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Zanobetti A, Ryan PH, Coull BA, Luttmann-Gibson H, Datta S, Blossom J, Brokamp C, Lothrop N, Miller RL, Beamer PI, Visness CM, Andrews H, Bacharier LB, Hartert T, Johnson CC, Ownby DR, Khurana Hershey GK, Joseph CL, Mendonça EA, Jackson DJ, Zoratti EM, Wright AL, Martinez FD, Seroogy CM, Ramratnam SK, Calatroni A, Gern JE, Gold DR. Early-Life Exposure to Air Pollution and Childhood Asthma Cumulative Incidence in the ECHO CREW Consortium. JAMA Netw Open 2024; 7:e240535. [PMID: 38416497 PMCID: PMC10902721 DOI: 10.1001/jamanetworkopen.2024.0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/31/2023] [Indexed: 02/29/2024] Open
Abstract
Importance Exposure to outdoor air pollution contributes to childhood asthma development, but many studies lack the geographic, racial and ethnic, and socioeconomic diversity to evaluate susceptibility by individual-level and community-level contextual factors. Objective To examine early life exposure to fine particulate matter (PM2.5) and nitrogen oxide (NO2) air pollution and asthma risk by early and middle childhood, and whether individual and community-level characteristics modify associations between air pollution exposure and asthma. Design, Setting, and Participants This cohort study included children enrolled in cohorts participating in the Children's Respiratory and Environmental Workgroup consortium. The birth cohorts were located throughout the US, recruited between 1987 and 2007, and followed up through age 11 years. The survival analysis was adjusted for mother's education, parental asthma, smoking during pregnancy, child's race and ethnicity, sex, neighborhood characteristics, and cohort. Statistical analysis was performed from February 2022 to December 2023. Exposure Early-life exposures to PM2.5 and NO2 according to participants' birth address. Main Outcomes and Measures Caregiver report of physician-diagnosed asthma through early (age 4 years) and middle (age 11 years) childhood. Results Among 5279 children included, 1659 (31.4%) were Black, 835 (15.8%) were Hispanic, 2555 (48.4%) where White, and 229 (4.3%) were other race or ethnicity; 2721 (51.5%) were male and 2596 (49.2%) were female; 1305 children (24.7%) had asthma by 11 years of age and 954 (18.1%) had asthma by 4 years of age. Mean values of pollutants over the first 3 years of life were associated with asthma incidence. A 1 IQR increase in NO2 (6.1 μg/m3) was associated with increased asthma incidence among children younger than 5 years (HR, 1.25 [95% CI, 1.03-1.52]) and children younger than 11 years (HR, 1.22 [95% CI, 1.04-1.44]). A 1 IQR increase in PM2.5 (3.4 μg/m3) was associated with increased asthma incidence among children younger than 5 years (HR, 1.31 [95% CI, 1.04-1.66]) and children younger than 11 years (OR, 1.23 [95% CI, 1.01-1.50]). Associations of PM2.5 or NO2 with asthma were increased when mothers had less than a high school diploma, among Black children, in communities with fewer child opportunities, and in census tracts with higher percentage Black population and population density; for example, there was a significantly higher association between PM2.5 and asthma incidence by younger than 5 years of age in Black children (HR, 1.60 [95% CI, 1.15-2.22]) compared with White children (HR, 1.17 [95% CI, 0.90-1.52]). Conclusions and Relevance In this cohort study, early life air pollution was associated with increased asthma incidence by early and middle childhood, with higher risk among minoritized families living in urban communities characterized by fewer opportunities and resources and multiple environmental coexposures. Reducing asthma risk in the US requires air pollution regulation and reduction combined with greater environmental, educational, and health equity at the community level.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Patrick H. Ryan
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Brent A. Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Heike Luttmann-Gibson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Soma Datta
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey Blossom
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Cole Brokamp
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Nathan Lothrop
- Asthma and Airways Disease Research Center, University of Arizona, Tucson
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | - Rachel L. Miller
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paloma I. Beamer
- Asthma and Airways Disease Research Center, University of Arizona, Tucson
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | | | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Leonard B. Bacharier
- Monroe Carell Jr Children’s Hospital at Vanderbilt, Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Nashville, Tennessee
| | - Tina Hartert
- Vanderbilt University School of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Nashville, Tennessee
| | | | - Dennis R. Ownby
- Division of Allergy and Immunology, Augusta University, Augusta, Georgia
| | | | | | | | - Daniel J. Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Anne L. Wright
- Asthma and Airways Disease Research Center, University of Arizona, Tucson
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
| | - Fernando D. Martinez
- Asthma and Airways Disease Research Center, University of Arizona, Tucson
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson
| | - Christine M. Seroogy
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Sima K. Ramratnam
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Mimura T, Ichinose T, Inoue KI, Yoshida Y, Fujishima H. Airborne Suspended Particulate Matter and the Prevalence of Allergic Conjunctivitis in Japan. Cureus 2024; 16:e53292. [PMID: 38435920 PMCID: PMC10906130 DOI: 10.7759/cureus.53292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The information on air pollution, encompassing total hydrocarbons, non-methane hydrocarbons, methane, carbon monoxide, nitrogen oxide, nitric oxide, oxidants, and SPM alongside data concerning daily weather conditions such as temperature, wind speed, and humidity, was gathered. Subsequently, the weekly mean values for outpatient visits, air pollution, and weather parameters were computed. Results The number of outpatient visits for allergic conjunctivitis was significantly associated with SPM levels (r = 0.70, p = 0.0037), oxidant levels (r = 0.70, p = 0.0038), wind speed (r = 0.48, p = 0.0472), and humidity (r = 0.77, p = 0.0009) from January to March, as well as SPM levels (r = 0.53, p = 0.0309) and carbon monoxide (r = 0.56, p = 0.0230) from April to June. Multivariate analysis showed that SPM (odds ratio = 1.37, p = 0.0161) and wind velocity (odds ratio = 1.52, p = 0.0038) were significant predictors of the number of outpatient visits from January to December. Conclusions SPM levels were the only independent predictor of outpatient visits for allergic conjunctivitis, suggesting that SPM contributes to the pathophysiology of this condition.
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Affiliation(s)
- Tatsuya Mimura
- Ophthalmology, Teikyo University School of Medicine, Tokyo, JPN
| | - Takamichi Ichinose
- Department of Health Science, Oita University of Nursing and Health Sciences, Oita, JPN
| | - Ken-Ichiro Inoue
- Graduate School of Nursing, University of Shizuoka, Shizuoka, JPN
| | - Yasuhiro Yoshida
- Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Fukuoka, JPN
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Dearborn LC, Hazlehurst MF, Loftus CT, Szpiro AA, Carroll KN, Moore PE, Adgent MA, Barrett ES, Nguyen RHN, Sathyanarayana S, LeWinn KZ, Bush NR, Kaufman JD, Karr CJ. Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy. Epidemiology 2023; 34:554-564. [PMID: 37042935 PMCID: PMC10563986 DOI: 10.1097/ede.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/12/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Infants experiencing bronchiolitis are at increased risk for asthma, but few studies have identified modifiable risk factors. We assessed whether early life air pollution influenced child asthma and wheeze at age 4-6 years among children with a history of bronchiolitis in the first postnatal year. METHODS Children with caregiver-reported physician-diagnosed bronchiolitis were drawn from ECHO-PATHWAYS, a pooled longitudinal cohort from six US cities. We estimated their air pollution exposure from age 1 to 3 years from validated spatiotemporal models of fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ). Caregivers reported children's current wheeze and asthma at age 4-6 years. We used modified Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for child, maternal, and home environmental factors. We assessed effect modification by child sex and maternal history of asthma with interaction models. RESULTS A total of 224 children had caregiver-reported bronchiolitis. Median (interquartile range) 2-year pollutant concentrations were 9.3 (7.8-9.9) µg/m 3 PM 2.5 , 8.5 (6.4-9.9) ppb NO 2 , and 26.6 (25.6-27.7) ppb O 3 . RRs (CI) for current wheeze per 2-ppb higher O 3 were 1.3 (1.0-1.7) and 1.4 (1.1-1.8) for asthma. NO 2 was inversely associated with wheeze and asthma whereas associations with PM 2.5 were null. We observed interactions between NO 2 and PM 2.5 and maternal history of asthma, with lower risks observed among children with a maternal history of asthma. CONCLUSION Our results are consistent with the hypothesis that exposure to modest postnatal O 3 concentrations increases the risk of asthma and wheeze among the vulnerable subpopulation of infants experiencing bronchiolitis.
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Affiliation(s)
- Logan C Dearborn
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Marnie F Hazlehurst
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Christine T Loftus
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - Kecia N Carroll
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ruby HN Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Sheela Sathyanarayana
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Nicole R Bush
- Department of Psychiatry and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Joel D Kaufman
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
- Department of Medicine, School of Medicine, University of Washington; Seattle, WA
| | - Catherine J Karr
- From the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
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Chakraborty J, Aun JJ. Social Inequities in Exposure to Traffic-Related Air and Noise Pollution at Public Schools in Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5308. [PMID: 37047923 PMCID: PMC10094516 DOI: 10.3390/ijerph20075308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
Although children are particularly vulnerable to the adverse impacts of vehicular pollution and spend significant portions of their time at school, previous studies have not examined or compared school-level social inequities in exposure to both traffic-related air and noise pollution in the same study area. We addressed this gap through a case study in Texas-the second-largest US state based on total population and number of children. Vehicular pollution exposure was measured using: (1) outdoor concentrations of nitrogen dioxide (NO2), a widely used proxy for traffic-related air pollution; and (2) road noise estimates from the US Department of Transportation's National Transportation Noise Mapping Tool. These variables were linked to data on locations and sociodemographic characteristics of children enrolled in Texas public schools. We found children attending schools with the highest exposure to both NO2 and road noise (top 25%) were significantly more likely to be Black, Hispanic, and eligible for free/reduced lunches (socioeconomically deprived). Results from multivariable generalized estimating equations that control for spatial clustering and other relevant factors revealed that schools with greater NO2 exposure were significantly more likely to serve racial/ethnic minority and younger students, while schools with greater exposure to road noise were significantly more likely to serve socioeconomically deprived and older students. These findings underscore the urgent need to reduce both air pollution and noise exposure at school locations, especially in schools attended by higher proportions of socially disadvantaged children that are often additionally burdened with other challenges.
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Burbank AJ, Hernandez ML, Jefferson A, Perry TT, Phipatanakul W, Poole J, Matsui EC. Environmental justice and allergic disease: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee. J Allergy Clin Immunol 2023; 151:656-670. [PMID: 36584926 PMCID: PMC9992350 DOI: 10.1016/j.jaci.2022.11.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/29/2022]
Abstract
Environmental justice is the concept that all people have the right to live in a healthy environment, to be protected against environmental hazards, and to participate in decisions affecting their communities. Communities of color and low-income populations live, work, and play in environments with disproportionate exposure to hazards associated with allergic disease. This unequal distribution of hazards has contributed to health disparities and is largely the result of systemic racism that promotes segregation of neighborhoods, disinvestment in predominantly racial/ethnic minority neighborhoods, and discriminatory housing, employment, and lending practices. The AAAAI Environmental Exposure and Respiratory Health Committee and Diversity, Equity and Inclusion Committee jointly developed this report to improve allergy/immunology specialists' awareness of environmental injustice, its roots in systemic racism, and its impact on health disparities in allergic disease. We present evidence supporting the relationship between exposure to environmental hazards, particularly at the neighborhood level, and the disproportionately high incidence and poor outcomes from allergic diseases in marginalized populations. Achieving environmental justice requires investment in at-risk communities to increase access to safe housing, clean air and water, employment opportunities, education, nutrition, and health care. Through policies that promote environmental justice, we can achieve greater health equity in allergic disease.
