A Case-Crossover Study to Investigate the Effects of Atmospheric Particulate Matter Concentrations, Season, and Air Temperature on Accident and Emergency Presentations for Cardiovascular Events in Northern Italy

Potentially toxic elements and lead isotopic signatures in the 10 μm fraction of urban dust: Environmental risk enhanced by resuspension of contaminated soils

In urban environments, soils are a sink of pollutants and might become a source of contamination, as they commonly display potentially toxic elements (PTE) concentrations above the legislative limits. Particularly, the inhalable fraction of soils (<10 μm) is enriched in PTE compared to bulk soils (BS). The enrichment makes these particles an environmental hazard because of their susceptibility to resuspension and their potential contribution to road dust (RD) and atmospheric particulate matter (PM10) pollution. To gain a better insight into urban contamination dynamics we studied the BS, the resuspended <10 μm fraction of BS (Res-BS) and RD (Res-RD) in a European historically industrialized and densely populated city. Compared to BS, the Res-BS and Res-RD showed higher PTE concentrations and a higher variability for most of the elements. Lead was the only PTE showing similar concentrations in all the matrices, suggesting shared sources and redistribution pathways within the city. Chemometric elaborations identified Res-BS as a transition between BS and Res-RD or, rather, a Res-RD precursor. Also, Pb was confirmed to be ubiquitous in all the media. In all the matrices, Pb isotopic signatures were investigated and compared with PM10 fingerprints from the same city. The anthropogenic isotopic signature in Res-BS and Res-RD was evident, and samples belonging to neighboring sites showed comparable isotopic ratios. The Res-BS appeared as a key driver for Pb distribution within the city both in Res-RD and in PM10. These results demonstrate the intimate interaction between urban environmental compartments (soil, road dust and PM10), and the active contribution of fine soil fractions to anthropogenic pollution, with relevant policy implications in urban areas since soils were found to contribute directly to air pollution.

Associations between Short-Term Air Pollution Exposure and the Peripheral Leukocyte Distribution in the Adult Male Population in Beijing, China

The inflammatory effects of air pollution exposure may account for increased public health risk. However, evidence regarding the effects of air pollution on peripheral blood leukocytes in the population is inconsistent. We investigated the association between the short-term effects of ambient air pollution and the peripheral blood leukocyte distribution in adult men in Beijing, China. From January 2015 to December 2019, a total of 11,035 men aged 22-45 years in Beijing were included in the study. Their peripheral blood routine parameters were measured. The ambient pollution monitoring parameters (particulate matter ≤ 10 µm (PM₁₀), PM_2.5, nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and ozone (O₃)) were collected daily. The potential association between ambient air pollution exposure and peripheral blood leukocyte count and classification was analyzed with generalized additive models (GAMs). After adjusting for confounding factors, PM_2.5, PM₁₀, SO₂, NO₂, O₃, and CO were significantly correlated with changes to at least one peripheral leukocyte subtype. Short-term and cumulative air pollutant exposure dramatically increased the participants' peripheral blood neutrophil, lymphocyte, and monocyte numbers and decreased eosinophils and basophils. Our results demonstrated that air pollution induced inflammation in the participants. The peripheral leukocyte count and classification can be utilized to evaluate the inflammation induced by air pollution in the exposed male population.

An Epidemiological Study to Investigate Links between Atmospheric Pollution from Farming and SARS-CoV-2 Mortality

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that long-term exposure to farming-related air pollutants might predispose to an increased risk of COVID-19-related death. To test this hypothesis, we performed an ecological study of five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily), linking all-cause mortality by province (administrative entities within regions) to data on atmospheric concentrations of particulate matter (PM_2.5 and PM₁₀) and ammonia (NH₃), which are mainly produced by agricultural activities. The study outcome was change in all-cause mortality during March-April 2020 compared with March-April 2015-2019 (period). We estimated all-cause mortality rate ratios (MRRs) by multivariate negative binomial regression models adjusting for air temperature, humidity, international import-export, gross domestic product and population density. We documented a 6.9% excess in MRR (proxy for COVID-19 mortality) for each tonne/km² increase in NH₃ emissions, explained by the interaction of the period variable with NH₃ exposure, considering all pollutants together. Despite the limitations of the ecological design of the study, following the precautionary principle, we recommend the implementation of public health measures to limit environmental NH₃ exposure, particularly while the COVID-19 pandemic continues. Future studies are needed to investigate any causal link between COVID-19 and farming-related pollution.

