Long-Term Coarse Particulate Matter Exposure Is Associated with Asthma among Children in Medicaid

The odds of developing asthma and wheeze among children and adolescents exposed to particulate matter: asystematic review and meta-analysis

BACKGROUND

Exposure to air pollution specifically particulate matter causes significant health risk to children which increases their susceptibility to respiratory diseases.

OBJECTIVES

This review aimed to pool the association between particulate matter exposure and childhood asthma and wheeze among children and adolescents.

METHODS

This review included observational study articles retrieved from electronic data bases such as PubMed, Google Scholar, Hinari, Science Direct, and Semantic Scholar from 1996 to June 17, 2024. Data were extracted and analyzed using Microsoft Excel 16 and STATA version 17, respectively. Joanna Briggs Institute evaluation criteria and I2 test statistics were used for quality and heterogeneity assessment, respectively.

RESULTS

Fourty seven studies with a total of 417,874 of children and adolescents met the inclusion criteria. The pooled odd ratio (OR) of the association between Particulate Matter with a diameter of 10 micrometers or less (PM10) and Particulate Matter with a diameter of 2.5 micrometers or less (PM2.5) with asthma were 1.04 (95% CI: 1.03-1.06, p < 0.001) with significant extreme heterogeneity (I² = 82.7%, p < 0.001) and 1.05 (95% CI 1.04-1.07, p < 0.001) with high heterogeneity (I² = 80.6%, p < 0.001) among the included studies, respectively. The overall pooled estimate indicates a statistically significant association between PM10 and wheeze, with OR of 1.06 (95% CI: 1.05, 1.07) and moderate heterogeneity among included studies (I²=57.5%, p < 0.007) where as more association was observed between PM2.5 and wheeze with OR of 1.15. (95% CI: 1.10, 1.20) with an (I² =72.8%, p < 0.001).

CONCLUSION

The findings of this systematic review and meta-analysis demonstrated a statistically significant association between exposure to both PM10 and PM2.5 and the occurrence of asthma and wheezing in children and adolescents. Both PM10 and PM2.5 are associated with increased odds of asthma and wheezing, with PM2.5 showing a stronger relationship. The significant levels of heterogeneity observed suggest variations across studies, which may be due to differences in study designs, exposure level and outcome measurement types. These findings indicate the need for strategies to reduce particle air pollution to mitigate its adverse effects on children's respiratory health.

Long-Term Greenness Effects of Urban Forests to Reduce PM10 Concentration: Does the Impact Benefit the Population Vulnerable to Asthma?

This study investigates the effect of urban forests in reducing particulate matter (PM) concentrations and its subsequent impact on the number of asthma care visits. Understanding the mechanisms behind the relationship between the greenness of blocking forests and the reduction in PM is crucial for assessing the associated human health benefits. This study analyzed the influencing factors for reducing long-term PM10 concentrations, utilizing the vegetation index and meteorological variables. Results showed that the reduction in PM10 began in 2011, five years after the establishment of the blocking forest. The annual mean PM10 concentrations decreased significantly, driven primarily by summer wind speed and summer Enhanced Vegetation Index (EVI), explaining approximately 62% of the variation. A decrease in the number of asthma care visits was observed, similar to the trend of PM10 reduction in the residential area and the increase in the greenness of the blocking forest. The influx of PM into the city, primarily driven by prevailing northwesterly winds, may have been mitigated by the growing blocking forest, contributing to a reduction in asthma-related medical visits among urban residents. In particular, since the onset of the COVID-19 pandemic in 2020, the increase in the PM2.5/PM10 ratio in residential areas has become more closely linked to the increase in asthma-related medical visits. It suggests another PM2.5 emission source in the residential area. The number of asthma care visits among children (under 11) and the elderly (over 65) exhibited a strong positive correlation with PM10 levels and a negative correlation with the Normalized Difference Vegetation Index (NDVI). This suggests a link between air quality improvement from the greenness of blocking forests with their capacity to capture PM and respiratory health outcomes, especially for the vulnerable groups to asthma. These findings highlight the need to manage pollutant sources such as transportation and the heating system in residential areas beyond industrial emissions as the point pollution source. The management policies have to focus on protecting vulnerable populations, such as children and the elderly, by implementing small-sized urban forests to adsorb the PM2.5 within the city and establishing blocking forests to prevent PM10 near the industrial complex.

Determinants of Indoor NO2 and PM2.5 Concentration in Senior Housing with Gas Stoves

Nitrogen dioxide (NO2) and particulate matter of 2.5 microns (PM2.5) are air pollutants that impact health, especially among vulnerable populations with respiratory disease. This study identifies factors influencing indoor NO2 and PM2.5 in low-income households of older adults with asthma who use gas stoves in Lowell, Massachusetts. Environmental sampling was conducted in 73 homes, measuring NO2, PM2.5, fractional stove-use, temperature, and humidity for 5-7 days. Participants were recruited between December 2020 and July 2022. Questionnaires were used to collect data on factors influencing indoor NO2 and PM2.5 concentrations. Daily outdoor NO2 and PM2.5 concentrations were obtained from a United States Environmental Protection Agency (EPA) monitoring station. Paired t-tests were conducted between indoor and outdoor NO2 and PM2.5 concentrations, and linear regression was used to evaluate factors influencing indoor NO2 and PM2.5 concentrations. The average indoor concentration for NO2 and PM2.5 were 21.8 (GSD = 2.1) ppb and 16.2 (GSD = 2.7) µg/m3, respectively. Indoor NO2 and PM2.5 concentrations exceeded outdoor concentrations significantly. In multiple regression models, season and pilot light stove use significantly predicted indoor NO2. Season and air freshener use for 6-7 days/week significantly predicted indoor PM2.5. Season-influenced higher indoor concentrations are likely due to reduced ventilation in colder months in the Northeast U.S.

Coarse particulate air pollution and mortality in a multidrug-resistant tuberculosis cohort

RATIONALE

The association between ambient coarse particulate matter (PM2.5-10) and mortality in multi-drug resistant tuberculosis (MDR-TB) patients has not yet been studied. The modifying effects of temperature and humidity on this association are completely unknown.

OBJECTIVES

To evaluate the effects of long-term PM2.5-10 exposures, and their modifications by temperature and humidity on mortality among MDR-TB patients.

METHODS

A Chinese cohort of 3469 MDR-TB patients was followed up from diagnosis until death, loss to follow-up, or the study's end, averaging 2567 days per patient. PM2.5-10 concentrations were derived from the difference between PM10 and PM2.5. Cox proportional hazard models estimated hazard ratios (HRs) per 3.74 μg/m3 (interquartile range, IQR) exposure to PM2.5-10 and all-cause mortality for the full cohort and individuals at distinct long-term and short-term temperature and humidity levels, adjusting for other air pollutants and potential covariates. Exposure-response relationships were quantified using smoothed splines.

RESULTS

Hazard ratios of 1.733 (95% CI, 1.407, 2.135) and 1.427 (1.114, 1.827) were observed for mortality in association with PM2.5-10 exposures for the full cohort under both long-term and short-term exposures to temperature and humidity. Modifying effects by temperature and humidity were heterogenous across sexes, age, treatment history, and surrounding environment measured by greenness and nighttime light levels. Nonlinear exposure-response curves suggestes a cumulative risk of PM2.5-10-related mortality starting from a low exposure concentration around 15 μg/m3.

CONCLUSION

Long-term exposure to PM2.5-10 poses significant harm among MDR-TB patients, with effects modified by temperature and humidity. Immediate surveillance of PM2.5-10 is crucial to mitigate the progression of MDR-TB severity, particularly due to co-exposures to air pollution and adverse weather conditions.

The short-term association between environmental variables and daily pediatric asthma patient visits in Hangzhou, China: A time-series study

Background

To date, a large number of studies have shown correlations between environmental variables and pediatric asthma in short-term lag time. However, their results are inconsistent. Therefore, we aimed to evaluate the short-term impact of environmental variables on daily pediatric asthma patients' visits (DPAPV) in Hangzhou, China, and find the most important risk factor.

Methods

Generalized additive distribution lag non-linear model (GAM-DLNM) was applied to explore the effect of environmental variables on DPAPV in single- and multi-variable models in Hangzhou, China from 2014 to 2021. Then, risk factors of pediatric asthma were selected (p < 0.05 both in single- and multi-variable models) and used weighted quantile sum (WQS) regression model to evaluate their relative importance.

