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Song X, Hu Y, Ma Y, Jiang L, Wang X, Shi A, Zhao J, Liu Y, Liu Y, Tang J, Li X, Zhang X, Guo Y, Wang S. Is short-term and long-term exposure to black carbon associated with cardiovascular and respiratory diseases? A systematic review and meta-analysis based on evidence reliability. BMJ Open 2022; 12:e049516. [PMID: 35504636 PMCID: PMC9066484 DOI: 10.1136/bmjopen-2021-049516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Adverse health effects of fine particles (particulate matter2.5) have been well documented by a series of studies. However, evidences on the impacts of black carbon (BC) or elemental carbon (EC) on health are limited. The objectives were (1) to explored the effects of BC and EC on cardiovascular and respiratory morbidity and mortality, and (2) to verified the reliability of the meta-analysis by drawing p value plots. DESIGN The systematic review and meta-analysis using adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and p value plots approach. DATA SOURCES PubMed, Embase and Web of Science were searched from inception to 19 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Time series, case cross-over and cohort studies that evaluated the associations between BC/EC on cardiovascular or respiratory morbidity or mortality were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcomes were analysed via a random effects model and reported as relative risk (RR) with 95% CI. The certainty of evidences was assessed by adapted GRADE. The reliabilities of meta-analyses were analysed by p value plots. RESULTS Seventy studies met our inclusion criteria. (1) Short-term exposure to BC/EC was associated with 1.6% (95% CI 0.4% to 2.8%) increase in cardiovascular diseases per 1 µg/m3 in the elderly; (2) Long-term exposure to BC/EC was associated with 6.8% (95% CI 0.4% to 13.5%) increase in cardiovascular diseases and (3) The p value plot indicated that the association between BC/EC and respiratory diseases was consistent with randomness. CONCLUSIONS Both short-term and long-term exposures to BC/EC were related with cardiovascular diseases. However, the impact of BC/EC on respiratory diseases did not present consistent evidence and further investigations are required. PROSPERO REGISTRATION NUMBER CRD42020186244.
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Affiliation(s)
- Xuping Song
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yue Hu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yan Ma
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Liangzhen Jiang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xinyi Wang
- Second Clinical College, Lanzhou University, Lanzhou, Gansu, China
| | - Anchen Shi
- Department of General Surgery, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Junxian Zhao
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yunxu Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yafei Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Tang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiayang Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoling Zhang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
| | - Yong Guo
- Department of Civil Affairs in Guizhou Province, Guizhou Province People's Government, Guiyang, Guizhou, China
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China
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Source-Apportioned PM2.5 and Cardiorespiratory Emergency Department Visits: Accounting for Source Contribution Uncertainty. Epidemiology 2020; 30:789-798. [PMID: 31469699 DOI: 10.1097/ede.0000000000001089] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite evidence suggesting that air pollution-related health effects differ by emissions source, epidemiologic studies on fine particulate matter (PM2.5) infrequently differentiate between particles from different sources. Those that do rarely account for the uncertainty of source apportionment methods. METHODS For each day in a 12-year period (1998-2010) in Atlanta, GA, we estimated daily PM2.5 source contributions from a Bayesian ensemble model that combined four source apportionment methods including chemical transport and receptor-based models. We fit Poisson generalized linear models to estimate associations between source-specific PM2.5 concentrations and cardiorespiratory emergency department visits (n = 1,598,117). We propagated uncertainty in the source contribution estimates through analyses using multiple imputation. RESULTS Respiratory emergency department visits were positively associated with biomass burning and secondary organic carbon. For a 1 µg/m increase in PM2.5 from biomass burning during the past 3 days, the rate of visits for all respiratory outcomes increased by 0.4% (95% CI 0.0%, 0.7%). There was less evidence for associations between PM2.5 sources and cardiovascular outcomes, with the exception of ischemic stroke, which was positively associated with most PM2.5 sources. Accounting for the uncertainty of source apportionment estimates resulted, on average, in an 18% increase in the standard error for rate ratio estimates for all respiratory and cardiovascular emergency department visits, but inflation varied across specific sources and outcomes, ranging from 2% to 39%. CONCLUSIONS This study provides evidence of associations between PM2.5 sources and some cardiorespiratory outcomes and quantifies the impact of accounting for variability in source apportionment approaches.