The Effect of Minimum and Maximum Air Temperatures in the Summer on Heat Stroke in Japan: A Time-Stratified Case-Crossover Study

An increase in the global surface temperature and changes in urban morphologies are associated with increased heat stress especially in urban areas. This can be one of the contributing factors underlying an increase in heat strokes. We examined the impact of summer minimum air temperatures, which often represent nighttime temperatures, as well as a maximum temperature on a heat stroke. We collected data from the records of daily ambulance transports for heat strokes and meteorological data for July and August of 2017–2019 in the Tottori Prefecture, Japan. A time-stratified case-crossover design was used to determine the association of maximum/minimum air temperatures and the incidence of heat strokes. We used a logistic regression to identify factors associated with the severity of heat strokes. A total of 1108 cases were identified with 373 (33.7%) calls originating in the home (of these, 59.8% were the age of ≥ 75). A total of 65.8% of cases under the age of 18 were related to exercise. Days with a minimum temperature ≥ 25 °C had an odds ratio (95% confidence interval) of 3.77 (2.19, 6.51) for the incidence of an exercise-related heat stroke (reference: days with a minimum temperature < 23 °C). The odds ratio for a heat stroke occurring at home or for calls for an ambulance to the home was 6.75 (4.47, 10.20). The severity of the heat stroke was associated with older age but not with air temperature. Minimum and maximum air temperatures may be associated with the incidence of heat strokes and in particular the former with non-exertional heat strokes.

Particulate Matter and Temperature: Increased Risk of Adverse Clinical Outcomes in Patients With Atrial Fibrillation

OBJECTIVE

To test the hypothesis that particulate matter with an aerodynamic diameter of less than 10 μm (PM₁₀) and temperature are associated with an increased risk of adverse clinical outcomes in patients with atrial fibrillation (AF) taking vitamin K antagonists (VKAs).

PATIENTS AND METHODS

We included patients with AF whose condition was stable while taking VKAs (international normalized ratio, 2.0 to 3.0) for 6 months seen in a tertiary hospital (recruitment from May 1, 2007, to December 1, 2007). During a median follow-up of 6.5 years (interquartile range, 4.3 to 7.9 years), ischemic strokes, major bleeding, adverse cardiovascular events, and mortality were recorded. From 2007 to 2016, data on average temperature and PM₁₀ were compared with clinical outcomes.

RESULTS

The study group included 1361 patients (663 [48.7%] male; median age, 76 years [interquartile range, 71 to 81 years]). High PM₁₀ and low temperatures were associated with higher risk of major bleeding (adjusted hazard ratio [aHR], 1.44; 95% CI, 1.22 to 1.70 and aHR, 1.03; 95% CI, 1.01 to 1.05, respectively) and mortality (aHR, 1.50; 95% CI, 1.34 to 1.69 and aHR, 1.04; 95% CI, 1.02 to 1.06, respectively); PM₁₀ was also associated with ischemic stroke and temperature with cardiovascular events. The relative risk (RR) for cardiovascular events and mortality increased in months in the lower quartile of temperature (RR, 1.12; 95% CI, 1.04 to 1.21 and RR, 1.41; 95% CI, 1.15 to 1.74, respectively). Comparing seasons, there were higher risks of cardiovascular events in spring, autumn, and winter than in summer, whereas the risk of mortality increased only in winter.

CONCLUSION

In patients with AF taking VKAs, high PM₁₀ and low temperature were associated with increased risk of ischemic stroke and cardiovascular events, respectively. Both factors increased major bleeding and mortality risks, which were higher during colder months and seasons.