1
|
Tsai YG, Chio CP, Yang KD, Lin CH, Yeh YP, Chang YJ, Chien JW, Wang SL, Huang SK, Chan CC. Long-term PM 2.5 exposure is associated with asthma prevalence and exhaled nitric oxide levels in children. Pediatr Res 2024:10.1038/s41390-023-02977-5. [PMID: 38263452 DOI: 10.1038/s41390-023-02977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/19/2023] [Accepted: 11/26/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Exhaled nitric oxide concentration (FENO) is a marker of airway inflammation. This study aimed to evaluate the association of air pollution exposure with FENO levels and asthma prevalence with respiratory symptoms in school children. METHODS We analyzed 4736 school children who reside in six townships near industrial areas in central Taiwan. We evaluated asthmatic symptoms, FENO, and conducted the environmental questionnaire. The personal exposure of PM2.5, NO, and SO2 was estimated using land-use regression models data on children's school and home addresses. RESULTS Annual exposure to PM2.5 was associated with increased odds of physician-diagnosed asthma (OR = 1.595), exercise-induced wheezing (OR = 1.726), itchy eyes (OR = 1.417), and current nasal problems (OR = 1.334) (P < 0.05). FENO levels in the absence of infection were positively correlated with age, previous wheezing, allergic rhinitis, atopic eczema, near the road, and for children with high exposure to PM2.5 (P < 0.05). An increase of 1 μg/m3 PM2.5 exposure was significantly associated with a 1.0% increase in FENO levels for children after adjusting for potential confounding variables, including exposures to NO and SO2. CONCLUSIONS Long-term exposures to PM2.5 posed a significant risk of asthma prevalence and airway inflammation in a community-based population of children. IMPACT Annual exposure to PM2.5 was associated with increased odds of physician-diagnosed asthma and nasal problems and itchy eyes. Long-term exposures to PM2.5 were significantly associated with FENO levels after adjusting for potential confounding variables. This is first study to assess the association between FENO levels and long-term air pollution exposures in children near coal-based power plants. An increase of 1 μg/m3 annual PM2.5 exposure was significantly associated with a 1.0% increase in FENO levels. Long-term exposures to PM2.5 posed a significant risk of asthma prevalence and airway inflammation in a community-based population of children.
Collapse
Affiliation(s)
- Yi-Giien Tsai
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan, ROC
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Chia-Pin Chio
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC
| | - Kuender D Yang
- Department of Pediatrics, Mackay Memorial Hospital, and Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ching-Hsiung Lin
- Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, ROC
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan, ROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Department of Recreation and Holistic Wellness, MingDao University, Changhua, Taiwan, ROC
| | - Yen-Po Yeh
- Changhua County Public Health Bureau, Changhua, Taiwan, ROC
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Jien-Wen Chien
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Rd, Zhunan, Miaoli County, Miaoli, Taiwan, ROC.
| | - Shau-Ku Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Rd, Zhunan, Miaoli County, Miaoli, Taiwan, ROC.
- Johns Hopkins Asthma and Allergy Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC.
| |
Collapse
|
2
|
Percival E, Collison AM, da Silva Sena CR, De Queiroz Andrade E, De Gouveia Belinelo P, Gomes GMC, Oldmeadow C, Murphy VE, Gibson PG, Karmaus W, Mattes J. The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers. Environ Health 2023; 22:84. [PMID: 38049853 PMCID: PMC10696885 DOI: 10.1186/s12940-023-01030-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Exhaled nitric oxide is a marker of airway inflammation. Air pollution induces airway inflammation and oxidative stress. Little is known about the impact of air pollution on exhaled nitric oxide in young infants. METHODS The Breathing for Life Trial recruited pregnant women with asthma into a randomised controlled trial comparing usual clinical care versus inflammometry-guided asthma management in pregnancy. Four hundred fifty-seven infants from the Breathing for Life Trial birth cohort were assessed at six weeks of age. Exhaled nitric oxide was measured in unsedated, sleeping infants. Its association with local mean 24-h and mean seven-day concentrations of ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, ammonia, particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in diameter was investigated. The air pollutant data were sourced from local monitoring sites of the New South Wales Air Quality Monitoring Network. The association was assessed using a 'least absolute shrinkage and selection operator' (LASSO) approach, multivariable regression and Spearman's rank correlation. RESULTS A seasonal variation was evident with higher median exhaled nitric oxide levels (13.6 ppb) in warmer months and lower median exhaled nitric oxide levels (11.0 ppb) in cooler months, P = 0.008. LASSO identified positive associations for exhaled nitric oxide with 24-h mean ammonia, seven-day mean ammonia, seven-day mean PM10, seven-day mean PM2.5, and seven-day mean ozone; and negative associations for eNO with seven-day mean carbon monoxide, 24-h mean nitric oxide and 24-h mean sulfur dioxide, with an R-square of 0.25 for the penalized coefficients. These coefficients selected by LASSO (and confounders) were entered in multivariable regression. The achieved R-square was 0.27. CONCLUSION In this cohort of young infants of asthmatic mothers, exhaled nitric oxide showed seasonal variation and an association with local air pollution concentrations.
Collapse
Affiliation(s)
- Elizabeth Percival
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Adam M Collison
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Carla Rebeca da Silva Sena
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Ediane De Queiroz Andrade
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia De Gouveia Belinelo
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Gabriela Martins Costa Gomes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | | | - Vanessa E Murphy
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Peter G Gibson
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Wilfried Karmaus
- Division of Epidemiology, School of Public Health, and Environmental Health Science, University of Memphis, BiostatisticsMemphis, TN, 38152, USA
| | - Joerg Mattes
- Asthma & Breathing Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
- Department of Paediatric Respiratory & Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia.
| |
Collapse
|
3
|
Bouma F, Nyberg F, Olin AC, Carlsen HK. Genetic susceptibility to airway inflammation and exposure to short-term outdoor air pollution. Environ Health 2023; 22:50. [PMID: 37386634 DOI: 10.1186/s12940-023-00996-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 06/02/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Air pollution is a large environmental health hazard whose exposure and health effects are unequally distributed among individuals. This is, at least in part, due to gene-environment interactions, but few studies exist. Thus, the current study aimed to explore genetic susceptibility to airway inflammation from short-term air pollution exposure through mechanisms of gene-environment interaction involving the SFTPA, GST and NOS genes. METHODS Five thousand seven hundred two adults were included. The outcome measure was fraction of exhaled nitric oxide (FeNO), at 50 and 270 ml/s. Exposures were ozone (O3), particulate matter < 10 µm (PM10), and nitrogen dioxide (NO2) 3, 24, or 120-h prior to FeNO measurement. In the SFTPA, GST and NOS genes, 24 single nucleotide polymorphisms (SNPs) were analyzed for interaction effects. The data were analyzed using quantile regression in both single-and multipollutant models. RESULTS Significant interactions between SNPs and air pollution were found for six SNPs (p < 0.05): rs4253527 (SFTPA1) with O3 and NOx, rs2266637 (GSTT1) with NO2, rs4795051 (NOS2) with PM10, NO2 and NOx, rs4796017 (NOS2) with PM10, rs2248814 (NOS2) with PM10 and rs7830 (NOS3) with NO2. The marginal effects on FeNO for three of these SNPs were significant (per increase of 10 µg/m3):rs4253527 (SFTPA1) with O3 (β: 0.155, 95%CI: 0.013-0.297), rs4795051 (NOS2) with PM10 (β: 0.073, 95%CI: 0.00-0.147 (single pollutant), β: 0.081, 95%CI: 0.004-0.159 (multipollutant)) and NO2 (β: -0.084, 95%CI: -0.147; -0.020 (3 h), β: -0.188, 95%CI: -0.359; -0.018 (120 h)) and rs4796017 (NOS2) with PM10 (β: 0.396, 95%CI: 0.003-0.790). CONCLUSIONS Increased inflammatory response from air pollution exposure was observed among subjects with polymorphisms in SFTPA1, GSTT1, and NOS genes, where O3 interacted with SFTPA1 and PM10 and NO2/NOx with the GSTT1 and NOS genes. This provides a basis for the further exploration of biological mechanisms as well as the identification of individuals susceptible to the effects of outdoor air pollution.
Collapse
Affiliation(s)
- Femke Bouma
- Department of Occupational and Environmental Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, BOX 414, 40530, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg University, Gothenburg, Sweden
| | - Anna-Carin Olin
- Department of Occupational and Environmental Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, BOX 414, 40530, Gothenburg, Sweden
| | - Hanne Krage Carlsen
- Department of Occupational and Environmental Health, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, BOX 414, 40530, Gothenburg, Sweden.
| |
Collapse
|
4
|
Lu C, Liu Q, Deng M, Liao H, Yang X, Ma P. Interaction of high temperature and NO 2 exposure on asthma risk: In vivo experimental evidence of inflammation and oxidative stress. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 869:161760. [PMID: 36702287 DOI: 10.1016/j.scitotenv.2023.161760] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Allergic asthma is a complicated respiratory disease with many concerns. Mounting epidemiological evidence linked temperature (T) and NO2 with allergic asthma, yet toxicological studies remain scarce. We conducted an in vivo study to explore toxicological evidence in T-NO2 interaction on allergic asthma, to investigate underlying toxicological mechanisms. 90 male Balb/c mice were randomly and equally divided into 6 groups including saline control, ovalbumin (OVA)-sensitized, OVA + 35 °C, OVA + NO2, OVA + 35 °C + NO2, and OVA + 35 °C + NO2 + capsazepine (CZP), adopting treatment for 38 days. We measured pulmonary functions of inspiratory resistance (Ri), expiratory resistance (Re) and airway compliance (Cldyn), serum protein biomarkers, indexes of pulmonary inflammation, histopathological changes and protective effects of CZP. Airway hyperresponsiveness (AHR) was aggravated by high T (35 °C) and NO2 (5 ppm) co-exposure with a series of aggravating asthmatic symptoms including airway wall thickening, lumen stenosis, goblet cell proliferation, mucus hypersecretion, and subepithelial fibrotic hyperplasia, providing evidence in the toxicological impact of high T-NO2 interaction. The biomarkers of serum immune functions (Total-IgE, OVA-sIgE and IL-4), pro-inflammation (IL-6 and TNF-α), oxidative stress cytokines (8-OHdG, ROS and MDA), airway resistance (Ri and Re), and TRPV1 expression significantly increased, while IFN-γ, GSH and airway compliance (Cldyn) significantly decreased with co-exposure to high T and NO2. We observed that CZP addition significantly ameliorated these toxicological effects and biomarker levels induced by heat-NO2 interaction. Our results suggest a toxicity of heat-NO2 interaction on asthma with clear mechanisms, which can be ameliorated by CZP, indicating that both oxidative stress and TRPV1 expression may be primarily responsible for asthma of heat-NO2-induced toxicity.
Collapse
Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha 410078, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Miaomiao Deng
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Xu Yang
- School of Public Health, Hubei University of Science and Technology, Xianning 437100, China
| | - Ping Ma
- School of Public Health, Hubei University of Science and Technology, Xianning 437100, China
| |
Collapse
|
5
|
Nauwelaerts SJD, Van Goethem N, De Cremer K, Sierra NB, Vercauteren J, Stroobants C, Bernard A, Nawrot T, Roosens NHC, De Keersmaecker SCJ. Noninvasive integrative approach applied to children in the context of recent air pollution exposure demonstrates association between fractional exhaled nitric oxide (FeNO) and urinary CC16. ENVIRONMENTAL RESEARCH 2023; 216:114441. [PMID: 36191620 DOI: 10.1016/j.envres.2022.114441] [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: 07/14/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Exposure to the air pollutant particulate matter (PM) is associated with increased risks of respiratory diseases and enhancement of airway inflammation in children. In the context of large scale air pollution studies, it can be challenging to measure fractional exhaled nitric oxide (FeNO) as indicator of lung inflammation. Urinary CC16 (U-CC16) is a potential biomarker of increased lung permeability and toxicity, increasing following short-term PM2.5 exposure. The single nucleotide polymorphism (SNP) CC16 G38A (rs3741240) affects CC16 levels and respiratory health. Our study aimed at assessing the use of U-CC16 (incl. CC16 G38A from saliva) as potential alternative for FeNO by investigating their mutual correlation in children exposed to PM. Samples from a small-scale study conducted in 42 children from urban (n = 19) and rural (n = 23) schools examined at two time points, were analysed. When considering recent (lag1) low level exposure to PM2.5 as air pollution measurement, we found that U-CC16 was positively associated with FeNO (β = 0.23; 95% CI [-0.01; 0.47]; p = 0.06) in an adjusted analysis using a linear mixed effects model. Further, we observed a positive association between PM2.5 and FeNO (β = 0.56; 95% CI [0.02; 1.09]; p = 0.04) and higher FeNO in urban school children as compared to rural school children (β = 0.72; 95% CI [0.12; 1.31]; p = 0.02). Although more investigations are needed, our results suggest that inflammatory responses evidenced by increased FeNO are accompanied by potential increased lung epithelium permeability and injury, evidenced by increased U-CC16. In future large scale studies, where FeNO measurement is less feasible, the integrated analysis of U-CC16 and CC16 G38A, using noninvasive samples, might be a suitable alternative to assess the impact of air pollution exposure on the respiratory health of children, which is critical for policy development at population level.