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Chen JH, Hu DT, Jia X, Niu W, Deng FR, Guo XB. [Monitoring metrics for short-term exposure to ambient ozone and pulmonary function and airway inflammation in healthy young adults]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:492-499. [PMID: 32541983 DOI: 10.19723/j.issn.1671-167x.2020.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the associations of different monitoring metrics for short-term exposure to ambient ozone (O3) with pulmonary function and airway inflammation in healthy young adults. METHODS A total of 97 healthy young college students were recruited and followed in a panel study conducted from December 2017 to June 2018. Each participant underwent 3 follow-up visits, and lung function and fractional exhaled nitric oxide (FeNO) were measured at each visit. Ambient air pollutant concentrations were obtained from the environment monitoring station of Beijing closest to the participant residences, and meteorological data were collected from China Meteorological Data Service Center. Linear mixed-effect models were applied to assess the associations between different monitoring metrics for ambient O3 short-term exposure with pulmonary function or airway inflammation in the healthy young adults. RESULTS During the study period, the P50 (P25, P75) values for ambient O3 concentration expressed as daily 1-hour maximum (O3-1 h max), daily maximum 8-hour average (O3-8 h max) and 24-hour average (O3-24 h avg) were 102.5 (76.8, 163.0) μg/m3, 91.1 (68.3, 154.3) μg/m3 and 61.6 (36.9, 81.7) μg/m3, respectively. The different monitoring metrics for short-term exposure to ambient O3 were significantly associated with reduced forced expiratory volume in the first second (FEV1) and increased FeNO. An interquartile range (IQR) increase in 6-d moving average of O3-1 h max (IQR=71.5 μg/m3) was associated with a 6.2% (95%CI: -11.8%, -0.5%) decrease in FEV1 and a 63.3% (95%CI: 13.8%, 134.3%) increase in FeNO. An IQR increase in 7-d moving average of O3-8 h max (IQR=62.0 μg/m3) was associated with a 6.2% (95%CI: -11.6%, -0.7%) decrease in FEV1and a 75.5% (95%CI: 19.3%, 158.0%) increase in FeNO. An IQR increase in 5-d moving average of O3-24 h avg (IQR=32.9 μg/m3) was associated with a 3.7% (95%CI: -7.1%, -0.2%) decrease in FEV1and a 25.3% (95%CI: 3.6%, 51.6%) increase in FeNO. There was no significant association between the three monitoring metrics for O3 exposure and peak expiratory flow (PEF). CONCLUSION Short-term exposure to ambient O3 was associated with decreased lung function and increased airway inflammation among the healthy young adults, and daily 1-hour maximum was more sensitively to the respiratory effects of O3.
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Affiliation(s)
- J H Chen
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - D T Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - X Jia
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - W Niu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - F R Deng
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - X B Guo
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
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Abrams JY, Klein M, Henneman LRF, Sarnat SE, Chang HH, Strickland MJ, Mulholland JA, Russell AG, Tolbert PE. Impact of air pollution control policies on cardiorespiratory emergency department visits, Atlanta, GA, 1999-2013. ENVIRONMENT INTERNATIONAL 2019; 126:627-634. [PMID: 30856450 DOI: 10.1016/j.envint.2019.01.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND Air pollution control policies resulting from the 1990 Clean Air Act Amendments were aimed at reducing pollutant emissions, ambient concentrations, and ultimately adverse health outcomes. OBJECTIVES As part of a comprehensive air pollution accountability study, we used a counterfactual study design to estimate the impact of mobile source and electricity generation control policies on health outcomes in the Atlanta, GA, metropolitan area from 1999 to 2013. METHODS We identified nine sets of pollution control policies, estimated changes in emissions in the absence of these policies, and employed those changes to estimate counterfactual daily ambient pollutant concentrations at a central monitoring location. Using a multipollutant Poisson time-series model, we estimated associations between observed pollutant levels and daily counts of cardiorespiratory emergency department (ED) visits at Atlanta hospitals. These associations were then used to estimate the number of ED visits prevented due to control policies, comparing observed to counterfactual daily concentrations. RESULTS Pollution control policies were estimated to substantially reduce ambient concentrations of the nine pollutants examined for the period 1999-2013. We estimated that pollutant concentration reductions resulting from the control policies led to the avoidance of over 55,000 cardiorespiratory disease ED visits in the five-county metropolitan Atlanta area, with greater proportions of visits prevented in later years as effects of policies became more fully realized. During the final two years of the study period, 2012-2013, the policies were estimated to prevent 16.5% of ED visits due to asthma (95% interval estimate: 7.5%, 25.1%), 5.9% (95% interval estimate: -0.4%, 12.3%) of respiratory ED visits, and 2.3% (95% interval estimate: -1.8%, 6.2%) of cardiovascular disease ED visits. DISCUSSION Pollution control policies resulting from the 1990 Clean Air Act Amendments led to substantial estimated reductions in ambient pollutant concentrations and cardiorespiratory ED visits in the Atlanta area.