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Affiliation(s)
- Allison J Burbank
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC.
| | - Michelle L Hernandez
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC
| | - Akilah Jefferson
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Wanda Phipatanakul
- Division of Asthma, Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Jill Poole
- Department of Internal Medicine, Division of Allergy and Immunology, University of Nebraska Medical Center, Omaha, Neb
| | - Elizabeth C Matsui
- Departments of Population Health and Pediatrics, Dell Medical School at University of Texas at Austin, Austin, Tex
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Thangavel P, Kim KY, Park D, Lee YC. Evaluation of Health Economic Loss Due to Particulate Matter Pollution in the Seoul Subway, South Korea. TOXICS 2023; 11:113. [PMID: 36850988 PMCID: PMC9960099 DOI: 10.3390/toxics11020113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
Evaluating an illness's economic impact is critical for developing and executing appropriate policies. South Korea has mandatory national health insurance in the form of NHIS that provides propitious conditions for assessing the national financial burden of illnesses. The purpose of our study is to provide a comprehensive assessment of the economic impact of PM2.5 exposure in the subway and a comparative analysis of cause-specific mortality outcomes based on the prevalent health-risk assessment of the health effect endpoints (chronic obstructive pulmonary disease (COPD), asthma, and ischemic heart disease (IHD)). We used the National Health Insurance database to calculate the healthcare services provided to health-effect endpoints, with at least one primary diagnosis in 2019. Direct costs associated with health aid or medicine, treatment, and indirect costs (calculated based on the productivity loss in health effect endpoint patients, transportation, and caregivers, including morbidity and mortality costs) were both considered. The total cost for the exposed population for these endpoints was estimated to be USD 437 million per year. Medical costs were the largest component (22.08%), followed by loss of productivity and premature death (15.93%) and other costs such as transport and caregiver costs (11.46%). The total incurred costs (per 1000 persons) were accounted to be USD 0.1771 million, USD 0.42 million, and USD 0.8678 million for COPD, Asthma, and IHD, respectively. Given that the economic burden will rise as the prevalence of these diseases rises, it is vital to adopt effective preventative and management methods strategies aimed at the appropriate population.
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Affiliation(s)
- Prakash Thangavel
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
| | - Kyoung Youb Kim
- Department of Mobile IoT, Osan University, 45 Cheonghak-ro, Osan-si 18119, Gyeonggi-do, Republic of Korea
| | - Duckshin Park
- Korea Railroad Research Institute (KRRI), 176 Cheoldobakmulkwan-ro, Uiwang-si 16105, Gyeonggi-do, Republic of Korea
| | - Young-Chul Lee
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Republic of Korea
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Jerrett M, Nau CL, Young DR, Butler RK, Batteate CM, Su J, Burnett RT, Kleeman MJ. Air pollution and meteorology as risk factors for COVID-19 death in a cohort from Southern California. ENVIRONMENT INTERNATIONAL 2023; 171:107675. [PMID: 36565571 PMCID: PMC9715495 DOI: 10.1016/j.envint.2022.107675] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Recent evidence links ambient air pollution to COVID-19 incidence, severity, and death, but few studies have analyzed individual-level mortality data with high quality exposure models. METHODS We sought to assess whether higher air pollution exposures led to greater risk of death during or after hospitalization in confirmed COVID-19 cases among patients who were members of the Kaiser Permanente Southern California (KPSC) healthcare system (N=21,415 between 06-01-2020 and 01-31-2022 of whom 99.85 % were unvaccinated during the study period). We used 1 km resolution chemical transport models to estimate ambient concentrations of several common air pollutants, including ozone, nitrogen dioxide, and fine particle matter (PM2.5). We also derived estimates of pollutant exposures from ultra-fine particulate matter (PM0.1), PM chemical species, and PM sources. We employed Cox proportional hazards models to assess associations between air pollution exposures and death from COVID-19 among hospitalized patients. FINDINGS We found significant associations between COVID-19 death and several air pollution exposures, including: PM2.5 mass, PM0.1 mass, PM2.5 nitrates, PM2.5 elemental carbon, PM2.5 on-road diesel, and PM2.5 on-road gasoline. Based on the interquartile (IQR) exposure increment, effect sizes ranged from hazard ratios (HR) = 1.12 for PM2.5 mass and PM2.5 nitrate to HR ∼ 1.06-1.07 for other species or source markers. Humidity and temperature in the month of diagnosis were also significant negative predictors of COVID-19 death and negative modifiers of the air pollution effects. INTERPRETATION Air pollution exposures and meteorology were associated the risk of COVID-19 death in a cohort of patients from Southern California. These findings have implications for prevention of death from COVID-19 and for future pandemics.
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Affiliation(s)
- Michael Jerrett
- Department of Environmental Health Sciences, University of California, Los Angeles 650 Charles Young Dr. S., 56-070 CHS Box 951772, Los Angeles, CA, 90095, United States.
| | - Claudia L Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Rebecca K Butler
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Christina M Batteate
- Department of Environmental Health Sciences, University of California, Los Angeles 650 Charles Young Dr. S., 56-070 CHS Box 951772, Los Angeles, CA, 90095, United States
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 2121 Berkeley Way, Room 5302, Berkeley, CA 94720, United States
| | - Richard T Burnett
- Population Studies Division, Environmental Health Directorate, Health Canada 251 Sir Frederick Banting Driveway, Ottawa, Ontario K1A 0K9, Canada
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California, Davis 1 Sheilds Avenue, Davis, CA 95616, United States
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Cheeseman MJ, Ford B, Anenberg SC, Cooper MJ, Fischer EV, Hammer MS, Magzamen S, Martin RV, van Donkelaar A, Volckens J, Pierce JR. Disparities in Air Pollutants Across Racial, Ethnic, and Poverty Groups at US Public Schools. GEOHEALTH 2022; 6:e2022GH000672. [PMID: 36467256 PMCID: PMC9714311 DOI: 10.1029/2022gh000672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/17/2023]
Abstract
We investigate socioeconomic disparities in air quality at public schools in the contiguous US using high resolution estimates of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) concentrations. We find that schools with higher proportions of people of color (POC) and students eligible for the federal free or reduced lunch program, a proxy for poverty level, are associated with higher pollutant concentrations. For example, we find that the median annual NO2 concentration for White students, nationally, was 7.7 ppbv, compared to 9.2 ppbv for Black and African American students. Statewide and regional disparities in pollutant concentrations across racial, ethnic, and poverty groups are consistent with nationwide results, where elevated NO2 concentrations were associated with schools with higher proportions of POC and higher levels of poverty. Similar, though smaller, differences were found in PM2.5 across racial and ethnic groups in most states. Racial, ethnic, and economic segregation across the rural-urban divide is likely an important factor in pollution disparities at US public schools. We identify distinct regional patterns of disparities, highlighting differences between California, New York, and Florida. Finally, we highlight that disparities exist not only across urban and non-urban lines but also within urban environments.
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Affiliation(s)
| | - Bonne Ford
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Susan C. Anenberg
- Milken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Matthew J. Cooper
- Air Emission Priorities DivisionEnvironment Climate Change CanadaDartmouthNSCanada
| | - Emily V. Fischer
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - Melanie S. Hammer
- Department of Energy, Environmental, and Chemical EngineeringWashington University in St. LouisSt. LouisMOUSA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health SciencesColorado State UniversityFort CollinsCOUSA
| | - Randall V. Martin
- Department of Energy, Environmental, and Chemical EngineeringWashington University in St. LouisSt. LouisMOUSA
| | - Aaron van Donkelaar
- Department of Energy, Environmental, and Chemical EngineeringWashington University in St. LouisSt. LouisMOUSA
| | - John Volckens
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - Jeffrey R. Pierce
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
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Kelchtermans J, Hakonarson H. The role of gene-ambient air pollution interactions in paediatric asthma. Eur Respir Rev 2022; 31:31/166/220094. [PMID: 36384702 PMCID: PMC9724879 DOI: 10.1183/16000617.0094-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022] Open
Abstract
Globally, asthma prevention and treatment remain a challenge. Ambient air pollution (AAP) is an environmental risk factor of special interest in asthma research. AAP is poorly defined and has been subdivided either by the origin of the air pollution or by the specific bioactive compounds. The link between AAP exposure and asthma exacerbations is well established and has been extensively reviewed. In this narrative review, we discuss the specific genetic variants that have been associated with increased AAP sensitivity and impact in paediatric asthma. We highlight the relative importance of variants associated with genes with a role in oxidant defences and the nuclear factor-κB pathway supporting a potential central role for these pathways in AAP sensitivity.
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Affiliation(s)
- Jelte Kelchtermans
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,The Center of Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA,Corresponding author: Jelte Kelchtermans ()
| | - Hakon Hakonarson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,The Center of Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA,Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Bahrami Asl F, Amini Rabati SE, Poureshgh Y, Kermani M, Kalan ME, Hosseini F, Dehghani A, Taghi Livari K. Ambient air pollutants and respiratory health outcomes in Tabriz and Urmia, two metropolises of Iran. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:812. [PMID: 36131102 DOI: 10.1007/s10661-022-10463-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/08/2022] [Indexed: 06/15/2023]
Abstract
Polluted air affects human life and it is crucial to assess air pollutants to inform policy and protect human lives. In this study, we sought to assess the respiratory outcomes associated with PM10, O3, SO2, and NO2 in the Iranian population. The required data, which included concentrations of air pollutants, meteorology, and population size, were obtained from the department of environment and meteorological organizations. The validity of the data was evaluated, and appropriate calculations were conducted on the data to extract the required values and parameters for modeling (using the AirQ2.2.3). This study was conducted in two megacities of Iran (Tabriz and Urmia) with over 2 million population. The annual averages of SO2, NO2, and PM10 concentrations were 9, 73, and 43 μg/m3 in Tabriz and 76, 29, and 76 μg/m3 in Urmia, respectively. Excess deaths from respiratory diseases associated with PM10 and SO2 were estimated to be 33.1 and 1.2 cases in Tabriz and 31.6 and 24.7 cases in Urmia, respectively. The proportions of hospitalizations for chronic obstructive pulmonary disease (COPD) attributable to SO2 and NO2 in Tabriz were 0.07% and 1.61%, respectively, whereas they were 2.84% and 0.48% in Urmia. O3 had an annual average of 56 μg/m3 in Tabriz and with 44.5 excess respiratory deaths and 42.5 excess hospital admissions for COPD, it had the greatest health impacts among the pollutants studied. Findings from this study add to the growing literature, especially from developing countries, that provides insights to help authorities and decision-makers develop and implement effective interventions to curb air pollution and save lives.
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Affiliation(s)
- Farshad Bahrami Asl
- Department of Environmental Health Engineering, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
| | | | - Yousef Poureshgh
- Department of Environmental Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahimi Kalan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, Carolina, NC, USA
- Department of Health Behavior, University of North Carolina, Chapel Hill, Carolina, NC, USA
- School of Health Professions, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Fatemeh Hosseini
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | - Anahita Dehghani
- Department of Environmental Health Engineering, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
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Cheng H, Narzo AD, Howell D, Yevdokimova K, Zhang J, Zhang X, Pan Q, Zhang Z, Rogers L, Hao K. Ambient Air Pollutants and Traffic Factors Were Associated with Blood and Urine Biomarkers and Asthma Risk. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7298-7307. [PMID: 35239329 DOI: 10.1021/acs.est.1c06916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The UK Biobank (UKBB) is a large population-based cohort that provides a unique opportunity to study the association between environmental exposure and biomarkers and to identify biomarkers as potential instruments for assessing exposure dose, health damage, and disease risks. On 462 063 participants of European ancestry, we characterized the relationship of 38 disease-relevant biomarkers, asthma diagnosis, ambient pollution, traffic factors, and genetic background. The air pollutant exposure on the UKBB cohort was fairly low (e.g., mean PM2.5 concentration at 10.0 μg/m3). Nevertheless, 30 biomarkers were in association with at least one environmental factor; e.g., C-reactive protein levels were positively associated with NO (padj = 2.99 × 10-4), NO2 (padj = 4.15 × 10-4), and PM2.5 (padj = 1.92 × 10-6) even after multiple testing adjustment. Asthma diagnosis was associated with four pollutants (NO, NO2, PM2.5, and PM10). The largest effect size was observed in PM2.5, where a 5 μg/m3 increment of exposure was associated with a 1.52 increase in asthma diagnosis (p = 4.41 × 10-13). Further, environmental exposure and genetic predisposition influenced biomarker levels and asthma diagnosis in an additive model. The exposure-biomarker associations identified in this study could serve as potential indicators for environmental exposure induced health damages. Our results also shed light on possible mechanisms whereby environmental exposure influences disease-causing biomarkers and in turn increases disease risk.