Collapse
Affiliation(s)
- Sarah J D Nauwelaerts
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium; Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Brussels, Belgium
| | - Nina Van Goethem
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen De Cremer
- Platform Chromatography and Mass Spectrometry, Sciensano, Brussels, Belgium
| | | | | | - Christophe Stroobants
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
| | - Alfred Bernard
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Brussels, Belgium
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nancy H C Roosens
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
| | | |
Collapse
|
6
|
Isa KNM, Jalaludin J, Hashim Z, Than LTL, Hashim JH, Norbäck D. Fungi composition in settled dust associated with fractional exhaled nitric oxide in school children with asthma. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158639. [PMID: 36089033 DOI: 10.1016/j.scitotenv.2022.158639] [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: 07/13/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Fungi exposure has been significantly linked to respiratory illness. However, numerous fungi taxa that are potentially allergenic still undocumented and leave a barrier to establishing a clear connection between exposure and health risks. This study aimed to evaluate the association of fungi composition in settled dust with fractional exhaled nitric oxide (FeNO) levels among school children with doctor-diagnosed asthma. A cross-sectional study was undertaken among secondary school students in eight schools in the urban area of Hulu Langat, Selangor, Malaysia. A total of 470 school children (aged 14 years old) were randomly selected and their FeNO levels were measured and allergic skin prick tests were conducted. The settled dust samples were collected and analysed by using metagenomic technique to determine the fungi composition. The general linear regression with complex sampling was employed to determine the interrelationship. In total, 2645 fungal operational taxonomic units (OTUs) were characterised from the sequencing process which belongs to Ascomycota (60.7 %), Basidiomycota (36.4 %), Glomeromycota (2.9 %) and Chytridiomycota (0.04 %). The top five mostly abundance in all dust samples were Aspergillus clavatus (27.2 %), followed by Hyphoderma multicystidium (12.2 %), Verrucoconiothyrium prosopidis (9.4 %), Ganoderma tuberculosum (9.2 %), and Heterochaete shearii (7.2 %). The regression results indicated that A. clavatus, Brycekendrickomyces acaciae, Candida parapsilosis, Hazslinszkyomyces aloes, H. multicystidium, H. shearii, Starmerella meliponinorum, V. prosopidis were associated in increased of FeNO levels among the asthmatic group at 0.992 ppb (95 % CI = 0.34-1.68), 2.887 ppb (95 % CI = 2.09-3.76), 0.809 ppb (95 % CI = 0.14-1.49), 0.647 ppb (95 % CI = 0.36-0.94), 1.442 ppb (95 % CI = 0.29-2.61), 1.757 ppb (95 % CI = 0.59-2.87), 1.092 ppb (95 % CI = 0.43-1.75) and 1.088 ppb (95 % CI = 0.51-1.62), respectively. To our knowledge, this is a new finding. The findings pointed out that metagenomics profiling of fungi could enhance our understanding of a complex interrelation between rare and unculturable fungi with airway inflammation.
Collapse
Affiliation(s)
- Khairul Nizam Mohd Isa
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor, Malaysia; Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, 43000 Kajang, Selangor, Malaysia
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor, Malaysia.
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor, Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology & Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor, Malaysia
| | - Jamal Hisham Hashim
- Department of Health Sciences, Faculty of Engineering and Life Science, Universiti Selangor, Shah Alam Campus, Seksyen 7, 40000 Shah Alam, Selangor, Malaysia
| | - Dan Norbäck
- Department of Medical Science, Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala University, 75185 Uppsala, Sweden
| |
Collapse
|
7
|
Chen Z, Sidell MA, Huang BZ, Chow T, Eckel SP, Martinez MP, Gheissari R, Lurmann F, Thomas DC, Gilliland FD, Xiang AH. Ambient Air Pollutant Exposures and COVID-19 Severity and Mortality in a Cohort of Patients with COVID-19 in Southern California. Am J Respir Crit Care Med 2022; 206:440-448. [PMID: 35537137 DOI: 10.1164/rccm.202108-1909oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Rationale: Ecological studies have shown air pollution associations with coronavirus disease (COVID-19) outcomes. However, few cohort studies have been conducted. Objectives: To conduct a cohort study investigating the association between air pollution and COVID-19 severity using individual-level data from the electronic medical record. Methods: This cohort included all individuals who received diagnoses of COVID-19 from Kaiser Permanente Southern California between March 1 and August 31, 2020. One-year and 1-month averaged ambient air pollutant (particulate matter ⩽2.5 μm in aerodynamic diameter [PM2.5], NO2, and O3) exposures before COVID-19 diagnosis were estimated on the basis of residential address history. Outcomes included COVID-19-related hospitalizations, intensive respiratory support (IRS), and ICU admissions within 30 days and mortality within 60 days after COVID-19 diagnosis. Covariates included socioeconomic characteristics and comorbidities. Measurements and Main Results: Among 74,915 individuals (mean age, 42.5 years; 54% women; 66% Hispanic), rates of hospitalization, IRS, ICU admission, and mortality were 6.3%, 2.4%, 1.5%, and 1.5%, respectively. Using multipollutant models adjusted for covariates, 1-year PM2.5 and 1-month NO2 average exposures were associated with COVID-19 severity. The odds ratios associated with a 1-SD increase in 1-year PM2.5 (SD, 1.5 μg/m3) were 1.24 (95% confidence interval [CI], 1.16-1.32) for COVID-19-related hospitalization, 1.33 (95% CI, 1.20-1.47) for IRS, and 1.32 (95% CI, 1.16-1.51) for ICU admission; the corresponding odds ratios associated with 1-month NO2 (SD, 3.3 ppb) were 1.12 (95% CI, 1.06-1.17) for hospitalization, 1.18 (95% CI, 1.10-1.27) for IRS, and 1.21 (95% CI, 1.11-1.33) for ICU admission. The hazard ratios for mortality were 1.14 (95% CI, 1.02-1.27) for 1-year PM2.5 and 1.07 (95% CI, 0.98-1.16) for 1-month NO2. No significant interactions with age, sex or ethnicity were observed. Conclusions: Ambient PM2.5 and NO2 exposures may affect COVID-19 severity and mortality.
Collapse
Affiliation(s)
- Zhanghua Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Margo A Sidell
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Brian Z Huang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Sandrah P Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| | - Roya Gheissari
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Duncan C Thomas
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank D Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; and
| |
Collapse
|
8
|
Carraro S, Ferraro VA, Zanconato S. Impact of air pollution exposure on lung function and exhaled breath biomarkers in children and adolescents. J Breath Res 2022; 16. [PMID: 35947967 DOI: 10.1088/1752-7163/ac8895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/10/2022] [Indexed: 11/12/2022]
Abstract
A growing number of scientific papers focus on the description and quantification of the detrimental effects of pollution exposure on human health. The respiratory system is one of the main targets of these effects and children are potentially a vulnerable population. Many studies analyzed the effects of short- and long-term exposure to air pollutants on children's respiratory function. Aim of the present narrative review is to summarize the results of the available cohort studies which investigated how children's lung function is affected by exposure to air pollution. In addition, an overview is provided on the association, in children, between pollution exposure and exhaled breath biomarkers, as possible indicators of the pathogenetic mechanisms involved in pollution-related lung damages. The identified cohort studies suggest that, beside the possible impact of recent exposure, early and lifetime exposure are the variables most consistently associated with a reduction in lung function parameters in both children and adolescents. As for the effect of air pollution exposure on exhaled breath biomarkers, the available studies show an association with increased exhaled nitric oxide, with increased concentrations of malondialdehyde and 8-isoprostane in exhaled breath condensate (EBC), and with EBC acidification. These studies, therefore, suggest lung inflammation and oxidative stress as possible pathogenetic mechanisms involved in pollution related lung damages. Taken together, the available data underscore the importance of the development and application of policies aimed at reducing air pollutant concentration, since the protection of children's lung function can have a beneficial impact on adults' respiratory health in the future.
Collapse
Affiliation(s)
- Silvia Carraro
- Women's and Children's Health Department, University of Padova, via Giustiniani 3, Padova, 35128, ITALY
| | - Valentina Agnese Ferraro
- Women's and Children's Health Department, University of Padova, via Giustiniani, 3, Padova, 35128, ITALY
| | - Stefania Zanconato
- Women's and Children's Health Department, University of Padova, via Giustiniani 3, Padova, 35128, ITALY
| |
Collapse
|
9
|
Parenteau AM, Alen NV, La J, Luck AT, Teichrow DJ, Daang EM, Nissen AT, Deer LK, Hostinar CE. Associations of air pollution with peripheral inflammation and cardiac autonomic physiology in children. New Dir Child Adolesc Dev 2022; 2022:125-154. [PMID: 35921508 DOI: 10.1002/cad.20474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Climate change-related disasters have drawn increased attention to the impact of air pollution on health. 122 children ages 9-11 years old, M(SD) = 9.91(.56), participated. Levels of particulate matter (PM2.5) near participants' homes were obtained from the Environmental Protection Agency. Cytokines were assayed from 100 child serum samples: IL-6, IL-8, IL-10, and TNFα. Autonomic physiology was indexed by pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), cardiac autonomic regulation (CAR), and cardiac autonomic balance (CAB). IL-6 was positively related to daily PM2.5 (r = .26, p = .009). IL-8 was negatively associated with monthly PM2.5 (r = -.23, p = .02). PEP was positively related to daily (r = .29, p = .001) and monthly PM2.5 (r = .18, p = .044). CAR was negatively associated with daily PM2.5 (r = -.29, p = .001). IL-10, TNFα, RSA, and CAB were not associated with PM2.5. Air pollution may increase risk of inflammation in children.
Collapse
Affiliation(s)
| | | | - Jennifer La
- University of California-San Francisco, San Francisco, California, USA
| | | | | | - Enya M Daang
- University of California-Davis, Davis, California, USA
| | - Adam T Nissen
- University of California-Davis, Davis, California, USA
| | | | | |
Collapse
|
10
|
Zhang Y, Eckel SP, Berhane K, Garcia E, Muchmore P, Molshatzki NBA, Rappaport EB, Linn WS, Habre R, Gilliland FD. Long-term exposures to air pollutants affect F eNO in children: a longitudinal study. Eur Respir J 2021; 58:13993003.00705-2021. [PMID: 34503981 DOI: 10.1183/13993003.00705-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/05/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Yue Zhang
- Dept of Internal Medicine, University of Utah, Salt Lake City, UT, USA .,Dept of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA.,Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Sandrah P Eckel
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kiros Berhane
- Dept of Biostatistics, Columbia University, New York, NY, USA
| | - Erika Garcia
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Edward B Rappaport
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - William S Linn
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank D Gilliland
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
11
|
Abramson MJ, Wigmann C, Altug H, Schikowski T. Ambient air pollution is associated with airway inflammation in older women: a nested cross-sectional analysis. BMJ Open Respir Res 2021; 7:7/1/e000549. [PMID: 32209644 PMCID: PMC7206912 DOI: 10.1136/bmjresp-2019-000549] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background Air pollution is a risk factor for chronic obstructive pulmonary disease (COPD). Fraction of exhaled nitric oxide (FeNO) could be a useful biomarker for health effects of air pollutants. However, there were limited data from older populations with higher prevalence of COPD and other inflammatory conditions. Methods We obtained data from the German Study on the influence of Air pollution on Lung function, Inflammation and Ageing. Spirometry and FeNO were measured by standard techniques. Air pollutant exposures were estimated following the European Study of Cohorts for Air Pollution Effects protocols, and ozone (O3) measured at the closest ground level monitoring station. Multiple linear regression models were fitted to FeNO with each pollutant separately and adjusted for potential confounders. Results In 236 women (mean age 74.6 years), geometric mean FeNO was 15.2ppb. Almost a third (n=71, 30.1%) of the women had some chronic inflammatory respiratory condition. A higher FeNO concentration was associated with exposures to fine particles (PM2.5), PM2.5absorbance and respirable particles (PM10). There were no significant associations with PMcoarse, NO2, NOx, O3 or length of major roads within a 1 km buffer. Restricting the analysis to participants with a chronic inflammatory respiratory condition, with or without impaired lung function produced similar findings. Adjusting for diabetes did not materially alter the findings. There were no significant interactions between individual pollutants and asthma or current smoking. Conclusions This study adds to the evidence to reduce ambient PM2.5 concentrations as low as possible to protect the health of the general population.
Collapse
Affiliation(s)
- Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Claudia Wigmann
- Environmental Epidemiology of Lung, Brain and Skin Aging, Leibniz Research Institute for Environmental Medicine, Dusseldorf, Nordrhein-Westfalen, Germany
| | - Hicran Altug
- Environmental Epidemiology of Lung, Brain and Skin Aging, Leibniz Research Institute for Environmental Medicine, Dusseldorf, Nordrhein-Westfalen, Germany
| | - Tamara Schikowski
- Environmental Epidemiology of Lung, Brain and Skin Aging, Leibniz Research Institute for Environmental Medicine, Dusseldorf, Nordrhein-Westfalen, Germany
| |
Collapse
|
12
|
Mendoza DL, Benney TM, Boll S. Long-term analysis of the relationships between indoor and outdoor fine particulate pollution: A case study using research grade sensors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145778. [PMID: 33647662 PMCID: PMC9753328 DOI: 10.1016/j.scitotenv.2021.145778] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 05/03/2023]
Abstract
The growing concern of air quality and its associated health-related impacts has led to increased awareness of pollutant exposure. Most human populations spend the majority of their time indoors and the COVID-19 pandemic has likely exacerbated this behavior. While significant amounts of research have focused on outdoor air quality, to date there have been no studies that examined simultaneous long-term trends on indoor and outdoor air quality on a site using research-grade sensors. We measured fine particulate matter (PM2.5) for a year using sensors located on the rooftop, air handling room, and indoor office space in a building and captured the impacts of three types of regularly occurring elevated pollution events: wintertime atmospheric inversions, wildfires, and fireworks. The events had different magnitudes and durations, and infiltration rates varied for each event leading to dissimilar indoor air pollution levels. The building's air handling unit and different environmental conditions (lower indoor humidity and temperature during the winter) combined to reduce indoor pollution from inversion events however, particulate matter from wildfires and fireworks infiltrated at higher rates. Together, this suggests possible intervention strategies, such as ventilation rates and filter upgrades, that could be used to mitigate contaminant intrusion during elevated pollution events. This year-long study illustrates an array of ways that elevated pollution events interact with the protective effects that buildings have against air pollution for its occupants. Furthermore, we show that outdoor air pollution is an important variable to consider when studying indoor air quality as contaminant infiltration is strongly dependent on the specific pollution source.