Results

There were 313,296 pediatric asthma patient records between 2014 and 2021. Both in single- and multi-variable models, PM2.5, PM10, and NO2 exhibited significant positive correlations in short-term lag time and these correlations reached their maximum in lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), and lag day 3 (RR = 1.04, 95%CI:1.02 to1.05), respectively. The WQS index showed that NO2 had the greatest relative importance (weight over 70 %). The relative importance of NO2 increased with time passing. Males were more susceptible to the adverse effects of NO2.

Conclusion

PM2.5, PM10, and NO2 had significant adverse effects on pediatric asthma. Among them, NO2 presented the greatest and most important adverse effect on the disease. Therefore, parents could give priority to paying attention to NO2 to control children's asthma.

Improved ambient air quality is associated with decreased prevalence of childhood asthma and infancy shortly after weaning is a sensitive exposure window

BACKGROUND

The urban ambient air quality has been largely improved in the past decade. It is unknown whether childhood asthma prevalence is still increasing in ever top-ranking city of Shanghai, whether the improved air quality is beneficial for children's asthma and what time window of exposure plays critical roles.

METHODS

Using a repeat cross-sectional design, we analyzed the association between early life exposure to particles and wheezing/asthma in each individual and combined surveys in 2011 and 2019, respectively, in 11,825 preschool children in Shanghai.

RESULTS

A significantly lower prevalence of doctor-diagnosed asthma (DDA) (6.6% vs. 10.5%, p < 0.001) and wheezing (10.5% vs. 23.2%, p < 0.001) was observed in 2019 compared to 2011. Exposure to fine particulate matter (PM2.5), coarse particles (PM2.5-10) and inhalable particles (PM10) was decreased in 2019 by 6.3%, 35.4%, and 44.7% in uterus and 24.3%, 20.2%, and 31.8% in infancy, respectively. Multilevel log-binomial regression analysis showed exposure in infancy had independent association with wheezing/DDA adjusting for exposure in uterus. For each interquartile range (IQR) increase of infancy PM2.5, PM2.5-10 and PM10 exposure, the odds ratios were 1.39 (95% confidence interval (CI): 1.24-1.56), 1.51 (95% CI:1.15-1.98) and 1.53 (95% CI:1.27-1.85) for DDA, respectively. The distributed lag non-linear model showed the sensitive exposure window (SEW) was 5.5-11 months after birth. Stratified analysis showed the SEWs were at or shortly after weaning, but only in those with <6 months of exclusive breastfeeding.

CONCLUSIONS

Improved ambient PM benefits in decreasing childhood asthma prevalence. We firstly reported the finding of SEW to PM at or closely after weaning on childhood asthma.

Development and performance evaluation of online monitors for near real-time measurement of total and water-soluble organic carbon in fine and coarse ambient PM

In this study, we developed two online monitors for total organic carbon (TOC) and water-soluble organic carbon (WSOC) measurements in fine (dp < 2.5μm) and coarse (2.5μm < dp < 10μm) particulate matter (PM), respectively. Their performance has been evaluated in laboratory and field tests to demonstrate the feasibility of using these monitors to measure near real-time concentrations, with consideration of their potential for being employed in long-term measurements. The fine PM collection setup was equipped with a versatile aerosol concentration enrichment system (VACES) connected to an aerosol-into-liquid-sampler (AILS), whereas two virtual impactors (VIs) in tandem with a modified BioSampler were used to collect coarse PM. These particle collection setups were in tandem with a Sievers M9 TOC analyzer to read TOC and WSOC concentrations in aqueous samples hourly. The average hourly TOC concentration measured by our developed monitors in fine and coarse PM were 5.17 ± 2.41 and 0.92 ± 0.29 μg/m3, respectively. In addition, our TOC readings showed good agreement and were comparable with those quantified using Sunset Lab EC/OC analyzer operating in parallel as a reference. Furthermore, we conducted field tests to produce diurnal profiles of fine PM-bound WSOC, which can show the effects of ambient temperature on maximum values in the nighttime chemistry of the winter, as well as on increased photochemical activities in afternoon peaks during the summer. According to our experimental campaign, WSOC mean values during the study period (3.07 μg/m3 for the winter and 2.7 μg/m3 for the summer) were in a comparable range with those of earlier studies in Los Angeles. Overall, our results corroborate the performance of our developed monitors in near real-time measurements of TOC and WSOC, which can be employed for future source apportionment studies in Los Angeles and other areas, aiding in understanding the health impacts of different pollution sources.

Development and Effectiveness of the School-Based Education Program for Coping With Particulate Matter

BACKGROUND

Adolescents are considered to be vulnerable to particulate matter (PM). This study aims to develop and verify the effectiveness of the "school-based education program for coping with particulate matter (SEPC_PM)." This program was designed by employing the health belief model.

METHODS

High school students between the ages of 15 and 18 in South Korea participated in the program. This study employed a nonequivalent control group pretest-posttest design. A total of 113 students participated in the study; of these, 56 students participated in the intervention group, and 57 in the control group. The intervention group received 8 intervention sessions the SEPC_PM over the course of 4 weeks.

RESULTS

After the completion of the program, the intervention group's knowledge about PM showed a statistically significant increase (t = 4.79, p < .001). The practice of engaging in health-managing behaviors to protect against PM also showed statistically significant improvement in the intervention group, with the greatest progress in practicing precaution when outdoors (t = 2.22, p = .029). No statistically significant changes were observed regarding other dependent variables. However, a subdomain of the variable of perceived self-efficacy for engaging in health-managing behaviors to protect against PM (degree of body cleansing after returning home) demonstrated a statistically significant increase in the intervention group (t = 1.99, p = .049).

CONCLUSIONS

The SEPC_PM may be proposed for incorporation into regular high school curricula to improve students' health by encouraging them to take necessary actions against PM.

Toxicity and chemical composition of commercial road palliatives versus oil and gas produced waters

Across the United States, road palliatives are applied to roads for maintenance operations that improve road safety. In the winter, solid rock salts and brine solutions are used to reduce the accumulation of snow and ice, while in the summer, dust suppressants are used to minimize fugitive dust emissions. Many of these products are chloride-based salts that have been linked to freshwater salinization, toxicity to aquatic organisms, and damage to infrastructure. To minimize these impacts, organic products have been gaining attention, though their widespread adoption has been limited due to their higher cost. In some states, using produced water from conventionally drilled oil and gas wells (OGPWs) on roads is permitted as a cost-effective alternative to commercial products, despite its typically elevated concentrations of heavy metals, radioactivity, and organic micropollutants. In this study, 17 road palliatives used for winter and summer road maintenance were collected and their chemical composition and potential human toxicity were characterized. Results from this study demonstrated that liquid brine solutions had elevated levels of trace metals (Zn, Cu, Sr, Li) that could pose risks to human and environmental health. The radium activity of liquid calcium chloride products was comparable to the activity of OGPWs and could be a significant source of radium to the environment. The organic fractions of evaluated OGPWs and chloride-based products posed little risk to human health. However, organic-based dust suppressants regulated toxicity pathways related to xenobiotic metabolism, lipid metabolism, endocrine disruption, and oxidative stress, indicating their use could lead to environmental harm and health risks to operators handing these products and residents living near treated roads.

Residential exposure to air pollution and adverse respiratory and allergic outcomes in children and adolescents living in a chipboard industrial area of Northern Italy

BACKGROUND

Chipboard production is a source of wood dust, formaldehyde, and combustion-related pollutants such as nitrogen dioxide (NO₂) and particulate matter (PM). In this cohort study, we assessed whether exposures to NO₂, formaldehyde, PM₁₀, PM_2.5, and black carbon were associated with adverse respiratory and allergic outcomes among all 7525 people aged 0-21 years residing in the Viadana district, an area in Northern Italy including the largest chipboard industrial park in the country.

METHODS

Data on hospitalizations, emergency room (ER) admissions, and specialist visits in pneumology, allergology, ophthalmology, and otorhinolaryngology were obtained from the Local Health Unit. Residential air pollution concentrations in 2013 (baseline) were derived using local (Viadana II), national (EPISAT), and continental (ELAPSE) exposure models. Associations were estimated using negative binomial regression models for counts of events occurred during 2013-2017, with follow-up time as an offset term and adjustment for sex, age, nationality, and a census-block socio-economic indicator.

