season (April-September), the risk of cardiovascular death increased by 1.29% (95% CI 0.26%, 2.33%) on Lag0. Interestingly, stratified analysis by gender showed that the associations of PM2.5, but not O3 exposure, could significantly increase cardiovascular mortality in females, but not males. The findings of this study especially underscored the adverse associations of PM2.5 and O3 exposure with females in specific seasons. More studies are needed to verify our findings and further investigate the underlying mechanisms. Graphical Abstract.
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Affiliation(s)
- Han Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Furong Zhu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ruoqian Lei
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chaowei Shen
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mei Yang
- Department of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Lertxundi A, Andiarena A, Martínez MD, Ayerdi M, Murcia M, Estarlich M, Guxens M, Sunyer J, Julvez J, Ibarluzea J. Prenatal exposure to PM 2.5 and NO 2 and sex-dependent infant cognitive and motor development. ENVIRONMENTAL RESEARCH 2019; 174:114-121. [PMID: 31055169 DOI: 10.1016/j.envres.2019.04.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/14/2019] [Accepted: 04/03/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to air pollutants including particulate matter (<2.5 μm of diameter,PM2.5)and nitrogen dioxide (NO2) has been identified as a potential risk factor for neuropsychological developmental and mental health disorders. OBJECTIVE This study aimed to analyze the associations between prenatal PM2.5 and NO2 exposure and cognitive functions in children at 4-6 years of age, including sex differences, and the modification effect of the duration predominant breastfeeding these associations. DESIGN This study was conducted as part of the INMA project, a population-based birth cohort study in Spain (n = 1119). Each of the pregnant mothers was assigned a prenatal exposure to PM2.5 and NO2 for their whole pregnancy based on their place of residence. At the 4-6 year-old follow-up, infants' neuropsychological development was assessed using McCarthy scales: Verbal, Perceptive-Manipulative, Numeric, General Cognitive, Memory and Motor (gross and fine). Between 6 and 14 months of age, information concerning breastfeeding was gathered with a questionnaire. Regression analyses were performed to estimate the associations between exposure and outcomes, accounting for potential confounders. The analyses were stratified by child sex and breastfeeding duration. RESULTS The majority of coefficients for the different cognitive domains were negative either for PM2.5 and NO2, though none was statistically significant. After stratifying by sex, the associations become even more negative for boys, with some of the associations becoming statistically significant (memory both for PM2.5 and NO2), and global cognition and verbal for NO2. Duration of predominant breastfeeding was not found to have a modifying effect. CONCLUSIONS These findings suggest a sex-dependent effects on neuropsychological development at 4-6 years of age, with a greater vulnerability in boys, specifically in domains related to memory, verbal and general cognition. No modifying effect was observed for duration of predominant breastfeeding.
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Affiliation(s)
- Aitana Lertxundi
- Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biodonostia Health Institute Research, San Sebastián, Basque Country, 20014, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain.