Collapse
Affiliation(s)
- Daniel L Mendoza
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA; Department of City & Metropolitan Planning, University of Utah, 375 S 1530 E, Suite 220, Salt Lake City, Utah 84112, USA; University of Utah School of Medicine, Pulmonary Division, 26 N 1900 E, Salt Lake City, UT 84132, USA.
| | - Tabitha M Benney
- Department of Political Science, University of Utah, 260 S Central Campus Drive, Salt Lake City, UT 84112, USA
| | - Sarah Boll
- State of Utah, Division of Facilities Construction and Management, 4315 S 2700 W, Floor 3, Salt Lake City, UT 84129, USA
| |
Collapse
|
13
|
Czubaj-Kowal M, Kurzawa R, Mazurek H, Sokołowski M, Friediger T, Polak M, Nowicki GJ. Relationship Between Air Pollution and the Concentration of Nitric Oxide in the Exhaled Air (FeNO) in 8-9-Year-Old School Children in Krakow. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136690. [PMID: 34206247 PMCID: PMC8296872 DOI: 10.3390/ijerph18136690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/13/2021] [Accepted: 06/20/2021] [Indexed: 11/16/2022]
Abstract
The consequences of air pollution pose one of the most serious threats to human health, and especially impact children from large agglomerations. The measurement of nitric oxide concentration in exhaled air (FeNO) is a valuable biomarker in detecting and monitoring airway inflammation. However, only a few studies have assessed the relationship between FeNO and the level of air pollution. The study aims to estimate the concentration of FeNO in the population of children aged 8–9 attending the third grade of public primary schools in Krakow, as well as to determine the relationship between FeNO concentration and dust and gaseous air pollutants. The research included 4580 children aged 8–9 years who had two FeNO measurements in the winter–autumn and spring–summer periods. The degree of air pollution was obtained from the Regional Inspectorate of Environmental Protection in Krakow. The concentration of pollutants was obtained from three measurement stations located in different parts of the city. The FeNO results were related to air pollution parameters. The study showed weak but significant relationships between FeNO and air pollution parameters. The most significant positive correlations were found for CO8h (r = 0.1491, p < 0.001), C6H6 (r = 0.1420, p < 0.001), PM10 (r = 0.1054, p < 0.001) and PM2.5 (r = 0.1112, p < 0.001). We suggest that particulate and gaseous air pollutants impact FeNO concentration in children aged 8–9 years. More research is needed to assess the impact of air pollution on FeNO concentration in children. The results of such studies could help to explain the increase in the number of allergic and respiratory diseases seen in children in recent decades.
Collapse
Affiliation(s)
- Marta Czubaj-Kowal
- Department of Paediatrics, Stefan Żeromski Specialist Hospital in Krakow, Na Skarpie 66 Str., PL-31-913 Krakow, Poland;
- Correspondence: ; Tel.: +48-604-433-428
| | - Ryszard Kurzawa
- Department of Alergology and Pneumonology, Institute of Tuberculosis and Lung Disorders, Prof. Jana Rudnika 3B Str., PL-34-700 Rabka-Zdrój, Poland;
| | - Henryk Mazurek
- Department of Pneumonology and Cystic Fibrosis, Institute of Tuberculosis and Lung Disorders, Prof. Jana Rudnika 3B Str., PL-34-700 Rabka-Zdrój, Poland;
| | - Michał Sokołowski
- Department of Paediatrics, Stefan Żeromski Specialist Hospital in Krakow, Na Skarpie 66 Str., PL-31-913 Krakow, Poland;
| | - Teresa Friediger
- Faculty of Health, Catholic University in Ruzomberok, Námestie A. Hlinku 48 Str., SK-034 01 Ruzomberok, Slovakia;
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Grzegórzecka 20 Str., PL-31-531 Krakow, Poland;
| | - Grzegorz Józef Nowicki
- Department of Family Medicine and Community Nursing, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland;
| |
Collapse
|
14
|
The Effect of Physical Activity on Spirometry and Fractional Exhaled Nitric Oxide in Adolescents—Longitudinal Study. SUSTAINABILITY 2021. [DOI: 10.3390/su13115770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Highly intense and chronic physical activity may cause an inflammatory process in the airways. The inflammatory process in the respiratory system can be measured either by the spirometry test and exhaled nitric oxide. The aim of this study was to assess the effect of different levels of physical activity on fractional exhaled nitric oxide (FeNO) and spirometry parameters. Fifty healthy students (volunteers) who were participating in physical activity classes (low level of physical activity) and attending sports training (high and medium level of physical activity) completed two indoor exercise training two to three weeks apart. FeNO was measured twice, at baseline and after 45–60 min of exercise followed by spirometry. There was no significant difference in FeNO values and spirometry parameters between the groups with different physical activity. However, students with the highest level of physical activity presented a higher and significant variance of FeNO levels in comparison to students with lower physical activity. Healthy young adults (professional sportspersons) have a higher internal variability of FeNO. That suggests the initial ongoing inflammatory process in the airways. Any level of physical activity does not affect spirometry parameters before and after training in young healthy adults.
Collapse
|
15
|
Amazouz H, Bougas N, Thibaudon M, Lezmi G, Beydon N, Bourgoin-Heck M, Just J, Momas I, Rancière F. Association between lung function of school age children and short-term exposure to air pollution and pollen: the PARIS cohort. Thorax 2021; 76:887-894. [PMID: 33593932 DOI: 10.1136/thoraxjnl-2020-215515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/12/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Daily levels of ambient air pollution and pollen may affect lung function but have rarely been studied together. We investigated short-term exposure to pollen and air pollution in relation to lung function in school-age children from a French population-based birth cohort. METHODS This study included 1063 children from the PARIS (Pollution and Asthma Risk: an Infant Study) cohort whose lung function and FeNO measurements were performed at age 8 years old. Exposure data were collected up to 4 days before testing. We estimated daily total pollen concentration, daily allergenic risk indices for nine pollen taxa, as well as daily concentrations of three air pollutants (particulate matter less than 10 µm (PM10), nitrogen dioxide (NO2), ozone (O3)). Children with similar pollen and air pollution exposure were grouped using multidimensional longitudinal cluster analysis. Associations between clusters of pollen and air pollution exposure and respiratory indices (FEV1, FVC, FeNO) were studied using multivariable linear and logistic regression models adjusted for potential confounders. RESULTS Four clusters of exposure were identified: no pollen and low air pollution (Cluster 1), grass pollen (Cluster 2), PM10 (Cluster 3) and birch/plane-tree pollen with high total pollen count (Cluster 4). Compared with children in Cluster 1, children in Cluster 2 had significantly lower FEV1 and FVC levels, and children from Cluster 3 had higher FeNO levels. For FEV1 and FVC, the associations appeared stronger in children with current asthma. Additional analysis suggested a joint effect of grass pollen and air pollution on lung function. CONCLUSION Daily ambient chemical and biological air quality could adversely influence lung function in children.
Collapse
Affiliation(s)
- Hélène Amazouz
- CRESS, Inserm, INRAE, HERA Team, Université de Paris, Paris, France
| | - Nicolas Bougas
- CRESS, Inserm, INRAE, HERA Team, Université de Paris, Paris, France
| | - Michel Thibaudon
- Réseau National de Surveillance Aérobiologique (RNSA), Brussieu, France
| | - Guillaume Lezmi
- Service de Pneumologie et d'Allergologie Pédiatriques, Hôpital Necker-Enfants Malades, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Nicole Beydon
- Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires (EFR), Hôpital Armand-Trousseau, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Mélisande Bourgoin-Heck
- Service d'Allergologie Pédiatrique, Hôpital d'Enfants Armand-Trousseau, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Jocelyne Just
- Service d'Allergologie Pédiatrique, Hôpital d'Enfants Armand-Trousseau, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Isabelle Momas
- CRESS, Inserm, INRAE, HERA Team, Université de Paris, Paris, France
- Faculté de Pharmacie de Paris, Université de Paris, Paris, France
- Cellule Cohorte, Direction de l'Action Sociale de l'Enfance et de la Santé, Mairie de Paris, Paris, France
| | - Fanny Rancière
- CRESS, Inserm, INRAE, HERA Team, Université de Paris, Paris, France
- Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| |
Collapse
|
16
|
Carvalho-Oliveira R, Amato-Lourenço LF, Almeida PS, Garcia BBM, Vieira WKM, Santana A, Motta Godinho-Netto MC, Carretero ME, Nascimento Saldiva PH, Mauad T. Effects of long-standing exposure to heavy-duty diesel vehicle traffic on respiratory symptoms and airway inflammation in older adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 268:115893. [PMID: 33126158 DOI: 10.1016/j.envpol.2020.115893] [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: 06/25/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 06/11/2023]
Abstract
In the present study, we evaluated the effects of chronic exposure to traffic from a heavy-duty diesel-fueled vehicle area on respiratory symptoms and airway inflammation in a nonsmoking adult and elderly population. Respiratory symptoms were evaluated by the ISAAC questionnaire (International Study of Asthma and Allergies questionnaire), and airway inflammation was assessed by fractional exhaled nitric oxide (FeNO). Forty volunteers were selected from the 112 volunteers who completed the ISAAC questionnaire for the measurement of FeNO. The FeNO population comprised seven men (six aged ≥ 64 years old, four aged ≥ 75 years old) and 32 women (27 aged ≥ 64 years old, nine aged ≥ 75 years old). FeNO levels were tracked for six months, from November 2014 to June 2015. Results: Twenty-four percent of the volunteers reported having had wheezing in the chest in the last 12 months. However, only 2.7% of the volunteers reported doctor-diagnosed asthma. There was a positive association between FeNO and pollutants in most of the study months. An increase of 1 μg m-3 in NO2 was associated with a mean increase of 1.08 ppb in FeNO, and an increase of 1 μg m-3 in O3 was associated with a mean increase of 1.06 ppb in FeNO. The relative risk for NO2 ranged from 1.009 to 1.32 and that for O3 ranged from 1.014 to 1.020. Conclusion: The frequency of respiratory symptoms was much higher than the previously described levels of 6% in the Brazilian adult population. In summary, a high frequency of respiratory symptoms and high levels of FeNO were described in an underdiagnosed adult population living very close to a heavy-duty diesel-traffic area. Older elderly adults presented greater susceptibility to airway inflammation than younger adults.
Collapse
Affiliation(s)
- Regiani Carvalho-Oliveira
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil; National Institute for Integrated Analysis of Environmental Risk (INAIRA), Brazil.
| | | | - Pâmela S Almeida
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil; Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP), Brazil
| | - Bianca B M Garcia
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil; Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP), Brazil
| | - William K M Vieira
- Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP), Brazil
| | - Ariane Santana
- Instituto Federal de Educação, Ciência e Tecnologia de São Paulo (IFSP), Brazil
| | | | - Maria E Carretero
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil
| | - Paulo H Nascimento Saldiva
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil; National Institute for Integrated Analysis of Environmental Risk (INAIRA), Brazil
| | - Thais Mauad
- Pathology Department, School of Medicine at Sao Paulo University (FMUSP), Brazil; National Institute for Integrated Analysis of Environmental Risk (INAIRA), Brazil
| |
Collapse
|
17
|
DeMarco AL, Hardenbrook R, Rose J, Mendoza DL. Air Pollution-Related Health Impacts on Individuals Experiencing Homelessness: Environmental Justice and Health Vulnerability in Salt Lake County, Utah. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8413. [PMID: 33202942 PMCID: PMC7697557 DOI: 10.3390/ijerph17228413] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022]
Abstract
Experiences of homelessness, although widely varied, are characterized by extensive time in public spaces, often outdoors. However, there has been little empirical research about the ways in which environmental factors affect individuals experiencing homelessness (IEHs). Therefore, the purpose of this study was to use an environmental justice approach to understand how cardiopulmonary health of IEHs is affected by episodic poor air quality in Salt Lake County. It was hypothesized that people who had experienced unsheltered homelessness and those who had been experiencing homelessness for longer periods of time would report greater health difficulties from poor air quality exposure. Through a combination of in-person semistructured interviews with IEHs (n = 138) and access to corresponding state-based service provider databases, researchers examined both overall descriptives of and relationships between types (sheltered and unsheltered) and duration (chronic and nonchronic) of homelessness. More than 61% of IEHs reported physical reactions to air pollution, 37% reported air pollution-related emotional stress, and more than 89% had sought medical attention for a condition related to air pollution. Findings indicate that while IEHs report a number of health effects related to poor air quality, there were no significant differences between individuals based on either sheltered status or duration of their experiences of homelessness. This study provides an initial empirical inquiry to understand how environmental disamenities negatively influence IEHs, as well as noting that sheltered status and duration of homelessness are less impactful than originally hypothesized.
Collapse
Affiliation(s)
- Angelina L. DeMarco
- Department of Anthropology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Rebecca Hardenbrook
- Department of Mathematics, University of Utah, Salt Lake City, UT 84112, USA;
| | - Jeff Rose
- Department of Parks, Recreation, and Tourism, University of Utah, Salt Lake City, UT 84112, USA;
| | - Daniel L. Mendoza
- Department of City & Metropolitan Planning, University of Utah, Salt Lake City, UT 84112, USA
- Department of Atmospheric Sciences, University of Utah, Salt Lake City, UT 84112, USA
| |
Collapse
|
18
|
Mendoza DL, Pirozzi CS, Crosman ET, Liou TG, Zhang Y, Cleeves JJ, Bannister SC, Anderegg WRL, Robert P. Impact of low-level fine particulate matter and ozone exposure on absences in K-12 students and economic consequences. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:114052. [PMID: 36284641 PMCID: PMC9590406 DOI: 10.1088/1748-9326/abbf7a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
High air pollution levels are associated with school absences. However, low level pollution impacts on individual school absences are under-studied. Understanding the variability of pollution at individual schools within an urban region could improve school recess decisions, better identify local pollution sources, and improve local economic impact assessments by providing granular information relevant to specific schools. We modelled PM2.5 and ozone concentrations at 36 schools from July 2015 to June 2018 using data from a dense, research grade regulatory sensor network. We determined exposures and daily absences at each school. We used a generalized estimating equations model to retrospectively estimate rate ratios for association between outdoor pollutant concentrations and school absences. We estimated lost school revenue, productivity, and family economic burden. PM2.5 and ozone concentrations and absence rates vary across the School District. Pollution exposure was associated with a rate ratio as high as 1.02 absences per μg m-3 and 1.01 per ppb increase for PM2.5 and ozone, respectively. Significantly, even PM2.5 and ozone exposure below the air quality index breakpoints for good air quality (<12.1 μg m-3 and <55 ppb, respectively) was associated with positive rate ratios of absences: 1.04 per μg m-3 and 1.01 per ppb increase, respectively. Granular local measurements enabled demonstration of air pollution impacts that varied between schools and were undetectable with averaged pollution levels. Reducing pollution by 50% would save $426000 per year districtwide. Pollution reduction benefits would be greatest in schools located in socioeconomically disadvantaged areas. Heterogeneity in exposure, disproportionately affecting socioeconomically disadvantaged schools, points to the need for fine resolution exposure estimation. The economic cost of absences associated with air pollution is substantial even excluding indirect costs such as hospital visits and medication. These findings may help elucidate the differential burden on individual schools and inform local decisions about recess and regulatory considerations for localized pollution sources.