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Affiliation(s)
- Joseph Y Abrams
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Mitchel Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucas R F Henneman
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Stefanie E Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Howard H Chang
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Armistead G Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Paige E Tolbert
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Estimating Acute Cardiorespiratory Effects of Ambient Volatile Organic Compounds. Epidemiology 2018; 28:197-206. [PMID: 27984424 DOI: 10.1097/ede.0000000000000607] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The health effects of ambient volatile organic compounds (VOCs) have received less attention in epidemiologic studies than other commonly measured ambient pollutants. In this study, we estimated acute cardiorespiratory effects of ambient VOCs in an urban population. METHODS Daily concentrations of 89 VOCs were measured at a centrally-located ambient monitoring site in Atlanta and daily counts of emergency department visits for cardiovascular diseases and asthma in the five-county Atlanta area were obtained for the 1998-2008 period. To understand the health effects of the large number of species, we grouped these VOCs a priori by chemical structure and estimated the associations between VOC groups and daily counts of emergency department visits in a time-series framework using Poisson regression. We applied three analytic approaches to estimate the VOC group effects: an indicator pollutant approach, a joint effect analysis, and a random effect meta-analysis, each with different assumptions. We performed sensitivity analyses to evaluate copollutant confounding. RESULTS Hydrocarbon groups, particularly alkenes and alkynes, were associated with emergency department visits for cardiovascular diseases, while the ketone group was associated with emergency department visits for asthma. CONCLUSIONS The associations observed between emergency department visits for cardiovascular diseases and alkenes and alkynes may reflect the role of traffic exhaust, while the association between asthma visits and ketones may reflect the role of secondary organic compounds. The different patterns of associations we observed for cardiovascular diseases and asthma suggest different modes of action of these pollutants or the mixtures they represent.
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Ye D, Klein M, Mulholland JA, Russell AG, Weber R, Edgerton ES, Chang HH, Sarnat JA, Tolbert PE, Ebelt Sarnat S. Estimating Acute Cardiovascular Effects of Ambient PM 2.5 Metals. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:027007. [PMID: 29467104 PMCID: PMC6066344 DOI: 10.1289/ehp2182] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/05/2017] [Accepted: 12/08/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Few epidemiologic studies have investigated health effects of water-soluble fractions of PM2.5 metals, the more biologically accessible fractions of metals, in their attempt to identify health-relevant components of ambient PM2.5. OBJECTIVES In this study, we estimated acute cardiovascular effects of PM2.5 components in an urban population, including a suite of water-soluble metals that are not routinely measured at the ambient level. METHODS Ambient concentrations of criteria gases, PM2.5, and PM2.5 components were measured at a central monitor in Atlanta, Georgia, during 1998-2013, with some PM2.5 components only measured during 2008-2013. In a time-series framework using Poisson regression, we estimated associations between these pollutants and daily counts of emergency department (ED) visits for cardiovascular diseases in the five-county Atlanta area. RESULTS Among the PM2.5 components we examined during 1998-2013, water-soluble iron had the strongest estimated effect on cardiovascular outcomes [R͡R=1.012 (95% CI: 1.005, 1.019), per interquartile range increase (20.46ng/m3)]. The associations for PM2.5 and other PM2.5 components were consistent with the null when controlling for water-soluble iron. Among PM2.5 components that were only measured during 2008-2013, water-soluble vanadium was associated with cardiovascular ED visits [R͡R=1.012 (95% CI: 1.000, 1.025), per interquartile range increase (0.19ng/m3)]. CONCLUSIONS Our study suggests cardiovascular effects of certain water-soluble metals, particularly water-soluble iron. The observed associations with water-soluble iron may also point to certain aspects of traffic pollution, when processed by acidifying sulfate, as a mixture harmful for cardiovascular health. https://doi.org/10.1289/EHP2182.