RESULTS

Median annual exposures to NO₂, PM₁₀, and PM_2.5 were below the European Union annual air quality standards (40, 40, and 25 μg/m³) but above the World Health Organization 2021 air quality guideline levels (10, 15, and 5 μg/m³). Exposures to NO₂ and PM_2.5 were significantly associated with higher rates of ER pneumology admissions (13 to 30 % higher rates per interquartile range exposure differences, all p < 0.01). Higher rates of allergology and ophthalmology visits were found for participants exposed to higher pollutants' concentrations. When considering the 4-km buffer around the industries, associations with respiratory hospitalizations became significant, and associations with ER pneumology admissions, allergology and ophthalmology visits became stronger. Formaldehyde was not associated with the outcomes considered.

CONCLUSION

Using administrative indicators of health effects a priori attributable to air pollution, we documented the adverse impact of long-term air pollution exposure in residential areas close to the largest chipboard industries in Italy. These findings, combined with evidence from previous studies, call for an action to improve air quality through preventive measures especially targeting emissions related to the industrial activities.

Evaluation of an air quality warning system for vulnerable and susceptible individuals in Korea: an interrupted time series analysis

OBJECTIVES

This study was conducted to elucidate the effects of an air quality warning system (AQWS) implemented in January 2015 in Korea by analyzing changes in the incidence and exacerbation rates of environmental diseases.

METHODS

Data from patients with environmental diseases were extracted from the National Health Insurance Service-National Sample Cohort database from 2010 to 2019, and data on environmental risk factors were acquired from the AirKorea database. Patient and meteorological data were linked based on residential area. An interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after AQWS introduction. Adjustment variables included seasonality, air pollutants (carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter less than 10 μm in diameter, and ozone), temperature, and humidity.

RESULTS

After AQWS implementation, the incidence of asthma gradually decreased by 20.5%. Cardiovascular disease and stroke incidence also significantly decreased (by 34.3 and 43.0%, respectively). However, no immediate or gradual decrease was identified in the exacerbation rate of any environmental disease after AQWS implementation. Sensitivity analyses were performed according to age, disability, and health insurance coverage type. Overall, the AQWS effectively mitigated the occurrence of most environmental diseases in Korea. However, the relationships between alarm system implementation and reduced incidence differed among diseases based on the characteristics of vulnerable and sensitive individuals.

CONCLUSIONS

Our results suggest that by tailoring the AQWS to demographic and sociological characteristics and providing enhanced education about the warning system, interventions can become an efficient policy tool to decrease air pollution- related health risks.

Housing Insecurity Among Patients With Cancer

Social determinants of health are the economic and environmental conditions under which people are born, live, work, and age that affect health. These structural factors underlie many of the long-standing inequities in cancer care and outcomes that vary by geography, socioeconomic status, and race and ethnicity in the United States. Housing insecurity, including lack of safe, affordable, and stable housing, is a key social determinant of health that can influence-and be influenced by-cancer care across the continuum, from prevention to screening, diagnosis, treatment, and survivorship. During 2021, the National Cancer Policy Forum of the National Academies of Science, Engineering, and Medicine sponsored a series of webinars addressing social determinants of health, including food, housing, and transportation insecurity, and their associations with cancer care and patient outcomes. This dissemination commentary summarizes the formal presentations and panel discussions from the webinar devoted to housing insecurity. It provides an overview of housing insecurity and health care across the cancer control continuum, describes health system interventions to minimize the impact of housing insecurity on patients with cancer, and identifies challenges and opportunities for addressing housing insecurity and improving health equity. Systematically identifying and addressing housing insecurity to ensure equitable access to cancer care and reduce health disparities will require ongoing investment at the practice, systems, and broader policy levels.

Effects of low-dust forages on dust exposure, airway cytology, and plasma omega-3 concentrations in Thoroughbred racehorses: A randomized clinical trial

BACKGROUND

Racehorses commonly develop evidence of mild asthma in response to dust exposure. Diets deficient in omega-3 polyunsaturated fatty acids (Ω-3) might exacerbate this response.

HYPOTHESIS

To compare dust exposure, bronchoalveolar lavage fluid (BALF) cytology, and plasma Ω-3 and specialized pro-resolving mediators (SPM) concentrations amongst racehorses fed dry hay, steamed hay, and haylage.

ANIMALS

Forty-three Thoroughbred racehorses.

METHODS

Prospective clinical trial. Horses were randomly assigned to be fed dry hay, steamed hay, or haylage for 6 weeks. Measures of exposure to dust in the breathing zone were obtained twice. At baseline, week-3, and week-6, BALF cytology was examined. Plasma lipid profiles and plasma SPM concentrations were examined at baseline and week 6. Generalized linear mixed models examined the effect of forage upon dust exposure, BALF cytology, Ω-3, and SPM concentrations.

RESULTS

Respirable dust was significantly higher for horses fed hay (least-square mean ± s.e.m. 0.081 ± 0.007 mg/m³ ) when compared with steamed hay (0.056 ± 0.005 mg/m³ , P = .01) or haylage (0.053 ± 0.005 mg/m³ , P < .01). At week 6, BALF neutrophil proportions in horses eating haylage (3.0% ± 0.6%) were significantly lower compared with baseline (5.1 ± 0.7, P = .04) and horses eating hay (6.3% ± 0.8%, P < .01). Plasma eicosapentaenoic acid to arachidonic acid ratios were higher in horses eating haylage for 6 weeks (0.51 ± 0.07) when compared with baseline (0.34 ± 0.05, P < .01) and horses eating steamed (0.24 ± 0.02, P < .01) or dry hay (0.25 ± 0.03, P < .01).

CONCLUSIONS AND CLINICAL IMPORTANCE

Steamed hay and haylage reduce dust exposure compared with dry hay, but only haylage increased the ratio of anti-inflammatory to pro-inflammatory lipids while reducing BAL neutrophil proportions within 6 weeks.

Air Pollution and Pediatric Respiratory Hospitalizations: Effect Modification by Particle Constituents and Oxidative Potential

Rationale: Outdoor particulate and gaseous air pollutants impair respiratory health in children, and these associations may be influenced by particle composition. Objectives: To examine whether associations between short-term variations in fine particulate air pollution, oxidant gases, and respiratory hospitalizations in children are modified by particle constituents (metals and sulfur) or oxidative potential. Methods: We conducted a case-crossover study of 10,500 children (0-17 years of age) across Canada. Daily fine particle mass concentrations and oxidant gases (nitrogen dioxide and ozone) were collected from ground monitors. Monthly estimates of fine particle constituents (metals and sulfur) and oxidative potential were also measured. Conditional logistic regression models were used to estimate associations between air pollutants and respiratory hospitalizations, above and below median values for particle constituents and oxidative potential. Measurements and Main Results: Lag-1 fine particulate matter mass concentrations were not associated with respiratory hospitalizations (odds ratio and 95% confidence interval per 10 μg/m³ increase in fine particulate matter: 1.004 [0.955-1.056]) in analyses ignoring particle constituents and oxidative potential. However, when models were examined above or below median metals, sulfur, and oxidative potential, positive associations were observed above the median. For example, the odds ratio and 95% confidence interval per 10 μg/m³ increase in fine particulate matter were 1.084 (1.007-1.167) when copper was above the median and 0.970 (0.929-1.014) when copper was below the median. Similar trends were observed for oxidant gases. Conclusions: Stronger associations were observed between outdoor fine particles, oxidant gases, and respiratory hospitalizations in children when metals, sulfur, and particle oxidative potential were elevated.

Multiancestral polygenic risk score for pediatric asthma

BACKGROUND

Asthma is the most common chronic condition in children and the third leading cause of hospitalization in pediatrics. The genome-wide association study catalog reports 140 studies with genome-wide significance. A polygenic risk score (PRS) with predictive value across ancestries has not been evaluated for this important trait.

OBJECTIVES

This study aimed to train and validate a PRS relying on genetic determinants for asthma to provide predictions for disease occurrence in pediatric cohorts of diverse ancestries.

METHODS

This study applied a Bayesian regression framework method using the Trans-National Asthma Genetic Consortium genome-wide association study summary statistics to derive a multiancestral PRS score, used one Electronic Medical Records and Genomics (eMERGE) cohort as a training set, used a second independent eMERGE cohort to validate the score, and used the UK Biobank data to replicate the findings. A phenome-wide association study was performed using the PRS to identify shared genetic etiology with other phenotypes.

