Health effects of carbon-containing particulate matter: focus on sources and recent research program results

Indoor and ambient black carbon and fine particulate matter associations with blood biomarkers in COPD patients

BACKGROUND

Systemic inflammation contributes to cardiovascular risk and chronic obstructive pulmonary disease (COPD) pathophysiology. Associations between systemic inflammation and exposure to ambient fine particulate matter (PM ≤ 2.5 μm diameter; PM2.5), and black carbon (BC), a PM2.5 component attributable to traffic and other sources of combustion, infiltrating indoors are not well described.

METHODS

Between 2012 and 2017, COPD patients completed in-home air sampling over one-week intervals, up to four times (seasonally), followed by measurement of plasma biomarkers of systemic inflammation, C-reactive protein (CRP) and interleukin-6 (IL-6), and endothelial activation, soluble vascular adhesion molecule-1 (sVCAM-1). Ambient PM2.5, BC and sulfur were measured at a central site. The ratio of indoor/ambient sulfur in PM2.5, a surrogate for fine particle infiltration, was used to estimate indoor BC and PM2.5 of ambient origin. Linear mixed effects regression with a random intercept for each participant was used to assess associations between indoor and indoor of ambient origin PM2.5 and BC with each biomarker.

RESULTS

144 participants resulting in 482 observations were included in the analysis. There were significant positive associations between indoor BC and indoor BC of ambient origin with CRP [%-increase per interquartile range (IQR);95 % CI (13.2 %;5.2-21.8 and 11.4 %;1.7-22.1, respectively)]. Associations with indoor PM2.5 and indoor PM2.5 of ambient origin were weaker. There were no associations with IL-6 or sVCAM-1.

CONCLUSIONS

In homes of patients with COPD without major sources of combustion, indoor BC is mainly attributable to the infiltration of ambient sources of combustion indoors. Indoor BC of ambient origin is associated with increases in systemic inflammation in patients with COPD, even when staying indoors.

Long-term exposure to fine particulate matter constituents in relation to chronic kidney disease: evidence from a large population-based study in China

The effects of long-term exposure to fine particulate matter (PM2.5) constituents on chronic kidney disease (CKD) are not fully known. This study sought to examine the association between long-term exposure to major PM2.5 constituents and CKD and look for potential constituents contributing substantially to CKD. This study included 81,137 adults from the 2018 to 2019 baseline survey of China Multi-Ethnic Cohort. CKD was defined by the estimated glomerular filtration rate. Exposure concentration data of 7 major PM2.5 constituents were assessed by satellite remote sensing. Logistic regression models were used to estimate the effect of each PM2.5 constituent exposure on CKD. The weighted quantile sum regression was used to estimate the effect of mixed exposure to all constituents. PM2.5 constituents had positive correlations with CKD (per standard deviation increase), with ORs (95% CIs) of 1.20 (1.02-1.41) for black carbon, 1.27 (1.07-1.51) for ammonium, 1.29 (1.08-1.55) for nitrate, 1.20 (1.01-1.43) for organic matter, 1.25 (1.06-1.46) for sulfate, 1.30 (1.11-1.54) for soil particles, and 1.63 (1.39-1.91) for sea salt. Mixed exposure to all constituents was positively associated with CKD (1.68, 1.32-2.11). Sea salt was the constituent with the largest weight (0.36), which suggested its importance in the PM2.5-CKD association, followed by nitrate (0.32), organic matter (0.18), soil particles (0.10), ammonium (0.03), BC (0.01). Sulfate had the least weight (< 0.01). Long-term exposure to PM2.5 sea salt and nitrate may contribute more than other constituents in increasing CKD risk, providing new evidence and insights for PM2.5-CKD mechanism research and air pollution control strategy.

Associations between source-apportioned PM2.5 and 30-day readmissions in heart failure patients

BACKGROUND

Air pollution exposure is a significant risk factor for morbidity and mortality, especially for those with pre-existing chronic disease. Previous studies highlighted the risks that long-term particulate matter exposure has for readmissions. However, few studies have evaluated source and component specific associations particularly among vulnerable patient populations.

OBJECTIVES

Use electronic health records from 5556 heart failure (HF) patients diagnosed between July 5, 2004 and December 31, 2010 that were part of the EPA CARES resource in conjunction with modeled source-specific fine particulate matter (PM_2.5) to estimate the association between exposure to source and component apportioned PM_2.5 at the time of HF diagnosis and 30-day readmissions.