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Affiliation(s)
- Dongni Ye
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mitchel Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Armistead G Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Rodney Weber
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Eric S Edgerton
- Atmospheric Research & Analysis, Inc., Cary, North Carolina, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jeremy A Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Paige E Tolbert
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Global Associations between Air Pollutants and Chronic Obstructive Pulmonary Disease Hospitalizations. A Systematic Review. Ann Am Thorac Soc 2017; 13:1814-1827. [PMID: 27314857 DOI: 10.1513/annalsats.201601-064oc] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Exacerbations are key events in chronic obstructive pulmonary disease (COPD), affecting lung function decline and quality of life. The effect of exposure to different air pollutants on COPD exacerbations is not clear. OBJECTIVES To carry out a systematic review, examining associations between air pollutants and hospital admissions for COPD exacerbations. METHODS MEDLINE, Embase, BIOSIS, Science Citation Index, and the Air Pollution Epidemiology Database were searched for publications published between 1980 and September 2015. Inclusion criteria were focused on studies presenting solely a COPD outcome defined by hospital admissions and a measure of gaseous air pollutants and particle fractions. The association between each pollutant and COPD admissions was investigated in metaanalyses using random effects models. Analyses were stratified by geographical clusters for investigation of the consistency of the evidence worldwide. MEASUREMENTS AND MAIN RESULTS Forty-six studies were included, and results for all the pollutants under investigation showed marginal positive associations; however, the number of included studies was small, the studies had high heterogeneity, and there was evidence of small-study bias. Geographical clustering of the effects of pollution on COPD hospital admissions was evident and reduced heterogeneity significantly. CONCLUSIONS The most consistent association was between a 1-mg/m3 increase in carbon monoxide level and COPD-related admissions (odds ratio, 1.02; 95% confidence interval, 1.01-1.03). The heterogeneity was moderate, and there was a consistent positive association in both Europe and North America, although levels were clearly below World Health Organization guideline values. There is mixed evidence on the effects of environmental pollution on COPD exacerbations. Limitations of previous studies included the low spatiotemporal resolution of pollutants, inadequate control for confounding factors, and the use of aggregated health data that ignored personal characteristics. The need for more targeted exposure estimates in a large number of geographical locations is evident.
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O'Lenick CR, Winquist A, Chang HH, Kramer MR, Mulholland JA, Grundstein A, Sarnat SE. Evaluation of individual and area-level factors as modifiers of the association between warm-season temperature and pediatric asthma morbidity in Atlanta, GA. ENVIRONMENTAL RESEARCH 2017; 156:132-144. [PMID: 28342349 PMCID: PMC5633283 DOI: 10.1016/j.envres.2017.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Previous studies have found associations between respiratory morbidity and high temperatures; however, few studies have explored associations in potentially sensitive sub-populations. METHODS We evaluated individual and area-level factors as modifiers of the association between warm-season (May-Sept.) temperature and pediatric respiratory morbidity in Atlanta. Emergency department (ED) visit data were obtained for children, 5-18 years old, with primary diagnoses of asthma or respiratory disease (diagnoses of upper respiratory infections, bronchiolitis, pneumonia, chronic obstructive pulmonary disease, asthma, or wheeze) in 20-county Atlanta during 1993-2012. Daily maximum temperature (Tmax) was acquired from the automated surface observing station at Atlanta Hartsfield International Airport. Poisson generalized linear models were used to estimate rate ratios (RR) between daily Tmax and asthma or respiratory disease ED visits, controlling for time and meteorology. Tmax effects were estimated for single-day lags of 0-6 days, for 3-, 5-, and 7-day moving averages and modeled with cubic terms to allow for non-linear relationships. Effect modification by individual factors (sex, race, insurance status) and area-level socioeconomic status (SES; ZIP code levels of poverty, education, and the neighborhood deprivation index) was examined via stratification. RESULTS Estimated RRs for Tmax and pediatric asthma ED visits were positive and significant for lag days 1-5, with the strongest single day association observed on lag day 2 (RR=1.06, 95% CI: 1.03, 1.09) for a change in Tmax from 27°C to 32°C (25th to 75th percentile). For the moving average exposure periods, associations increased as moving average periods increased. We observed stronger RRs between Tmax and asthma among males compared to females, non-white children compared to white children, children with private insurance compared to children with Medicaid, and among children living in high compared to low SES areas. Associations between Tmax and respiratory disease ED visits were weak and non-significant (p-value>0.05). CONCLUSIONS Results suggest socio-demographic factors (race/ethnicity, insurance status, and area-level SES) may confer vulnerability to temperature-related pediatric asthma morbidity. Our findings of weaker associations among children with Medicaid compared to other health insurance types and among children living in low compared to high SES areas run counter to our belief that children from disadvantaged households or ZIP codes would be more vulnerable to the respiratory effects of temperature. The potential reasons for these unexpected results are explored in the discussion.