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Affiliation(s)
- Haoxiang Cheng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | | | - Daniel Howell
- Division of Pulmonary Critical Care, Woodhull Hospital, New York University, New York, New York 11206, United States
| | - Kateryna Yevdokimova
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jushan Zhang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
- College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | | | - Qi Pan
- Sema4, Stamford, Connecticut 06902, United States
| | - Zhongyang Zhang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Linda Rogers
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
- Sema4, Stamford, Connecticut 06902, United States
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12
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Krall JR, Keller JP, Peng RD. Assessing the health estimation capacity of air pollution exposure prediction models. Environ Health 2022; 21:35. [PMID: 35300698 PMCID: PMC8928613 DOI: 10.1186/s12940-022-00844-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The era of big data has enabled sophisticated models to predict air pollution concentrations over space and time. Historically these models have been evaluated using overall metrics that measure how close predictions are to monitoring data. However, overall methods are not designed to distinguish error at timescales most relevant for epidemiologic studies, such as day-to-day errors that impact studies of short-term health associations. METHODS We introduce frequency band model performance, which quantifies health estimation capacity of air quality prediction models for time series studies of air pollution and health. Frequency band model performance uses a discrete Fourier transform to evaluate prediction models at timescales of interest. We simulated fine particulate matter (PM2.5), with errors at timescales varying from acute to seasonal, and health time series data. To compare evaluation approaches, we use correlations and root mean squared error (RMSE). Additionally, we assess health estimation capacity through bias and RMSE in estimated health associations. We apply frequency band model performance to PM2.5 predictions at 17 monitors in 8 US cities. RESULTS In simulations, frequency band model performance rates predictions better (lower RMSE, higher correlation) when there is no error at a particular timescale (e.g., acute) and worse when error is added to that timescale, compared to overall approaches. Further, frequency band model performance is more strongly associated (R2 = 0.95) with health association bias compared to overall approaches (R2 = 0.57). For PM2.5 predictions in Salt Lake City, UT, frequency band model performance better identifies acute error that may impact estimated short-term health associations. CONCLUSIONS For epidemiologic studies, frequency band model performance provides an improvement over existing approaches because it evaluates models at the timescale of interest and is more strongly associated with bias in estimated health associations. Evaluating prediction models at timescales relevant for health studies is critical to determining whether model error will impact estimated health associations.
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Affiliation(s)
- Jenna R. Krall
- Department of Global and Community Health, George Mason University, 4400 University Drive, MS 5B7, Fairfax, VA 22030 USA
| | - Joshua P. Keller
- Department of Statistics, Colorado State University, 1877 Campus Delivery, Fort Collins, CO 80523 USA
| | - Roger D. Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
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Citerne A, Roda C, Viola M, Rancière F, Momas I. Early postnatal exposure to traffic-related air pollution and asthma in adolescents: vulnerability factors in the PARIS birth cohort. ENVIRONMENTAL RESEARCH 2021; 201:111473. [PMID: 34116015 DOI: 10.1016/j.envres.2021.111473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Associations between early traffic-related air pollution (TRAP) exposure and respiratory and allergic morbidity in adolescents are inconsistent. However, sub-groups might be more vulnerable to the health effects of this exposure. OBJECTIVES We investigated associations between early exposure to TRAP and respiratory and allergic morbidity at age 13 years in the PARIS birth cohort, and potential modifying effects of sex, parental allergy, stressful family event and lower respiratory tract infections (LRTI). METHODS This study deals with data from 732 children of the PARIS birth cohort followed up using repeated questionnaires until 13 years of age. Prenatal TRAP exposure was assessed by measuring daily concentrations of nitrogen dioxide at the nearest station to mother's home. Early postnatal TRAP exposure was calculated for each child during the first year of life by a nitrogen oxides (NOx) air dispersion model taking into account both residence and daycare. Associations between TRAP exposures and asthma, rhinitis and related symptoms were assessed using multivariable logistic regression models adjusted for potential confounding factors. Effect modification was explored by testing multiplicative interactions. RESULTS An increase in interquartile range (17.0 μg/m3) of early postnatal NOx exposure was positively related to current asthma (adjusted odds ratio aOR = 1.21; 95% confidence interval CI: 1.02, 1.43), severe wheeze (aOR = 1.23; 95% CI: 1.02, 1.47) and persistent asthma at 13 years old (aOR = 1.26; 95% CI: 1.03, 1.55) and tended to be associated with asthma ever. Parental history of allergy, asthma, early stressful family event and LRTI modified these associations with TRAP exposure. No relationship with rhinitis was found. Prenatal TRAP exposure did not show any association with respiratory and allergic morbidity. DISCUSSION This study is one of the first to show several modifiers of the association between early postnatal TRAP exposure and asthma at adolescence. Not all adolescents seem equally affected by early postnatal TRAP exposure: those presenting parental history of allergy, especially asthma, those with early stressful family event or LRTI appear to be more vulnerable.
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Affiliation(s)
- Antoine Citerne
- Health Environmental Risk Assessment (HERA) Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France
| | - Célina Roda
- Health Environmental Risk Assessment (HERA) Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France; Université de Paris, Faculté de Pharmacie de Paris, Paris, France
| | - Malika Viola
- Health Environmental Risk Assessment (HERA) Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France
| | - Fanny Rancière
- Health Environmental Risk Assessment (HERA) Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France; Université de Paris, Faculté de Pharmacie de Paris, Paris, France.
| | - Isabelle Momas
- Health Environmental Risk Assessment (HERA) Team, CRESS, Université de Paris, Inserm, INRAE, Paris, France; Université de Paris, Faculté de Pharmacie de Paris, Paris, France; Cellule Cohorte, Direction de l'Action Sociale de l'Enfance et de la Santé, Mairie de Paris, Paris, France
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14
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Associations of Air Pollution and Pediatric Asthma in Cleveland, Ohio. ScientificWorldJournal 2021; 2021:8881390. [PMID: 34566522 PMCID: PMC8460381 DOI: 10.1155/2021/8881390] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 07/09/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
Air pollution has been associated with poor health outcomes and continues to be a risk factor for respiratory health in children. While higher particulate matter (PM) levels are associated with increased frequency of symptoms, lower lung function, and increase airway inflammation from asthma, the precise composition of the particles that are more highly associated with poor health outcomes or healthcare utilization are not fully elucidated. PM is measured quantifiably by current air pollution monitoring systems. To better determine sources of PM and speciation of such sources, a particulate matter (PM) source apportionment study, the Cleveland Multiple Air Pollutant Study (CMAPS), was conducted in Cleveland, Ohio, in 2009-2010, which allowed more refined assessment of associations with health outcomes. This article presents an evaluation of short-term (daily) and long-term associations between motor vehicle and industrial air pollution components and pediatric asthma emergency department (ED) visits by evaluating two sets of air quality data with healthcare utilization for pediatric asthma. Exposure estimates were developed using land use regression models for long-term exposures for nitrogen dioxide (NO2) and coarse (i.e., with aerodynamic diameters between 2.5 and 10 μm) particulate matter (PM) and the US EPA Positive Matrix Factorization receptor model for short-term exposures to fine (<2.5 μm) and coarse PM components. Exposure metrics from these two approaches were used in asthma ED visit prevalence and time series analyses to investigate seasonal-averaged short- and long-term impacts of both motor vehicles and industry emissions. Increased pediatric asthma ED visits were found for LUR coarse PM and NO2 estimates, which were primarily contributed by motor vehicles. Consistent, statistically significant associations with pediatric asthma visits were observed, with short-term exposures to components of fine and coarse iron PM associated with steel production. Our study is the first to combine spatial and time series analysis of ED visits for asthma using the same periods and shows that PM related to motor vehicle emissions and iron/steel production are associated with increased pediatric asthma visits.
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Kim S, Carson KA, Chien AL. The association between urinary polycyclic aromatic hydrocarbon metabolites and atopic triad by age and body weight in the US population. J DERMATOL TREAT 2021; 33:2488-2494. [PMID: 34461804 DOI: 10.1080/09546634.2021.1970705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are generated during the incomplete combustion of coal/oil/gas and waste. The role of PAH exposure in the atopic triad remains poorly understood. Due to their lipophilic nature, PAHs deposit in adipocytes, potentially placing elderly and those who are overweight at higher risk. OBJECTIVE To investigate the association between urinary PAHs and symptoms of atopic triad (chronic pruritus, sneezing, and wheezing). METHODS Binary multivariable logistic regression was performed to estimate the association of nine urinary PAHs and atopic diseases followed by subgroup analyses by age (children 6-17, adults 18-49, elderly ≥50 years) and body mass index (BMI) (normal: BMI <25, overweight: BMI ≥ 25 kg/m2) among 2,242 participants of National Health and Nutrition Examination Survey 2005-2006 dataset. RESULTS 1-hydroxynaphthalene (1-NAP) and hydroxyfluorenes (FLUs) were positively associated with wheezing. When stratified by age, positive associations were found between 1-NAP with wheezing in children/adults and 2-/3-FLU with wheezing in adults/elderly. 3-hydroxyphenanthrene (3-PHE) and 1-hydroxypyrene were positively associated with chronic pruritus in elderly. When stratified by BMI, positive associations were found between 2-PHE with chronic pruritus, 1-NAP and FLUs with wheezing in overweight. CONCLUSION Urinary PAH levels were positively associated with atopic triad and this connection was influenced by age and BMI.
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Affiliation(s)
- Sooyoung Kim
- Department of Dermatology, Soonchunhyang University Hospital, Seoul, South Korea.,Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kathryn A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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16
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Lipsitt J, Chan-Golston AM, Liu J, Su J, Zhu Y, Jerrett M. Spatial analysis of COVID-19 and traffic-related air pollution in Los Angeles. ENVIRONMENT INTERNATIONAL 2021; 153:106531. [PMID: 33812043 PMCID: PMC7983457 DOI: 10.1016/j.envint.2021.106531] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 05/05/2023]
Affiliation(s)
- Jonah Lipsitt
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, United States
| | - Alec M Chan-Golston
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, CA 95343, United States
| | - Jonathan Liu
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, United States
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94604, United States
| | - Yifang Zhu
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, United States
| | - Michael Jerrett
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, United States; Center for Healthy Climate Solutions, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, United States.
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17
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Abellard A, Pappalardo AA. Overview of severe asthma, with emphasis on pediatric patients: a review for practitioners. J Investig Med 2021; 69:1297-1309. [PMID: 34168068 DOI: 10.1136/jim-2020-001752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/03/2022]
Abstract
Asthma is the most common life-threatening chronic disease in children. Although guidelines exist for the diagnosis and treatment of asthma, treatment of severe, pediatric asthma remains difficult. Limited studies in the pediatric population on new asthma therapies, complex issues with adolescence and adherence, health disparities, and unequal access to guideline-based care complicate the care of children with severe, persistent asthma. The purpose of this review is to provide an overview of asthma, including asthma subtypes, comorbidities, and risk factors, to discuss diagnostic considerations and pitfalls and existing treatments, and then present existing and emerging therapeutic approaches to asthma management. An improved understanding of asthma heterogeneity, clinical characteristics, inflammatory patterns, and pathobiology can help further guide the management of severe asthma in children. More studies are needed in the pediatric population to understand emerging therapeutics application in children. Effective multimodal strategies tailored to individual characteristics and a commitment to address risk factors, modifiers, and health disparities may help reduce the burden of asthma in the USA.
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Affiliation(s)
- Arabelle Abellard
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Andrea A Pappalardo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA .,Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
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18
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Combined Effect of Hot Weather and Outdoor Air Pollution on Respiratory Health: Literature Review. ATMOSPHERE 2021. [DOI: 10.3390/atmos12060790] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Association between short-term exposure to ambient air pollution and respiratory health is well documented. At the same time, it is widely known that extreme weather events intrinsically exacerbate air pollution impact. Particularly, hot weather and extreme temperatures during heat waves (HW) significantly affect human health, increasing risks of respiratory mortality and morbidity. Concurrently, a synergistic effect of air pollution and high temperatures can be combined with weather–air pollution interaction during wildfires. The purpose of the current review is to summarize literature on interplay of hot weather, air pollution, and respiratory health consequences worldwide, with the ultimate goal of identifying the most dangerous pollution agents and vulnerable population groups. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, and Scopus, focusing only on peer-reviewed journal articles published in English from 2000 to 2021. The main findings demonstrate that the increased level of PM10 and O3 results in significantly higher rates of respiratory and cardiopulmonary mortality. Increments in PM2.5 and PM10, O3, CO, and NO2 concentrations during high temperature episodes are dramatically associated with higher admissions to hospital in patients with chronic obstructive pulmonary disease, daily hospital emergency transports for asthma, acute and chronic bronchitis, and premature mortality caused by respiratory disease. Excessive respiratory health risk is more pronounced in elderly cohorts and small children. Both heat waves and outdoor air pollution are synergistically linked and are expected to be more serious in the future due to greater climate instability, being a crucial threat to global public health that requires the responsible involvement of researchers at all levels. Sustainable urban planning and smart city design could significantly reduce both urban heat islands effect and air pollution.