RESULTS

The multiancestral asthma PRS was associated with asthma in the 2 pediatric validation datasets. Overall, the multiancestral asthma PRS has an area under the curve (AUC) of 0.70 (95% CI, 0.69-0.72) in the pediatric validation 1 and AUC of 0.66 (0.65-0.66) in the pediatric validation 2 datasets. We found significant discrimination across pediatric subcohorts of European (AUC, 95% CI, 0.60 and 0.66), African (AUC, 95% CI, 0.61 and 0.66), admixed American (AUC, 0.64 and 0.70), Southeast Asian (AUC, 0.65), and East Asian (AUC, 0.73) ancestry. Pediatric participants with the top 5% PRS had 2.80 to 5.82 increased odds of asthma compared to the bottom 5% across the training, validation 1, and validation 2 cohorts when adjusted for ancestry. Phenome-wide association study analysis confirmed the strong association of the identified PRS with asthma (odds ratio, 2.71, PFDR = 3.71 × 10-65) and related phenotypes.

CONCLUSIONS

A multiancestral PRS for asthma based on Bayesian posterior genomic effect sizes identifies increased odds of pediatric asthma.

The association between air pollution and childhood asthma: United States, 2010-2015

OBJECTIVE

The current population-based study examines the association between county-level ambient air pollution and childhood asthma.

METHODS

Data from the nationally representative 2010-2015 National Health Interview Survey were linked to nationwide fine particulate matter (PM2.5) air pollution data at the county-level from the National Environmental Public Health Tracking Network which utilizes air quality monitoring stations and modeled PM2.5 measurements (Downscaler model data) and adjusted by county-level socioeconomic characteristics data from the 2010-2015 American Community Survey. Multilevel modeling techniques were used to assess the association between PM2.5 annual concentrations (quartiles < 8.11, 8.11-9.50, 9.51-10.59, ≥ 10.60 µg/m3) and current childhood asthma along with two asthma outcomes (episode in the past year, emergency room (ER) visit due to asthma).

RESULTS

From 2010 to 2015, there were significant declines in PM2.5 concentrations and asthma outcomes. In unadjusted models, children living in areas with higher PM2.5 concentrations were more likely to have current asthma, ≥1 asthma episode in the past year, and ≥1 ER visit due to asthma compared with children living in areas with the lowest quartile (< 8.11 µg/m3). After adjusting for characteristics at the county, geographic, and child and family-level, significant associations remained for asthma episode, and ER visit among children living in areas with PM2.5 annual concentrations between 9.51 and 10.59 µg/m3 (3rd quartile) compared with children living in areas with the lowest quartile.

CONCLUSIONS

This study adds to the limited literature by incorporating nationally representative county-, child-, and family-level data to provide a multi-level analysis of the associations between air pollution and childhood asthma in the U.S.

Road tunnel-derived coarse, fine and ultrafine particulate matter: physical and chemical characterization and pro-inflammatory responses in human bronchial epithelial cells

BACKGROUND

Traffic particulate matter (PM) comprises a mixture of particles from fuel combustion and wear of road pavement, tires and brakes. In countries with low winter temperatures the relative contribution of mineral-rich PM from road abrasion may be especially high due to use of studded tires during winter season. The aim of the present study was to sample and characterize size-fractioned PM from two road tunnels paved with different stone materials in the asphalt, and to compare the pro-inflammatory potential of these fractions in human bronchial epithelial cells (HBEC3-KT) in relation to physicochemical characteristics.

METHODS

The road tunnel PM was collected with a vacuum pump and a high-volume cascade impactor sampler. PM was sampled during winter, both during humid and dry road surface conditions, and before and after cleaning the tunnels. Samples were analysed for hydrodynamic size distribution, content of elemental carbon (EC), organic carbon (OC) and endotoxin, and the capacity for acellular generation of reactive oxygen species. Cytotoxicity and pro-inflammatory responses were assessed in HBEC3-KT cells after exposure to coarse (2.5-10 μm), fine (0.18-2.5 μm) and ultrafine PM (≤ 0.18 μm), as well as particles from the respective stone materials used in the pavement.

RESULTS

The pro-inflammatory potency of the PM samples varied between road tunnels and size fractions, but showed more marked responses than for the stone materials used in asphalt of the respective tunnels. In particular, fine samples showed significant increases as low as 25 µg/mL (2.6 µg/cm²) and were more potent than coarse samples, while ultrafine samples showed more variable responses between tunnels, sampling conditions and endpoints. The most marked responses were observed for fine PM sampled during humid road surface conditions. Linear correlation analysis showed that particle-induced cytokine responses were correlated to OC levels, while no correlations were observed for other PM characteristics.

CONCLUSIONS

The pro-inflammatory potential of fine road tunnel PM sampled during winter season was high compared to coarse PM. The differences between the PM-induced cytokine responses were not related to stone materials in the asphalt. However, the ratio of OC to total PM mass was associated with the pro-inflammatory potential.

The influence of urban exposures and residence on childhood asthma

Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in-home allergen concentrations have yielded inconsistent results. Population-level interventions including smoking bans in public places and legislation to decrease traffic-related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community-level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.

Air pollution and hospitalization of patients with idiopathic pulmonary fibrosis in Beijing: a time-series study

Background

A small number of studies suggested that air pollution was associated with idiopathic pulmonary fibrosis (IPF) exacerbation, incidence and mortality. However, no studies to date were conducted in regions where air pollution is substantial. We aimed to investigate whether there are associations between acute increases in air pollution and hospitalization of patients with a confirmed primary diagnosis of IPF in Beijing.

Methods

Daily count of IPF hospitalizations (International Classification of Disease-10th Revision, J84.1) was obtained from an administrative database for 2013–2017 while daily city-wide average concentrations of PM₁₀, PM_2.5, NO₂, Ozone, SO₂ were obtained from 35 municipal monitoring stations for the same period. The association between daily IPF hospitalization and average concentration of each pollutant was analyzed with a generalized additive model estimating Poisson distribution.

Results

Daily 24-h mean PM_2.5 concentration during 2013–2017 was 76.7 μg/m³. The relative risk (RR) of IPF hospitalization per interquartile range (IQR) higher (72 μg/m³) in PM_2.5 was 1.049 (95% CI 1.024–1.074) and 1.031 (95% CI 1.007–1.056) for lag0 and moving averages 0–1 days respectively. No significant associations were observed for other lags. Statistically significant positive associations were also observed at lag0 with SO₂, Ozone and NO₂ (in men only). Positive associations were seen at moving averages 0–30 days for PM₁₀ (RR per 86 μg/m³: 1.021, 95% CI 0.994–1.049), NO₂ (RR per 30 μg/m³: 1.029, 95% CI 0.999–1.060), and SO₂ (RR per 15 μg/m³: 1.060 (95% CI 1.025–1.097), but not with PM_2.5 or Ozone.

Conclusions

Despite improvement in air quality since the implementation of clean air policy in 2013, acute exposure to higher levels of air pollution is significantly associated with IPF hospitalization in Beijing. Air quality policy should be continuously enforced to protect vulnerable IPF populations as well as the general public.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12931-022-01998-8.

Microplastic occurrence in settled indoor dust in schools

This study examines for the first time the characteristics and human exposure of microplastics (MPs) in settled indoor dust in schools. An average of 195 MPs·g^-1 of dust were detected in settled indoor composite dust samples from 28 schools in Shiraz. White-transparent microfibres with lengths 500-1000 μm were the most abundant type of MP found among the samples examined. Polyethylene terephthalate and polypropylene MPs were dominant across all types of MP found including microfibres. MPs had generally smooth morphology with sharp or regular edges which could have been released to the environment as primary MPs. Among all sampling sites, higher concentrations of MPs were found in the south and centre of the city. These were areas affected by high population density, high traffic load and high presence of industrial units and workshops. Principal Component Analysis (PCA) showed a positive strong correlation between sampling sites and MP physical characteristics. The PCA plots revealed that MP sheets and fragments were prevalent in sites in the North of Shiraz, whereas microfibres were mainly associated with sites in the South. The levels of MPs in the South of Shiraz were greater than in the rest of the country and the wind direction and topography were found to be important factors affecting the MP distribution observed. Compared to other population groups, elementary school students had relatively high exposure risk to MPs. This study reveals that microfibres are widespread in Shiraz' schools and pose a high exposure risk to MPs for young students.