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Affiliation(s)
- Cassandra R O'Lenick
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Drive NW, Atlanta, GA 30332 USA.
| | - Andrew Grundstein
- Department of Geography, University of Georgia, 210 Field St., Athens, GA 30602, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Socioeconomic Status and Non-Fatal Adult Injuries in Selected Atlanta (Georgia USA) Hospitals. Prehosp Disaster Med 2017; 32:403-413. [PMID: 28359343 DOI: 10.1017/s1049023x17000255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Injury mortality data for adults in the United States and other countries consistently show higher mortality for those with lower socioeconomic status (SES). Data are sparse regarding the role of SES among adult, non-fatal US injuries. The current study estimated non-fatal injury risk by household income using hospital emergency department (ED) visits. METHODS A total of 1,308,892 ED visits at 10 Atlanta (Georgia USA) hospitals from 2001-2004 (347,866 injuries) were studied. The SES was based on US census-block group income, with subjects assigned to census blocks based on reported residence. Logistic regression was used to determine risk by SES for injuries versus all other ED visits, adjusting for demographics, hospital, and weather. Supplemental analyses using hospital data from 2010-2013, without data on SES, were conducted to determine whether earlier patterns by race, age, and gender persisted. RESULTS Risk for many injury categories increased with higher income. Odds ratio by quartiles of increasing income (lowest quartile as referent, 95% confidence interval [CI] given for upper most quartile) were 1.00, 1.23, 1.34, 1.40 (95% CI 1.36-1.45) for motor vehicle accidents; 1.00, 1.03, 1.11, 1.24 (95% CI 1.20-1.29) for being struck by objects; 1.00. 0.99, 1.04, 1.12 (95% CI 1.00-1.25) for suicide; and 1.00, 1.03, 1.05, 1.12 (95% CI 1.09-1.15) for falls. In contrast, decreased injury risk with increased household income was seen for assaults (1.00, 0.83, 0.73, 0.67 [95% CI 0.63-0.72], by increasing quartiles). These trends by income did not differ markedly by race and gender. Whites generally had less risk of injuries, with the exception of assaults and motor vehicle accidents. Males had higher risk of injury than females, with the exception of falls and suicide attempts. Patterns of risk for race, age, and gender were consistent between 2001-2004 and 2010-2013. CONCLUSION For most non-fatal injuries, those with higher income had more risk of ED visits, although the opposite was true for assault. Hulland E , Chowdhury R , Sarnat S , Chang HH , Steenland K . Socioeconomic status and non-fatal adult injuries in selected Atlanta (Georgia USA) hospitals. Prehosp Disaster Med. 2017;32(4):403-413.
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Heidari L, Winquist A, Klein M, O'Lenick C, Grundstein A, Ebelt Sarnat S. Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100982. [PMID: 27706089 PMCID: PMC5086721 DOI: 10.3390/ijerph13100982] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/22/2016] [Accepted: 09/22/2016] [Indexed: 11/16/2022]
Abstract
Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI) may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED) visits were collected in Atlanta, Georgia, USA during 1993-2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index) modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels) was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research.
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Affiliation(s)
- Leila Heidari
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Mitchel Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Cassandra O'Lenick
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrew Grundstein
- Department of Geography, Franklin College of Arts and Sciences, The University of Georgia, 210 Field Street, Athens, GA 30602, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Song X, Liu Y, Hu Y, Zhao X, Tian J, Ding G, Wang S. Short-Term Exposure to Air Pollution and Cardiac Arrhythmia: A Meta-Analysis and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070642. [PMID: 27367707 PMCID: PMC4962183 DOI: 10.3390/ijerph13070642] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/18/2016] [Accepted: 06/22/2016] [Indexed: 12/23/2022]
Abstract
The objective was to assess the transient association between air pollution and cardiac arrhythmia. Five databases were searched for studies investigating the association between daily increases in air pollutants (PM2.5, PM10, carbon monoxide, nitrogen dioxide, sulfur dioxide and ozone) and arrhythmia hospitalization or arrhythmia mortality. Two reviewers independently selected studies, extracted data, and assessed risk of bias. Outcomes were analyzed via a random-effects model and reported as relative risk and 95% confidence interval. 25 studies satisfied our inclusion criteria and 23 contributed to the meta-analysis. Arrhythmia hospitalization or mortality were associated with increases in PM2.5 (RR = 1.015 per 10 μg/m³, 95% CI: 1.006-1.024), PM10 (RR = 1.009 per 10 μg/m³, 95% CI: 1.004-1.014), carbon monoxide (RR = 1.041 per 1 ppm, 95% CI: 1.017-1.065), nitrogen dioxide (RR = 1.036 per 10 ppb, 95% CI: 1.020-1.053), and sulfur dioxide (RR = 1.021 per 10 ppb, 95% CI: 1.003-1.039), but not ozone (RR = 1.012 per 10 ppb, 95% CI: 0.997-1.027). Both particulate and gaseous components, with the exception of ozone, have a temporal association with arrhythmia hospitalization or mortality. Compared with Europe and North America, a stronger association was noted in Asia.