| | - Ainara Andiarena
- Biodonostia Health Institute Research, San Sebastián, Basque Country, 20014, Spain; School of Psychology, University of the Basque Country(UPV/EHU), San Sebastián, 20080, Spain
| | - María Dolores Martínez
- Biodonostia Health Institute Research, San Sebastián, Basque Country, 20014, Spain; Environment and Regional Planning Department, Basque Government, Vitoria, 01010, Spain
| | - Mikel Ayerdi
- Biodonostia Health Institute Research, San Sebastián, Basque Country, 20014, Spain; Sub-directorate for Public Health of Gipuzkoa, BasqueGovernment, San Sebastián, 20013, Spain
| | - Mario Murcia
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-UniversitatJaume I-Universitat de València, Valencia, 46020, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-UniversitatJaume I-Universitat de València, Valencia, 46020, Spain
| | - Monica Guxens
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, 08003, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, 3015CN, the Netherlands; PompeuFabraUniversity, Barcelona, Catalonia, 08003, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, 08003, Spain; PompeuFabraUniversity, Barcelona, Catalonia, 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Catalonia, 08003, Spain
| | - Jordi Julvez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, 08003, Spain; PompeuFabraUniversity, Barcelona, Catalonia, 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Catalonia, 08003, Spain
| | - Jesús Ibarluzea
- Biodonostia Health Institute Research, San Sebastián, Basque Country, 20014, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; School of Psychology, University of the Basque Country(UPV/EHU), San Sebastián, 20080, Spain; Sub-directorate for Public Health of Gipuzkoa, BasqueGovernment, San Sebastián, 20013, Spain
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Xue T, Guan T, Liu Y, Zheng Y, Guo J, Fan S, Zhang Q. A national case-crossover study on ambient ozone pollution and first-ever stroke among Chinese adults: Interpreting a weak association via differential susceptibility. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 654:135-143. [PMID: 30439690 DOI: 10.1016/j.scitotenv.2018.11.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 05/27/2023]
Abstract
Evidence suggesting an association between ozone exposure and stroke risk remains inconsistent; variations in the distributions of susceptibilities of the study populations may explain some of it. We examined the hypothesis in a general Chinese population. During 2013-2015, 1356 first-ever stroke events were selected from a large representative sample, the China National Stroke Screening Survey (CNSSS) database; daily maximal 8-hour ozone concentrations were obtained from spatiotemporally interpolated estimates of in-situ observations over China. We conducted a time-stratified case-crossover design to assess associations between stroke risk and ambient ozone exposure. Next, potential effect modifiers were identified using interaction analyses. Final, a well-established approach was applied to estimate individual-level susceptibility (i.e., the individual-specific effect given a certain combination of multiple effect-modifiers) and its probability distribution among all the CNSSS participants (n = 1,292,010). With adjustments for temperature, relative humidity and ambient fine particulate matter exposure, a 10-μg/m3 increment in mean ozone levels 2-3 day prior to symptom onset was associated with a 3.0% change in stroke risk (95% confidence interval: -1.2%, 7.3%). This association was statistically significantly enhanced by male gender, rural residence and low vegetable and fruit consumption. The subgroup results suggested that a fraction of the population might be considerably affected by ozone, regardless of the insignificant association in average level. The analysis of susceptibility distribution further indicated that the ozone-stroke association was statistically significantly positive in 14% of the general population. Susceptibility to ozone-related stroke significantly varied among Chinese adults. Characterizing individual-level susceptibility reveals the complexity underlying the weak average effect of ozone, and supports to plan subpopulation-specific interventions to mitigate the stroke risk.
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Affiliation(s)
- Tao Xue
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Tianjia Guan
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yixuan Zheng
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Jian Guo
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyuan Fan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
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Raza A, Dahlquist M, Jonsson M, Hollenberg J, Svensson L, Lind T, Ljungman PLS. Ozone and cardiac arrest: The role of previous hospitalizations. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:1-8. [PMID: 30399483 DOI: 10.1016/j.envpol.2018.10.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/06/2018] [Accepted: 10/08/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Several studies have reported associations between exposure to particulate matter and incidence of out-of-hospital cardiac arrest (OHCA) and some have observed associations with ozone (O3). There are no studies investigating susceptibility based on previous disease history to short-term O3 exposure and the risk of OHCA. AIM To investigate the role of previous cardiovascular-related hospitalizations in modifying the associations between the risk of OHCA and short-term increase in O3 concentrations. METHODS A time-stratified case-crossover analysis of 11,923 OHCA registered in the Swedish Register for Cardiopulmonary Resuscitation from 2006 to 2014 was performed. Using personal identification numbers, OHCA were linked to all previous hospitalizations in Sweden since 1987 to create susceptible groups based on the principal diagnosis code at discharge. Susceptibility was based on hospitalization for i) acute myocardial infarction; ii) heart failure; iii) arrhythmias; iv) diabetes; v) hypertension; and vi) stroke. Moving 2 and 24-h averages for O3, PM2.5, PM10, and NO2 were constructed from hourly averages. RESULTS A 10 μg/m3 higher 2-h average O3 concentration was associated with a 2% higher risk of OHCA (95% CI, 0% 3%). Associations were similar for 24-h average O3 and in individuals with or without hospitalizations for AMI, heart failure, diabetes, hypertension or stroke. Individuals with previous hospitalizations for arrhythmias had a lower risk of OHCA with higher O3. No associations were observed for other pollutants. CONCLUSIONS Short-term exposure to O3 was associated with an elevated risk of OHCA, however, previous hospitalizations for cardiovascular diseases were not associated with additionally augmented risks.