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Shairsingh KK, Brook JR, Mihele CM, Evans GJ. Characterizing long-term NO 2 concentration surfaces across a large metropolitan area through spatiotemporal land use regression modelling of mobile measurements. ENVIRONMENTAL RESEARCH 2021; 196:111010. [PMID: 33716024 DOI: 10.1016/j.envres.2021.111010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 01/12/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
A spatiotemporal land use regression (LUR) model optimized to predict nitrogen dioxide (NO2) concentrations obtained from on-road, mobile measurements collected in 2015-16 was independently evaluated using concentrations observed at multiple sites across Toronto, Canada, obtained more than ten years earlier. This spatiotemporal LUR modelling approach improves upon estimates of historical NO2 concentrations derived from the previously used method of back-extrapolation. The optimal spatiotemporal LUR model (R2 = 0.71 for prediction of NO2 data in 2002 and 2004) uses daily average NO2 concentrations observed at multiple long-term monitoring sites and hourly average wind speed recorded at a single site, along with spatial predictors based on geographical information system data, to estimate NO2 levels for time periods outside of those used for model development. While the model tended to underestimate samplers located close to the roadway, it showed great accuracy when estimating samplers located beyond 100 m which are probably more relevant for exposure at residences. This study shows that spatiotemporal LUR models developed from strategic, multi-day (30 days in 3 different months) mobile measurements can enhance LUR model's ability to estimate long-term, intra-urban NO2 patterns. Furthermore, the mobile sampling strategy enabled this new LUR model to cover a larger domain of Toronto and outlying suburban communities, thereby increasing the potential population for future epidemiological studies.
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Affiliation(s)
- Kerolyn K Shairsingh
- Department of Chemical Engineering and Applied Chemistry. University of Toronto, Toronto, Ontario, M5S 3E5, Canada.
| | - Jeffrey R Brook
- Department of Chemical Engineering and Applied Chemistry. University of Toronto, Toronto, Ontario, M5S 3E5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada.
| | - Cristian M Mihele
- Environment and Climate Change Canada, North York, Ontario, M3H 5T4, Canada
| | - Greg J Evans
- Department of Chemical Engineering and Applied Chemistry. University of Toronto, Toronto, Ontario, M5S 3E5, Canada
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20
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de Homdedeu M, Cruz MJ, Sánchez-Díez S, Gómez-Ollés S, Ojanguren I, Ma D, Muñoz X. Role of diesel exhaust particles in the induction of allergic asthma to low doses of soybean. ENVIRONMENTAL RESEARCH 2021; 196:110337. [PMID: 33130171 DOI: 10.1016/j.envres.2020.110337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Exposure to environmental pollutants such as diesel exhaust particles (DEP) increases the risk of asthma and asthma exacerbation. However, the exact mechanisms inducing asthma to low doses of allergens remain poorly understood. The present study aimed to analyse the immunomodulatory effect of the inhalation of DEP in a mouse model exposed to non-asthmagenic doses of soybean hull extract (SHE). MATERIAL AND METHODS BALB/c ByJ mice were randomly divided into four experimental groups. Two groups received nasal instillations of saline and the other two groups received 3 mg ml-1 SHE during 5 days per week for 3 weeks. One group in each pair also received 150 μg of DEP in the same instillations 3 days per week. SHE-specific IgE levels, oxidative stress, leukocyte pattern and optical projection tomography (OPT) imaging studies were assessed. RESULTS Inhalation of SHE and/or DEP increased levels of H2O2 in BAL, while coexposure to SHE and DEP increased SHE-specific IgE levels in serum. Inhalation of SHE alone increased eosinophils, B cells, total and resident monocytes and decreased levels of NK cells, while inhalation of DEP increased neutrophils and decreased total monocytes. Regarding dendritic cells (DC), the inhalation of SHE and/or DEP increased the total population, while the inhalation of SHE alone increased Th2-related DCs (CD11b + Ly6C-) and decreased tolerogenic DCs (CD11b-Ly6C-). However, coexposure to SHE and DEP increased oxidative stress-sensitive DCs (CD11b-Ly6C+) and decreased Th1-related DCs (CD11b + Ly6C+). As regards macrophages, inhalation of SHE and DEP decreased total and alveolar populations. DEP deposition in lung tissue did not differ between groups. CONCLUSION Coexposure to DEP activates the asthmatic response to low doses of soy by triggering the immune response and oxidative stress.
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Affiliation(s)
- M de Homdedeu
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M J Cruz
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - S Sánchez-Díez
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Gómez-Ollés
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Ojanguren
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Ma
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Muñoz
- Pulmonology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER Enfermedades Respiratorias (CibeRes), Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
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21
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Radhakrishnan D, Bota SE, Price A, Ouédraogo A, Husein M, Clemens KK, Shariff SZ. Comparison of childhood asthma incidence in 3 neighbouring cities in southwestern Ontario: a 25-year longitudinal cohort study. CMAJ Open 2021; 9:E433-E442. [PMID: 33947701 PMCID: PMC8101639 DOI: 10.9778/cmajo.20200130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Air pollution is a known trigger for exacerbations among individuals with asthma, but its role in the development of new-onset asthma is unclear. We compared the rate of new asthma cases in Sarnia, a city with high pollution levels, with the rates in 2 neighbouring regions in southwestern Ontario, Canada. METHODS Using a population-based birth cohort design and linked health administrative data, we compared the hazard of incident asthma among children 0 to 10 years of age between those born in Lambton (Sarnia) and those born in Windsor and London-Middlesex, for the period Apr. 1, 1993, to Mar. 31, 2009. We used Cox proportional hazards models to adjust for year of birth and exposure to air pollutants (nitrogen dioxide, sulphur dioxide [SO2], ozone and small particulate matter [PM2.5]), as well as maternal, geographic and socioeconomic factors. RESULTS Among 114 427 children, the highest incidence of asthma was in Lambton, followed by Windsor and London-Middlesex (30.3, 24.4 and 19.8 per 1000 person-years, respectively; p < 0.001). Relative to Lambton, the hazard of asthma, adjusted for socioeconomic and perinatal factors, was lower in Windsor (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.67-0.77) and London-Middlesex (HR 0.65, 95% CI 0.61-0.69). Inclusion of air pollutants attenuated this relative difference in both Windsor (HR 0.79, 95% CI 0.62-1.01) and London-Middlesex (HR 0.89, 95% CI 0.64-1.24). INTERPRETATION We identified a higher incidence of asthma among children born in Lambton (Sarnia) relative to 2 other regions in southwestern Ontario. Higher levels of air pollution (particularly SO2 and PM2.5) in this region, as experienced by children in their first year of life, may be contributory.
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Affiliation(s)
- Dhenuka Radhakrishnan
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont.
| | - Sarah E Bota
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
| | - April Price
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
| | - Alexandra Ouédraogo
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
| | - Murad Husein
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
| | - Kristin K Clemens
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
| | - Salimah Z Shariff
- Children's Hospital of Eastern Ontario Research Institute (Radhakrishnan); Department of Pediatrics (Radhakrishnan), University of Ottawa; ICES uOttawa (Radhakrishnan), Ottawa, Ont.; ICES Western (Bota, Ouédraogo, Clemens, Shariff); London Health Sciences Centre (Price, Husein); Departments of Pediatrics (Price), of Surgery (Husein), of Medicine (Clemens), and of Epidemiology and Biostatistics (Clemens), Western University; Lawson Health Research Institute (Price, Husein, Shariff), London, Ont
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22
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Toledanes YD, Tran L, Lara J, Injijian N, Neeki A, Dong F, Mejia Aguilar MD, Borger K, Neeki MM. The Impact of Quality Improvement Measures in the Management of Asthma Patients in Juvenile Detention Facilities. Cureus 2021; 13:e13351. [PMID: 33747652 PMCID: PMC7968705 DOI: 10.7759/cureus.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Asthma is a serious chronic lung disease with a significant economic burden. The population of the San Bernardino County Juvenile Detention and Assessment Centers have higher odds of asthma as compared to the general population. Research has shown that a significant number of patients with a prior history of asthma were misdiagnosed. A protocol using objective testing, along with the detailed patient's history, was successfully implemented to verify the diagnosis and guide more effective medical care. After the implementation of those steps, the prevalence of asthma was found to be lower with the new protocol, from 18.1% in the pre-protocol period to 11.2% in the post-protocol period. This decrease resulted in an associated reduction in both direct and indirect healthcare costs and more efficient medical care.
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Affiliation(s)
- Yvette D Toledanes
- Public Health, San Bernardino County Department of Probation, San Bernardino, USA
| | - Louis Tran
- Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA.,Emergency Medicine, California University of Science and Medicine, Colton, USA
| | - Jocelyn Lara
- Public Health, San Bernardino County Department of Probation, San Bernardino, USA
| | - Natali Injijian
- Public Health, San Bernardino County Department of Probation, San Bernardino, USA
| | - Arianna Neeki
- Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
| | - Fanglong Dong
- Clinical Research, Arrowhead Regional Medical Center, Colton, USA
| | | | - Kylee Borger
- Public Health, California University of Science and Medicine, San Bernardino, USA
| | - Michael M Neeki
- Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA.,Emergency Medicine, California University of Science and Medicine, Colton, USA.,Emergency Medicine, San Bernardino County Department of Probation, San Bernardino, USA
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23
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Lawrence J, Martins M, Liu M, Koutrakis P. Measurement of the gross alpha activity of the fine fractions of road dust and near-roadway ambient particle matter. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2021; 71:147-155. [PMID: 33198592 DOI: 10.1080/10962247.2020.1850543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 06/11/2023]
Abstract
Traffic-related air pollution, including direct exhaust emissions and road dust (RD), impacts individuals living near busy roads. We recently conducted a study to investigate the sources and composition of tailpipe and non-tailpipe traffic emissions, where we collected and analyzed samples of ambient air fine particulate matter (PM2.5) and fine RD (RD2.5) at different distances from major roadways. We analyzed a subset of the samples, including those collected at the roadside and local background, for their alpha activity level. Subsequently, we investigated whether there is a distance-related decay in the alpha activity in RD2.5 or PM2.5 similar to those observed for traffic-related species in PM2.5 and RD2.5. We found that the alpha activity of ambient air PM2.5 (Bq/mg) was more than an order of magnitude higher than the activity level of the corresponding RD2.5 sample, suggesting that PM2.5 may be more toxic than RD2.5. Using mixed-effects regression models, we found that ambient PM2.5 alpha activity was significantly higher during the cold months than during warm months, and that the background was higher than the roadside (though not significantly). In contrast, the RD2.5 alpha activity was significantly higher at the background site compared to the roadside but was not significantly affected by season. In addition to sampling position, both Zn and elemental carbon (EC) were significant predictors of RD2.5 alpha activity. In addition, the roadside RD2.5 activity levels were found to be higher at highways as compared to secondary roads. While traffic-related emissions do not appear to be significant sources of either ambient PM2.5 or RD2.5 alpha activity, the RD2.5 results suggest that traffic-related particles may contribute to RD2.5 alpha-activity. Implications: Many studies have reported the effects of traffic-related particulate matter (PM) on human health, and there is growing interest in the health effects of exposure to environmental PM alpha activity. This is the first study to report on the alpha activity of road dust (RD) or near-roadway ambient PM. We found that the alpha activity of ambient PM is twenty times higher than RD, suggesting that ambient PM may be more toxic. In PM and RD, the alpha activities were higher at background sites than at the roadside, indicating that traffic-related emissions are not a significant source of particulate radioactivity.
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Affiliation(s)
- Joy Lawrence
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Marco Martins
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Man Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
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24
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Cisneros R, Gharibi H, Entwistle MR, Tavallali P, Singhal M, Schweizer D. Nitrogen dioxide and asthma emergency department visits in California, USA during cold season (November to February) of 2005 to 2015: A time-stratified case-crossover analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 754:142089. [PMID: 33254941 DOI: 10.1016/j.scitotenv.2020.142089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 06/12/2023]
Abstract
Nitrogen dioxide (NO2) is responsible for aggravating respiratory diseases, particularly asthma. The aim of this study is to investigate the association between NO2 exposure and asthma emergency department (ED) visits during the cold season (November-February) in five populated locations (Sacramento, San Francisco, Fresno, Los Angeles, and San Diego) of California from 2005 to 2015 (1320 Days). Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with a 5 ppb increase in NO2 concentration for the 19,735 ED visits identified. An increase in NO2 exposure increased the odds of having asthma ED visits for the studied population. The potential effect modification by sex (female and male), race (White, Black, Hispanic, and Asian), and age (2-5, 6-18, 19-40, 41-64, and ≥65) was explored. A 5 ppb increase in the concentration of NO2 during lag 0-30 was associated with a 56% increase in the odds of having an asthma ED visit (OR = 1.560, CI: 1.428-1.703). Sex was not found to be a modifier. Asthma ED visits among all the races/ethnicities (except Asians) were associated with NO2 exposure. Whites had the highest OR 75% (OR = 1.750, CI: 1.417-2.160) at lag 0-30 in response to NO2 exposure. The association between NO2 exposure and asthma ED visits was positive among all age groups except for 19 to 40 years old; the OR was higher among 2 to 18 year old (at lag 0-30: age group 2-5 (OR = 1.699, CI: 1.399-2.062), and age group 6-18 (OR = 1.568, CI 1.348-1.825)). For stratification by location, San Diego and Fresno were found to have the highest OR, compared to the other studied locations.