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Affiliation(s)
- Xuping Song
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Yu Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Yuling Hu
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Xiaoyan Zhao
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Guowu Ding
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Shigong Wang
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China.
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Winquist A, Grundstein A, Chang HH, Hess J, Sarnat SE. Warm season temperatures and emergency department visits in Atlanta, Georgia. ENVIRONMENTAL RESEARCH 2016; 147:314-23. [PMID: 26922412 PMCID: PMC4821766 DOI: 10.1016/j.envres.2016.02.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/18/2016] [Accepted: 02/17/2016] [Indexed: 05/03/2023]
Abstract
PURPOSE Extreme heat events will likely increase in frequency with climate change. Heat-related health effects are better documented among the elderly than among younger age groups. We assessed associations between warm-season ambient temperature and emergency department (ED) visits across ages in Atlanta during 1993-2012. METHODS We examined daily counts of ED visits with primary diagnoses of heat illness, fluid/electrolyte imbalances, renal disease, cardiorespiratory diseases, and intestinal infections by age group (0-4, 5-18, 19-64, 65+years) in relation to daily maximum temperature (TMX) using Poisson time series models that included cubic terms for TMX at single-day lags of 0-6 days, controlling for maximum dew-point temperature, time trends, week day, holidays, and hospital participation periods. We estimated rate ratios (RRs) and 95% confidence intervals (CI) for TMX changes from 27°C to 32°C (25th to 75th percentile) and conducted extensive sensitivity analyses. RESULTS We observed associations between TMX and ED visits for all internal causes, heat illness, fluid/electrolyte imbalances, renal diseases, asthma/wheeze, diabetes, and intestinal infections. Age groups with the strongest observed associations were 65+years for all internal causes [lag 0 RR (CI)=1.022 (1.016-1.028)] and diabetes [lag 0 RR=1.050 (1.008-1.095)]; 19-64 years for fluid/electrolyte imbalances [lag 0 RR=1.170 (1.136-1.205)] and renal disease [lag 1 RR=1.082 (1.065-1.099)]; and 5-18 years for asthma/wheeze [lag 2 RR=1.059 (1.030-1.088)] and intestinal infections [lag 1 RR=1.120 (1.041-1.205)]. CONCLUSIONS Varying strengths of associations between TMX and ED visits by age suggest that optimal interventions and health-impact projections would account for varying heat health impacts across ages.
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Affiliation(s)
- Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrew Grundstein
- Department of Geography, University of Georgia, 210 Field Street, Atlanta, GA 30322, USA.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Jeremy Hess
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Liu Y, Yan S, Poh K, Liu S, Iyioriobhe E, Sterling DA. Impact of air quality guidelines on COPD sufferers. Int J Chron Obstruct Pulmon Dis 2016; 11:839-72. [PMID: 27143874 PMCID: PMC4846081 DOI: 10.2147/copd.s49378] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. Objective This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. Methods PubMed and Google Scholar were utilized to search for articles related to our study’s focus. Search terms included “COPD exacerbation”, “air pollution”, “air quality guidelines”, “air quality standards”, “COPD morbidity and mortality”, “chronic bronchitis”, and “air pollution control” separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Results Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. Conclusion There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries’ socioeconomic conditions to reduce the air pollution exposure and COPD burden.
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Affiliation(s)
- Youcheng Liu
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Shuang Yan
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Karen Poh
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Suyang Liu
- Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Emanehi Iyioriobhe
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - David A Sterling
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Nirel R, Maimon N, Fireman E, Agami S, Eyal A, Peretz A. Respiratory hospitalizations of children living near a hazardous industrial site adjusted for prevalent dust: A case–control study. Int J Hyg Environ Health 2015; 218:273-9. [DOI: 10.1016/j.ijheh.2014.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 11/10/2014] [Accepted: 12/06/2014] [Indexed: 11/25/2022]
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15
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Winquist A, Schauer JJ, Turner JR, Klein M, Sarnat SE. Impact of ambient fine particulate matter carbon measurement methods on observed associations with acute cardiorespiratory morbidity. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:215-221. [PMID: 25138293 DOI: 10.1038/jes.2014.55] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 06/03/2023]
Abstract
Elemental carbon (EC) and organic carbon (OC) represent a substantial portion of particulate matter <2.5 μm in diameter (PM2.5), and have been associated with adverse health effects. EC and OC are commonly measured using the National Institute of Occupational Safety and Health (NIOSH) method or the Interagency Monitoring of Protected Visual Environments (IMPROVE) method. Measurement method differences could have an impact on observed epidemiologic associations. Daily speciated PM2.5 data were obtained from the St Louis-Midwest Supersite, and St Louis emergency department (ED) visit data were obtained from the Missouri Hospital Association for the period June 2001 to April 2003. We assessed acute associations between cardiorespiratory ED visits and EC and OC from NIOSH and IMPROVE methods using Poisson generalized linear models controlling for temporal trends and meteorology. Associations were generally similar for EC and OC from the different measurement methods. The most notable difference between methods was observed for congestive heart failure and EC (for example, warm season rate ratios (95% confidence intervals) per interquartile range change in EC concentration were: NIOSH=1.06 (0.99-1.13), IMPROVE=1.01 (0.96-1.07)). Overall, carbon measurement method had little impact on acute associations between EC, OC, and ED visits. Some specific differences were observed, however, which may be related to particle composition.