METHODS

We used zero-inflated mixed effects Poisson models with a random intercept for zip code to model associations while adjusting for age at diagnosis, year of diagnosis, race, sex, smoking status, and neighborhood socioeconomic status. We undertook several sensitivity analyses to explore the impact of geocoding precision and other factors on associations and expressed associations per interquartile range increase in exposures.

RESULTS

We observed associations between 30-day readmissions and an interquartile range increase in gasoline- (16.9% increase; 95% confidence interval = 4.8%, 30.4%) and diesel-derived PM_2.5 (9.9% increase; 95% confidence interval = 1.7%, 18.7%), and the secondary organic carbon component of PM_2.5 (SOC; 20.4% increase; 95% confidence interval = 8.3%, 33.9%). Associations were stable in sensitivity analyses, and most consistently observed among Black study participants, those in lower income areas, and those diagnosed with HF at an earlier age. Concentration-response curves indicated a linear association for diesel and SOC. While there was some non-linearity in the gasoline concentration-response curve, only the linear component was associated with 30-day readmissions.

DISCUSSION

There appear to be source specific associations between PM_2.5 and 30-day readmissions particularly for traffic-related sources, potentially indicating unique toxicity of some sources for readmission risks that should be further explored.

Characterization of the short-term temporal variability of road dust chemical mixtures and meteorological profiles in a near-road urban site in British Columbia

Implications: Non-tailpipe emissions driven by springtime road dust in northern latitude communities is increasing in importance for air pollution control and improving our understanding of the health effects of chemical mixtures from particulate matter exposure. High-volume samples from a near-road site indicated that days affected by springtime road dust are substantively different from other days with respect to particulate matter mixture composition and meteorological drivers. The high load of trace elements in PM₁₀ on high road dust days has important implications for the acute toxicity of inhaled air and subsequent health effects. The complex relationships between road dust and weather identified in this study may facilitate further research on the health effects of chemical mixtures related to road dust while also highlighting potential changes in this unique form of air pollution as the climate changes.

Induction of toxicity in human colon cells and organoids by size- and composition-dependent road dust

Environmental pollution, including the annual resurgence of particulate matter derived from road dust, is a serious issue worldwide. Typically, the size of road dust is less than 10 μm; thus, road dust can penetrate into human organs, including the brain, through inhalation and intake by mouth. Therefore, the toxicity of road dust has been intensively studied in vitro and in vivo. However, in vitro systems, including 2D cell cultures, cannot mimic complex human organs, and there are several discrepancies between in vivo and human systems. Here, we used human colon cells and organoids to evaluate the cytotoxicity of particulate matter derived from road dust. The toxicity of road dust collected in industrialized and high traffic areas and NIST urban particulate matter reference samples were evaluated in 2D and 3D human colon cells as well as colon organoids and their characteristics were carefully examined. Data suggest that the size and elemental compositions of road dust can correlate with colon organoid toxicity, and thus, a more careful assessment of the size and elemental compositions of road dust should be conducted to predict its effect on human health.

Role of Secondary Organic Matter on Soot Particle Toxicity in Reconstituted Human Bronchial Epithelia Exposed at the Air-Liquid Interface

Secondary organic matter (SOM) formed from gaseous precursors constitutes a major mass fraction of fine particulate matter. However, there is only limited evidence on its toxicological impact. In this study, air-liquid interface cultures of human bronchial epithelia were exposed to different series of fresh and aged soot particles generated by a miniCAST burner combined with a micro smog chamber (MSC). Soot cores with geometric mean mobility diameters of 30 and 90 nm were coated with increasing amounts of SOM, generated from the photo-oxidation of mesitylene and ozonolysis of α-pinene. At 24 h after exposure, the release of lactate dehydrogenase (LDH), indicating cell membrane damage, was measured and proteome analysis, i.e. the release of 102 cytokines and chemokines to assess the inflammatory response, was performed. The data indicate that the presence of the SOM coating and its bioavailability play an important role in cytotoxicity. In particular, LDH release increased with increasing SOM mass/total particle mass ratio, but only when SOM had condensed on the outer surface of the soot cores. Proteome analysis provided further evidence for substantial interference of coated particles with essential properties of the respiratory epithelium as a barrier as well as affecting cell remodeling and inflammatory activity.