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Affiliation(s)
- Auriba Raza
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-171 77, Stockholm, Sweden.
| | - Marcus Dahlquist
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-171 77, Stockholm, Sweden
| | - Martin Jonsson
- Center for Resuscitation Science, Department of Medicine Solna, Karolinska Institutet, Sweden, Stockholm, Sweden
| | - Jacob Hollenberg
- Center for Resuscitation Science, Department of Medicine Solna, Karolinska Institutet, Sweden, Stockholm, Sweden
| | - Leif Svensson
- Center for Resuscitation Science, Department of Medicine Solna, Karolinska Institutet, Sweden, Stockholm, Sweden
| | - Tomas Lind
- Department of Occupational and Environmental Medicine, Stockholm County Council, Torsplan, Solnavägen 4, 113 65, Stockholm, Sweden
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-171 77, Stockholm, Sweden; Department of Cardiology, Danderyds Sjukhus, Mörbygårdsvägen 88, 182 88, Danderyd, Sweden
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Song J, Liu Y, Zheng L, Gui L, Zhao X, Xu D, Wu W. Acute effects of air pollution on type II diabetes mellitus hospitalization in Shijiazhuang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:30151-30159. [PMID: 30151787 DOI: 10.1007/s11356-018-3016-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/20/2018] [Indexed: 05/23/2023]
Abstract
UNLABELLED Air pollution has been considered as an important contributor to diabetes development. However, the evidence is fewer in developing countries where air pollution concentrations were much higher. In this study, we conduct a time-series study to investigate the acute adverse effect of six air pollutants on type II diabetes mellitus (T2DM) hospitalization in Shijiazhuang, China. An over-dispersed passion generalized addictive model adjusted for weather conditions, day of the week, and long-term and seasonal trends was used. Finally, a 10-μg/m3 increase of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) corresponded to 0.53% (95% confidence interval = 0.22-0.83), 0.32% (95% CI = 0.10-0.55), 0.55% (95% CI = 0.04-1.07), 1.27% (95% CI = 0.33-2.22), and 0.04% (95% CI = 0.02-0.06) increment of T2DM hospitalization, respectively. The effects of PM2.5, PM10, and CO were robust when adjusted for co-pollutants. The associations appeared to be a little stronger in the cool season than in the warm season. And stronger associations were found in male and elderly (≥ 65 years) than in female and younger people (35-65 years). Our results contribute to the limited data in the scientific literature on acute effects of air pollution on type II diabetes mellitus in developing countries. MAIN FINDINGS This is the first adverse effect evidence of air pollution on T2DM in Shijiazhuang, a severely polluted city in China. Males were more vulnerable than females in severe pollution.
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Affiliation(s)
- Jie Song
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China.
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, Xinxiang, 453003, China.