Collapse
Affiliation(s)
- Daniel L Mendoza
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, RM 819, Salt Lake City, UT 84112, United States of America
| | - Cheryl S Pirozzi
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
| | - Erik T Crosman
- Department of Life, Earth, and Environmental Sciences, West Texas A&M University, Happy State Bank Academic & Research Building, Suite 262, Canyon, TX 79016, United States of America
| | - Theodore G Liou
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
- Center for Quantitative Biology, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, United States of America
| | - Jessica J Cleeves
- Center for Science and Mathematics Education, University of Utah, 155 S 1452 E, RM 452, Salt Lake City, UT 84112, United States of America
| | - Stephen C Bannister
- Department of Economics, University of Utah, 260 Central Campus Drive, RM 4100, Salt Lake City, UT 84112, United States of America
| | - William R L Anderegg
- School of Biological Sciences, University of Utah, 257 S 1400 E, Salt Lake City, UT 84112, United States of America
| | - Paine Robert
- Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, School of Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, United States of America
| |
Collapse
|
19
|
Yeh KW, Chen CT, Lee PC, Huang JL, Yan DC, Chen LC, Lin SJ, Yao TC, Wu CD, Wan GH. Outdoor air pollutants exposure associated with pulmonary function and EBC pH value in atopic asthmatic and non-asthmatic children. J Asthma 2020; 58:1278-1284. [PMID: 32597339 DOI: 10.1080/02770903.2020.1788075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Air pollution is associated with the prevalence of respiratory diseases. This study aimed to evaluate the impacts of outdoor air pollutants and indoor Dermatophagoides pteronyssinus 1 (Der p 1) exposure on levels of fractional exhaled nitric oxide (FeNO), exhaled breath condensate (EBC) pH, and pulmonary function in atopic children. METHODS This study recruited 59 atopic mild-to-moderate asthmatic children and 23 atopic non-asthmatic children. Data on personal characteristics, FeNO, EBC pH, and pulmonary function were collected. Group 1 allergens of Der p 1 were measured on the tops of mattresses and on bedroom floors in the children's homes, and outdoor air pollutant concentrations were estimated from air quality monitoring stations, using the ordinary kriging method. RESULTS Exposure levels of outdoor air pollutants, except for particulate matter (PM)2.5, for the recruited children met outdoor air quality standards set by the Taiwan Environmental Protection Agency. The lag effect of outdoor PM10 exposure was negatively associated with the forced expiratory volume in one second (FEV1) [(Lag 1: β=-0.771, p = 0.028), and O3 (Lag 1-7: β=-2.02, p = 0.04, Lag 1-28: β=-3.213, p = 0.029)]. Median pulmonary function parameters differed significantly in forced vital capacity (FVC) (p = 0.004) and FEV1 (p = 0.024) values between atopic asthmatic and non-asthmatic children. No association was found between the FeNO/EBC pH level and exposure to Der p 1 allergen and air pollutants in the recruited children. CONCLUSIONS Outdoor PM10 and O3 exposure was associated with reduction in FEV1 in atopic asthmatic and non-asthmatic children.
Collapse
Affiliation(s)
- Kuo-Wei Yeh
- Department of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Tsung Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Chen Lee
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jing-Long Huang
- Department of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Dah-Chin Yan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Pediatrics, Division of Taipei Pediatrics, Children's Medical Center, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Respiratory Therapy, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Chen Chen
- Department of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Syh-Jae Lin
- Department of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Chieh Yao
- Department of Pediatrics, Division of Allergy, Asthma, and Rheumatology, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
| | - Gwo-Hwa Wan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.,Department of Obstetrics and Gynaecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| |
Collapse
|
20
|
He L, Cui X, Li Z, Teng Y, Barkjohn KK, Norris C, Fang L, Lin L, Wang Q, Zhou X, Hong J, Li F, Zhang Y, Schauer JJ, Black M, Bergin MH, Zhang JJ. Malondialdehyde in Nasal Fluid: A Biomarker for Monitoring Asthma Control in Relation to Air Pollution Exposure. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:11405-11413. [PMID: 32822160 DOI: 10.1021/acs.est.0c02558] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Fine particulate matter (PM2.5) and ozone (O3) may exert oxidative damage in the nose, which is hypothesized to be associated with worsened asthma symptoms. This study, hence, is to explore whether an oxidative stress biomarker, malondialdehyde (MDA) in the nasal fluid, has the potential to aid personalized asthma control. In a panel study of 43 asthmatic children, 5-13 years old, each child was measured 4 times with a 2-week interval between consecutive clinic visits. At each visit, nasal fluid and urine samples were collected, and fractional exhaled nitric oxide (FeNO) was measured as a biomarker of pulmonary inflammation. In addition to nasal MDA, urinary MDA and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured as biomarkers of systemic oxidative stress. We also assessed asthma symptoms using the Childhood Asthma-Control Test (C-ACT). We found that interquartile range (IQR) increases in 24 h average personal PM2.5 exposure (22.2-33.5 μg/m3), estimated 0 to 5 days prior to a clinic visit, were associated with increased nasal MDA concentrations by 38.6-54.9%. Similarly, IQR increases in 24 h average personal O3 exposure (7.7-8.2 ppb) estimated 2 to 4 days prior were associated with increased nasal MDA by 22.1-69.4%. Only increased PM2.5 exposure was associated with increased FeNO. Increased nasal MDA concentration was associated with decreased total and individual C-ACT scores, indicating worsening of asthma symptoms. However, no significant associations were observed between urinary MDA or 8-OHdG and C-ACT scores. The results confirm that oxidative stress plays an important role in linking air pollution exposure and adverse respiratory health effects. These findings support that MDA in the nasal fluid may serve as a useful biomarker for monitoring asthma status, especially in relation to PM2.5 and O3 exposures, two known risk factors of asthma exacerbation.
Collapse
Affiliation(s)
- Linchen He
- Nicholas School of the Environment, Duke University, Durham, North Carolina 27708, United States
- Global Health Institute, Duke University, Durham, North Carolina 27708, United States
| | - Xiaoxing Cui
- Nicholas School of the Environment, Duke University, Durham, North Carolina 27708, United States
| | - Zhen Li
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yanbo Teng
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province 215316, China
| | - Karoline K Barkjohn
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Christina Norris
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Lin Fang
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Lili Lin
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qian Wang
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xiaojian Zhou
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Feng Li
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - James J Schauer
- Department of Civil and Environmental Engineering, College of Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States
| | - Marilyn Black
- Underwriters Laboratories, Inc, Marietta, Georgia 30067, United States
| | - Michael H Bergin
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Junfeng Jim Zhang
- Nicholas School of the Environment, Duke University, Durham, North Carolina 27708, United States
- Global Health Institute, Duke University, Durham, North Carolina 27708, United States
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province 215316, China
| |
Collapse
|
21
|
Long A, Bunning B, Sampath V, DeKruyff RH, Nadeau KC. Epigenetics and the Environment in Airway Disease: Asthma and Allergic Rhinitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1253:153-181. [PMID: 32445095 DOI: 10.1007/978-981-15-3449-2_6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Asthma and rhinitis are complex, heterogeneous diseases characterized by chronic inflammation of the upper and lower airways. While genome-wide association studies (GWAS) have identified a number of susceptible loci and candidate genes associated with the pathogenesis of asthma and allergic rhinitis (AR), the risk-associated alleles account for only a very small percent of the genetic risk. In allergic airway and other complex diseases, it is thought that epigenetic modifications, including DNA methylation, histone modifications, and non-coding microRNAs, caused by complex interactions between the underlying genome and the environment may account for some of this "missing heritability" and may explain the high degree of plasticity in immune responses. In this chapter, we will focus on the current knowledge of classical epigenetic modifications, DNA methylation and histone modifications, and their potential role in asthma and AR. In particular, we will review epigenetic variations associated with maternal airway disease, demographics, environment, and non-specific associations. The role of specific genetic haplotypes in environmentally induced epigenetic changes are also discussed. A major limitation of many of the current studies of asthma epigenetics is that they evaluate epigenetic modifications in both allergic and non-allergic asthma, making it difficult to distinguish those epigenetic modifications that mediate allergic asthma from those that mediate non-allergic asthma. Additionally, most DNA methylation studies in asthma use peripheral or cord blood due to poor accessibility of airway cells or tissue. Unlike DNA sequences, epigenetic alterations are quite cell- and tissue-specific, and epigenetic changes found in airway tissue or cells may be discordant from that of circulating blood. These two confounding factors should be considered when reviewing epigenetic studies in allergic airway disease.
Collapse
Affiliation(s)
- Andrew Long
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, 94305, USA.,Department of Pharmacy, Lucile Packard Children's Hospital, Stanford, CA, 94304, USA
| | - Bryan Bunning
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, 94305, USA
| | - Vanitha Sampath
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, 94305, USA
| | - Rosemarie H DeKruyff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, 94305, USA
| | - Kari C Nadeau
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, 94305, USA.
| |
Collapse
|
22
|
Olaniyan T, Jeebhay M, Röösli M, Naidoo RN, Künzli N, de Hoogh K, Saucy A, Badpa M, Baatjies R, Parker B, Leaner J, Dalvie MA. The association between ambient NO 2 and PM 2.5 with the respiratory health of school children residing in informal settlements: A prospective cohort study. ENVIRONMENTAL RESEARCH 2020; 186:109606. [PMID: 32371276 DOI: 10.1016/j.envres.2020.109606] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/25/2020] [Accepted: 04/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND No previous epidemiological study has investigated the combined association of long-term ambient nitrogen dioxide (NO2) and particulate matter of diameter size-2.5 (PM2.5) exposure with asthma outcomes among schoolchildren in Africa. OBJECTIVES This study investigated the independent and co-pollutant association of long-term exposures to ambient air pollutants on asthma-associated outcomes in a cohort of schoolchildren in the Western Cape Province of South Africa. METHODS A total of 590 grade-4 schoolchildren residing in four informal settlements were studied. Spirometry and fractional exhaled nitric-oxide (FeNO) measurements were conducted, including a standardized questionnaire administered to caregivers at baseline and 12-months follow-up. Annual NO2 and PM2.5 levels were estimated for each child's home using land-use regression modelling. Single- and two-pollutant models were constructed to assess the independent and co-pollutant association of both air pollutants (NO2 and PM2.5) on new cases of asthma-associated outcomes adjusting-for host characteristics, indoor exposures and study area. RESULTS The annual average concentration of PM2.5 and NO2 were 10.01μg/m3 and 16.62μg/m3 respectively, across the four study areas, and were below the local Standards of 20μg/m3 and 40μg/m3, for both pollutants, respectively. In the two-pollutant-adjusted models, an interquartile range (IQR) increase of 14.2μg/m3 in NO2 was associated with an increased risk of new onset of ocular-nasal symptoms (adjusted odds ratio-aOR: 1.63, 95% CI: 1.01-2.60), wheezing (aOR: 3.57, 95% CI: 1.18-10.92), more than two or more asthma symptom score (aOR: 1.71, 95% CI: 1.02-2.86), and airway inflammation defined as FeNO > 35 ppb (aOR: 3.10, 95% CI: 1.10-8.71), independent of PM2.5 exposures. CONCLUSION This study provided evidence that ambient NO2 levels below local standards and international guidelines, independent of PM2.5 exposure, increases new cases of asthma-associated outcomes after 12-months.
Collapse
Affiliation(s)
- Toyib Olaniyan
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Mohamed Jeebhay
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Division of Occupational Medicine, University of Cape Town, Cape Town, South Africa.
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | | | - Nino Künzli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Apolline Saucy
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Mahnaz Badpa
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Roslynn Baatjies
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, 7700, South Africa.
| | - Bhawoodien Parker
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa.
| | - Joy Leaner
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa.
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|
23
|
Chen JH, Hu DT, Jia X, Niu W, Deng FR, Guo XB. [Monitoring metrics for short-term exposure to ambient ozone and pulmonary function and airway inflammation in healthy young adults]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:492-499. [PMID: 32541983 DOI: 10.19723/j.issn.1671-167x.2020.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the associations of different monitoring metrics for short-term exposure to ambient ozone (O3) with pulmonary function and airway inflammation in healthy young adults. METHODS A total of 97 healthy young college students were recruited and followed in a panel study conducted from December 2017 to June 2018. Each participant underwent 3 follow-up visits, and lung function and fractional exhaled nitric oxide (FeNO) were measured at each visit. Ambient air pollutant concentrations were obtained from the environment monitoring station of Beijing closest to the participant residences, and meteorological data were collected from China Meteorological Data Service Center. Linear mixed-effect models were applied to assess the associations between different monitoring metrics for ambient O3 short-term exposure with pulmonary function or airway inflammation in the healthy young adults. RESULTS During the study period, the P50 (P25, P75) values for ambient O3 concentration expressed as daily 1-hour maximum (O3-1 h max), daily maximum 8-hour average (O3-8 h max) and 24-hour average (O3-24 h avg) were 102.5 (76.8, 163.0) μg/m3, 91.1 (68.3, 154.3) μg/m3 and 61.6 (36.9, 81.7) μg/m3, respectively. The different monitoring metrics for short-term exposure to ambient O3 were significantly associated with reduced forced expiratory volume in the first second (FEV1) and increased FeNO. An interquartile range (IQR) increase in 6-d moving average of O3-1 h max (IQR=71.5 μg/m3) was associated with a 6.2% (95%CI: -11.8%, -0.5%) decrease in FEV1 and a 63.3% (95%CI: 13.8%, 134.3%) increase in FeNO. An IQR increase in 7-d moving average of O3-8 h max (IQR=62.0 μg/m3) was associated with a 6.2% (95%CI: -11.6%, -0.7%) decrease in FEV1and a 75.5% (95%CI: 19.3%, 158.0%) increase in FeNO. An IQR increase in 5-d moving average of O3-24 h avg (IQR=32.9 μg/m3) was associated with a 3.7% (95%CI: -7.1%, -0.2%) decrease in FEV1and a 25.3% (95%CI: 3.6%, 51.6%) increase in FeNO. There was no significant association between the three monitoring metrics for O3 exposure and peak expiratory flow (PEF). CONCLUSION Short-term exposure to ambient O3 was associated with decreased lung function and increased airway inflammation among the healthy young adults, and daily 1-hour maximum was more sensitively to the respiratory effects of O3.