Integrative analysis to explore the biological association between environmental skin diseases and ambient particulate matter

Although numerous experimental studies have suggested a significant association between ambient particulate matter (PM) and respiratory damage, the etiological relationship between ambient PM and environmental skin diseases is not clearly understood. Here, we aimed to explore the association between PM and skin diseases through biological big data analysis. Differential gene expression profiles associated with PM and environmental skin diseases were retrieved from public genome databases. The co-expression among them was analyzed using a text-mining-based network analysis software. Activation/inhibition patterns from RNA-sequencing data performed with PM_2.5-treated normal human epidermal keratinocytes (NHEK) were overlapped to select key regulators of the analyzed pathways. We explored the adverse effects of PM on the skin and attempted to elucidate their relationships using public genome data. We found that changes in upstream regulators and inflammatory signaling networks mediated by MMP-1, MMP-9, PLAU, S100A9, IL-6, and S100A8 were predicted as the key pathways underlying PM-induced skin diseases. Our integrative approach using a literature-based co-expression analysis and experimental validation not only improves the reliability of prediction but also provides assistance to clarify underlying mechanisms of ambient PM-induced dermal toxicity that can be applied to screen the relationship between other chemicals and adverse effects.

Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial

BACKGROUND

Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide.

OBJECTIVE

Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru.

METHODS

We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25-64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and regular behavioral messaging, whereas controls continued their biomass cooking practices. During the second year, control participants received a free LPG stove, regular behavioral messaging, and vouchers to obtain LPG tanks from a nearby distributor, whereas fuel distribution stopped for intervention participants. We collected 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM) with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization.

RESULTS

Baseline mean  [ ± standard deviation  ( SD ) ] PM 2.5 (kitchen area concentrations 1,220 ± 1,010 vs. 1,190 ± 880   μ g / m 3 ; personal exposure 126 ± 214 vs. 104 ± 100   μ g / m 3 ), CO (kitchen 53 ± 49 vs. 50 ± 41  ppm ; personal 7 ± 8 vs. 7 ± 8  ppm ), and BC (kitchen 180 ± 120 vs. 210 ± 150   μ g / m 3 ; personal 19 ± 16 vs. 21 ± 22   μ g / m 3 ) were similar between control and intervention participants. Intervention participants had consistently lower mean  ( ± SD ) concentrations at the 12-month visit for kitchen (41 ± 59   μ g / m 3 , 3 ± 6   μ g / m 3 , and 8 ± 13  ppm ) and personal exposures (26 ± 34   μ g / m 3 , 2 ± 3   μ g / m 3 , and 3 ± 4  ppm ) to PM 2.5 , BC, and CO when compared to controls during the first year. In the second year, we observed comparable HAP reductions among controls after the voucher-based intervention for LPG fuel was implemented (24-month visit PM 2.5 , BC, and CO kitchen mean concentrations of 34 ± 74   μ g / m 3 , 3 ± 5   μ g / m 3 , and 6 ± 6  ppm and personal exposures of 17 ± 15   μ g / m 3 , 2 ± 2   μ g / m 3 , and 3 ± 4  ppm , respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit PM 2.5 , BC, and CO kitchen mean concentrations of 561 ± 1,251   μ g / m 3 , 82 ± 124   μ g / m 3 , and 23 ± 28  ppm and personal exposures of 35 ± 38   μ g / m 3 , 6 ± 6   μ g / m 3 , and 4 ± 5  ppm , respectively).

DISCUSSION

Both home delivery and voucher-based provision of free LPG over a 1-y period, in combination with provision of a free LPG stove and longitudinal behavioral messaging, reduced HAP to levels below 24-h World Health Organization air quality guidelines. Moreover, the effects of the intervention on HAP persisted for a year after fuel delivery stopped. Such strategies could be applied in LPG programs to reduce HAP and potentially improve health. https://doi.org/10.1289/EHP10054.