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Affiliation(s)
- Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, USA.
| | - Hamed Gharibi
- Health Sciences Research Institute, University of California, Merced, USA.
| | | | - Pooya Tavallali
- Electrical Engineering and Computer Science, University of California, Merced, USA.
| | - Mukesh Singhal
- Electrical Engineering and Computer Science, University of California, Merced, USA.
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, USA; USDA Forest Service, Pacific Southwest Region, 1600 Tollhouse Road, Clovis, CA 93611, USA.
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25
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Commodore S, Ferguson PL, Neelon B, Newman R, Grobman W, Tita A, Pearce J, Bloom MS, Svendsen E, Roberts J, Skupski D, Sciscione A, Palomares K, Miller R, Wapner R, Vena JE, Hunt KJ. Reported Neighborhood Traffic and the Odds of Asthma/Asthma-Like Symptoms: A Cross-Sectional Analysis of a Multi-Racial Cohort of Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E243. [PMID: 33396261 PMCID: PMC7794885 DOI: 10.3390/ijerph18010243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/11/2020] [Accepted: 12/25/2020] [Indexed: 11/16/2022]
Abstract
Asthma in children poses a significant clinical and public health burden. We examined the association between reported neighborhood traffic (a proxy for traffic-related air pollution) and asthma among 855 multi-racial children aged 4-8 years old who participated in the Environmental Influences on Child Health Outcomes (ECHO) cohort. We hypothesized that high neighborhood traffic density would be associated with the prevalence of asthma. Asthma/asthma-like symptoms (defined as current and/or past physician diagnosed asthma, past wheezing, or nighttime cough or wheezing in the past 12 months) was assessed by parental report. The relationship between neighborhood traffic and asthma/asthma-like symptoms was assessed using logistic regression. The prevalence of asthma/asthma-like symptoms among study participants was 23%, and 15% had high neighborhood traffic. Children with significant neighborhood traffic had a higher odds of having asthma/asthma-like symptoms than children without neighborhood traffic [adjusted OR = 2.01 (95% CI: 1.12, 3.62)] after controlling for child's race-ethnicity, age, sex, maternal education, family history of asthma, play equipment in the home environment, public parks, obesity and prescribed asthma medication. Further characterization of neighborhood traffic is needed since many children live near high traffic zones and significant racial/ethnic disparities exist.
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Affiliation(s)
- Sarah Commodore
- Department of Environmental and Occupational Health, Indiana University, Bloomington, IN 47405, USA
| | - Pamela L. Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - William Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL 60611, USA;
| | - Alan Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - John Pearce
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
| | - Michael S. Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA;
| | - Erik Svendsen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
| | - James Roberts
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Daniel Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, NY 11365, USA;
- Department of Obstetrics and Gynecology, Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, NY 10021, USA
| | - Anthony Sciscione
- Department of Obstetrics and Gynecology, Christiana Care Health System, Wilmington, DE 19899, USA;
| | - Kristy Palomares
- Department of Obstetrics and Gynecology, Saint Peter’s University Hospital, New Brunswick, NJ 08901, USA;
| | - Rachel Miller
- Department of Medicine, Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Ronald Wapner
- Columbia University Irving Medical Center, Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA;
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
| | - Kelly J. Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (P.L.F.); (B.N.); (J.P.); (E.S.); (J.E.V.); (K.J.H.)
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26
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Abstract
Globally, exposure to ambient air pollutants is responsible for premature mortality and is implicated in the development and exacerbation of several acute and chronic lung disease across all ages. In this article, we discuss the source apportionment of ambient pollutants and the respiratory health effects in humans. We specifically discuss the evidence supporting ambient pollution in the development of asthma and chronic obstructive pulmonary disease and acute exacerbations of each condition. Practical advice is given to health care providers in how to promote a healthy environment and advise patients with chronic conditions to avoid unsafe air quality.
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Affiliation(s)
- Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jahred Liddie
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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27
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Liu W, Huang C, Cai J, Fu Q, Zou Z, Sun C, Zhang J. Prenatal and postnatal exposures to ambient air pollutants associated with allergies and airway diseases in childhood: A retrospective observational study. ENVIRONMENT INTERNATIONAL 2020; 142:105853. [PMID: 32585502 DOI: 10.1016/j.envint.2020.105853] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/24/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
It's inconsistent about associations of early exposures to outdoor air pollutants with allergies and airway diseases in childhood. Here, we investigated associations of prenatal and postnatal exposures to outdoor nitrogen dioxide (NO2), sulphur dioxide (SO2), and PM10 (particulate matter with an aerodynamic diameter ≤ 10 μm) with asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema in childhood. We surveyed 3,177 preschoolers who never change residences since birth in Shanghai, China. Parents reported information regarding children's health status. Daily-averaged concentrations of these pollutants in the children's gestation and in the first year of lifetime for district where children lived were collected by Shanghai Environmental Monitoring Center. After adjusting for covariates, exposures to higher level of NO2 during different trimesters of gestation and of the first year of lifetime had significant associations with the increased odds of asthma, hay fever, rhinitis, pneumonia, and eczema in childhood. Associations of NO2 exposures in the early trimesters of gestation and of the first year of lifetime with pneumonia were stronger than in the later trimesters, whereas associations of NO2 exposures in the early trimesters with hay fever and eczema were weaker than in the later trimesters. Our results indicated that prenatal and postnatal exposures to outdoor NO2 could be risk factors for allergies and airway diseases in childhood. Both dose and duration were related with the influence degree of early NO2 exposure on childhood allergies and airway diseases.
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Affiliation(s)
- Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jialing Zhang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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28
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Gehring U, Wijga AH, Koppelman GH, Vonk JM, Smit HA, Brunekreef B. Air pollution and the development of asthma from birth until young adulthood. Eur Respir J 2020; 56:13993003.00147-2020. [PMID: 32299858 DOI: 10.1183/13993003.00147-2020] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/20/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Air pollution is associated with asthma development in children and adults, but the impact on asthma development during the transition from adolescence to adulthood is unclear. Adult studies lack historical exposures and consequently cannot assess the relevance of exposure during different periods of life. We assessed the relevance of early-life and more recent air pollution exposure for asthma development from birth until early adulthood. METHODS We used data of 3687 participants of the prospective Dutch PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort and linked asthma incidence until age 20 years to estimated concentrations of nitrogen dioxide (NO2), particulate matter with a diameter <2.5 μm (PM2.5), <10 μm (PM10), and 2.5-10 μm, and PM2.5 absorbance ("soot") at the residential address. We assessed overall and age-specific associations with air pollution exposure with discrete time-hazard models, adjusting for potential confounders. RESULTS Overall, we found higher incidence of asthma until the age of 20 years with higher exposure to all pollutants at the birth address (adjusted odds ratio (95% CI) ranging from 1.09 (1.01-1.18) for PM10 to 1.20 (1.10-1.32) for NO2) per interquartile range increase) that were rather persistent with age. Similar associations were observed with more recent exposure defined as exposure at the current home address. In two-pollutant models with particulate matter, associations with NO2 persisted. CONCLUSIONS Exposure to air pollution, especially from motorised traffic, early in life may have long-term consequences for asthma development, as it is associated with an increased risk of developing asthma through childhood and adolescence into early adulthood.
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Affiliation(s)
- Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alet H Wijga
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Gerard H Koppelman
- Dept of Pediatric Pulmonology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Dept of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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29
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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.
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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.
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Cao B, Chen Y, McIntyre RS. Comprehensive review of the current literature on impact of ambient air pollution and sleep quality. Sleep Med 2020; 79:211-219. [PMID: 32912798 DOI: 10.1016/j.sleep.2020.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 02/08/2023]
Abstract
Air pollution is associated with increasing morbidity, mortality and decreasing health and life span. Accumulating epidemiological and experimental evidence has shown that exposure to ambient air pollutants such as particulate matters (PM) and gaseous components [eg, nitrogen dioxide (NO2), ozone (O3)] has detrimental effects on sleep quality. We conducted this comprehensive review to explore the association between ambient air pollution and sleep quality. A systematic search was conducted with the databases of PubMed and Web of Science from inception to November 2019. Overall, 15 studies with 133,695 subjects that evaluated the association between ambient air pollution and sleep quality were conducted in 10 different countries (ie, USA, Brazil, Canada, Chile, China, Egypt, Germany, Iran, Mexico, and Turkey). Most included studies in the current review have shown that one or more air pollutants have negative influences on sleep quality. Air pollutants might be one of the triggers for poor sleep quality via disparate mechanisms including but not limited to the central ventilator control centers, central nervous system, allergic and non-allergic mechanisms. The possible association between air pollution and select chronic diseases (eg, mental illnesses, cardiovascular diseases) and behaviors (eg, impulsivity) may also play important roles in explaining the association between ambient air pollution and sleep quality. The associations and underlying mechanisms between ambient air pollutants and sleep quality need to be clarified with long-term, multi-centered cohort studies.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, PR China.
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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Hassoun Y, James C, Bernstein DI. The Effects of Air Pollution on the Development of Atopic Disease. Clin Rev Allergy Immunol 2020; 57:403-414. [PMID: 30806950 DOI: 10.1007/s12016-019-08730-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO2), nitric oxide (NO), sulfur dioxide (SO2), particulate matter (PM2.5 and PM10), carbon monoxide (CO), and carbon dioxide (CO2). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.
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Affiliation(s)
- Yasmin Hassoun
- Division of Immunology, Allergy, and Rheumatology, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267-0563, USA
| | - Christine James
- Division of Immunology, Allergy, and Rheumatology, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267-0563, USA
| | - David I Bernstein
- Division of Immunology, Allergy, and Rheumatology, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267-0563, USA.
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Permaul P, Gaffin JM, Petty CR, Baxi SN, Lai PS, Sheehan WJ, Camargo CA, Gold DR, Phipatanakul W. Obesity may enhance the adverse effects of NO 2 exposure in urban schools on asthma symptoms in children. J Allergy Clin Immunol 2020; 146:813-820.e2. [PMID: 32197971 DOI: 10.1016/j.jaci.2020.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sparse data address the effects of nitrogen dioxide (NO2) exposure in inner-city schools on obese students with asthma. OBJECTIVE We sought to evaluate relationships between classroom NO2 exposure and asthma symptoms and morbidity by body mass index (BMI) category. METHODS The School Inner-City Asthma Study enrolled students aged 4 to 13 years with asthma from 37 inner-city schools. Students had baseline determination of BMI percentile. Asthma symptoms, morbidity, pulmonary inflammation, and lung function were monitored throughout the subsequent academic year. Classroom NO2 data, linked to enrolled students, were collected twice per year. We determined the relationship between classroom NO2 levels and asthma outcomes by BMI stratification. RESULTS A total of 271 predominantly black (35%) or Hispanic students (35%) were included in analyses. Fifty percent were normal weight (5-84th BMI percentile), 15% overweight (≥85-94th BMI percentile), and 35% obese (≥95th BMI percentile). For each 10-parts per billion increase in NO2, obese students had a significant increase in the odds of having an asthma symptom day (odds ratio [OR], 1.86; 95% CI, 1.15-3.02) and in days caregiver changed plans (OR, 4.24; 95% CI, 2.33-7.70), which was significantly different than normal weight students who exhibited no relationship between NO2 exposure and symptom days (OR, 0.90; 95% CI, 0.57-1.42; pairwise interaction P = .03) and change in caregiver plans (OR, 1.37; 95% CI, 0.67-2.82; pairwise interaction P = .02). Relationships between NO2 levels and lung function and fractional exhaled nitric oxide did not differ by BMI category. If we applied a conservative Holm-Bonferroni correction for 16 comparisons (obese vs normal weight and overweight vs normal weight for 8 outcomes), these findings would not meet statistical significance (all P > .003). CONCLUSIONS Obese BMI status appears to increase susceptibility to classroom NO2 exposure effects on asthma symptoms in inner-city children. Environmental interventions targeting indoor school NO2 levels may improve asthma health for obese children. Although our findings would not remain statistically significant after adjustment for multiple comparisons, the large effect sizes warrant future study of the interaction of obesity and pollution in pediatric asthma.
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Affiliation(s)
- Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian/Weill Cornell Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Children's National Health System, Washington, DC; George Washington University School of Medicine, Washington, DC
| | - Carlos A Camargo
- Harvard Medical School, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Mass
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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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.
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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.