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Affiliation(s)
- Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jamie J Schauer
- Civil and Environmental Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jay R Turner
- Environmental and Chemical Engineering, Washington University, St Louis, Missouri, USA
| | - Mitch Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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16
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Chen YC, Weng YH, Chiu YW, Yang CY. Short-Term Effects of Coarse Particulate Matter on Hospital Admissions for Cardiovascular Diseases: A Case-Crossover Study in a Tropical City. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:1241-53. [PMID: 26408041 DOI: 10.1080/15287394.2015.1083520] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study was undertaken to determine whether there was an association between coarse particles (PM2.5-10) levels and frequency of hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions for CVD, including ischemic heart disease (IHD), stroke, congestive heart failure (CHF), and arrhythmias, and ambient air pollution data levels for Kaohsiung were obtained for the period 2006-2010. The relative risk of hospital admissions for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased rates of admissions for CVD were significantly associated with higher coarse PM levels only on cool days (< 25°C), with a 10-μg/m(3) elevation in PM2.5-10 concentrations associated with a 3% (95% CI = 2-4%) rise in IHD admissions, 5% (95% CI = 4-6%) increase in stroke admissions, 3% (95% CI = 1-6%) elevation in CHF admissions, and 3% (95% CI = 0-6%) rise in arrhythmias admissions. No significant associations were found between coarse particle levels and number of hospital admissions for CVD on warm days. In the two-pollutant models, PM2.5-10 levels remained significantly correlated with higher rate of CVD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. Compared to the effect estimate associated with a 10-μg/m(3) increase in PM2.5 levels, effect estimates of frequency of CVD-related admissions associated with a 10-μg/m(3) rise in coarse PM levels were weaker. This study provides evidence that higher levels of PM2.5-10 enhance the risk of hospital admissions for CVD.
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Affiliation(s)
- Ying-Chen Chen
- a Department of Public Health, College of Health Sciences , Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Yi-Hao Weng
- b Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital , Chang Gung University College of Medicine , Taipei , Taiwan
| | - Ya-Wen Chiu
- c Master Program in Global Health and Development, College of Public Health and Nutrition , Taipei Medical University , Taipei , Taiwan
| | - Chun-Yuh Yang
- d Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, and Division of Environmental Health and Occupational Medicine , National Health Research Institute , Miaoli , Taiwan
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Dionisio KL, Baxter LK, Chang HH. An empirical assessment of exposure measurement error and effect attenuation in bipollutant epidemiologic models. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:1216-24. [PMID: 25003573 PMCID: PMC4216163 DOI: 10.1289/ehp.1307772] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 07/03/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Using multipollutant models to understand combined health effects of exposure to multiple pollutants is becoming more common. However, complex relationships between pollutants and differing degrees of exposure error across pollutants can make health effect estimates from multipollutant models difficult to interpret. OBJECTIVES We aimed to quantify relationships between multiple pollutants and their associated exposure errors across metrics of exposure and to use empirical values to evaluate potential attenuation of coefficients in epidemiologic models. METHODS We used three daily exposure metrics (central-site measurements, air quality model estimates, and population exposure model estimates) for 193 ZIP codes in the Atlanta, Georgia, metropolitan area from 1999 through 2002 for PM2.5 and its components (EC and SO4), as well as O3, CO, and NOx, to construct three types of exposure error: δspatial (comparing air quality model estimates to central-site measurements), δpopulation (comparing population exposure model estimates to air quality model estimates), and δtotal (comparing population exposure model estimates to central-site measurements). We compared exposure metrics and exposure errors within and across pollutants and derived attenuation factors (ratio of observed to true coefficient for pollutant of interest) for single- and bipollutant model coefficients. RESULTS Pollutant concentrations and their exposure errors were moderately to highly correlated (typically, > 0.5), especially for CO, NOx, and EC (i.e., "local" pollutants); correlations differed across exposure metrics and types of exposure error. Spatial variability was evident, with variance of exposure error for local pollutants ranging from 0.25 to 0.83 for δspatial and δtotal. The attenuation of model coefficients in single- and bipollutant epidemiologic models relative to the true value differed across types of exposure error, pollutants, and space. CONCLUSIONS Under a classical exposure-error framework, attenuation may be substantial for local pollutants as a result of δspatial and δtotal with true coefficients reduced by a factor typically < 0.6 (results varied for δpopulation and regional pollutants).