Collapse
Affiliation(s)
- J H Chen
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - D T Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - X Jia
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - W Niu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - F R Deng
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - X B Guo
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| |
Collapse
|
24
|
Girguis MS, Li L, Lurmann F, Wu J, Breton C, Gilliland F, Stram D, Habre R. Exposure Measurement Error in Air Pollution Studies: The Impact of Shared, Multiplicative Measurement Error on Epidemiological Health Risk Estimates. AIR QUALITY, ATMOSPHERE, & HEALTH 2020; 13:631-643. [PMID: 32601528 PMCID: PMC7323995 DOI: 10.1007/s11869-020-00826-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/08/2020] [Indexed: 05/29/2023]
Abstract
Spatiotemporal air pollution models are increasingly being used to estimate health effects in epidemiological studies. Although such exposure prediction models typically result in improved spatial and temporal resolution of air pollution predictions, they remain subject to shared measurement error, a type of measurement error common in spatiotemporal exposure models which occurs when measurement error is not independent of exposures. A fundamental challenge of exposure measurement error in air pollution assessment is the strong correlation and sometimes identical (shared) error of exposure estimates across geographic space and time. When exposure estimates with shared measurement error are used to estimate health risk in epidemiological analyses, complex errors are potentially introduced, resulting in biased epidemiological conclusions. We demonstrate the influence of using a three-stage spatiotemporal exposure prediction model and introduce formal methods of shared, multiplicative measurement error (SMME) correction of epidemiological health risk estimates. Using our three-stage, ensemble learning based nitrogen oxides (NOx) exposure prediction model, we quantified SMME. We conducted an epidemiological analysis of wheeze risk in relation to NOx exposure among school-aged children. To demonstrate the incremental influence of exposure modeling stage, we iteratively estimated the health risk using assigned exposure predictions from each stage of the NOx model. We then determined the impact of SMME on the variance of the health risk estimates under various scenarios. Depending on the stage of the spatiotemporal exposure model used, we found that wheeze odds ratio ranged from 1.16 to 1.28 for an interquartile range increase in NOx. With each additional stage of exposure modeling, the health effect estimate moved further away from the null (OR=1). When corrected for observed SMME, the health effects confidence intervals slightly lengthened, but our epidemiological conclusions were not altered. When the variance estimate was corrected for the potential "worst case scenario" of SMME, the standard error further increased, having a meaningful influence on epidemiological conclusions. Our framework can be expanded and used to understand the implications of using exposure predictions subject to shared measurement error in future health investigations.
Collapse
Affiliation(s)
- Mariam S Girguis
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lianfa Li
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Jun Wu
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA
| | - Carrie Breton
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank Gilliland
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel Stram
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
25
|
Dimakopoulou K, Douros J, Samoli E, Karakatsani A, Rodopoulou S, Papakosta D, Grivas G, Tsilingiridis G, Mudway I, Moussiopoulos N, Katsouyanni K. Long-term exposure to ozone and children's respiratory health: Results from the RESPOZE study. ENVIRONMENTAL RESEARCH 2020; 182:109002. [PMID: 31855698 DOI: 10.1016/j.envres.2019.109002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Although there is evidence on the effects of short-term ozone (O3) exposures on children's respiratory health, few studies have reported results on the effects of long-term exposures. We report the effects of long-term exposure to O3 on respiratory health outcomes in 10-11-year old children. METHODS We conducted a panel study in a sample of the general population of school children in two cities with high average O3 concentrations, Athens and Thessaloniki, Greece. All 186 participating students were followed up intensively for 5 weeks spreading across a school year. Data was collected through questionnaires, weekly personal O3 measurements, spirometry, FeNO and time-activity diaries. Long-term O3 exposure was assessed using fixed site measurements and modeling, calibrated for personal exposures. The associations between measured lung function parameters and lung function growth over the study period, as well as FeNO and the occurrence of symptoms with long-term O3 exposure were assessed through the application of multiple mixed effects 2-level regression models, adjusting for confounders and for short-term exposures. RESULTS A 10 μg/m3 increase in calibrated long-term O3exposure, using measurements from fixed site monitors was associated with lower FVC and FEV1 by 17 mL (95% Confidence Interval: 5-28) and 13 mL (3-21) respectively and small decreases in lung growth: 0.008% (0.002-0.014%) for FVC and 0.006% (0.000-0.012%) in FEV1 over the study period. No association was observed with PEF, FeNO or the occurrence of symptoms. A similar pattern was observed when the exposure estimates from the dispersion models were employed. CONCLUSIONS Our study provides evidence that long-term O3 exposure is associated with reduced lung volumes and growth.
Collapse
Affiliation(s)
- Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece
| | - John Douros
- Laboratory of Heat Transfer and Environmental Engineering, Aristotle University of Thessaloniki, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece
| | - Anna Karakatsani
- 2nd Pulmonary Department, ATTIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece
| | - Despina Papakosta
- Pulmonary Department, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Grivas
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, 15236, Athens, Greece
| | - George Tsilingiridis
- Laboratory of Heat Transfer and Environmental Engineering, Aristotle University of Thessaloniki, Greece
| | - Ian Mudway
- MRC Centre for Environment and Health, School of Population Health & Environmental Sciences, King's College London, UK
| | - Nicholas Moussiopoulos
- Laboratory of Heat Transfer and Environmental Engineering, Aristotle University of Thessaloniki, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece; MRC Centre for Environment and Health, School of Population Health & Environmental Sciences, King's College London, UK.
| |
Collapse
|
26
|
Cakmak S, Kauri L, Mahmud M, Shutt R, Liu L, Rigden M, Kumarathasan P, Vincent R, Thomson EM, Dales R. Effect of industrial point-source air pollutants on fractional exhaled nitric oxide in healthy volunteers. ENVIRONMENTAL RESEARCH 2020; 181:108965. [PMID: 31796259 DOI: 10.1016/j.envres.2019.108965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 11/05/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Few studies have examined the effects of industrial, fixed-site sources of air pollution on lung inflammation in nearby residents. We investigated the effects of short-term exposure to ambient air near a steel plant on the fractional exhaled concentration of nitric oxide (FeNO), a measure of airway inflammation, in healthy volunteers. METHODS A cross-over study design was used. Fifty-nine non-smoking participants (mean age 24 years) were randomly assigned to each of two 5-day exposure scenarios: breathing ambient air adjacent to a steel plant or 5 km away at a college campus site. FeNO and on-site air pollutants were measured daily. Mixed effects linear regression models were used for data analysis, adjusting for sex, temperature, humidity and day of week. RESULTS Compared with the college site, PM 2.5, ultrafine PM, SO2, NO2 and CO levels were significantly greater near the steel plant. FeNO was 15.3% (95% CI, 6.6%, 24.8%) higher near the plant compared to the college site. CONCLUSIONS Exposure to ambient air near a steel plant was associated with increased airway inflammation as measured by exhaled nitric oxide.
Collapse
Affiliation(s)
- Sabit Cakmak
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Lisa Kauri
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Mamun Mahmud
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Robin Shutt
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Ling Liu
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Marc Rigden
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | | | - Renaud Vincent
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Canada
| | - Robert Dales
- Environmental Health Science and Research Bureau, Health Canada, Canada.
| |
Collapse
|
27
|
Zhao T, Markevych I, Standl M, Schikowski T, Berdel D, Koletzko S, Jörres RA, Nowak D, Heinrich J. Short-term exposure to ambient ozone and inflammatory biomarkers in cross-sectional studies of children and adolescents: Results of the GINIplus and LISA birth cohorts. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113264. [PMID: 31563778 DOI: 10.1016/j.envpol.2019.113264] [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: 07/16/2019] [Revised: 09/03/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND While exposure to ambient particulate matter (PM) and nitrogen dioxide (NO2) is thought to be associated with diseases via inflammatory response, the association between exposure to ozone, an oxidative pollutant, and inflammation has been less investigated. AIM We analyzed associations between short-term exposure to ozone and three inflammatory biomarkers among children and adolescents. METHODS These cross-sectional analyses were based on two follow-ups of the GINIplus and LISA German birth cohorts. We included 1330 10-year-old and 1591 15-year-old participants. Fractional exhaled nitric oxide (FeNO) and high-sensitivity C-reactive protein (hs-CRP) were available for both age groups while interleukin (IL)-6 was measured at 10 years only. Maximum 8-h averages of ozone and daily average concentrations of NO2 and PM with an aerodynamic diameter <10 μm (PM10) were adopted from two background monitoring stations 0 (same day), 1, 2, 3, 5, 7, 10 and 14 days prior to the FeNO measurement or blood sampling. To assess associations, we utilized linear regression models for FeNO, and logistic regressions for IL-6 and hs-CRP, adjusting for potential covariates and co-pollutants NO2 and PM10. RESULTS We found that short-term ozone exposure was robustly associated with higher FeNO in adolescents at age 15, but not at age 10. No consistent associations were observed between ozone and IL-6 in children aged 10 years. The relationship between hs-CRP levels and ozone was J-shaped. Relatively low ozone concentrations (e.g., <120 μg/m³) were associated with reduced hs-CRP levels, while high concentrations (e.g., ≥120 μg/m³) tended to be associated with elevated levels for both 10- and 15-year-old participants. CONCLUSIONS Our study demonstrates significant associations between short-term ozone exposure and FeNO at 15 years of age and a J-shaped relationship between ozone and hs-CRP. The finding indicates that high ozone exposure may favor inflammatory responses in adolescents, especially regarding airway inflammation.
Collapse
Affiliation(s)
- Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Sibylle Koletzko
- Department of Pediatrics, Dr. von Hauner Children's Hospital Munich, University Hospital, LMU Munich, Munich, Germany; Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland
| | - Rudolf A Jörres
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, Munich, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Comprehensive Pneumology Center (CPC) Munich, Member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
28
|
Rachel M, Biesiadecki M, Aebisher D, Galiniak S. Exhaled nitric oxide in pediatric patients with respiratory disease. J Breath Res 2019; 13:046007. [PMID: 31234165 DOI: 10.1088/1752-7163/ab2c3d] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Measurement of nitric oxide (NO) levels in exhaled air from the upper and lower airways is currently used as a non-invasive marker of inflammation in respiratory diseases. Assessment of NO exhaled from the lower air respiratory tract is considered to be a quick method for confirmation and control of asthma in patients as well as an estimation of treatment efficiency. The main aim of this study was to determine differences between levels of exhaled nitric oxide (fractional exhaled NO; FeNO) in patients with respiratory disease as measured by an electrochemical analyzer. Measurements were taken in 352 pediatric patients aged 4-17 with cystic fibrosis (CF) (n = 43), asthma (n = 69), allergic rhinitis (AR) (n = 70), asthma and AR (n = 128) and non-diseased children (n = 42) recruited from the Allergology Outpatient Department, Provincial Hospital No 2, Rzeszów. The second objective of this study was to assess any correlations between FeNO and clinical parameters of patients. The level of FeNO in patients with CF was normal when compared with control subjects (10.8 ± 2.9 versus 11.4 ± 6 ppb). We found significantly higher FeNO in patients with asthma (26.6 ± 15.3 ppb, p < 0.001), AR (18.4 ± 9.6 ppb, p < 0.01) as well as in patients with both asthma and AR (43.3 ± 31.1 ppb, p < 0.001) when compared to healthy children. Statistical analysis revealed a positive correlation between FeNO and age, height and weight of control subjects, and height in children with AR. FeNO was independent of sex, BMI, spirometry and blood results as well as the type of residence in control children and subjects with CF, asthma, AR and combined asthma and AR. In conclusion, we found normal levels of FeNO in children with CF and elevated levels in patients with asthma, AR and combined asthma and AR as compared to control subjects. Due to conflicting data, there is still a need for additional research, especially related to regarding factors that affect FeNO levels in respiratory disease.
Collapse
Affiliation(s)
- Marta Rachel
- Faculty of Medicine, University of Rzeszów, Warzywna 1, 35-315 Rzeszów, Poland. Allergology Outpatient Department, Provincial Hospital No 2, Lwowska 60, 35-301 Rzeszów, Poland
| | | | | | | |
Collapse
|
29
|
Guo H, Yang W, Jiang L, Lyu Y, Cheng T, Gao B, Li X. Association of short-term exposure to ambient air pollutants with exhaled nitric oxide in hospitalized patients with respiratory-system diseases. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 168:394-400. [PMID: 30396136 DOI: 10.1016/j.ecoenv.2018.10.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/21/2018] [Accepted: 10/24/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Previous studies have suggested that exposure to ambient air pollutants may adversely affect human health. However, few studies have examined the health effects of exposure to ambient air pollutants in hospitalized patients. OBJECTIVES To evaluate the association between short-term exposure to ambient air pollutants and exhaled nitric oxide fraction (FeNO) in a large cohort of hospitalized patients. METHODS FeNO was detected for 2986 hospitalized patients (ages 18-88 years). Daily average concentrations of SO2, NO2, O3, CO, PM2.5 and PM10 in 2014 and 2015 were obtained from nine fixed-site monitoring stations. Multiple linear regression models were chosen to assess the associations of exposure to ambient air pollutants with FeNO while adjusting for confounding variables. Lagged variable models were selected to determine the association between FeNO and ambient air pollutants concentrations with lags of up to 7 days prior to FeNO testing. RESULTS Interquartile-range (IQR) increases in the daily average SO2 (8.00 μg/m3) and PM2.5 (37.0 μg/m3) were strongly associated with increases in FeNO, with increases of 3.41% [95% confidence interval (CI), 0.94-5.93%] and 2.72% (95%CI, -0.09% to 5.61%), respectively. However, FeNO levels were not statistically associated with PM10, NO2, O3 or CO. In the two-pollutant models, the maximum correlation was for ambient SO2. We also found that FeNO was associated with IQR increases in daily average ambient concentrations of SO2 up to 3 and 4 days after the exposure events. CONCLUSIONS Short-term exposure to SO2 and PM2.5 were positively correlated with FeNO levels in hospitalized patients in Shanghai.
Collapse
Affiliation(s)
- Huibin Guo
- Department of Environmental Science & Engineering, Fudan University, Shanghai 200438, PR China
| | - Wenlan Yang
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Li Jiang
- Department of Environmental Science & Engineering, Fudan University, Shanghai 200438, PR China
| | - Yan Lyu
- Department of Environmental Science & Engineering, Fudan University, Shanghai 200438, PR China
| | - Tiantao Cheng
- Department of Environmental Science & Engineering, Fudan University, Shanghai 200438, PR China
| | - Beilan Gao
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Xiang Li
- Department of Environmental Science & Engineering, Fudan University, Shanghai 200438, PR China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, PR China.
| |
Collapse
|
30
|
Barański K, Zejda JE. Between-occasion repeatability of fractional exhaled nitric oxide measurements in children. ACTA ACUST UNITED AC 2019. [PMID: 29538544 PMCID: PMC6104541 DOI: 10.1590/s1806-37562017000000127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of the study was to assess short-term repeatability of measurements of fractional exhaled nitric oxide (FENO) and its correlates in children in the 6- to 9-year age bracket participating in a respiratory epidemiological survey. FENO was measured in two sessions one week apart in 101 children. Participants were divided into three groups: asymptomatic (n = 76); symptomatic (n = 14); and asthma (n = 11). Absolute and relative differences between the measurements, as well as concordance correlation coefficients, were used in order to assess repeatability. The two FENO measurements were strongly correlated (0.98). Although intragroup comparisons of the two measurements were not significantly different (p = 0.2), intergroup comparisons were. FENO measurements are reproducible in children in epidemiological settings.