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Liu Y, Pan J, Zhang H, Shi C, Li G, Peng Z, Ma J, Zhou Y, Zhang L. Short-Term Exposure to Ambient Air Pollution and Asthma Mortality. Am J Respir Crit Care Med 2020; 200:24-32. [PMID: 30871339 DOI: 10.1164/rccm.201810-1823oc] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Rationale: Short-term exposure to air pollution has been associated with asthma exacerbation and increased healthcare use caused by asthma, but its effect on asthma mortality remains largely unknown. Objectives: To quantitatively assess the association between short-term exposure to air pollution and asthma mortality. Methods: We investigated 4,454 individuals who lived in Hubei province, China, and died from asthma between 2013 and 2018. A case-crossover design and conditional logistic regression models were applied for data analyses. Exposures to particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), particulate matter ≤10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were estimated by inverse distance weighted averages of all monitoring stations within 50 km from each case's home address. Measurements and Main Results: Each interquartile range (IQR) increase of PM2.5 (lag 3; IQR, 47.1 μg/m3), NO2 (lag 03; IQR, 26.3 μg/m3), and O3 (lag 3; IQR, 52.9 μg/m3) were positively associated with asthma mortality, with odds ratios of 1.07 (95% confidence interval, 1.01-1.12), 1.11 (95% confidence interval, 1.01-1.22), and 1.09 (95% confidence interval, 1.01-1.18), respectively. There was no evidence of departure from linearity for these associations. Further adjustment for other pollutants did not change the associations materially. We did not observe significant associations between PM10, SO2, and CO exposures and asthma mortality. Overall, the estimates remained consistent in various sensitivity analyses. Conclusions: Our results provide new evidence that short-term exposures to PM2.5, NO2, and O3 may increase asthma mortality risk. Further studies are needed to confirm our findings in other populations.
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Affiliation(s)
- Yuewei Liu
- 1 Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Jingju Pan
- 3 Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hai Zhang
- 2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Chunxiang Shi
- 4 National Meteorological Information Center, Beijing, China; and
| | - Guo Li
- 5 Department of Neurology, Tongji Hospital, and
| | - Zhe Peng
- 2 Hubei Provincial Key Laboratory for Applied Toxicology and
| | - Jixuan Ma
- 6 Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Zhou
- 6 Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lan Zhang
- 3 Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
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Barthelemy J, Sanchez K, Miller MR, Khreis H. New Opportunities to Mitigate the Burden of Disease Caused by Traffic Related Air Pollution: Antioxidant-Rich Diets and Supplements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020630. [PMID: 31963738 PMCID: PMC7014349 DOI: 10.3390/ijerph17020630] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 12/13/2022]
Abstract
Air pollution is associated with premature mortality and a wide spectrum of diseases. Traffic-related air pollution (TRAP) is one of the most concerning sources of air pollution for human exposure and health. Until TRAP levels can be significantly reduced on a global scale, there is a need for effective shorter-term strategies to prevent the adverse health effects of TRAP. A growing number of studies suggest that increasing antioxidant intake, through diet or supplementation, may reduce this burden of disease. In this paper, we conducted a non-systematic literature review to assess the available evidence on antioxidant-rich diets and antioxidant supplements as a strategy to mitigate adverse health effects of TRAP in human subjects. We identified 11 studies that fit our inclusion criteria; 3 of which investigated antioxidant-rich diets and 8 of which investigated antioxidant supplements. Overall, we found consistent evidence that dietary intake of antioxidants from adherence to the Mediterranean diet and increased fruit and vegetable consumption is effective in mitigating adverse health effects associated with TRAP. In contrast, antioxidant supplements, including fish oil, olive oil, and vitamin C and E supplements, presented conflicting evidence. Further research is needed to determine why antioxidant supplementation has limited efficacy and whether this relates to effective dose, supplement formulation, timing of administration, or population being studied. There is also a need to better ascertain if susceptible populations, such as children, the elderly, asthmatics and occupational workers consistently exposed to TRAP, should be recommended to increase their antioxidant intake to reduce their burden of disease. Policymakers should consider increasing populations' antioxidant intake, through antioxidant-rich diets, as a relatively cheap and easy preventive measure to lower the burden of disease associated with TRAP.
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Affiliation(s)
- Jillian Barthelemy
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
| | - Kristen Sanchez
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
| | - Mark R. Miller
- Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Haneen Khreis
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A & M Transportation Institute (TTI), College Station, TX 77843, USA; (J.B.); (K.S.)
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain
- Correspondence:
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Hauptman M, Gaffin JM, Petty CR, Sheehan WJ, Lai PS, Coull B, Gold DR, Phipatanakul W. Proximity to major roadways and asthma symptoms in the School Inner-City Asthma Study. J Allergy Clin Immunol 2020; 145:119-126.e4. [PMID: 31557500 PMCID: PMC6949366 DOI: 10.1016/j.jaci.2019.08.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Traffic proximity has been associated with adverse respiratory health outcomes. Less is known about the combined impact of residential and school exposures on pediatric asthma. OBJECTIVE We sought to use spatial analysis methodology to analyze residential and school proximity to major roadways and pediatric asthma morbidity. METHODS The School Inner-City Asthma Study (n = 350) recruited school-aged children with asthma. Each participant's school and home addresses were geocoded, and distances from major roadways were measured to calculate a composite measure accounting for both home and school traffic exposure. Generalized estimating equation models were clustered by subject and adjusted for age, race/ethnicity, sex, income, environmental tobacco smoke, controller medication, upper respiratory tract infections, and seasonality. RESULTS The majority of participants (62%) attended schools within 100 m from major roadways, and 40% also resided within 100 m of major roadways. In multivariate analyses major roadway proximity was independently associated with increased asthma symptom days. At greater than the threshold of 100 m, children had 29% less odds of a symptom day over the past 2 weeks for each 100-m increase in distance from a major roadway (odds ratio, 0.71; 95% CI, 0.58-0.87; P < .01). Children farther from a major roadway also had significantly less reported health care use (odds ratio, 0.63; 95% CI, 0.47-0.85; P < .01) and were significantly less likely to have poor asthma control (odds ratio, 0.80; 95% CI, 0.69-0.94; P < .01). There was not a meaningful association between distance to a major roadway and lung function outcomes. CONCLUSIONS Proximity to a major roadway, a composite measure of home and school exposure but primarily driven by home exposure, was associated with greater asthma morbidity. More studies are needed to evaluate the independent effect of school distance to a roadway on asthma morbidity.
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Affiliation(s)
- Marissa Hauptman
- Division of General Pediatrics, Boston Children's Hospital, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
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Mohammed AM, Ibrahim YH, Saleh IA. Estimation of hospital admission respiratory disease cases attributed to exposure to SO 2 and NO 2 in two different sectors of Egypt. Afr Health Sci 2019; 19:2892-2905. [PMID: 32127865 PMCID: PMC7040343 DOI: 10.4314/ahs.v19i4.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Air Q2.2.3 was used to predicted hospital admissions respiratory disease cases due to SO2 and NO2 exposure in two sectors of Egypt during December 2015 to November 2016. Levels were 19, 22 µg/m3 at Ain Sokhna sector and 92, 78 µg/m3 at Shoubra El-Khaima sector for SO2 and NO2, respectively. These levels were less than the Egyptian Permissible limits (125 µg/m3 in urban and 150 µg/m3 in industrial for SO2, 150 µg/m3 in urban and industrial for NO2). Results showed that relative risks were 1.0330 (1.0246 - 1.0414) and 1.0229 (1.0171 - 1.0287) at Ain Sokhna sector while they were 1.0261 (1.0195 - 1.0327) and 1.0226 (1.0169 - 1.0283) at Shoubra El-Khaima sector for SO2 and NO2, respectively. The highest cases of HARD were found in Shoubra El-Khaima sector; 311 cases at 120 - 129 µg/m3 of SO2 and 234 cases at 120 - 129 µg/m3 of NO2. While, in Ain Sokhna, HARD were 18 cases at 50 - 59 µg/m3 of SO2 and 15 cases at 60 - 69 µg/m3 of NO2. The excess cases found in Shoubra El-Khaima sector as compared to those in Ain Sokhna sector, may be attributed to the higher density of population and industries in Shoubra El-Khaima sector.
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Affiliation(s)
- Atef Mf Mohammed
- Air Pollution Research Department, Environmental Research Division, National Research Centre, Giza, Egypt
| | - Yasser H Ibrahim
- Air Pollution Research Department, Environmental Research Division, National Research Centre, Giza, Egypt
| | - Inas A Saleh
- Air Pollution Research Department, Environmental Research Division, National Research Centre, Giza, Egypt
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38
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Chaput JP, Tremblay MS, Katzmarzyk PT, Fogelholm M, Mikkilä V, Hu G, Lambert EV, Maher C, Maia J, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, LeBlanc AG. Outdoor time and dietary patterns in children around the world. J Public Health (Oxf) 2019; 40:e493-e501. [PMID: 29684210 DOI: 10.1093/pubmed/fdy071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/04/2018] [Indexed: 12/31/2022] Open
Abstract
Background Whether outdoor time is linked to dietary patterns of children has yet to be empirically tested. The objective of this study was to examine the association between outdoor time and dietary patterns of children from 12 countries around the world. Methods This multinational, cross-sectional study included 6229 children 9-11 years of age. Children self-reported the time that they spent outside before school, after school and on weekends. A composite score was calculated to reflect overall daily outdoor time. Dietary patterns were assessed using a food frequency questionnaire, and two components were used for analysis: healthy and unhealthy dietary pattern scores. Results On average, children spent 2.5 h outside per day. After adjusting for age, sex, parental education, moderate-to-vigorous physical activity, screen time and body mass index z-score, greater time spent outdoors was associated with healthier dietary pattern scores. No association was found between outdoor time and unhealthy dietary pattern scores. Similar associations between outdoor time and dietary patterns were observed for boys and girls and across study sites. Conclusions Greater time spent outside was associated with a healthier dietary pattern in this international sample of children. Future research should aim to elucidate the mechanisms behind this association.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Canada
| | | | | | | | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Carol Maher
- University of South Australia, Adelaide, Australia
| | - Jose Maia
- CIFI2D, University of Porto, Porto, Portugal
| | - Timothy Olds
- University of South Australia, Adelaide, Australia
| | | | | | | | - Catrine Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.,University of Massachusetts Amherst, Amherst, USA
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Li Z, Xu X, Thompson LA, Gross HE, Shenkman EA, DeWalt DA, Huang IC. Longitudinal Effect of Ambient Air Pollution and Pollen Exposure on Asthma Control: The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study. Acad Pediatr 2019; 19:615-623. [PMID: 31128384 PMCID: PMC8981069 DOI: 10.1016/j.acap.2019.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 03/18/2019] [Accepted: 03/31/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although exposure to air pollution and pollen is associated with asthma exacerbation and increased health care use, longitudinal effects of fine particulate matter 2.5 (PM2.5), ozone (O3), and pollen exposure on asthma control status in pediatric patients are understudied. This study investigated effects of exposure to PM2.5, O3, and pollen on asthma control status among pediatric patients with asthma. METHODS A total of 229 dyads of pediatric patients with asthma and their parents were followed for 15 months. The Asthma Control and Communication Instrument was used to measure asthma control, which was reported weekly by parents during a 26-week period. PM2.5 and O3 data were collected from the US Environmental Protection Agency Air Quality System. Pollen data were obtained from Intercontinental Marketing Services Health. Mean air pollutant and pollen exposures within 7 days before the reporting of asthma control were used to estimate weekly exposures for each participant. Linear mixed-effects models were performed to test associations of PM2.5, O3, and pollen exposure with asthma control status. Sensitivity analyses were performed to evaluate the robustness of findings by different exposure monitoring days per week and distances between monitoring sites and participants' residences. RESULTS Elevated PM2.5 concentration and pollen severity were associated with poorer asthma control status (P < .05), yet elevated O3 concentration was marginally associated with better asthma control (P < .1). CONCLUSIONS Poorer asthma control status was associated with elevated PM2.5 and pollen severity. Reducing harmful outdoor environmental ambient exposure may improve asthma outcomes in children and adolescents.
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Affiliation(s)
- Zheng Li
- College of Nursing and Health Professions, Valparaiso University, Valparaiso, IN, USA
| | - Xiaohui Xu
- Department of Epidemiology and Statistics, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
| | - Lindsay A. Thompson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Heather E. Gross
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth A. Shenkman
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Darren A. DeWalt
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - I-Chan Huang
- College of Nursing and Health Professions, Valparaiso University, Valparaiso, Ind (Z Li); Department of Epidemiology and Statistics, School of Public Health, Texas A&M Health Science Center, College Station (X Xu); Departments of Pediatrics (LA Thompson); Health Outcomes & Biomedical Informatics (EA Shenkman), College of Medicine, University of Florida, Gainesville; Cecil G. Sheps Center for Health Services Research (HE Gross); Department of Medicine, School of Medicine (DA DeWalt), University of North Carolina at Chapel Hill; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tenn (I-C Huang).