Making Sense of Sensor Data: How Local Environmental Conditions Add Value to Social Science Research

Recent advances in computing technologies have enabled the development of low-cost, compact weather and air quality monitors. The U.S. federally funded Array of Things (AoT) project has deployed more than 140 such sensor nodes throughout the City of Chicago. This paper combines a year's worth of AoT sensor data with household data collected from 450 elderly Chicagoans in order to explore the feasibility of using previously unavailable data on local environmental conditions to improve traditional neighborhood research. Specifically, we pilot the use of AoT sensor data to overcome limitations in research linking air pollution to poor physical and mental health and find support for recent findings that exposure to pollutants contributes to both respiratory and dementia-related diseases. We expect that this support will become even stronger as sensing technologies continue to improve and more AoT nodes come online, enabling additional applications to social science research where environmental context matters.

COVID-19 Pandemic–Related Reductions in Pediatric Asthma Exacerbations Corresponded with an Overall Decrease in Respiratory Viral Infections

Background

Respiratory viruses, air pollutants, and aeroallergens are all implicated in worsening pediatric asthma symptoms, but their relative contributions to asthma exacerbations are poorly understood. A significant decrease in asthma exacerbations has been observed during the coronavirus disease 2019 pandemic, providing a unique opportunity to study how major asthma triggers correlate with asthma activity.

Objective

To determine whether changes in respiratory viruses, air pollutants, and/or aeroallergens during the coronavirus disease 2019 pandemic were concomitant with decreased asthma exacerbations.

Methods

Health care utilization and respiratory viral testing data between January 1, 2015, and December 31, 2020, were extracted from the Children’s Hospital of Philadelphia Care Network’s electronic health record. Air pollution and allergen data were extracted from US Environmental Protection Agency public databases and a National Allergy Bureau–certified station, respectively. Pandemic data (2020) were compared with historical data.

Results

Recovery of in-person asthma encounters during phased reopening (June 6 to November 15, 2020) was uneven: primary care well and specialty encounters reached 94% and 74% of prepandemic levels, respectively, whereas primary care sick and hospital encounters reached 21% and 40% of prepandemic levels, respectively. During the pandemic, influenza A and influenza B decreased to negligible frequency when compared with prepandemic cases, whereas respiratory syncytial virus and rhinovirus infections decreased to low (though nonnegligible) prepandemic levels, as well. No changes in air pollution or aeroallergen levels relative to historical observations were noted.

Conclusions

Our results suggest that viral respiratory infections are a primary driver of pediatric asthma exacerbations. These findings have broad relevance to both clinical practice and the development of health policies aimed at reducing asthma morbidity.

Using Bayesian time-stratified case-crossover models to examine associations between air pollution and "asthma seasons" in a low air pollution environment

Many areas of the United States have air pollution levels typically below Environmental Protection Agency (EPA) regulatory limits. Most health effects studies of air pollution use meteorological (e.g., warm/cool) or astronomical (e.g., solstice/equinox) definitions of seasons despite evidence suggesting temporally-misaligned intra-annual periods of relative asthma burden (i.e., “asthma seasons”). We introduce asthma seasons to elucidate whether air pollutants are associated with seasonal differences in asthma emergency department (ED) visits in a low air pollution environment. Within a Bayesian time-stratified case-crossover framework, we quantify seasonal associations between highly resolved estimates of six criteria air pollutants, two weather variables, and asthma ED visits among 66,092 children ages 5–19 living in South Carolina (SC) census tracts from 2005 to 2014. Results show that coarse particulates (particulate matter <10 μm and >2.5 μm: PM_10-2.5) and nitrogen oxides (NO_x) may contribute to asthma ED visits across years, but are particularly implicated in the highest-burden fall asthma season. Fine particulate matter (<2.5 μm: PM_2.5) is only associated in the lowest-burden summer asthma season. Relatively cool and dry conditions in the summer asthma season and increased temperatures in the spring and fall asthma seasons are associated with increased ED visit odds. Few significant associations in the medium-burden winter and medium-high-burden spring asthma seasons suggest other ED visit drivers (e.g., viral infections) for each, respectively. Across rural and urban areas characterized by generally low air pollution levels, there are acute health effects associated with particulate matter, but only in the summer and fall asthma seasons and differing by PM size.

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial

We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6-12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14-day integrated samples of endotoxin in settled dust and PM₁₀ and PM_10-2.5 in the air of the children's bedrooms at baseline and one-year follow-up, and used linear regression to compare follow-up levels, adjusting for baseline. Seventy-one families (36 HEPA, 35 control) completed the study. Baseline geometric mean (GSD) endotoxin loadings were 1565 (6.3) EU/m² and 2110 (4.9) EU/m² , respectively, in HEPA vs. control homes while PM₁₀ and PM_10-2.5 were 22.5 (1.9) μg/m³ and 9.5 (2.9) μg/m³ , respectively, in HEPA homes, and 19.8 (1.8) μg/m³ and 7.7 (2.0) μg/m³ , respectively, in control homes. At follow-up, HEPA families had 46% lower (95% CI, 31%-57%) PM₁₀ on average than control families, consistent with prior studies. In the best-fit heterogeneous slopes model, HEPA families had 49% (95% CI, 6%-110%) and 89% lower (95% CI, 28%-177%) PM_10-2.5 at follow-up, respectively, at 50th and 75th percentile baseline concentrations. Endotoxin loadings did not differ significantly at follow-up (4% lower, HEPA homes; 95% CI, -87% to 50%).

A study on the short-term effect of particulate matter pollution on hospital visits for asthma in children in Shanghai, China

Recently, particulate matter pollution has been worsening, which has been affecting the asthma visits in children. In this study, we assessed the short-term effects of PM₁₀ and PM_2.5 on asthma visits in children in Shanghai, China from January 1, 2009 and December 31, 2010, using a generalized additive model. We controlled the confounding factors, such as long-term trends, week day effect, and weather elements. The lag effects of different age subgroups (≤ 2 yr, 3-5 yr, and 6-18 yr subgroups) were performed. The results showed significant effects of PM₁₀ and PM_2.5 on asthma visits in children, though the seasonal lags varied for the three age subgroups. In general, the effect of PM_2.5 on asthma visits in children was stronger and more acute than that of PM₁₀. PM_2.5 showed the highest relative risk of 1.192 at lag 0 day in summer; and PM₁₀ showed the highest relative risk of 1.073 at lag 3 day in autumn. Overall, particulate matter pollution showed a greater effect on relatively younger children. In particular, the ≤ 2 yr subgroup showed the highest seasonal relative risk of PM₁₀. Especially, seasonal relative risk of PM₁₀ in autumn for the ≤ 2 yr subgroup was much higher than that for the other two subgroups. The 3-5 yr and 6-18 yr subgroups showed the highest seasonal relative risk of PM_2.5 in summer and winter, respectively. But the pediatric visits data we obtained cannot reflect the true prevalence of asthma and multiple visits. Thus, selection bias may exist in our analysis.

Long-term exposure to fine particulate matter and incident asthma among elderly adults

RATIONALE

Although an association of fine particulate matter (PM_2.5) with asthma incidence has been assumed, there is insufficient evidence regarding the effect of long-term exposure to PM_2.5 on incident asthma among elderly adults.

OBJECTIVES

This study aimed to investigate an association between long-term exposure to PM_2.5 and incident asthma among elderly adults in South Korea.

METHODS

Adults ≥65 years of age (n = 1,220,645) who did not visit hospitals for asthma during a washout period (between 2008 and 2010) were followed up until 2016 using data from the National Health Insurance System in South Korea. Incident asthma was defined as the number of patients with a primary diagnostic code of asthma who visited hospitals more than twice. We linked the health data with district-level PM_2.5 concentrations and estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident asthma after adjusting for potential confounders in time-varying Cox proportional hazard models.

MEASUREMENTS AND MAIN RESULTS

Over 5,942,256 person-years, 54,522 patients developed asthma, with an incidence of 9.2 cases/1000 person-years. A 10 μg/m³ increase in the 36-month mean PM_2.5 concentration was significantly associated with a 9% increase in incident asthma (HR = 1.09, 95% CI: 1.04-1.14). This association was found to be robust for different definitions of incident asthma and washout periods.