Collapse
Affiliation(s)
- Kamil Barański
- . Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan E Zejda
- . Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
31
|
Dauchet L, Hulo S, Cherot-Kornobis N, Matran R, Amouyel P, Edmé JL, Giovannelli J. Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults. ENVIRONMENT INTERNATIONAL 2018; 121:610-619. [PMID: 30312964 DOI: 10.1016/j.envint.2018.09.036] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Air pollution impacts health by increasing mortality and the incidence of acute events in unhealthy individuals. In contrast, the acute effects of pollution in healthy individuals are less obvious. The present study was designed to evaluate the associations between short-term exposure to air pollution on one hand and lung function, and inflammatory markers on the other in middle-aged, non-smoking adults with no respiratory disease, in two urban areas in northern France. METHODS A sample of 1506 non-smoking adults (aged from 40 to 65) with no respiratory disease was selected from the participants in the 2011-2013 cross-sectional Enquête Littoral Souffle Air Biologie Environnement (ELISABET) survey in two urban areas in the northern France. We evaluated the associations between (i) mean levels of particulate matter with aerodynamic diameter < 10 μm (PM10), nitrogen dioxide (NO2) and ozone (O3) exposure on the day and the day before the study examination for each participant, and (ii) spirometry data and levels of inflammatory markers. Coefficients of multiple linear regression models were expressed (except for the forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio) as the percentage change [95% confidence interval] per 10 μg increment in each pollutant. RESULTS Levels of PM10, NO2 and O3 exposure were below or only close to the World Health Organization's recommended limits in our two study areas. An increment in NO2 levels was significantly associated with a lower FEV1/FVC ratio (-0.38 [-0.64; -0.12]), a lower forced expiratory flow between 25% and 75% of FVC (FEF25-75%) (-1.70 [-3.15; -0.23]), and a lower forced expiratory flow measured at 75% of FVC (FEF75%) (-3.07 [-4.92; -1.18]). An increment in PM10 levels was associated with lower FEF75% (-1.41 [-2.79; -0.01]) and a non-significant elevation in serum levels of high-sensitivity C-reactive protein (+3.48 [-0.25; 7.36], p = 0.07). Lastly, an increment in O3 levels was associated with a significantly higher blood eosinophil count (+2.41 [0.10; 4.77]) and a non-significant elevation in fractional exhaled nitric oxide (+2.93 [-0.16; 6.13], p = 0.06). CONCLUSION A short-term exposure to air pollution was associated with a subclinical decrement in distal lung function and increment in inflammatory markers in healthy inhabitants of two urban areas in France. If these exploratory results are confirmed, this could suggest that even moderate levels of air pollution could have an impact on respiratory health on the general population, and not solely on susceptible individuals.
Collapse
Affiliation(s)
- Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Sébastien Hulo
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Nathalie Cherot-Kornobis
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| | - Jean-Louis Edmé
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Jonathan Giovannelli
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
| |
Collapse
|
32
|
Guo H. Comparisons of combined oxidant capacity and redox-weighted oxidant capacity in their association with increasing levels of FeNO. CHEMOSPHERE 2018; 211:584-590. [PMID: 30096571 DOI: 10.1016/j.chemosphere.2018.07.191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Some ozone (O3) and nitrogen dioxides (NO2) health effects studies use Ox (sum value) as a surrogate. However, little is known about how this related to Oxwt (weighted value). OBJECTIVE We investigated the effects of redox-weighted oxidant capacity (Oxwt) on fractional exhaled nitric oxide (FeNO), a biomarker of airway inflammation, in a set of chronic obstructive pulmonary disease (COPD) patients. We also compare combined oxidant capacity (Ox) and Oxwt in their associations with increasing levels of FeNO. METHODS We measured FeNO values in 600 participants who have COPD at Shanghai Pulmonary Hospital. Ox was calculated directly by the sum of O3 and NO2. The redox-weighted oxidant capacity was calculated by denoting Oxwt as the weighted average of redox potentials. We applied generalized additive models (GAM) to investigate the impacts of Ox and Oxwt on FeNO levels, respectively. We fitted the same models for the influence of O3 and NO2 individually and jointly on FeNO levels to compare the result of Ox and Oxwt. RESULTS Oxwt were significantly linked with FeNO levels. The impact was robustest in current day after exposure, and were closely linked with the adjustment of PM2.5. A 10 μg m-3 increase in average Oxwt concentrations was linked to 0.88 (95% CI: -1.46, 3.28) increase, whereas a 10 μg m-3 increase in average Ox concentration was linked to 0.62 (95% CI: -0.79, 2.07) increase in FeNO. In two-pollutant models, an increase of 10 μg m-3 in average O3 concentrations with adjustment of NO2 was associated with 0.57 (95% CI: -1.26, 2.01) increase in FeNO. The impact estimates of Ox and Oxwt were statistically significant among males, non-smoking and elders who age above 65 years old. CONCLUSIONS This analysis demonstrated that Oxwt is used as a better indicator of atmospheric oxidative capacity as a proxy of O3 and NO2 in further epidemiological studies.
Collapse
Affiliation(s)
- Huibin Guo
- Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China.
| |
Collapse
|
33
|
Shang J, Khuzestani RB, Huang W, An J, Schauer JJ, Fang D, Cai T, Tian J, Yang S, Guo B, Zhang Y. Acute changes in a respiratory inflammation marker in guards following Beijing air pollution controls. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 624:1539-1549. [PMID: 29929263 DOI: 10.1016/j.scitotenv.2017.12.109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/06/2017] [Accepted: 12/11/2017] [Indexed: 05/21/2023]
Abstract
The adverse respiratory health effects of PM2.5 have been studied. However, the epidemiological evidence for the association of specific PM2.5 sources with health outcomes is still limited. This study investigated the association between PM2.5 components and sources with a biomarker of acute respiratory inflammation (FeNO) in guards. Personal exposure was estimated by microenvironment samplers and FeNO measurements were carried out before, during and after the Victory Day Military Parade in Beijing. Four sources were determined by factor analysis, including urban pollution, dust, alloy steel abrasion and toxic metals. A mixed-effect model was used to estimate the associations of FeNO with PM2.5 sources and chemical constituents, controlling for age, BMI, smoke activity, physical activity, waist circumference, temperature and relative humidity. In summary, large concentration decreases in PM2.5 concentration and PM2.5 chemical constituents were observed in both roadside and indoor environments during the air control periods, immediately followed by statistically significant decreases in FeNO of roadside guards and patrol guards. Besides, statistically significant increases in FeNO were found to be associated with interquartile range (IQR) increases in some pollutants, with an increase of 1.45ppb (95% CI: 0.69, 2.20), 0.65ppb (95% CI: 0.13, 1.17), 1.48ppb (95% CI: 0.60, 2.35), 0.82ppb (95% CI: 0.44, 1.20), 0.77ppb (95% CI: 0.42, 1.11) in FeNO for mass, sulfate, BC, Ca2+ and Sm, respectively. In addition, compared to alloy steel abrasion and toxic metals, urban pollution and dust factors were more associated with acute airway inflammation for highly-exposed populations.
Collapse
Affiliation(s)
- Jing Shang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Reza Bashiri Khuzestani
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Wei Huang
- Institute for Environmental Reference Materials of Ministry of Environmental Protection, Beijing, China
| | - Jianxiong An
- Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University, Beijing 100012, China
| | - James J Schauer
- Environmental Chemistry and Technology Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Dongqing Fang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tianqi Cai
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jingyu Tian
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Shujian Yang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bo Guo
- Shandong Key Laboratory of Water Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Shandong University, Shandong 250100, China
| | - Yuanxun Zhang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; CAS Center for Excellence in Regional Atmospheric Environment, Chinese Academy of Sciences, Xiamen, 361021, China; Huairou Eco-Environmental Observatory, Chinese Academy of Sciences, Beijing, 101408, China.
| |
Collapse
|
34
|
Clifford S, Mazaheri M, Salimi F, Ezz WN, Yeganeh B, Low-Choy S, Walker K, Mengersen K, Marks GB, Morawska L. Effects of exposure to ambient ultrafine particles on respiratory health and systemic inflammation in children. ENVIRONMENT INTERNATIONAL 2018. [PMID: 29514111 DOI: 10.1016/j.envint.2018.02.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
It is known that ultrafine particles (UFP, particles smaller than 0.1 μm) can penetrate deep into the lungs and potentially have adverse health effects. However, epidemiological data on the health effects of UFP is limited. Therefore, our objective was to test the hypothesis that exposure to UFPs is associated with respiratory health status and systemic inflammation among children aged 8 to 11 years. We conducted a cross-sectional study among 655 children (43.3% male) attending 25 primary (elementary) schools in the Brisbane Metropolitan Area, Australia. Ultrafine particle number concentration (PNC) was measured at each school and modelled at homes using Land Use Regression to derive exposure estimates. Health outcomes were respiratory symptoms and diagnoses, measured by parent-completed questionnaire, spirometric lung function, exhaled nitric oxide (FeNO), and serum C reactive protein (CRP). Exposure-response models, adjusted for potential personal and environmental confounders measured at the individual, home and school level, were fitted using Bayesian methods. PNC was not independently associated with respiratory symptoms, asthma diagnosis or spirometric lung function. However, PNC was positively associated with an increase in CRP (1.188-fold change per 1000 UFP cm-3 day/day (95% credible interval 1.077 to 1.299)) and an increase in FeNO among atopic participants (1.054 fold change per 1000 UFP cm-3 day/day (95% CrI 1.005 to 1.106)). UFPs do not affect respiratory health outcomes in children but do have systemic effects, detected here in the form of a positive association with a biomarker for systemic inflammation. This is consistent with the known propensity of UFPs to penetrate deep into the lung and circulatory system.
Collapse
Affiliation(s)
- Sam Clifford
- International Laboratory for Air Quality and Health, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Brisbane, Australia
| | - Mandana Mazaheri
- International Laboratory for Air Quality and Health, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Farhad Salimi
- University Centre for Rural Health - North Coast, School of Public Health, University of Sydney, Australia; Menzies Institute for Medical Research, University of Tasmania, Australia; Centre for Air quality and health Research and evaluation (NHMRC Centre of Research Excellence), Australia
| | - Wafaa Nabil Ezz
- Woolcock Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Bijan Yeganeh
- International Laboratory for Air Quality and Health, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Centre for Air quality and health Research and evaluation (NHMRC Centre of Research Excellence), Australia
| | - Samantha Low-Choy
- Griffith Social & Behavioural Research College, Griffith University, Mt Gravatt, Queensland, Australia
| | | | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Brisbane, Australia
| | - Guy B Marks
- Centre for Air quality and health Research and evaluation (NHMRC Centre of Research Excellence), Australia; Woolcock Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
| |
Collapse
|
35
|
Relationship of Meteorological and Air Pollution Parameters with Pneumonia in Elderly Patients. Emerg Med Int 2018; 2018:4183203. [PMID: 29755789 PMCID: PMC5884022 DOI: 10.1155/2018/4183203] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 02/18/2018] [Indexed: 12/14/2022] Open
Abstract
Background and Purpose In this study, we aimed to evaluate the relationship between pneumonia and meteorological parameters (temperature, humidity, precipitation, airborne particles, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), nitrite oxide (NO), and nitric oxide (NOX)) in patients with the diagnosis of pneumonia in the emergency department. Methods Our study was performed retrospectively with patients over 65 years of age who were diagnosed with pneumonia. The meteorological variables in the days of diagnosing pneumonia were compared with the meteorological variables in the days without diagnosis of pneumonia. The sociodemographic characteristics, complete blood count of the patients, and meteorological parameters (temperature, humidity, precipitation, airborne particles, SO2, CO, NO2, NO, and NOX) were investigated. Results When the temperature was high and low, the number of days consulted due to pneumonia was related to low air temperature (p < 0.05). During the periods when PM 10, NO, NO2, NOX, and CO levels were high, the number of days referred for pneumonia was increased (p < 0.05). Conclusion As a result, climatic (temperature, humidity, pressure levels, rain, etc.) and environmental factors (airborne particles, CO, NO, and NOX) were found to be effective in the number of patients admitted to the hospital due to pneumonia.
Collapse
|
36
|
Mentz G, Robins TG, Batterman S, Naidoo RN. Acute respiratory symptoms associated with short term fluctuations in ambient pollutants among schoolchildren in Durban, South Africa. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 233:529-539. [PMID: 29102883 PMCID: PMC5764788 DOI: 10.1016/j.envpol.2017.10.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 05/10/2023]
Abstract
Ambient air pollution has been associated with adverse respiratory outcomes, especially among children with asthma. This study reports on associations between daily ambient air pollutant concentrations and the respiratory symptoms of schoolchildren living in Durban, South Africa. This city is Africa's busiest port and a key hub for imported crude oil and exported refined petroleum and petrochemical products, and it experiences a mixture of air pollutants that reflects emissions from industry, traffic and biomass burning. Children in four communities in the highly industrialized southern portion of the city were compared to children of similar socio-economic profiles living in the north of the city. One school was selected in each community. A total of 423 children were recruited. Symptom logs were completed every 1.5-2 h over 3-week period in each of four seasons. Ambient concentrations of NO2, NO, SO2, CO, O3, PM2.5 and PM10 were measured throughout the study. Generalized estimating equation (GEE) models were used to estimate odds ratios (ORs) and assess lag effects (1-5 days) using single pollutant (single lags or distributed lags) models. Concentrations of SO2 and NOx were markedly higher in the south, while PM10 did not vary. Significant increase in the odds ratios of cough were identified for the various lags analyzed. The OR of symptoms was further increased among those living in the south compared to the north. In conclusion, in this analysis of over 70,000 observations, we provide further evidence that exposure to PM10, SO2, NO2 and NO is associated with significantly increased occurrence of respiratory symptoms among children. This was evident for cough, shortness of breath, and chest tightness, across the four pollutants and for different lags of exposure. This is the first study describing these changes in sub-Saharan Africa.