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Gharibi H, Entwistle MR, Schweizer D, Tavallali P, Thao C, Cisneros R. Methyl-bromide and asthma emergency department visits in California, USA from 2005 to 2011. J Asthma 2019; 57:1227-1236. [PMID: 31311358 DOI: 10.1080/02770903.2019.1645167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Urban monitors of Methyl bromide (MBr), not typically near application sites, are used to investigate the impact of ambient concentrations on asthma Emergency Department (ED) visits.Methods: 4262 ED visits from August to February of 2005 to 2011 in Central and Southern California were selected from California's Office of Statewide Health Planning and Development (OSHPD). A bidirectional-symmetric case-crossover study design using conditional logistic regression model was used to obtain the odds ratio (OR) and 95% confidence interval associated with a 0.01 ppb (interquartile range) increase in MBr.Results: The population sample was comprised of 46.0% male and 53.9% females. Ethnic groups included 32.0% Non-Hispanic White, 23.5% Non-Hispanic Black, and 44.4% Hispanic. Age distribution was between 2 and 5 years old (11.6%), 6 and 18 years old (23.5%), 19 and 40 years old (29.3%), 41 and 64 years old (24.1%), and 65 or older (6.9%). There was a positive association between MBr and asthma ED visits among Non-Hispanic Blacks [OR: 1.065 (95% confidence intervals: 1.019, 1.108)] and Hispanics [OR: 1.107 (95% confidence intervals: 1.043, 1.173)], while Non-Hispanic Whites did not have an association with asthma ED visits. Positive association between MBr and asthma ED visits was found only among 6 to 18 [OR: 1.071 (95% confidence intervals: 1.016, 1.125)] years old.Conclusion: An increase in MBr concentration was found to be associated with an increase of the odds of having asthma ED visits in California among 6 to 18 years old and disproportionately affects Non-Hispanic Blacks and Hispanics over Non-Hispanic Whites.
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Affiliation(s)
- Hamed Gharibi
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Marcela R Entwistle
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Donald Schweizer
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA.,USDA Forest Service, Pacific Southwest Region, Clovis, CA, USA
| | - Pooya Tavallali
- Electrical Engineering and Computer Science, University of California, Merced, Merced, CA, USA
| | - Chia Thao
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Ricardo Cisneros
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA.,Public Health, University of California, Merced, Merced, CA, USA
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Abstract
Asthma in inner-city children is often severe and difficult to control. Residence in poor and urban areas confers increased asthma morbidity even after adjusting for ethnicity, age, and gender. Higher exposure to household pests, such as cockroaches and mice, pollutants and tobacco smoke exposure, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, and heath care access also contribute to increased asthma morbidity in this population. Since 1991, the National Institutes of Allergy and Infectious Diseases established research networks: the National Cooperative Inner-City Asthma Study (NCICAS), the Inner-City Asthma Study (ICAS), and the Inner-City Asthma Consortium (ICAC), to improve care for this at risk population. The most striking finding of the NCICAS is the link between asthma morbidity and the high incidence of allergen sensitization and exposure, particularly cockroach. The follow-up ICAS confirmed that reductions in household cockroach and dust mite were associated with reduction in the inner-city asthma morbidity. The ICAC studies have identified that omalizumab lowered fall inner-city asthma exacerbation rate; however, the relationship between inner-city asthma vs immune system dysfunction, respiratory tract infections, prenatal environment, and inner-city environment is still being investigated. Although challenging, certain interventions for inner-city asthma children have shown promising results. These interventions include family-based interventions such as partnering families with asthma-trained social workers, providing guidelines driven asthma care as well as assured access to controller medication, home-based interventions aim at elimination of indoor allergens and tobacco smoke exposure, school-based asthma programs, and computer/web-based asthma programs.
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Garcia E, Berhane KT, Islam T, McConnell R, Urman R, Chen Z, Gilliland FD. Association of Changes in Air Quality With Incident Asthma in Children in California, 1993-2014. JAMA 2019; 321:1906-1915. [PMID: 31112259 PMCID: PMC6537847 DOI: 10.1001/jama.2019.5357] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Exposure to air pollutants is a well-established cause of asthma exacerbation in children; whether air pollutants play a role in the development of childhood asthma, however, remains uncertain. OBJECTIVE To examine whether decreasing regional air pollutants were associated with reduced incidence of childhood asthma. DESIGN, SETTING, AND PARTICIPANTS A multilevel longitudinal cohort drawn from 3 waves of the Southern California Children's Health Study over a period of air pollution decline. Each cohort was followed up from 4th to 12th grade (8 years): 1993-2001, 1996-2004, and 2006-2014. Final follow-up for these data was June 2014. Population-based recruitment was from public elementary schools. A total of 4140 children with no history of asthma and residing in 1 of 9 Children's Health Study communities at baseline were included. EXPOSURES Annual mean community-level ozone, nitrogen dioxide, and particulate matter less than 10 μm (PM10) and less than 2.5 μm (PM2.5) in the baseline year for each of 3 cohorts. MAIN OUTCOMES AND MEASURES Prospectively identified incident asthma, collected via questionnaires during follow-up. RESULTS Among the 4140 children included in this study (mean [SD] age at baseline, 9.5 [0.6] years; 52.6% female [n = 2 179]; 58.6% white [n = 2273]; and 42.2% Hispanic [n = 1686]), 525 incident asthma cases were identified. For nitrogen dioxide, the incidence rate ratio (IRR) for asthma was 0.80 (95% CI, 0.71-0.90) for a median reduction of 4.3 parts per billion, with an absolute incidence rate decrease of 0.83 cases per 100 person-years. For PM2.5, the IRR was 0.81 (95% CI, 0.67-0.98) for a median reduction of 8.1 μg/m3, with an absolute incidence rate decrease of 1.53 cases per 100 person-years. For ozone, the IRR for asthma was 0.85 (95% CI, 0.71-1.02) for a median reduction of 8.9 parts per billion, with an absolute incidence rate decrease of 0.78 cases per 100 person-years. For PM10, the IRR was 0.93 (95% CI, 0.82-1.07) for a median reduction of 4.0 μg/m3, with an absolute incidence rate decrease of 0.46 cases per 100 person-years. CONCLUSIONS AND RELEVANCE Among children in Southern California, decreases in ambient nitrogen dioxide and PM2.5 between 1993 and 2014 were significantly associated with lower asthma incidence. There were no statistically significant associations for ozone or PM10.
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Affiliation(s)
- Erika Garcia
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Kiros T. Berhane
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Talat Islam
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Rob McConnell
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Robert Urman
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Zhanghua Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Frank D. Gilliland
- Department of Preventive Medicine, University of Southern California, Los Angeles
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Parvez F, Wagstrom K. A hybrid modeling framework to estimate pollutant concentrations and exposures in near road environments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:144-153. [PMID: 30711580 DOI: 10.1016/j.scitotenv.2019.01.218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/03/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Traffic related air pollution is one of the major local sources of pollution challenging most urban populations. Current air quality modeling approaches can estimate the concentrations of air pollutants on either regional or local scales but cannot effectively estimate concentrations from the combination of regional and local sources at both local and regional scales simultaneously. This study describes a hybrid modeling framework, HYCAMR, combining a regional model, CAMx, and a local-scale dispersion model, R-LINE, to estimate concentrations of both primary and secondary species at high temporal (hourly) and spatial (40 m) resolution. HYCAMR utilizes all the chemical and physical processes available in CAMx and the Particulate Matter Source Apportionment Technology (PSAT) tool to estimate concentrations from both onroad and nonroad emission sources. HYCAMR employs R-LINE, to estimate the normalized dispersion of pollutant mass from onroad emission sources, from primary and secondary roads, at high resolution. Applying R-LINE for one day per month using average daily meteorology yields seasonally-resolved spatial dispersion profiles at low computational cost. Combining the R-LINE spatial dispersion profile with CAMx concentration estimates yields an estimate of the combined concentrations for a range of pollutants at high spatial and temporal resolution. In three major cities in Connecticut, HYCAMR shows strong temporal and seasonal variability in NOx, PM2.5, and elemental carbon (EC) concentrations. This study evaluates HYCAMR year 2011 estimates of NO2 and PM2.5 against two sources: satellite-based estimates at coarse resolution and regression model estimates at census block group resolution. In this evaluation, HYCAMR demonstrates improved agreement with the land-use regression modeling and mixed agreement with satellite-based estimates when compared to the regional CAMx estimates.
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Affiliation(s)
- Fatema Parvez
- Department of Chemical and Biomolecular Engineering, University of Connecticut 191 Auditorium Road, Unit 3222. Storrs, CT 06269-3222, United States of America.
| | - Kristina Wagstrom
- Department of Chemical and Biomolecular Engineering, University of Connecticut 191 Auditorium Road, Unit 3222. Storrs, CT 06269-3222, United States of America.
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Shairsingh KK, Jeong CH, Evans GJ. Transboundary and traffic influences on air pollution across two Caribbean islands. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 653:1105-1110. [PMID: 30759550 DOI: 10.1016/j.scitotenv.2018.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 06/09/2023]
Abstract
Exposure to ambient air pollution has been linked to adverse health outcomes ranging from asthma to premature mortality. However, little to no information exists on the exposure of residents and visitors in the Caribbean islands. While a few previous studies have quantified levels of PM10 (particulate matter <10 μm) from Sahara dust in Trinidad, our study focussed on a local source of air pollution, traffic emissions. Mass concentrations of black carbon (BC) and PM2.5 (PM <2.5 μm) were measured at ten locations across the islands of Trinidad and Tobago over a three-week period. PM2.5 concentrations were observed to be heavily influenced by air masses showing origins from the Sahara Desert (31%), North America (26%) and Atlantic Ocean (42%), which resulted in similar average concentrations between the two islands. Average concentrations of BC were five times higher in Trinidad than Tobago (2.0 vs 0.43 μg/m3). In addition, BC in Trinidad was three times higher near than away from major roads (2.21 vs. 0.72 μg/m3), with concentrations reaching levels comparable to those near highways in large Metropolitan cities. The elevated BC concentrations observed in this study suggests that significant exposure to diesel exhaust is occurring in Trinidad, with significant contributions from traffic.
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Affiliation(s)
- Kerolyn K Shairsingh
- Southern Ontario Centre for Atmospheric Aerosol Research, Dept. of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON M5S3E5, Canada.
| | - Cheol-Heon Jeong
- Southern Ontario Centre for Atmospheric Aerosol Research, Dept. of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON M5S3E5, Canada
| | - Greg J Evans
- Southern Ontario Centre for Atmospheric Aerosol Research, Dept. of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON M5S3E5, Canada
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45
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Chen Z, Herting MM, Chatzi L, Belcher BR, Alderete TL, McConnell R, Gilliland F. Regional and traffic-related air pollutants are associated with higher consumption of fast food and trans fat among adolescents. Am J Clin Nutr 2019; 109:99-108. [PMID: 30596809 PMCID: PMC6358030 DOI: 10.1093/ajcn/nqy232] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 08/09/2018] [Indexed: 12/21/2022] Open
Abstract
Background Air pollution exposures are novel contributors to the growing childhood obesity epidemic. One possible mechanism linking air pollution exposures and obesity is through changes in food consumption patterns. Objective The aim of this study was to examine the longitudinal association between childhood exposure to air pollutants and changes in diet among adolescents. Design School-age children were enrolled in the Southern California Children's Health Study during 1993-1994 (n = 3100) and were followed for 4-8 y. Community-level regional air pollutants [e.g., nitrogen dioxide (NO2), elemental carbon (EC), and fine particles with aerodynamic diameter <2.5 µm (PM2.5)] were measured at central monitoring stations. Line dispersion modeling was used to estimate concentrations of traffic-related air pollutants based on nitrogen oxides (NOx) at participants' residential addresses. In addition, self-reported diet information was collected annually using a structured youth/adolescent food-frequency questionnaire during 1997-2001. Generalized linear mixed-effects models were used in the association analyses. Results Higher exposures to regional and traffic-related air pollutants were associated with intake of a high-trans-fat diet, after adjusting for confounders including socioeconomic status and access to fast food in the community. A 2-SD (12.2 parts per billion) increase in regional NO2 exposure was associated with a 34% increased risk of consuming a high-trans-fat diet compared with a low-trans-fat diet (OR: 1.34; 95% CI: 1.05, 1.72). In addition, higher exposures to acid vapor, EC, PM2.5, and non-freeway NOx were all associated with higher consumption of dietary trans fat (all P < 0.04). Notably, higher exposures to regional NO2, acid vapor, and EC were also associated with a higher consumption of fast food (all P < 0.05). Conclusions Childhood exposures to regional and traffic-related air pollutants were associated with increased consumption by adolescents of trans fat and fast foods. Our results indicate that air pollution exposures may contribute to obesogenic behaviors. This study was registered at clinicaltrials.gov as NCT03379298.