Suppression of Airway Allergic Reactions by a Photocatalytic Filter Using Mouse Model

Photocatalytic filters installed in air purifiers have been used to purify spaces by decomposing allergenic substances. However, we have not found any reports that evaluate the effectiveness of photocatalytic filters in suppressing allergic reactions in living organisms. In this study, we intratracheally instilled ovalbumin (OVA) into OVA-sensitized mice after the OVA was photocatalyzed by a titanium dioxide (TiO₂) filter, and verified the experimental model for evaluating the allergy-suppressing effect of photocatalysts. Mice were sensitized to OVA (10 µg/mouse) four times, and were intratracheally instilled with OVA (10 µg/mouse) after photocatalysis three times. Non-sensitized animals were instilled with normal saline following the same exposure schedule. The mice were dissected 24 h after final exposure. The OVA after photocatalysis significantly decreased the number of eosinophils in bronchoalveolar lavage fluid, and the concentration of OVA-specific IgE and IgG1 in serum, which were elevated in untreated OVA. Moreover, our experimental model showed the suppression of allergic reactions in mice, along with the decomposition of OVA after photocatalysis using the photocatalytic filter. Taken together, our experimental model for evaluating allergic reactions in the respiratory tract suggested that the allergy-suppressing effect of the photocatalytic filter can be evaluated.

Household air pollution and blood markers of inflammation: A cross-sectional analysis

Household air pollution (HAP) from biomass stoves is a leading risk factor for cardiopulmonary outcomes; however, its toxicity pathways and relationship with inflammation markers are poorly understood. Among 180 adult women in rural Peru, we examined the cross-sectional exposure-response relationship between biomass HAP and markers of inflammation in blood using baseline measurements from a randomized trial. We measured markers of inflammation (CRP, IL-6, IL-10, IL-1β, and TNF-α) with dried blood spots, 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM_2.5 ), black carbon (BC), and carbon monoxide (CO), and 48-h kitchen concentrations of nitrogen dioxide (NO₂ ) in a subset of 97 participants. We conducted an exposure-response analysis between quintiles of HAP levels and markers of inflammation. Markers of inflammation were more strongly associated with kitchen area concentrations of BC than PM_2.5 . As expected, kitchen area BC concentrations were positively associated with TNF-α (pro-inflammatory) concentrations and negatively associated with IL-10, an anti-inflammatory marker, controlling for confounders in single- and multi-pollutant models. However, contrary to expectations, kitchen area BC and NO₂ concentrations were negatively associated with IL-1β, a pro-inflammatory marker. No associations were identified for IL-6 or CRP, or for any marker in relation to personal exposures.

Toxicity of airborne particles-established evidence, knowledge gaps and emerging areas of importance

Epidemiological research has taught us a great deal about the health effects of airborne particulate matter (PM), particularly cardiorespiratory effects of combustion-related particles. This has been matched by toxicological research to define underlying mechanistic pathways. To keep abreast of the substantial challenges that air pollution continues to throw at us requires yet more strides to be achieved. For example, being aware of the most toxic components/sources and having a definitive idea of the range of associated disease outcomes. This review discusses approaches designed to close some of these knowledge gaps. These include a focus on particles arising from non-exhaust PM at the roadside and microplastics-both of which are becoming more relevant in the light of a shift in PM composition in response to global pressure to reduce combustion emissions. The application of hypothesis-free approaches in both mechanistic studies and epidemiology in unveiling unexpected relationships and generating novel insights is also discussed. Previous work, strengthening the evidence for both the adverse effects and benefits of intervention tell us that the sooner we act to close knowledge gaps, increase awareness and develop creative solutions, the sooner we can reduce the public health burden attributable to these complex and insidious environmental pollutants. This article is part of a discussion meeting issue 'Air quality, past present and future'.

Indoor air chemistry: Terpene reaction products and airway effects

Reactive chemistry is ubiquitous indoors with a wealth of complex oxidation reactions; some of these are initiated by both homogeneous and heterogeneous reaction of ozone with unsaturated organic compounds and subsequent the hydroxyl radical, either in the gas-phase or on reactive surfaces. One major focus has been the reaction of common and abundant terpene-based fragrances in indoor air emitted from many wood-based materials, a variety of consumer products, and citrus fruits and flowers. Inhalation of the terpenes themselves are generally not considered a health concern (both acute and long-term) due to their low indoor air concentrations; however, their gas- and surface reactions with ozone and the hydroxyl radical produce a host of products, both gaseous, i. a. formaldehyde, and ultrafine particles formed by condensation/nucleation processes. These reaction products may be of health concern. Human cell bioassays with key reaction products from ozone-initiated terpene reactions have shown some inflammatory reactions, but results are difficult to interpret for human exposure and risk assessment. Acute effects like sensory irritation in eyes and airways are unlikely or present at very low intensity in real life conditions based on rodent and human exposure studies and known thresholds for sensory irritation in eyes and airways and derived human reference values for airflow limitation and pulmonary irritation. Some fragrances and their ozone-initiated reaction products may possess anti-inflammatory properties. However, long-term effects of the reaction products as ultrafine particles are poorly explored. Material and product surfaces with high ozone deposition velocities may significantly impact the perceived air quality by altered emissions from both homogeneous and heterogeneous surface reactions.