Collapse
Affiliation(s)
- Graciela Mentz
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Thomas G Robins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Room 321, George Campbell Building, Durban, 4041, South Africa.
| |
Collapse
|
37
|
Li H, Wu S, Pan L, Xu J, Shan J, Yang X, Dong W, Deng F, Chen Y, Shima M, Guo X. Short-term effects of various ozone metrics on cardiopulmonary function in chronic obstructive pulmonary disease patients: Results from a panel study in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 232:358-366. [PMID: 28987568 DOI: 10.1016/j.envpol.2017.09.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/09/2017] [Accepted: 09/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Short-term exposure to ambient air pollution has been associated with lower pulmonary function and higher blood pressure (BP). However, controversy remains regarding the relationship between ambient multiple daily ozone (O3) metrics and cardiopulmonary health outcomes, especially in the developing countries. OBJECTIVES To investigate and compare the short-term effects of various O3 metrics on pulmonary function, fractional exhaled nitric oxide (FeNO) and BP in a panel study of COPD patients. METHODS We measured pulmonary function, FeNO and BP repeatedly in a total of 43 patients with COPD for 215 home visits. Daily hourly ambient O3 concentrations were obtained from central-monitoring stations close to subject residences. We calculated various O3 metrics [daily 1-h maximum (O3-1 h max), maximum 8-h average (O3-8 h max) and 24-h average (O3-24 h avg)] based on the hourly data. Daily indoor O3 concentrations were estimated based on estimated indoor/outdoor O3 ratios. Linear mixed-effects models were used to estimate associations of various O3 metrics with cardiopulmonary function variables. RESULTS An interquartile range (IQR) increase in ambient O3-8 h max (80.5 μg/m3, 5-d) was associated with a 5.9% (95%CI: -11.0%, -0.7%) reduction in forced expiratory volume in 1 s (FEV1) and a 6.2% (95%CI: -10.9%, -1.5%) reduction in peak expiratory flow (PEF). However, there were no significant negative associations between ambient O3-1 h max, O3-24 h avg and FEV1, PEF. An IQR increase in ambient O3-1 h max (85.3 μg/m3, 6-d) was associated with a 6.7 mmHg (95%CI: 0.7, 12.7) increase in systolic BP. The estimated indoor O3 were still significantly associated with reduction of FEV1 and PEF. No significant associations were found between various O3 metrics and FeNO. CONCLUSIONS Our results provide clues for the adverse cardiopulmonary effects associated with various O3 metrics in COPD patients and highlight that O3-8 h max was more closely associated with respiratory health variables.
Collapse
Affiliation(s)
- Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Lu Pan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Jiao Shan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Yahong Chen
- Respiratory Department, Peking University Third Hospital, Beijing, China
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
38
|
Alves AGF, de Azevedo Giacomin MF, Braga ALF, Sallum AME, Pereira LAA, Farhat LC, Strufaldi FL, de Faria Coimbra Lichtenfels AJ, de Santana Carvalho T, Nakagawa NK, Silva CA, Farhat SCL. Influence of air pollution on airway inflammation and disease activity in childhood-systemic lupus erythematosus. Clin Rheumatol 2017; 37:683-690. [PMID: 29098476 DOI: 10.1007/s10067-017-3893-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/14/2017] [Accepted: 10/24/2017] [Indexed: 02/06/2023]
Abstract
Exposure to fine particles may trigger pulmonary inflammation/systemic inflammation. The objective of this study was to investigate the association between daily individual exposure to air pollutants and airway inflammation and disease activity in childhood-onset systemic lupus erythematosus (cSLE) patients. A longitudinal panel study was carried out in 108 consecutive appointments with cSLE patients without respiratory diseases. Over four consecutive weeks, daily individual measures of nitrogen dioxide (NO2), fine particulate matter (PM2.5), ambient temperature, and humidity were obtained. This cycle was repeated every 2.5 months along 1 year, and cytokines of exhaled breath condensate-EBC [interleukins (IL) 6, 8, 17 and tumoral necrose factor-α (TNF-α)], fractional exhaled NO (FeNO), and disease activity parameters were collected weekly. Specific generalized estimation equation models were used to assess the impact of these pollutants on the risk of Systemic Lupus Erythematous Disease Activity Index 2000 (SLEDAI-2K) ≥ 8, EBC cytokines, and FeNO, considering the fixed effects for repetitive measurements. The models were adjusted for inflammatory indicators, body mass index, infections, medication, and weather variables. An IQR increase in PM2.5 4-day moving average (18.12 μg/m3) was associated with an increase of 0.05 pg/ml (95% CI 0.01; 0.09, p = 0.03) and 0.04 pg/ml (95% CI 0.02; 0.06, p = 0.01) in IL-17 and TNF-α EBC levels, respectively. Additionally, a short-term effect on FeNO was observed: the PM2.5 3-day moving average was associated with a 0.75 ppb increase (95% CI 0.38; 1.29, p = 0.03) in FeNO. Also, an increase of 1.47 (95% CI 1.10; 1.84) in the risk of SLEDAI-2K ≥ 8 was associated with PM2.5 7-day moving average. Exposure to inhalable fine particles increases airway inflammation/pulmonary and then systemic inflammation in cSLE patients.
Collapse
Affiliation(s)
- Andressa Guariento Ferreira Alves
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Pediatric Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Maria Fernanda de Azevedo Giacomin
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Pediatric Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Alfésio Luis Ferreira Braga
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Experimental Air Pollution, LIM05, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Santos, Brazil
| | - Adriana Maluf Elias Sallum
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Pediatric Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Luiz Alberto Amador Pereira
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratory of Experimental Air Pollution, LIM05, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Santos, Brazil
| | - Luis Carlos Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fernando Louzada Strufaldi
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana Julia de Faria Coimbra Lichtenfels
- Laboratory of Experimental Air Pollution, LIM05, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
- Laboratory of Experimental Therapeutics, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - Tômas de Santana Carvalho
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - Naomi Kondo Nakagawa
- Laboratory of Experimental Air Pollution, LIM05, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - Clovis Artur Silva
- Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Pediatric Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - Sylvia Costa Lima Farhat
- Pediatric Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
- Laboratory of Experimental Air Pollution, LIM05, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil.
| |
Collapse
|
39
|
Zhang Y, Salam MT, Berhane K, Eckel SP, Rappaport EB, Linn WS, Habre R, Bastain TM, Gilliland FD. Genetic and epigenetic susceptibility of airway inflammation to PM 2.5 in school children: new insights from quantile regression. Environ Health 2017; 16:88. [PMID: 28821285 PMCID: PMC5563051 DOI: 10.1186/s12940-017-0285-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 07/11/2017] [Indexed: 05/16/2023]
Abstract
BACKGROUND The fractional concentration of exhaled nitric oxide (FeNO) is a biomarker of airway inflammation that has proved to be useful in investigations of genetic and epigenetic airway susceptibility to ambient air pollutants. For example, susceptibility to airway inflammation from exposure to particulate matter with aerodynamic diameter < =2.5 μm (PM2.5) varies by haplotypes and promoter region methylation in inducible nitric oxide synthase (iNOS encoded by NOS2). We hypothesized that PM2.5 susceptibility associated with these epigenetic and genetic variants may be greater in children with high FeNO from inflamed airways. In this study, we investigated genetic and epigenetic susceptibility to airborne particulate matter by examining whether the joint effects of PM2.5, NOS2 haplotypes and iNOS promoter methylation significantly vary across the distribution of FeNO in school children. METHODS The study included 940 school children in the southern California Children's Health Study who provided concurrent buccal samples and FeNO measurements. We used quantile regression to examine susceptibility by estimating the quantile-specific joint effects of PM2.5, NOS2 haplotype and methylation on FeNO. RESULTS We discovered striking differences in susceptibility to PM2.5 in school children. The joint effects of short-term PM2.5 exposure, NOS2 haplotypes and methylation across the FeNO distribution were significantly larger in the upper tail of the FeNO distribution, with little association in its lower tail, especially among children with asthma and Hispanic white children. CONCLUSION School-aged children with higher FeNO have greater genetic and epigenetic susceptibility to PM2.5, highlighting the importance of investigating effects across the entire distribution of FeNO.
Collapse
Affiliation(s)
- Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84018 USA
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT USA
- Veteran Affairs Salt Lake City Health Care System, Salt Lake City, UT USA
| | - Muhammad T. Salam
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
- Department of Psychiatry, Kern Medical, Bakersfield, CA USA
| | - Kiros Berhane
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Sandrah P. Eckel
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Edward B. Rappaport
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - William S. Linn
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Rima Habre
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Theresa M. Bastain
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Frank D. Gilliland
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| |
Collapse
|
40
|
Acute effects of ambient temperature and particulate air pollution on fractional exhaled nitric oxide: A panel study among diabetic patients in Shanghai, China. J Epidemiol 2017. [PMID: 28645522 PMCID: PMC5623015 DOI: 10.1016/j.je.2017.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Epidemiological studies have shown the associations of ambient temperature and particulate matter (PM) air pollution with respiratory morbidity and mortality. However, the underlying mechanisms have not been well characterized. The aim of this study is to investigate the associations of temperature and fine and coarse PM with fractional exhaled nitric oxide (FeNO), a well-established biomarker of respiratory inflammation. Methods We conducted a longitudinal panel study involving six repeated FeNO tests among 33 type 2 diabetes mellitus patients from April to June 2013 in Shanghai, China. Hourly temperature and PM concentrations were obtained from a nearby fixed-site monitoring station. We then explored the associations between temperature, PM, and FeNO using linear mixed-effect models incorporated with distributed lag nonlinear models for the lagged and nonlinear associations. The interactions between temperature and PM were evaluated using stratification analyses. Results We found that both low and high temperature, as well as increased fine and coarse PM, were significantly associated with FeNO. The cumulative relative risk of FeNO was 1.75% (95% confidence interval [CI], 1.04–2.94) comparing 15 °C to the referent temperature (24 °C) over lags 0–9 days. A 10 μg/m3 increase in fine and coarse PM concentrations were associated with 1.18% (95% CI, 0.18–2.20) and 1.85% (95% CI, 0.62–3.09) FeNO in lag 0–1 days, respectively. PM had stronger effects on cool days than on warm days. Conclusions This study suggested low ambient temperature, fine PM, and coarse PM might elevate the levels of respiratory inflammation. Our findings may help understand the epidemiological evidence linking temperature, particulate air pollution, and respiratory health. Both low and high temperatures were significantly associated with FeNO. The increases of fine and coarse PM concentrations were associated with FeNO. Both fine and coarse PM had stronger effects in cool days.
Collapse
|
41
|
Yoda Y, Takagi H, Wakamatsu J, Ito T, Nakatsubo R, Horie Y, Hiraki T, Shima M. Acute effects of air pollutants on pulmonary function among students: a panel study in an isolated island. Environ Health Prev Med 2017; 22:33. [PMID: 29165154 PMCID: PMC5664589 DOI: 10.1186/s12199-017-0646-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/20/2017] [Indexed: 11/23/2022] Open
Abstract
Background Many epidemiological studies on the health effects of air pollutants have been carried out in regions with major sources such as factories and automobiles. However, the health effects of air pollutants in regions without major sources remain unclear. This study investigated the acute effects of ambient air pollution on pulmonary function among healthy students in an isolated island without major artificial sources of air pollutants. Methods A panel study was conducted of 43 healthy subjects who attended a school in an isolated island in the Seto Inland Sea, Japan. We measured the forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) every morning for about 1 month in May 2014. Ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5), particulate matter between 2.5 and 10 μm in diameter (PM10-2.5), black carbon (BC), ozone (O3), and nitrogen dioxide (NO2) were measured. The associations between the concentrations of air pollutants and pulmonary function were analyzed using mixed-effects models. Results A decrease in FEV1 was significantly associated with BC concentrations (−27.28 mL [95%confidence interval (CI):−54.10,−0.46] for an interquartile range (IQR) increase of 0.23 μg/m3). The decrease in PEF was significantly associated with indoor O3 concentrations (−8.03 L/min [95% CI:−13.02,−3.03] for an IQR increase of 11 ppb). Among subjects with a history of allergy, an increase in PM2.5 concentrations was significantly associated with low FEV1. In subjects with a history of asthma, an inverse association between the indoor O3 concentration and pulmonary function was observed. Conclusions Our results demonstrate that increases in BC and O3 concentrations have acute effects on the pulmonary function among students in an isolated island without major artificial sources of air pollutants. Electronic supplementary material The online version of this article (doi:10.1186/s12199-017-0646-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yoshiko Yoda
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hiroshi Takagi
- National Institute of Technology, Yuge College, Kamijima, Ehime, Japan
| | - Junko Wakamatsu
- National Institute of Technology, Yuge College, Kamijima, Ehime, Japan
| | - Takeshi Ito
- National Institute of Technology, Yuge College, Kamijima, Ehime, Japan
| | - Ryouhei Nakatsubo
- Hyogo Prefectural Institute of Environmental Sciences, Kobe, Hyogo, Japan
| | - Yosuke Horie
- Hyogo Prefectural Institute of Environmental Sciences, Kobe, Hyogo, Japan
| | - Takatoshi Hiraki
- Hyogo Prefectural Institute of Environmental Sciences, Kobe, Hyogo, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| |
Collapse
|
42
|
Grivas G, Dimakopoulou K, Samoli E, Papakosta D, Karakatsani A, Katsouyanni K, Chaloulakou A. Ozone exposure assessment for children in Greece - Results from the RESPOZE study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 581-582:518-529. [PMID: 28062110 DOI: 10.1016/j.scitotenv.2016.12.159] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/23/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
Ozone exposure of 179 children in Athens and Thessaloniki, Greece was assessed during 2013-2014, by repeated weekly personal measurements, using passive samplers. O3 was also monitored at school locations of participants to characterize community-level ambient exposure. Average personal concentrations in the two cities (5.0 and 2.8ppb in Athens and Thessaloniki, respectively) were considerably lower than ambient concentrations (with mean personal/ambient ratios of 0.13-0.15). The temporal variation of personal concentrations followed the -typical for low-latitude areas- pattern of cold-warm seasons. However, differences were detected between temporal distributions of personal and ambient concentrations, since personal exposures were affected by additional factors which present seasonal variability, such as outdoor activity and house ventilation. Significant spatial contrasts were observed between urban and suburban areas, for personal concentrations in Athens, with higher exposure for children residing in the N-NE part of the area. In Thessaloniki, spatial variations in personal concentrations were less pronounced, echoing the spatial pattern of ambient concentrations, a result of complex local meteorology and the smaller geographical expansion of the study area. Ambient concentration was identified as the most important factor influencing personal exposures (correlation coefficients between 0.36 and 0.67). Associations appeared to be stronger with ambient concentrations measured at school locations of children, than to those reported by the nearest site of the air quality monitoring network, indicating the importance of community-representative outdoor monitoring for characterization of personal-ambient relationships. Time spent outdoors by children was limited (>90% of the time they remained indoors), but -due to the lack of indoor sources- it was found to exert significant influence on personal concentrations, affecting inter-subject and spatiotemporal variability. Additional parameters that were identified as relevant for the determination of personal concentrations were indoor ventilation conditions (specifically indoor times with windows open) and the use of wood-burning in open fireplaces for heating as an ozone sink.