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Affiliation(s)
- Zhanghua Chen
- Division of Environmental Health and Preventive Medicine,Address correspondence to ZC (e-mail: )
| | | | - Leda Chatzi
- Division of Environmental Health and Preventive Medicine
| | - Britni R Belcher
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Tanya L Alderete
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO
| | - Rob McConnell
- Division of Environmental Health and Preventive Medicine
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Association between Traffic Related Air Pollution and the Development of Asthma Phenotypes in Children: A Systematic Review. Int J Chronic Dis 2018; 2018:4047386. [PMID: 30631772 PMCID: PMC6304508 DOI: 10.1155/2018/4047386] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Traffic related air pollution (TRAP) has long been associated with the onset of childhood asthma. The relationship between TRAP exposure and the development of childhood asthma phenotypes is less understood. To better understand this relationship, we performed a systematic review of the literature studying childhood TRAP exposure and the development of childhood asthma and wheezing phenotypes (transient, persistent, and late-onset asthma/wheezing phenotypes). Methods A literature search was performed in PubMed, Embase, and Scopus databases for current literature, returning 1706 unique articles. After screening and selection, 7 articles were included in the final review. Due to the low number of articles, no meta-analysis was performed. Results TRAP exposure appears to be associated with both transient and persistent asthma/wheezing phenotypes. However, there was little evidence to suggest a relationship between TRAP exposure and late-onset asthma/wheezing. The differing results may be in part due to the heterogeneity in study methods and asthma/wheezing phenotype definitions, in addition to other factors such as genetics. Conclusion TRAP exposure may be associated with transient and persistent asthma/wheezing phenotypes in children. The low number of studies and differing results suggest that further studies are warranted.
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Martikainen MV, Rönkkö TJ, Schaub B, Täubel M, Gu C, Wong GW, Li J, Pekkanen J, Komppula M, Hirvonen MR, Jalava PI, Roponen M. Integrating farm and air pollution studies in search for immunoregulatory mechanisms operating in protective and high-risk environments. Pediatr Allergy Immunol 2018; 29:815-822. [PMID: 30152886 DOI: 10.1111/pai.12975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Studies conducted in farm environments suggest that diverse microbial exposure promotes children's lung health. The underlying mechanisms are unclear, and the development of asthma-preventive strategies has been delayed. More comprehensive investigation of the environment-induced immunoregulation is required for better understanding of asthma pathogenesis and prevention. Exposure to air pollution, including particulate matter (PM), is a risk factor for asthma, thus providing an excellent counterpoint for the farm-effect research. Lack of comparable data, however, complicates interpretation of the existing information. We aimed to explore the immunoregulatory effects of cattle farm dust (protective, Finland) and urban air PM (high-risk, China) for the first time using identical research methods. METHODS We stimulated PBMCs of 4-year-old children (N = 18) with farm dust and size-segregated PM and assessed the expression of immune receptors CD80 and ILT4 on dendritic cells and monocytes as well as cytokine production of PBMCs. Environmental samples were analysed for their composition. RESULTS Farm dust increased the percentage of cells expressing CD80 and the cytokine production of children's immune cells, whereas PM inhibited the expression of important receptors and the production of soluble mediators. Although PM samples induced parallel immune reactions, the size-fraction determined the strength of the effects. CONCLUSIONS Our study demonstrates the significance of using the same research framework when disentangling shared and distinctive immune pathways operating in different environments. Observed stimulatory effects of farm dust and inhibitory effects of PM could shape responses towards respiratory pathogens and allergens, and partly explain differences in asthma prevalence between studied environments.
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Affiliation(s)
- Maria-Viola Martikainen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Teemu J Rönkkö
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Bianca Schaub
- Department of Allergy and Pulmonology, University Children's Hospital, Dr. von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Martin Täubel
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Cheng Gu
- School of the Environment, Nanjing University, Nanjing, China
| | - Gary Wk Wong
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juha Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Mika Komppula
- Atmospheric Research Centre of Eastern Finland, Finnish Meteorological Institute, Kuopio, Finland
| | - Maija-Riitta Hirvonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pasi I Jalava
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
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Buteau S, Doucet M, Tétreault LF, Gamache P, Fournier M, Brand A, Kosatsky T, Smargiassi A. A population-based birth cohort study of the association between childhood-onset asthma and exposure to industrial air pollutant emissions. ENVIRONMENT INTERNATIONAL 2018; 121:23-30. [PMID: 30172232 DOI: 10.1016/j.envint.2018.08.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Studies of the association between air pollution and asthma onset have mostly focused on urban and traffic-related air pollution. We investigated the associations between exposure to industrial emissions and childhood-onset asthma in a population-based birth cohort in Quebec, Canada, 2002-2011. METHODS The cohort was built from administrative health databases. We developed separately for PM2.5 and SO2 different metrics representing children's time-varying residential exposure to industrial emissions: 1) yearly number of tons of air pollutant emitted by industries located within 2.5 km of the residence; 2) distance to the nearest "major emitter" (≥100 tons) of either PM2.5 and SO2 within 7.5 km of the residence, and; 3) tons of air pollutant emitted by the nearest "major emitter" within 7.5 km, weighted by the inverse of the distance and the percentage of time that the residence was downwind. To handle the large number of zeros (i.e., children unexposed) we decomposed the exposure variable into two covariates simultaneously included in the regression model: a binary indicator of exposure and a continuous exposure variable centered at the mean value among exposed children. We performed Cox models using age as the time axis, adjusted for gender, material and social deprivation and calendar year. We indirectly adjusted for unmeasured secondhand smoke. RESULTS The cohort included 722,667 children and 66,559 incident cases of asthma. Across the different exposure metrics, mean percentage changes in the risk of asthma onset in children exposed to the mean relative to those unexposed ranged from 4.5% (95% CI: 2.8, 6.3%) to 10.6% (95% CI: 6.2, 15.2%) for PM2.5 and, from 1.1% (95% CI: -0.1, 3.3%) to 8.9% (95% CI: 7.1, 11.1%) for SO2. Indirect adjustment for secondhand smoke did not substantially affect the associations. In children exposed, the risk of asthma onset increased with the magnitude of the exposure for all metrics, except the distance to the nearest major emitter of SO2. CONCLUSIONS In this population-based birth cohort, residential exposure to industrial air pollutant emissions was associated with childhood-onset asthma. Additional studies with improved models for estimating exposure to industrial point-sources are needed to further support the observed associations.
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Affiliation(s)
- Stéphane Buteau
- Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mariève Doucet
- Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada; Department of Medicine, Laval University, Quebec, Quebec, Canada
| | | | - Philippe Gamache
- Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada
| | - Michel Fournier
- Montreal's Public Health Department, Montreal, Quebec, Canada
| | - Allan Brand
- Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada
| | - Tom Kosatsky
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Audrey Smargiassi
- Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada; Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Quebec, Canada; University of Montreal, Public Health Research Institute, Montreal, Quebec, Canada.
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49
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Huang S, Lawrence J, Kang CM, Li J, Martins M, Vokonas P, Gold DR, Schwartz J, Coull BA, Koutrakis P. Road proximity influences indoor exposures to ambient fine particle mass and components. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 243:978-987. [PMID: 30248605 DOI: 10.1016/j.envpol.2018.09.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 05/09/2023]
Abstract
Exposure to traffic-related PM2.5 mass and its components can affect human health. Meanwhile, indoor concentrations are better exposure predictors as compared to outdoor concentrations because individuals spend the majority of their time indoors. We estimated the impact of traffic emissions on indoor PM2.5 mass and its species as a function of road proximity in Massachusetts. A linear regression model was built using 662 indoor samples and 580 ambient samples. Analysis shows that indoor exposures to traffic-related particles increased dramatically with road proximity. We defined relative concentration decrease, R(α), as the ratio of the indoor concentration at perpendicular distance α in meters from the closest major road to the indoor concentration at 1800 m from the major road. R(13) values for PM2.5 mass and Black Carbon (BC) were 1.3 (95%CI: 1.4, 1.6) and 2.1 (95%CI: 1.3, 2.8) for A12 roads, and 1.3 (95%CI: 1.2, 1.4) and 1.2 (95%CI: 1.1, 1.3) for A3 roads. R(α) values were also estimated for Fe, Mn, Mo, Sr and Ti for A12 roads, and Ca, Cu, Fe, Mn, Mo, Ni, Si, Sr, V and Zn for A3 roads. R(α) values for species associated mainly with brakes, tires or road dust (e.g., Mn, Mo and Sr) were higher than others. For A12 roads, R(13) values for Mn and Mo were 10.9 (95%CI: 0.9, 20.9) and 6.5 (95%CI: 1.4, 11.5), and ranged from 1.3 to 2.1 for other species; for A3 roads, R(13) values for Mn, Mo and Sr were 1.9 (95%CI: 1.1, 2.9), 1.8 (95%CI: 1.1, 2.4), and 8.5 (95%CI: 5.9, 10.9), and ranged from 1.2 to 1.6 for others. Our results indicate a significant impact of local traffic emissions on indoor air, which depends on road proximity. Thus road proximity which has been used in many epidemiological studies is a reasonable exposure metric.
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Affiliation(s)
- Shaodan Huang
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Joy Lawrence
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Choong-Min Kang
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Jing Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Marco Martins
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Pantel Vokonas
- VA Normative Aging Study, VA Boston Healthcare System, Boston 02130, USA; Boston University School of Medicine, Boston, 02118, USA
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Healtlh, Boston 02115, USA.
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Knibbs LD, Cortés de Waterman AM, Toelle BG, Guo Y, Denison L, Jalaludin B, Marks GB, Williams GM. The Australian Child Health and Air Pollution Study (ACHAPS): A national population-based cross-sectional study of long-term exposure to outdoor air pollution, asthma, and lung function. ENVIRONMENT INTERNATIONAL 2018; 120:394-403. [PMID: 30125857 DOI: 10.1016/j.envint.2018.08.025] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
Abstract
Most studies of long-term air pollution exposure and children's respiratory health have been performed in urban locations with moderate pollution levels. We assessed the effect of outdoor nitrogen dioxide (NO2), as a proxy for urban air pollution, on current asthma and lung function in Australia, a low-pollution setting. We undertook a national population-based cross-sectional study of children aged 7-11 years living in 12 Australian cities. We collected information on asthma symptoms from parents via questionnaire and measured children's lung function (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC]) and fractional exhaled nitric oxide [FeNO]). We estimated recent NO2 exposure (last 12 months) using monitors near each child's school, and used a satellite-based land-use regression (LUR) model to estimate NO2 at each child's school and home. Our analysis comprised 2630 children, among whom the prevalence of current asthma was 14.9%. Mean (±SD) NO2 exposure was 8.8 ppb (±3.2) and 8.8 ppb (±2.3) for monitor- and LUR-based estimates, respectively. Mean percent predicted post-bronchodilator FEV1 and FVC were 101.7% (±10.5) and 98.8% (±10.5), respectively. The geometric mean FeNO concentration was 9.4 ppb (±7.1). An IQR increase in NO2 (4.0 ppb) was significantly associated with increased odds of having current asthma; odds ratios (ORs) were 1.24 (95% CI: 1.08, 1.43) and 1.54 (95% CI: 1.26, 1.87) for monitor- and LUR-based estimates, respectively. Increased NO2 exposure was significantly associated with decreased percent predicted FEV1 (-1.35 percentage points [95% CI: -2.21, -0.49]) and FVC (-1.19 percentage points [95% CI: -2.04, -0.35], and an increase in FeNO of 71% (95% CI: 38%, 112%). Exposure to outdoor NO2 was associated with adverse respiratory health effects in this population-based sample of Australian children. The relatively low NO2 levels at which these effects were observed highlight the potential benefits of continuous exposure reduction.
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Affiliation(s)
- Luke D Knibbs
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia.
| | | | - Brett G Toelle
- Woolcock Institute of Medical Research, The University of Sydney, NSW 2006, Australia; Sydney Local Health District, Sydney, NSW 2050, Australia
| | - Yuming Guo
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; Department of Epidemiology and Biostatistics, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Lyn Denison
- ERM Services Australia, Melbourne, VIC 3000, Australia
| | - Bin Jalaludin
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute, Liverpool, NSW 2170, Australia
| | - Guy B Marks
- Centre for Air Pollution, Energy and Health Research, Glebe, NSW 2037, Australia; Woolcock Institute of Medical Research, The University of Sydney, NSW 2006, Australia; South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW 2170, Australia
| | - Gail M Williams
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
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