CONCLUSION

Long-term exposure to PM_2.5 was associated with the incidence of asthma in elderly adults. This finding provides evidence of an association between PM_2.5 and adult-onset asthma.

Asthma and air pollution: recent insights in pathogenesis and clinical implications

PURPOSE OF REVIEW

Air pollution has adverse effects on the onset and morbidity of respiratory diseases, including asthma. In this review, we discuss recent insights into the effects of air pollution on the incidence and exacerbation of asthma. We focus on epidemiological studies that describe the association between air pollution exposure and development, mortality, persistence and exacerbations of asthma among different age groups. Moreover, we also provide an update on translational studies describing the mechanisms behind this association.

RECENT FINDINGS

Mechanisms linking air pollutants such as particulate matter, nitrogen dioxide (NO2) and ozone to the development and exacerbation of asthma include the induction of both eosinophilic and neutrophilic inflammation driven by stimulation of airway epithelium and increase of pro-inflammatory cytokine production, oxidative stress and DNA methylation changes. Although exposure during foetal development is often reported as a crucial timeframe, exposure to air pollution is detrimental in people of all ages, thus influencing asthma onset as well as increase in asthma prevalence, mortality, persistence and exacerbation.

SUMMARY

In conclusion, this review highlights the importance of reducing air pollution levels to avert the progressive increase in asthma incidence and morbidity.

Prevalence and Correlates of Food Allergy Among Medicaid-Enrolled United States Children

OBJECTIVE

The objective of this study is to provide a comprehensive epidemiological profile detailing food allergy (FA) prevalence and related correlates among Medicaid-enrolled children.

METHODS

The 2012 Medicaid Analytic eXtract person-level 100% files for 50 states and the District of Columbia were analyzed. The analytic sample of 23,825,160 included all children ages 0 to 19 years as of January 1, 2012 who were continuously enrolled in Medicaid in 2012. The prevalence of FA was measured using International Classification of Diseases, Ninth Revision, Clinical Modification codes and compared with other atopic conditions (atopic dermatitis, allergic rhinitis, and asthma). Logistic regression was used to evaluate child characteristics associated with FA.

RESULTS

The prevalence of FA among Medicaid-enrolled children was less than 1% (0.6%). State-level prevalence ranged from a high of 1.4% in Alaska to a low of 0.2% in Nevada. Race and ethnicity were associated with FA such that Asian, Black, and Pacific Islander/Native Hawaiian children had a higher odds of FA, while Hispanic and Native American children had 15% and 24% lower odds of FA, respectively, compared with White children.

CONCLUSIONS

Compared with estimates of parent-reported, physician-diagnosed FA in the general population, the claims-based prevalence of FA among Medicaid-enrolled children is substantially lower. Racial and ethnic differences are consistent with the general population. The findings signal a need to better understand reasons for these differences including awareness, access to care, and service utilization patterns in this population.

A case-crossover study of short-term air pollution exposure and the risk of stillbirth in California, 1999-2009

BACKGROUND

Associations between ambient air pollution and stillbirth have recently been explored, but most studies have focused on long-term (trimester or gestational averages) rather than short-term (within one week) air pollution exposures.

OBJECTIVE

To evaluate whether short-term exposures to criteria air pollutants are associated with increased risk of stillbirth.

METHODS

Using air pollution and fetal death certificate data from 1999 to 2009, we assessed associations between acute prenatal air pollution exposure and stillbirth in California. In a time-stratified case-crossover study, we analyzed single day and/or cumulative average days (up to a 6 day lag) of exposure to fine (PM_2.5) and coarse particles (PM_10-2.5), ozone (O₃), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO) for mothers estimated to reside within 10 km of a pollution monitor based on reported zip code. We also examined potential confounding by apparent temperature or co-pollutants, and effect modification by maternal demographic factors, fetal sex, gestational age, and cause of stillbirth.

RESULTS

Stillbirth cases in the primary analyses ranged between 1,203 and 13,018, depending on the pollutant. For an IQR increase in SO₂ (lag 4), O₃ (lag 4), and PM_10-2.5 (lag 2), we found a 2.8% (95% confidence interval (CI) 0.2%, 5.5%), 5.8% (95% CI 1.6%, 10.1%), and 6.1% (95% CI 0.1%, 12.4%) increase in the odds of stillbirth, respectively. Additional adjustment by apparent temperature had little effect on the SO₂ association but slightly attenuated O₃ (adjusted % change: 4.2% (95% CI -0.2%, 8.9%) and PM_10-2.5 (5.7% (95% CI -1.1%, 13.0%)) associations, while other co-pollutants had minimal impact. Associations were observed specifically for stillbirths from obstetric complications and in women with higher educational attainment.

CONCLUSIONS

This study provides evidence for associations between prenatal short-term air pollution exposure, specifically SO₂, O_3, and PM_10-2.5, and stillbirth in California and warrants replication of findings in other settings.

Indoor air quality prediction using optimizers: A comparative study

Indoor air pollution (IAP) has become a serious concern for developing countries around the world. As human beings spend most of their time indoors, pollution exposure causes a significant impact on their health and well-being. Long term exposure to particulate matter (PM) leads to the risk of chronic health issues such as respiratory disease, lung cancer, cardiovascular disease. In India, around 200 million people use fuel for cooking and heating needs; out of which 0.4% use biogas; 0.1% electricity; 1.5% lignite, coal or charcoal; 2.9% kerosene; 8.9% cow dung cake; 28.6% liquified petroleum gas and 49% use firewood. Almost 70% of the Indian population lives in rural areas, and 80% of those households rely on biomass fuels for routine needs. With 1.3 million deaths per year, poor air quality is the second largest killer in India. Forecasting of indoor air quality (IAQ) can guide building occupants to take prompt actions for ventilation and management on useful time. This paper proposes prediction of IAQ using Keras optimizers and compares their prediction performance. The model is trained using real-time data collected from a cafeteria in the Chandigarh city using IoT sensor network. The main contribution of this paper is to provide a comparative study on the implementation of seven Keras Optimizers for IAQ prediction. The results show that SGD optimizer outperforms other optimizers to ensure adequate and reliable predictions with mean square error = 0.19, mean absolute error = 0.34, root mean square error = 0.43, R2 score = 0.999555, mean absolute percentage error = 1.21665%, and accuracy = 98.87%.

Microplastics Differ Between Indoor and Outdoor Air Masses: Insights from Multiple Microscopy Methodologies

The abundance and distribution of microplastic (<5 mm) has become a growing concern, particularly over the past decade. Research to date has focused on water, soil, and organism matrices but generally disregarded air. We explored airborne microplastic inside and outside of buildings in coastal California by filtering known volumes of air through glass fiber filters, which were then subsequently characterized with a variety of microscopy techniques: gross traditional microscopy, fluorescent microscopy following staining with Nile red, micro-Raman spectroscopy, and micro-Fourier transform infrared (µFT-IR) spectroscopy. Microplastics permeated the air, with indoor (3.3 ± 2.9 fibers and 12.6 ± 8.0 fragments m^-3; mean ± 1 SD) harboring twice as much as outdoor air (0.6 ± 0.6 fibers and 5.6 ± 3.2 fragments m^-3). Microplastic fiber length did not differ significantly between indoor and outdoor air, but indoor microplastic fragments (58.6 ± 55 µm) were half the size of outdoor fragments (104.8 ± 64.9 µm). Micro-Raman and FT-IR painted slightly different pictures of airborne plastic compounds, with micro-Raman suggesting polyvinyl chloride dominates indoor air, followed by polyethylene (PE) and µFT-IR showing polystyrene dominates followed by PE and polyethylene terephthalate. The ubiquity of airborne microplastic points to significant new potential sources of plastic inputs to terrestrial and marine ecosystems and raises significant concerns about inhalation exposure to humans both indoors and outdoors.

Pediatric Asthma Health Care Utilization, Viral Testing, and Air Pollution Changes During the COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery.

OBJECTIVE

We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic.

METHODS

For the time period January 17 to May 17, 2015 to 2020, asthma-related encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia electronic health records, and pollution data for 4 criteria air pollutants were extracted from AirNow. Changes in encounter characteristics, viral testing patterns, and air pollution before and after Mar 17, 2020, the date public health interventions to limit viral transmission were enacted in Philadelphia, were assessed and compared with data from 2015 to 2019 as a historical reference.