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Liheng Zheng
- Hebei Chest Hospital, Shijiazhuang, 050041, China
| | - Lihui Gui
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xiangmei Zhao
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Dongqun Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, Xinxiang, 453003, China
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Day DB, Clyde MA, Xiang J, Li F, Cui X, Mo J, Gong J, Weschler CJ, Zhang Y, Zhang JJ. Age modification of ozone associations with cardiovascular disease risk in adults: a potential role for soluble P-selectin and blood pressure. J Thorac Dis 2018; 10:4643-4652. [PMID: 30174917 DOI: 10.21037/jtd.2018.06.135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Studies have suggested that age increases susceptibility to ozone-associated mortality, but the underlying mechanisms are unclear. In a previous study, personal exposure to ozone was significantly associated with a platelet activation biomarker, plasma soluble P-selectin (sCD62P), and blood pressure in 89 healthy adults, aged 22-52 years. The present study examines whether age modifies these associations in the same adults and in additional adults. Methods Interaction terms of age and exposure were analyzed using hierarchical Bayesian mixed effects ridge regressions. Data from a similar additional study involving 71 healthy participants, aged 19-26 years, were pooled with the data from the first study to evaluate age effect modification when more young adults were added to the analysis. Results In the 89 adults, significant age interactions were observed for past 24-hour and 2-week ozone exposures and sCD62P. Based on the pooled data (89 plus 71 adults), a 10 ppb increase in 24-hour ozone exposure was associated with increases in sCD62P and systolic blood pressure (SBP) by 22.3% (95% CI: 14.3%, 31.2%) and 1.35 (-0.18, 2.84) mmHg, respectively, at age 25; these values increased to 48.6% (32.7%, 65.1%) and 4.98 (2.56, 7.35) mmHg, respectively, at age 40. Conclusions These results mechanistically suggest that increasing age enhances cardiovascular effects of ozone.
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Affiliation(s)
- Drew B Day
- Global Health Institute and Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Merlise A Clyde
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - Jianbang Xiang
- Department of Building Science, Tsinghua University, Beijing 100084, China.,Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Feng Li
- Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaoxing Cui
- Global Health Institute and Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Jinhan Mo
- Department of Building Science, Tsinghua University, Beijing 100084, China.,Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Jicheng Gong
- College of Environmental Sciences and Engineering and Beijing Innovation Center for Engineering Science and Advanced Technology, Peking University, Beijing 100871, China
| | - Charles J Weschler
- Department of Building Science, Tsinghua University, Beijing 100084, China.,Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China.,Environmental and Occupational Health Sciences Institute, Rutgers University, Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China.,Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Junfeng Jim Zhang
- Global Health Institute and Nicholas School of the Environment, Duke University, Durham, NC, USA.,College of Environmental Sciences and Engineering and Beijing Innovation Center for Engineering Science and Advanced Technology, Peking University, Beijing 100871, China.,Duke Kunshan University, Kunshan 215347, China
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Scortichini M, De Sario M, de'Donato FK, Davoli M, Michelozzi P, Stafoggia M. Short-Term Effects of Heat on Mortality and Effect Modification by Air Pollution in 25 Italian Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081771. [PMID: 30126130 PMCID: PMC6122066 DOI: 10.3390/ijerph15081771] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 01/03/2023]
Abstract
Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural mortality in 25 Italian cities. Time-series analysis was run for each city. To evaluate interaction, a tensor product between mean air temperature (lag 0⁻3) and either PM10 or ozone (both lag 0⁻5) was defined and temperature estimates were extrapolated at low, medium, and high levels of pollutants. Heat effects were estimated as percent change in mortality for increases in temperature between 75th and 99th percentiles. Results were pooled by geographical area. Differential temperature-mortality risks by air pollutants were found. For PM10, estimates ranged from 3.9% (low PM10) to 14.1% (high PM10) in the North, from 3.6% to 24.4% in the Center, and from 7.5% to 21.6% in the South. Temperature-related mortality was similarly modified by ozone in northern and central Italy, while no effect modification was observed in the South. This study underlines the synergistic effects of heat and air pollution on mortality. Considering the predicted increase in heat waves and stagnation events in the Mediterranean countries such as Italy, it is time to enclose air pollution within public health heat prevention plans.