Collapse
Affiliation(s)
- Georgios Grivas
- School of Chemical Engineering, National Technical University of Athens, GR 15780, Greece.
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, 75, Mikras Asias Street, 115 27 Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, 75, Mikras Asias Street, 115 27 Athens, Greece
| | - Despina Papakosta
- Pulmonary Department, G. Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna Karakatsani
- 2nd Pulmonary Department, "ATTIKON" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, 75, Mikras Asias Street, 115 27 Athens, Greece; Department of Primary Care & Public Health Sciences and MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | | |
Collapse
|
43
|
Usemann J, Fuchs O, Anagnostopoulou P, Korten I, Gorlanova O, Röösli M, Latzin P, Frey U. Predictive value of exhaled nitric oxide in healthy infants for asthma at school age. Eur Respir J 2016; 48:925-8. [PMID: 27390276 DOI: 10.1183/13993003.00439-2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/12/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Oliver Fuchs
- University Children's Hospital Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany Comprehensive Pneumology Centre Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Pinelopi Anagnostopoulou
- Division of Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Insa Korten
- University Children's Hospital Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland University of Basel, Basel, Switzerland
| | - Philipp Latzin
- University Children's Hospital Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Dept of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel (UKBB), Basel, Switzerland
| |
Collapse
|
44
|
Chen Z, Salam MT, Toledo-Corral C, Watanabe RM, Xiang AH, Buchanan TA, Habre R, Bastain TM, Lurmann F, Wilson JP, Trigo E, Gilliland FD. Ambient Air Pollutants Have Adverse Effects on Insulin and Glucose Homeostasis in Mexican Americans. Diabetes Care 2016; 39:547-54. [PMID: 26868440 PMCID: PMC4806768 DOI: 10.2337/dc15-1795] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/04/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Recent studies suggest that air pollution plays a role in type 2 diabetes (T2D) incidence and mortality. The underlying physiological mechanisms have yet to be established. We hypothesized that air pollution adversely affects insulin sensitivity and secretion and serum lipid levels. RESEARCH DESIGN AND METHODS Participants were selected from BetaGene (n = 1,023), a study of insulin resistance and pancreatic β-cell function in Mexican Americans. All participants underwent DXA and oral and intravenous glucose tolerance tests and completed dietary and physical activity questionnaires. Ambient air pollutant concentrations (NO2, O3, and PM2.5) for short- and long-term periods were assigned by spatial interpolation (maximum interpolation radius of 50 km) of data from air quality monitors. Traffic-related air pollution from freeways (TRAP) was estimated using the dispersion model as NOx. Variance component models were used to analyze individual and multiple air pollutant associations with metabolic traits. RESULTS Short-term (up to 58 days cumulative lagged averages) exposure to PM2.5 was associated with lower insulin sensitivity and HDL-to-LDL cholesterol ratio and higher fasting glucose and insulin, HOMA-IR, total cholesterol, and LDL cholesterol (LDL-C) (all P ≤ 0.036). Annual average PM2.5 was associated with higher fasting glucose, HOMA-IR, and LDL-C (P ≤ 0.043). The effects of short-term PM2.5 exposure on insulin sensitivity were largest among obese participants. No statistically significant associations were found between TRAP and metabolic outcomes. CONCLUSIONS Exposure to ambient air pollutants adversely affects glucose tolerance, insulin sensitivity, and blood lipid concentrations. Our findings suggest that ambient air pollutants may contribute to the pathophysiology in the development of T2D and related sequelae.
Collapse
Affiliation(s)
- Zhanghua Chen
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Muhammad T Salam
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Psychiatry, Kern Medical Center, Bakersfield, CA
| | - Claudia Toledo-Corral
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Public Health, California State University, Los Angeles, CA
| | - Richard M Watanabe
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Physiology and Biophysics, Keck School of Medicine of the University of Southern California, Los Angeles, CA Diabetes and Obesity Research Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Thomas A Buchanan
- Department of Physiology and Biophysics, Keck School of Medicine of the University of Southern California, Los Angeles, CA Diabetes and Obesity Research Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA Division of Diabetes and Endocrinology, Department of Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Rima Habre
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Theresa M Bastain
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | | | - John P Wilson
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA
| | - Enrique Trigo
- Division of Diabetes and Endocrinology, Department of Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Frank D Gilliland
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| |
Collapse
|
45
|
Inducible Nitric Oxide Synthase Promoter Haplotypes and Residential Traffic-Related Air Pollution Jointly Influence Exhaled Nitric Oxide Level in Children. PLoS One 2015; 10:e0145363. [PMID: 26714306 PMCID: PMC4695093 DOI: 10.1371/journal.pone.0145363] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/01/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Exhaled nitric oxide (FeNO), a biomarker of airway inflammation, predicts asthma risk in children. We previously found that the promoter haplotypes in inducible nitric oxide synthase (NOS2) and exposure to residential traffic independently influence FeNO level. Because NOS2 is inducible by environmental exposures such as traffic-related exposure, we tested the hypothesis that common NOS2 promoter haplotypes modulate the relationship between residential traffic-related exposure and FeNO level in children. METHODS In a cross-sectional population-based study, subjects (N = 2,457; 7-11 year-old) were Hispanic and non-Hispanic white children who participated in the Southern California Children's Health Study and had FeNO measurements. For residential traffic, lengths of local roads within circular buffers (50m, 100m and 200m radii around homes) around the subjects' homes were estimated using geographic information system (GIS) methods. We interrogated the two most common NOS2 promoter haplotypes that were found to affect FeNO level. RESULTS The relationship between local road lengths within 100m and 200m circular buffers and FeNO level varied significantly by one of the NOS2 promoter haplotypes (P-values for interaction between road length and NOS2 promoter haplotype = 0.02 and 0.03, respectively). In children who had ≤250m of local road lengths within 100m buffer around their homes, those with two copies of the haplotype had significantly lower FeNO (adjusted geometric mean = 11.74ppb; 95% confidence intervals (CI): 9.99 to 13.80) than those with no copies (adjusted geometric mean = 15.28ppb; 95% CI: 14.04 to 16.63) with statistically significant trend of lower FeNO level with increasing number of haplotype copy (P-value for trend = 0.002). In contrast, among children who had >250m of local road lengths within 100m buffer, FeNO level did not significantly differ by the haplotype copy-number (P-value for trend = 0.34). Similar interactive effects of this haplotype and local road lengths within 200m buffer on FeNO were also observed. CONCLUSIONS Higher exposure from residential traffic nullifies the protective effect of one common NOS2 promoter haplotype on FeNO level. Regulation of traffic-related pollution may protect children's respiratory health.
Collapse
|
46
|
Chemical Composition of Indoor and Outdoor PM2.5 in Three Schools in the City of Rome. ATMOSPHERE 2015. [DOI: 10.3390/atmos6101422] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Chen R, Zhao A, Chen H, Zhao Z, Cai J, Wang C, Yang C, Li H, Xu X, Ha S, Li T, Kan H. Cardiopulmonary benefits of reducing indoor particles of outdoor origin: a randomized, double-blind crossover trial of air purifiers. J Am Coll Cardiol 2015; 65:2279-87. [PMID: 26022815 DOI: 10.1016/j.jacc.2015.03.553] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 03/15/2015] [Accepted: 03/19/2015] [Indexed: 10/25/2022]
Abstract
BACKGROUND Indoor exposure to fine particulate matter (PM2.5) from outdoor sources is a major health concern, especially in highly polluted developing countries such as China. Few studies have evaluated the effectiveness of indoor air purification on the improvement of cardiopulmonary health in these areas. OBJECTIVES This study sought to evaluate whether a short-term indoor air purifier intervention improves cardiopulmonary health. METHODS We conducted a randomized, double-blind crossover trial among 35 healthy college students in Shanghai, China, in 2014. These students lived in dormitories that were randomized into 2 groups and alternated the use of true or sham air purifiers for 48 h with a 2-week washout interval. We measured 14 circulating biomarkers of inflammation, coagulation, and vasoconstriction; lung function; blood pressure (BP); and fractional exhaled nitric. We applied linear mixed-effect models to evaluate the effect of the intervention on health outcome variables. RESULTS On average, air purification resulted in a 57% reduction in PM2.5 concentration, from 96.2 to 41.3 μg/m3, within hours of operation. Air purification was significantly associated with decreases in geometric means of several circulating inflammatory and thrombogenic biomarkers, including 17.5% in monocyte chemoattractant protein-1, 68.1% in interleukin-1β, 32.8% in myeloperoxidase, and 64.9% in soluble CD40 ligand. Furthermore, systolic BP, diastolic BP, and fractional exhaled nitrous oxide were significantly decreased by 2.7%, 4.8%, and 17.0% in geometric mean, respectively. The impacts on lung function and vasoconstriction biomarkers were beneficial but not statistically significant. CONCLUSIONS This intervention study demonstrated clear cardiopulmonary benefits of indoor air purification among young, healthy adults in a Chinese city with severe ambient particulate air pollution. (Intervention Study on the Health Impact of Air Filters in Chinese Adults; NCT02239744).
Collapse
Affiliation(s)
- Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Ang Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Honglei Chen
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Cuicui Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Huichu Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, Florida
| | - Sandie Ha
- Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, Florida
| | - Tiantian Li
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
| |
Collapse
|
48
|
Kim HB, Eckel SP, Kim JH, Gilliland FD. Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 8:12-21. [PMID: 26540497 PMCID: PMC4695403 DOI: 10.4168/aair.2016.8.1.12] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/29/2015] [Indexed: 11/20/2022]
Abstract
Nitric oxide (NO) is endogenously released in the airways, and the fractional concentration of NO in exhaled breath (FeNO) is now recognized as a surrogate marker of eosinophilic airway inflammation that can be measured using a noninvasive technique suitable for young children. Although FeNO levels are affected by several factors, the most important clinical determinants of increased FeNO levels are atopy, asthma, and allergic rhinitis. In addition, air pollution is an environmental determinant of FeNO that may contribute to the high prevalence of allergic disease. In this review, we discuss the mechanism for airway NO production, methods for measuring FeNO, and determinants of FeNO in children, including host and environmental factors such as air pollution. We also discuss the clinical utility of FeNO in children with asthma and allergic rhinitis and further useful directions using FeNO measurement.
Collapse
Affiliation(s)
- Hyo Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Sandrah P Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, California, USA
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Korea. .,Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea
| | - Frank D Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, California, USA.
| |
Collapse
|
49
|
Mirowsky J, Gordon T. Noninvasive effects measurements for air pollution human studies: methods, analysis, and implications. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:354-80. [PMID: 25605444 PMCID: PMC6659729 DOI: 10.1038/jes.2014.93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/26/2014] [Accepted: 11/05/2014] [Indexed: 05/09/2023]
Abstract
Human exposure studies, compared with cell and animal models, are heavily relied upon to study the associations between health effects in humans and air pollutant inhalation. Human studies vary in exposure methodology, with some work conducted in controlled settings, whereas other studies are conducted in ambient environments. Human studies can also vary in the health metrics explored, as there exists a myriad of health effect end points commonly measured. In this review, we compiled mini reviews of the most commonly used noninvasive health effect end points that are suitable for panel studies of air pollution, broken into cardiovascular end points, respiratory end points, and biomarkers of effect from biological specimens. Pertinent information regarding each health end point and the suggested methods for mobile collection in the field are assessed. In addition, the clinical implications for each health end point are summarized, along with the factors identified that can modify each measurement. Finally, the important research findings regarding each health end point and air pollutant exposures were reviewed. It appeared that most of the adverse health effects end points explored were found to positively correlate with pollutant levels, although differences in study design, pollutants measured, and study population were found to influence the magnitude of these effects. Thus, this review is intended to act as a guide for researchers interested in conducting human exposure studies of air pollutants while in the field, although there can be a wider application for using these end points in many epidemiological study designs.
Collapse
Affiliation(s)
- Jaime Mirowsky
- Department of Environmental Medicine, New York University School of Medicine, Nelson Institute of Environmental Medicine, Tuxedo, New York, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, Nelson Institute of Environmental Medicine, Tuxedo, New York, USA
| |
Collapse
|
50
|
Abstract
OBJECTIVES To investigate the role of storage mites in the development of allergic diseases among ham production workers, and to search for early alterations in lung function tests and early inflammation markers in exhaled air. Respiratory allergies due to storage mites have been reported in people with various occupations but, although such mites are unavoidable when curing ham, there are no published data concerning ham production workers. SETTING Secondary care. DESIGN Experimental cross-sectional study. PARTICIPANTS 220 participants (110 ham production workers and 110 controls) were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES Workers answered a medical questionnaire, and underwent spirometry and fraction of exhaled nitric oxide at 50 mL/s (FeNO₅₀) measurements. Those with allergic symptoms also underwent skin prick tests to determine their sensitisation to airborne allergens. A methacholine test was performed in symptomatic participants when spirometry was normal to assess airways hyper-responsiveness. RESULTS Symptomatic storage mite sensitisation was observed in 16 workers (14.5%) (rhinoconjunctivitis in 15 (63%) and asthma in (4%)) and 2 controls (1.8%; p=0.001). Higher FeNO₅₀ values in exposed symptomatic workers compared with healthy control participants (34.65±7.49 vs 13.29±4.29 ppb; p<0.001) suggested bronchial and nasal involvement, although their lung function parameters were normal. Regardless of exposure, a FeNO₅₀ value of 22.5 ppb seems to be 100% sensitive and 99.4% specific in distinguishing allergic and non-allergic participants. Multivariate analysis of FeNO₅₀ values in the symptomatic participants showed that they were positively influenced by IgE-mediated allergy (p=0.001) and reported symptom severity (p=0.041), and negatively by smoking status (p=0.049). CONCLUSIONS Ham processing workers, as well as workers involved in any meat processing work that includes curing, should be informed about the occupational risk of sensitisation to mites.
Collapse
Affiliation(s)
- Federica Tafuro
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Erminia Ridolo
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Matteo Goldoni
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Marcello Montagni
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Antonio Mutti
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Massimo Corradi
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| |
Collapse
|