RESULTS

After March 17, 2020, in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient). Video telemedicine, which was not previously available, became the most highly used asthma encounter modality (61% of all visits), and telephone encounters increased by 19%. Concurrently, asthma-related systemic steroid prescriptions and frequency of rhinovirus test positivity decreased, although air pollution levels did not substantially change, compared with historical trends.

CONCLUSIONS

The COVID-19 pandemic in Philadelphia was accompanied by changes in pediatric asthma health care delivery patterns, including reduced admissions and systemic steroid prescriptions. Reduced rhinovirus infections may have contributed to these patterns.

Relationship between different particle size fractions and all-cause and cause-specific emergency ambulance dispatches

BACKGROUND

Evidence on the relationship between different particle size fractions and emergency ambulance dispatches (EAD) remains limited and sparse.

METHODS

We collected daily data of EAD, ambient air pollution and meteorological data from 2014 to 2018 in Guangzhou, China. We used a generalized additive model with covariate adjustments to estimate the associations between different particle size fractions and EAD related to all-cause, cardiovascular diseases, and respiratory diseases. Several subgroup and sensitivity analyses were also performed.

RESULTS

Significant associations were observed between PM_2.5, PM_2.5-10, PM₁₀ and EADs. A 10 μg/m³ increase of PM_2.5, PM_2.5-10, and PM₁₀ was associated with an increase of 0.98% (95% CI: 0.67, 1.28%), 2.06% (95% CI: 1.44, 2.68%), and 0.75% (95%CI: 0.53, 0.96%) in all-cause EAD, with an increase of 0.69% (95% CI: 0.00, 1.39%), 2.04% (95% CI: 0.64, 3.45%), and 0.60% (95%CI: 0.11,1.10%) in cardiovascular-related EAD, and an increase of 1.14% (95% CI: 0.25, 2.04%), 2.52% (95% CI: 0.72, 4.35%), and 0.89% (95%CI: 0.25,1.52%) in respiratory-related EAD at lag03, respectively. The results were robust in subgroup and sensitivity analyses.

CONCLUSIONS

This study revealed that PM_2.5, PM_2.5-10 and PM₁₀ were significantly related with risks of all-cause and cause-specific EAD. More evidence of high quality may be needed to further support our results in this ecological study.

Air quality intervention during the Nanjing youth olympic games altered PM sources, chemical composition, and toxicological responses

Ambient particulate matter (PM) is a leading global environmental health risk. Current air quality regulations are based on airborne mass concentration. However, PM from different sources have distinct chemical compositions and varied toxicity. Connections between emission control measures, air quality, PM composition, and toxicity remain insufficiently elucidated. The current study assessed the composition and toxicity of PM collected in Nanjing, China before, during, and after an air quality intervention for the 2014 Youth Olympic Games. A co-culture model that mimics the alveolar epithelium with the associated macrophages was created using A549 and THP-1 cells. These cells were exposed to size-segregated inhalable PM samples. The composition and toxicity of the PM samples were influenced by several factors including seasonal variation, emission sources, and the air quality intervention. For example, we observed a size-dependent shift in particle mass concentrations during the air quality intervention with an emphasized proportion of smaller particles (PM_2.5) present in the air. The roles of industrial and fuel combustion and traffic emissions were magnified during the emission control period. Our analyses revealed that the PM samples demonstrated differential cytotoxic potencies at equal mass concentrations between sampling periods, locations, and time of day, influenced by variations in the predominant emission sources. Coal combustion and industrial emissions were the most important sources affecting the toxicological responses and displayed the least variation in emission contributions between the sampling periods. In conclusion, emission control mitigated cytotoxicity and oxidative stress for particles larger than 0.2 μm, but there was inadequate evidence to determine if it was the key factor reducing the harmful effects of PM_0.2.

Selecting a Scale for Spatial Confounding Adjustment

Unmeasured, spatially-structured factors can confound associations between spatial environmental exposures and health outcomes. Adding flexible splines to a regression model is a simple approach for spatial confounding adjustment, but the spline degrees of freedom do not provide an easily interpretable spatial scale. We describe a method for quantifying the extent of spatial confounding adjustment in terms of the Euclidean distance at which variation is removed. We develop this approach for confounding adjustment with splines and using Fourier and wavelet filtering. We demonstrate differences in the spatial scales these bases can represent and provide a comparison of methods for selecting the amount of confounding adjustment. We find the best performance for selecting the amount of adjustment using an information criterion evaluated on an outcome model without exposure. We apply this method to spatial adjustment in an analysis of fine particulate matter and blood pressure in a cohort of United States women.

Indoor Air Quality Monitoring Systems for Enhanced Living Environments: A Review toward Sustainable Smart Cities

Smart cities follow different strategies to face public health challenges associated with socio-economic objectives. Buildings play a crucial role in smart cities and are closely related to people’s health. Moreover, they are equally essential to meet sustainable objectives. People spend most of their time indoors. Therefore, indoor air quality has a critical impact on health and well-being. With the increasing population of elders, ambient-assisted living systems are required to promote occupational health and well-being. Furthermore, living environments must incorporate monitoring systems to detect unfavorable indoor quality scenarios in useful time. This paper reviews the current state of the art on indoor air quality monitoring systems based on Internet of Things and wireless sensor networks in the last five years (2014–2019). This document focuses on the architecture, microcontrollers, connectivity, and sensors used by these systems. The main contribution is to synthesize the existing body of knowledge and identify common threads and gaps that open up new significant and challenging future research directions. The results show that 57% of the indoor air quality monitoring systems are based on Arduino, 53% of the systems use Internet of Things, and WSN architectures represent 33%. The CO2 and PM monitoring sensors are the most monitored parameters in the analyzed literature, corresponding to 67% and 29%, respectively.

Association between coarse particulate matter (PM10-2.5) and nasopharyngeal carcinoma among Taiwanese men

The nasopharyngeal tract traps mainly coarse particles in inhaled air. Soluble carcinogenic compounds, endotoxins, and trace metals contained in these particles are potential causes of inflammation and oxidative stress which could enhance carcinogenesis. The aim of this study was to determine the association between coarse particulate matter (PM10-2.5) and nasopharyngeal cancer (NPC). A total of 521,098 men (355 cases and 520,743 non-cases), aged ≥40 years were included in this study. Data were retrieved from the Taiwan Cancer Registry, the Adult Preventive Medical Services Database, and the Air Quality Monitoring Database. PM10-2.5 was significantly associated with a higher risk of NPC after adjusting for SO2, NOx, O3, age, body mass index, smoking, alcohol drinking, betel nut chewing, exercise, hypertension, diabetes, and hyperlipidemia. With PM10-2.5<20.44 μg/m3 as the reference, the ORs and 95% CIs were 1.47; 1.03-2.11, 1.34; 0.94-1.91, and 1.68; 1.16-2.44 for 20.44≤PM10-2.5<24.08, 24.08≤PM10-2.5<29.27, and PM10-2.5≥29.27 μg/m3, respectively. PM10-2.5 remained significantly associated with a higher risk of NPC after further adjustments were made for the aforementioned covariates and PM2.5 The ORs; 95% CIs were 1.42; 0.96 to 2.12, 1.41; 0.94 to 2.10, and 1.71; 1.10 to 2.66 for 20.44≤PM10-2.5<24.08, 24.08≤PM10-2.5<29.27, and PM10-2.5≥29.27 μg/m3, respectively. In conclusion, PM10-2.5 was significantly associated with a higher risk of NPC in Taiwanese men.