Quartz filter-based thermal desorption gas chromatography mass spectrometry for in-situ molecular level measurement of ambient organic aerosols

Thermal desorption aerosol gas chromatography (TAG) is an effective technique for online chemical characterization of organics in atmospheric fine particulate matter (PM_2.5) on the molecular level. Unlike the previously reported impactor- or metal filter-based TAG, in this study, a replaceable quartz filter-based TAG (Q-TAG) was developed to achieve online measurement of organic constituents in ambient PM_2.5. A homemade device for automatic online sampling and pretreatment of aerosols was developed and coupled with gas chromatography-mass spectrometry (GC-MS) by a 4-port valve. Performance of the Q-TAG system was evaluated using C7 - C40 n-alkanes to cover a wide range of volatility. C11 - C40 could be measured by Q-TAG. The response of their peaks depends on their volatility and thermal desorption conditions (the desorption time and the flow rate). Under the optimized conditions, good precision (<12%), acceptable linearity (R²> 0.98) and high sensitivity (detection limits from 0.02 to 0.01 ng) of C13 - C40 were obtained. The developed Q-TAG system was applied for online analysis of organic species in ambient PM_2.5. The Q-TAG is suitable for detection of semi and low volatile organic species in particulate matter, and its filter can be easily changed, making it a useful tool in molecular characterization of ambient organic aerosols.

Genotoxicity of fine and coarse fraction ambient particulate matter in immortalised normal (TT1) and cancer-derived (A549) alveolar epithelial cells

Human exposure to airborne particulate matter (PM) is associated with adverse cardiopulmonary health effects, including lung cancer. Ambient PM represents a heterogeneous mixture of chemical classes including transition metals, polycyclic aromatic hydrocarbons (PAHs) and their derivatives such as nitro-PAHs, many of which are classified as putative carcinogens. As the primary site of human exposure to PM is the lungs, we investigated the response of two alveolar epithelial cell lines, the tumour-derived A549 and newly described TT1 cells, to fine and coarse PM collected from background and roadside locations. We show that coarse PM elicits a genotoxic response in the TT1 cells, with the strongest signal associated with the background sample. This response could be recapitulated using the organic extract derived from this sample. No responses were observed in PM-challenged A549 cells. Fine PM failed to elicit a genotoxic response in either cell line despite the higher PAH concentrations within this fraction. Consistent with the lack of a simplistic association between PM PAH content and the observed genotoxic response, TT1 cells treated with benzo[a]pyrene (BaP) demonstrated no increase in the selected markers. In contrast, a pattern of response was observed in TT1 cells challenged with 3-nitrobenzanthrone (3-NBA) similar to that with coarse PM. Together, these data illustrated the suitability of the TT1 cell line for assessing PM-induced genotoxicity and challenge the contention that fine roadside PM poses the higher cancer risk. Furthermore, the response to 3-NBA and not BaP suggests a major contribution of nitro-PAHs to the overall toxicity of PM. Environ. Mol. Mutagen. 59:290-301, 2018. © 2018 The Authors Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society.

The reduction of summer sulfate and switch from summertime to wintertime PM2.5 concentration maxima in the United States

Exposure to particulate matter air pollution with a nominal mean aerodynamic diameter less than or equal to 2.5 μm (PM_2.5) has been associated with health effects including cardiovascular disease and death. Here, we add to the understanding of urban and rural PM_2.5 concentrations over large spatial and temporal scales in recent years. We used high-quality, publicly-available air quality monitoring data to evaluate PM_2.5 concentration patterns and changes during the years 2000-2015. Compiling and averaging measurements collected across the U.S. revealed that PM_2.5 concentrations from urban sites experienced seasonal maxima in both winter and summer. Within each year from 2000 to 2008, the maxima of urban summer peaks were greater than winter peaks. However, from 2012 to 2015, the maxima of urban summertime PM_2.5 peaks were smaller than the urban wintertime PM_2.5 maxima, due to a decrease in the magnitude of summertime maxima with no corresponding decrease in the magnitude of winter maxima. PM_2.5 measurements at rural sites displayed summer peaks with magnitudes relatively similar to those of urban sites, and negligible to no winter peaks through the time period analyzed. Seasonal variations of urban and rural PM_2.5 sulfate, PM_2.5 nitrate, and PM_2.5 organic carbon (OC) were also assessed. Summer peaks in PM_2.5 sulfate decreased dramatically between 2000 and 2015, whereas seasonal PM_2.5 OC and winter PM_2.5 nitrate concentration maxima remained fairly consistent. These findings demonstrate that PM_2.5 concentrations, especially those occurring in the summertime, have declined in the U.S. from 2000 to 2015. In addition, reduction strategies targeting sulfate have been successful and the decrease in PM_2.5 sulfate contributed to the decline in total PM_2.5.