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Affiliation(s)
- Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
| | - Manuela De Sario
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
| | - Francesca K de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
- Institute of Environmental medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
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The Association Between PM2.5 and Ozone and the Prevalence of Diabetes Mellitus in the United States, 2002 to 2008. J Occup Environ Med 2018; 60:594-602. [PMID: 29634612 PMCID: PMC8851375 DOI: 10.1097/jom.0000000000001332] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To examine the association between air pollution and diabetes prevalence in the United States, 2002 to 2008. METHODS Annual average particulate matter (PM2.5) and ozone concentrations were calculated using daily county-level data from the CDC's Tracking Network. Individual-level outcome and covariate data were obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System for 862,519 individuals. We used Poisson regression analyses to examine associations between each air pollutant (per 10-unit increase) with diabetes, including regional sub-analyses. Analyses were adjusted for year, age, sex, race, ethnicity, education, income, smoking status, body mass index, exercise, and asthma. RESULTS Positive associations between each pollutant and diabetes were found (PM2.5: prevalence ratio [PR] = 1.10; 95% confidence interval [CI] = 1.03, 1.17; ozone: PR = 1.06; 95% CI = 1.03, 1.09). There was limited evidence of effect modification by region. CONCLUSIONS Interventions to reduce ambient air pollution may help alleviate the diabetes burden in the US.
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Gariazzo C, Stafoggia M, Bruzzone S, Pelliccioni A, Forastiere F. Association between mobile phone traffic volume and road crash fatalities: A population-based case-crossover study. ACCIDENT; ANALYSIS AND PREVENTION 2018; 115:25-33. [PMID: 29544134 DOI: 10.1016/j.aap.2018.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/11/2018] [Accepted: 03/04/2018] [Indexed: 05/21/2023]
Abstract
Use of mobile phones while driving is known to cause crashes with possible fatalities. Different habits of mobile phone use might be distracting forces and display differential impacts on accident risk; the assessment of the relative importance is relevant to implement prevention, mitigation, and control measures. This study aimed to assess the relationship between the use of mobile phones at population level and road crash fatalities in large urban areas. Data on road crashes with fatalities were collected from seven Italian metropolitan areas and matched in time and space with high resolution mobile phone traffic volume data about calls, texts, Internet connections and upload/download data. A case-crossover study design was applied to estimate the relative risks of road accident for increases in each type of mobile phone traffic volumes in underlying population present in the small areas where accidents occurred. Effect modification was evaluated by weekday/weekend, hour of the day, meteorological conditions, and street densities. Positive associations between road crashes rates and the number of calls, texts, and Internet connections were found, with incremental risks of 17.2% (95% Confidence Interval [CI] 7.7, 27.6), 8.4% (CI 0.7, 16.8), and 54.6% (CI 34.0, 78.5) per increases (at 15 min intervals) of 5 calls/100 people, 3 text/100 people, and 40 connections/100 people, respectively. Small differences across cities were detected. Working days, nighttime and morning hours were associated with greater phone use and more road accidents. The relationship between mobile phone use and road fatalities at population level is strong. Strict controls on cellular phone in the vehicle may results in a large health benefit.