Trends in ambient ozone, nitrogen dioxide, and particulate matter concentrations over the Maltese Islands and the corresponding health impacts

This study presents an overview of the air pollution levels in the Maltese Islands including trends in particulate matter (PM), ozone (O₃) and nitrogen dioxide (NO₂) at four monitoring stations in Malta and one in Gozo between 2008 and 2017. In addition, the health impacts associated with long-term exposure to annual mean PM_2.5 and NO₂ are estimated at each site. Irrespective of the site, PM₁₀ and PM_2.5 concentrations show statistically significant decreasing trends while statistically significant increasing trends are noted for the coarse fraction, PM_2.5-10 and O₃. Trends for the different pollutants vary for each site and differ from the overall trend both in magnitude and sign especially for NO₂ concentrations. The attributable fraction (AF) associated with long-term exposure to PM_2.5 and NO₂ ranges from 0.67% (CI: 0.27%,1.07%) in Għarb to 11.79% (CI: 7.77,15.45) in Msida (2011). The corresponding attributable mortality is estimated to reach a maximum of 119 (CI: 78,156) attributable deaths associated with long-term exposure to PM_2.5 in Msida in 2011. This paper thus highlights the importance of continuous air quality monitoring in distinctively different conurbations especially for pollutants showing increasing trends and is the first to outline the potential long-term health effects of air pollutant concentrations in the Maltese Islands.

Benefits of influenza vaccination on the associations between ambient air pollution and allergic respiratory diseases in children and adolescents: New insights from the Seven Northeastern Cities study in China

BACKGROUND

Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents.

METHODS

A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO₂) and particulate matter with aerodynamic diameters ≤1 μm (PM₁), ≤2.5 μm (PM_2.5) and ≤10 μm (PM₁₀)] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates.

RESULTS

We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM₁ and PM_2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM₁, doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57-2.27) vs 1.65 (95%CI: 1.36-2.00); current wheeze: OR: 1.50 (95%CI: 1.22-1.85) vs 1.10 (95%CI: 0.89-1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15-1.66) vs 1.21 (95%CI: 1.00-1.46). For PM_2.5, doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52-2.14) vs 1.57 (95%CI: 1.32-1.88); current wheeze: OR: 1.46 (95%CI: 1.21-1.76) vs 1.11 (95%CI: 0.91-1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14-1.60) vs 1.19 (95%CI: 1.00-1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM₁-related and PM_2.5-related current wheeze were decreased by 26.67% (95%CI: 1.04%-45.66%) and 23.97% (95%CI: 0.21%-42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05).

CONCLUSIONS

Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.

Numerical modeling of particle deposition in the conducting airways of asthmatic children

Mounting evidence has linked long- and short-term exposure to particulate air pollution with the incidence and exacerbation of asthma in children, but the biological pathogenesis is unclear. We examined the deposition of particles in the airways of asthmatic children. A planar and symmetric model of airways for 4-year-old asthmatic children was considered. Airflow and particle deposition in the upper (G3-G6) and lower (G9-G12) conducting airways were numerically investigated using computation fluid dynamics (CFD) method. We considered the manifestation of moderate (30% reduction in airway diameter) and severe (60% reduction) asthma. Micron particles (1-10 µm) were considered. We found that particle deposition in the asthmatic children was significantly higher than that in healthy children. The deposition efficiency increased slowly with particle size for healthy children, but increased rapidly for asthmatic children, such that smaller particles could be deposited in the conducting airways of asthmatics. For healthy children, particles were deposited by inertial impaction and gravitational sedimentation respectively in the upper and lower airways, but deposited by inertial impaction in asthmatic children. The severity of the asthma increased the particle deposition in the airways. Our study indicated that asthmatic children were more susceptible to the effect of particulate air pollution. The constricted airways increased the particle deposition by inertial impaction, which may be the biological pathogenesis that causes the hospitalization of asthma in children. Avoiding exposure during air pollution events will be an effective measure to reduce the asthma attack.

Particle and organic vapor emissions from children's 3-D pen and 3-D printer toys

Objective: Fused filament fabrication "3-dimensional (3-D)" printing has expanded beyond the workplace to 3-D printers and pens for use by children as toys to create objects.Materials and methods: Emissions from two brands of toy 3-D pens and one brand of toy 3-D printer were characterized in a 0.6 m3 chamber (particle number, size, elemental composition; concentrations of individual and total volatile organic compounds (TVOC)). The effects of print parameters on these emission metrics were evaluated using mixed-effects models. Emissions data were used to model particle lung deposition and TVOC exposure potential.Results: Geometric mean particle yields (106-1010 particles/g printed) and sizes (30-300 nm) and TVOC yields ( Collapse

Key Words

• 3-D printing
• children
• exposure
• particles
• toys
• volatile organic compounds

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MESH Headings

• Air Pollution, Indoor/analysis
• Child
• Environmental Monitoring/methods
• Humans
• Particle Size
• Particulate Matter/analysis
• Play and Playthings
• Printing, Three-Dimensional
• Volatile Organic Compounds/analysis

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Grants

• CC999999 Intramural CDC HHS
• R01 ES015022 NIEHS NIH HHS

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Affiliation(s)

Jinghai Yi Department of Physiology and Pharmacology, and the Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, 26506
Matthew G. Duling National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Lauren N. Bowers National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Alycia K. Knepp National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Ryan F. LeBouf National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Timothy R. Nurkiewicz Department of Physiology and Pharmacology, and the Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, 26506 National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Anand Ranpara National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Todd Luxton U.S. Environmental Protection Agency, Office of Research and Development, National Risk Management Research Laboratory, Cincinnati, OH, 45224
Stephen B. Martin National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Dru A. Burns National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Derek M. Peloquin Oak Ridge Institute for Science and Education, Oak Ridge, TN, 37830
Eric J. Baumann Pegasus Technical Services, Cincinnati, OH, 45268
M. Abbas Virji National Institute for Occupational Safety and Health, Morgantown, WV, 26505
Aleksandr B. Stefaniak National Institute for Occupational Safety and Health, Morgantown, WV, 26505

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Collaborators Collapse

PM1 in Ambient and Indoor Air—Urban and Rural Areas in the Upper Silesian Region, Poland

(1) Background: The work presents results of concentration measurements of PM1, collected in the indoor air of four preschool buildings in Gliwice and its environs (Silesia Province) and in ambient air in the vicinity of four working hard coal power plants and four coking plants located in southern Poland. (2) Methods: The samples of <1 µm, 1–2.5 µm, 2.5–10 µm, and >10 µm fractions were collected with the use of Dekati® PM10 cascade impactor, and concentrations of seven trace elements (Cd, Cr, Mn, Ni, Pb, Sb, and Se) were determined. (3) Results: The concentrations of PM1 changed in the range of 3.1 μg/m3–65.3 μg/m3. Among trace elements, the highest concentrations in indoor air were evidenced for Cr (129–219 ng/m3), while in outdoor air for Pb (12.6–21.2 ng/m3). Principal Component Analysis PCA analysis extracted three factors of rural dusts, city dusts, and natural soils. (4) Conclusions: The paper points to accumulation of carcinogenic Cd, Cr, and Ni in indoor air, and significant contribution of trace elements in PM1, which, owing to long-lasting exposure and elevated sensitivity of developing organisms, may evoke effects on health of children.

Short-term effect of PM2.5 on pediatric asthma incidence in Shanghai, China

Recent epidemiological studies pointed out that air pollution has a significant impact on pediatric asthma. Shanghai is one of the biggest cities in China, and the short-term effect of atmospheric particulate matter on the incidence of pediatric asthma has become a hot topic. From January 1, 2009, to December 31, 2010, we used daily measurements of pollutant concentrations, daily weather data, and daily records of pediatric asthma hospital visits from local authorities to evaluate the short-term effect of air pollution on pediatric asthma incidence in Shanghai, China. We used a generalized additive model (GAM) in the analysis, and the controlled confounding factors include long-term trends, day-of-the-week effects, and weather elements. We divided the entire study group into different age-subgroups. In addition, we took a variety of lag models into consideration. The results showed a strong connection between concentrations of fine particulate matter (PM_2.5) and pediatric asthma hospital visits from 2009 to 2010 in Shanghai, China. For the entire study group, the greatest relative risk (RR) of PM_2.5 on pediatric asthma hospital visits was 1.060 on a lag of 4 days. As for the three different age-subgroups, the greatest RR of PM_2.5 on pediatric asthma hospital visits was 1.061 (at a lag of 5 days), 1.071 (at a lag of 4 days), and 1.052 (at a lag of 2 days), for the under-2-year-olds, 3-to-5-year-olds, and the 6-to-18-year-olds, respectively. The overall short-term effect of PM_2.5 on pediatric asthma hospital visits was relatively stronger in younger children. Within the year, we detected the strongest seasonal effect of PM_2.5 on pediatric asthma hospital visits in Summer. When adding other air pollutants in the analysis model, RR of PM_2.5 on pediatric asthma hospital visits would be increased.