Effects by inhalation of abundant fragrances in indoor air - An overview

Odorous compounds (odors) like fragrances may cause adverse health effects. To assess their importance by inhalation, we have reviewed how the four major abundant and common airborne fragrances (α-pinene (APN), limonene (LIM), linalool (LIL), and eugenol (EUG)) impact the perceived indoor air quality as odor annoyance, sensory irritation and sensitization in the airways. Breathing and cardiovascular effects, and work performance, and the impact in the airways of ozone-initiated gas- and particle phase reactions products have also been assessed. Measured maximum indoor concentrations for APN, LIM and LIL are close to or above their odor thresholds, but far below their thresholds for sensory irritation in the eyes and upper airways; no information could be traced for EUG. Likewise, reported risk values for long-term effects are far above reported indoor concentrations. Human exposure studies with mixtures of APN and LIM and supported by animal inhalation models do not support sensitization of the airways at indoor levels by inhalation that include other selected fragrances. Human exposure studies, in general, indicate that reported lung function effects are likely due to the perception rather than toxic effects of the fragrances. In general, effects on the breathing rate and mood by exposure to the fragrances are inconclusive. The fragrances may increase the high-frequency heart rate variability, but aerosol exposure during cleaning activities may result in a reduction. Distractive effects influencing the work performance by fragrance/odor exposure are consistently reported, but their persistence over time is unknown. Mice inhalation studies indicate that LIM or its reaction mixture may possess anti-inflammatory properties. There is insufficient information that ozone-initiated reactions with APN or LIM at typical indoor levels cause airway effects in humans. Limited experimental information is available on long-term effects of ozone-initiated reaction products of APN and LIM at typical indoor levels.

Ambient Air Pollution and Morbidity in Chinese

The rapid economic growth in China is coupled with a severe ambient air pollution, which poses a huge threat to human health and the sustainable development of social economy. The rapid urbanization and industrialization over the last three decades have placed China as one of countries with the greatest disease burden in world. Notably, the prevalence rate of chronic noncommunicable diseases (CND), including respiratory diseases, CVD, and stroke, in 2010 reaches 16.9%. The continuous growth of the incidence of CND urgent needs for effective regulatory action for health protection. This study aims to evaluate the impact of rapid urbanization on status of ambient air pollution and associated adverse health effects on the incidence and the burden of CND and risk assessment. Our findings would be greatly significant in the prediction of the risk of ambient air pollution on CND and for evidence-based policy making and risk management in China.

Neurodegenerative and neurological disorders by small inhaled particles

The world's population is steadily ageing and as a result, health conditions related to ageing, such as dementia, have become a major public health concern. In 2001, it was estimated that there were almost 5 million Europeans suffering from Alzheimer's disease (AD) and this figure has been projected to almost double by 2040. About 40% of people over 85 suffer from AD, and another 10% from Parkinson's disease (PD). The majority of AD and PD cases are of sporadic origin and environmental factors play an important role in the aetiology. Epidemiological research identified airborne particulate matter (PM) as one of the environmental factors potentially involved in AD and PD pathogenesis. Also, cumulating evidence demonstrates that the smallest sizes of the inhalable fraction of ambient particulate matter, also referred to as ultrafine particulate matter or nano-sized particles, are capable of inducing effects beyond the respiratory system. Translocation of very small particles via the olfactory epithelium in the nose or via uptake into the circulation has been demonstrated through experimental rodent studies with engineered nanoparticles. Outdoor air pollution has been linked to several health effects including oxidative stress and neuroinflammation that may ultimately result in neurodegeneration and cognitive impairment. This review aims to evaluate the relationship between exposure to inhaled ambient particles and neurodegeneration.