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Affiliation(s)
- Claudio Gariazzo
- INAIL, Department of Occupational & Environmental Medicine, Via Fontana Candida 1, 00040, Monteporzio Catone (RM), Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Armando Pelliccioni
- INAIL, Department of Occupational & Environmental Medicine, Via Fontana Candida 1, 00040, Monteporzio Catone (RM), Italy
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Linares C, Carmona R, Salvador P, Díaz J. Impact on mortality of biomass combustion from wildfires in Spain: A regional analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 622-623:547-555. [PMID: 29223078 DOI: 10.1016/j.scitotenv.2017.11.321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 04/13/2023]
Abstract
Studies that analyse the impact on mortality of particulate matter (PM) produced by biomass combustion from wildfires mostly focus on a single city or on cities in different countries, with very few concentrating on one country as a whole. Accordingly, the aim of this paper was to analyse the impact that PM has on daily mortality in Spain on days with biomass combustion from wildfires. To analyse natural PM advections the Ministry of Agriculture and Fishing, Food & Environment divides Spain into 9 geographical regions. One province representative of each region for was selected analysis purposes, with provincial daily natural-cause mortality across the period 2004-2009 as the dependent variable, and daily mean PM concentrations in the provincial capital as the independent variable. We controlled for the effect of other chemical pollutants (NO2 and O3), maximum daily temperature on heat-wave days, day of the week, trends, seasonalities and the autoregressive nature of the series, using generalised linear models with the Poisson regression link to calculate relative risks (RRs) and the increase in RR (IRR) of PM-related mortality. The analysis was performed for days with and without biomass advections (DBA and DNBA respectively), with a breakdown by year, summer, and the remainder of the year (i.e., excluding summer). The results indicated that daily mean PM concentrations were higher on DBA than on DNBA, with statistically significant differences in most provinces. Furthermore, PM10 was associated with higher daily mortality on DBA in regions where wildfires were most frequent, but not in the remaining provinces. This translated as an IRR per 10μg/m3 of PM of 7.93 (2.36-13.81) in the North-west, 3.76 (1.36-6.22) in the Centre and 4.46 (2.99-5.94) in the South-west, values which in all cases were statistically higher than those obtained on DNBA. The increase in PM caused by biomass advections from wildfires is linked to a significant IRR of mortality in Spain. Hence, the fact that wildfires are likely to become increasingly frequent in the context of climate change makes this type of analysis particularly necessary.
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Affiliation(s)
- C Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - R Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - P Salvador
- Environmental Department of Research, Centre for Energy, Environment and Technology (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas/CIEMAT), Madrid, Spain
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
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Newell K, Kartsonaki C, Lam KBH, Kurmi O. Cardiorespiratory health effects of gaseous ambient air pollution exposure in low and middle income countries: a systematic review and meta-analysis. Environ Health 2018; 17:41. [PMID: 29669550 PMCID: PMC5907176 DOI: 10.1186/s12940-018-0380-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/29/2018] [Indexed: 05/16/2023]
Abstract
BACKGROUND Lack of research on the effects of gaseous pollutants (nitrogen oxides [NOx], sulfur dioxide [SO2], carbon monoxide [CO] and ozone [O3]) in the ambient environment on health outcomes from within low and middle income countries (LMICs) is leading to reliance on results from studies performed within high income countries (HICs). This systematic review and meta-analysis examines the cardiorespiratory health effects of gaseous pollutants in LMICs exclusively. METHODS Systematic searching was carried out and estimates pooled by pollutant, lag and outcome, and presented as excess relative risk per 10 μg/m3 (NOx, SO2, O3) or 1 ppm (CO) increase pollutant. Sub-group analysis was performed examining estimates by specific outcomes, city and co-pollutant adjustment. RESULTS Sixty studies met the inclusion criteria, most (44) from the East Asia and Pacific region. A 10 μg/m3 increase in same day NOx was associated with 0.92% (95% CI: 0.44, 1.39), and 0.70% (0.01, 1.40) increases in cardiovascular and respiratory mortality respectively, same day NOx was not associated with morbidity. Same day sulfur dioxide was associated with 0.73% (0.04, 1.42) and 0.50% (0.01, 1.00) increases in respiratory morbidity and in cardiovascular mortality respectively. CONCLUSIONS Acute exposure to gaseous ambient air pollution (AAP) is associated with increases in morbidity and mortality in LMICs, with greatest associations observed for cardiorespiratory mortality.
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Affiliation(s)
- Katherine Newell
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Om Kurmi
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Raza A, Dahlquist M, Lind T, Ljungman PLS. Susceptibility to short-term ozone exposure and cardiovascular and respiratory mortality by previous hospitalizations. Environ Health 2018; 17:37. [PMID: 29653570 PMCID: PMC5899411 DOI: 10.1186/s12940-018-0384-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/05/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Ozone (O3) has been associated with cardiorespiratory mortality although few studies have explored susceptible populations based on prior disease. We aimed to investigate the role of previous hospitalization on the association between short-term exposure to O3 and cardiovascular (CV) and respiratory mortality. METHODS We performed time series analyses using generalized additive models and case-crossover on 136,624 CV and 23,281 respiratory deaths in Stockholm County (1990-2010). Deaths were linked to hospital admissions data. We constructed 2-day and 7-day averages using daily 8-h maximum for O3 and hourly values for PM2.5, PM10, NO2, and NOx from a fixed monitor. RESULTS We observed a 0.7% (95% CI: 0.1%, 1.3%) and 2.7% (95% CI: 0.8%, 4.6%) higher risk of CV and respiratory death per 10 μg/m3 higher 2-day and 7-day average O3 respectively. Individuals previously hospitalized for myocardial infarction demonstrated 1.8% (95% CI: 0.4%, 3.4%) higher risk of CV death per 10 μg/m3 higher 2-day average O3 and similar associations were observed in individuals with no previous hospitalization for any cause. Individuals with previous hospitalizations did not show susceptibility towards O3-related risk of respiratory mortality. We observed no associations for other pollutants. CONCLUSION Short-term ozone exposure is associated with CV and respiratory mortality and our results may suggest higher susceptibility to CV mortality following O3 exposure in individuals previously hospitalized for myocardial infarction. Higher risks were also observed in individuals with cardiovascular death as their first presentation of disease.
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Affiliation(s)
- Auriba Raza
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
| | - Marcus Dahlquist
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
| | - Tomas Lind
- Center for Occupational and Environmental Medicine, Stockholm County Council, Solnavägen 4, 113 65 Stockholm, Sweden
| | - Petter L. S. Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
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Dastoorpoor M, Khanjani N, Bahrampour A, Goudarzi G, Aghababaeian H, Idani E. Short-term effects of air pollution on respiratory mortality in Ahvaz, Iran. Med J Islam Repub Iran 2018; 32:30. [PMID: 30159281 PMCID: PMC6108243 DOI: 10.14196/mjiri.32.30] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Indexed: 11/30/2022] Open
Abstract
Background: Urban air pollutants may affect respiratory mortality. This study was conducted to investigate this effect in Ahvaz, one of the most polluted cities in the world. Methods: The impact of 7 major air pollutants including O3, PM10, NO2, CO, and SO2 were evaluated on respiratory mortality in different gender and age groups using a quasi-Poisson, second degree polynomial constrained, distributed lag model, with single and cumulative lag structures adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holiday. Data were analyzed using the dlnm package in R x64 3.2.5 software. Significance level was set at less than 0.05. Results: In adjusted models, for each IQR increase of O3 in the total population, the risk ratio (RR) for respiratory deaths in 0 to 14- day lags was, respectively, 1.009 (95% CI:1.001-1.016) and 1.009 (95% CI:1.002-1.017), and it was 1.021 (95% CI: 1.002-1.040) in cumulative 0 to 14- day lags. For PM10, in the total population and in adjusted models after 0 to 14- day lags and in cumulative lags of 0 to 14 for an IQR increase in the mean concentration of PM10, the RR for respiratory deaths increased significantly and was, respectively, 1.027 (95% CI:1.002-1.051), 1.029 (95% CI:1.006-1.052), and 1.065 (95% CI:1.005-1.128). NO2 showed a significant association with respiratory deaths only in the 18 to 60 year- old age group and in 9- day lags (RR= 1.318, 95% CI:1.002-1.733). Finally, the results showed that for an IQR increase in the mean concentration of CO and SO2, the adjusted RR for respiratory deaths in 9- day lags in the total population was, respectively, RR= 1.058 (95% CI:1.008-1.111) and 1.126 (95% CI:1.034-1.220). Conclusion: Air pollution in Ahvaz is probably causing increased respiratory mortality.
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Affiliation(s)
- Maryam Dastoorpoor
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Bahrampour
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Esmaeil Idani
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Collart P, Dramaix M, Levêque A, Mercier G, Coppieters Y. Concentration-response curve and cumulative effects between ozone and daily mortality: an analysis in Wallonia, Belgium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:147-158. [PMID: 29564909 DOI: 10.1080/09603123.2018.1453050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
Many studies have shown an association between ozone and mortality. However, little data is available on the cumulative effects of ozone on health. A time-series analysis using a Poisson regression was used to measure the impact of ozone on non-traumatic mortality in Wallonia over the period 2000-2012. Initially, a single-lag model was tested. Then a distributed-lag non-linear model was used in order to verify the cumulative effects of ozone on mortality. Our study confirms the existence of an association between ozone and mortality. The linear model without threshold shows a higher sensitivity in persons aged 75 and over (ERR = 0.7, 95 % CI: 0.4; 1.0 %) compared to younger people (ages 25-74) (ERR = 0.2, 95 % CI: - 0.2; 0.6 %). Taking cumulative effects into account, men and women aged 25-74 have an ozone sensitivity equivalent to those over 75.
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Affiliation(s)
- Philippe Collart
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Michèle Dramaix
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Alain Levêque
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Gwenaëlle Mercier
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Yves Coppieters
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
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Nuvolone D, Petri D, Voller F. The effects of ozone on human health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:8074-8088. [PMID: 28547375 DOI: 10.1007/s11356-017-9239-3] [Citation(s) in RCA: 169] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/09/2017] [Indexed: 04/16/2023]
Abstract
Ozone is a highly reactive, oxidative gas associated with adverse health outcome, including mortality and morbidity. Data from monitoring sites worldwide show levels of ozone often exceeding EU legislation threshold and the more restrictive WHO guidelines for the protection of human health. Well-established evidence has been produced for short-term effects, especially on respiratory and cardiovascular systems, associated to ozone exposure. Less conclusive is the evidence for long-term effects, reporting suggestive associations with respiratory mortality, new-onset asthma in children and increased respiratory symptom effects in asthmatics. The growing epidemiological evidence and the increasing availability of routinely collected data on air pollutant concentrations and health statistics allow to produce robust estimates in health impact assessment routine. Most recent estimates indicate that in 2013 in EU-28, 16,000 premature deaths, equivalent to 192,000 years of life lost, are attributable to ozone exposure. Italy shows very high health impact estimates among EU countries, reporting 3380 premature deaths and 61 years of life lost (per 100,000 inhabitants) attributable to ozone exposure.
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Affiliation(s)
- Daniela Nuvolone
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy.
| | - Davide Petri
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
| | - Fabio Voller
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
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Short-term Exposure to Ozone and Mortality in Subjects With and Without Previous Cardiovascular Disease. Epidemiology 2018; 27:663-9. [PMID: 27258325 DOI: 10.1097/ede.0000000000000520] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exposure to ground level ozone (O3) is a public health problem associated with a range of risks across population subgroups. Our aim was to investigate the role of previous cardiovascular diseases (CVDs) in mortality related to short-term O3 exposure. METHODS Deaths between 1990 and 2010 in Stockholm County were matched with previous hospitalizations in Swedish registries. An urban background monitoring station provided hourly values of air quality data, from which we calculated 8-hour running averages and daily 8-hour maximum. We analyzed associations between daily O3 concentrations and mortality among persons with and without previous CVD hospitalization with a generalized additive model adjusted for time trend, influenza, and weather. We also performed two-pollutant models. RESULTS There were 302,283 nontrauma-related deaths, out of which 196,916 had previous CVD hospitalization. The mean concentration of daily maximum 8-hour O3 was 62.9 μg/m. An average 10 μg/m increase in the same and preceding day was associated with an increased mortality of 1.72% (95% confidence interval: 0.44%, 3.02%) in those with prior admission for acute myocardial infarction (AMI), which was more than three times higher than for those with no previous AMI (0.50, 95% confidence interval: 0.10%, 0.89%, P value for interaction 0.098). The association between O3 and mortality remained essentially unchanged in two-pollutant models with NO2, NOx, and PM10. CONCLUSIONS Our study indicates that short-term exposure to O3 is associated with increased mortality in those with a previous hospitalization for AMI.
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