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Affiliation(s)
- Kathie L Dionisio
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
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Dionisio KL, Isakov V, Baxter LK, Sarnat JA, Sarnat SE, Burke J, Rosenbaum A, Graham SE, Cook R, Mulholland J, Özkaynak H. Development and evaluation of alternative approaches for exposure assessment of multiple air pollutants in Atlanta, Georgia. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:581-592. [PMID: 24064532 DOI: 10.1038/jes.2013.59] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/15/2013] [Indexed: 06/02/2023]
Abstract
Measurements from central site (CS) monitors are often used as estimates of exposure in air pollution epidemiological studies. As these measurements are typically limited in their spatiotemporal resolution, true exposure variability within a population is often obscured, leading to potential measurement errors. To fully examine this limitation, we developed a set of alternative daily exposure metrics for each of the 169 ZIP codes in the Atlanta, GA, metropolitan area, from 1999 to 2002, for PM(2.5) and its components (elemental carbon (EC), SO(4)), O(3), carbon monoxide (CO), and nitrogen oxides (NOx). Metrics were applied in a study investigating the respiratory health effects of these pollutants. The metrics included: (i) CS measurements (one CS per pollutant); (ii) air quality model results for regional background pollution; (iii) local-scale AERMOD air quality model results; (iv) hybrid air quality model estimates (a combination of (ii) and (iii)); and (iv) population exposure model predictions (SHEDS and APEX). Differences in estimated spatial and temporal variability were compared by exposure metric and pollutant. Comparisons showed that: (i) both hybrid and exposure model estimates exhibited high spatial variability for traffic-related pollutants (CO, NO(x), and EC), but little spatial variability among ZIP code centroids for regional pollutants (PM(2.5), SO(4), and O(3)); (ii) for all pollutants except NO(x), temporal variability was consistent across metrics; (iii) daily hybrid-to-exposure model correlations were strong (r>0.82) for all pollutants, suggesting that when temporal variability of pollutant concentrations is of main interest in an epidemiological application, the use of estimates from either model may yield similar results; (iv) exposure models incorporating infiltration parameters, time-location-activity budgets, and other exposure factors affect the magnitude and spatiotemporal distribution of exposure, especially for local pollutants. The results of this analysis can inform the development of more appropriate exposure metrics for future epidemiological studies of the short-term effects of particulate and gaseous ambient pollutant exposure in a community.
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Affiliation(s)
- Kathie L Dionisio
- National Exposure Research Laboratory, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
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Sarnat SE, Sarnat JA, Mulholland J, Isakov V, Özkaynak H, Chang HH, Klein M, Tolbert PE. Application of alternative spatiotemporal metrics of ambient air pollution exposure in a time-series epidemiological study in Atlanta. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:593-605. [PMID: 23963512 DOI: 10.1038/jes.2013.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 05/20/2013] [Indexed: 05/19/2023]
Abstract
Exposure error in studies of ambient air pollution and health that use city-wide measures of exposure may be substantial for pollutants that exhibit spatiotemporal variability. Alternative spatiotemporal metrics of exposure for traffic-related and regional pollutants were applied in a time-series study of ambient air pollution and cardiorespiratory emergency department visits in Atlanta, GA, USA. Exposure metrics included daily central site monitoring for particles and gases; daily spatially refined ambient concentrations obtained from regional background monitors, local-scale dispersion, and hybrid air quality models; and spatially refined ambient exposures from population exposure models. Health risk estimates from Poisson models using the different exposure metrics were compared. We observed stronger associations, particularly for traffic-related pollutants, when using spatially refined ambient concentrations compared with a conventional central site exposure assignment approach. For some relationships, estimates of spatially refined ambient population exposures showed slightly stronger associations than corresponding spatially refined ambient concentrations. Using spatially refined pollutant metrics, we identified socioeconomic disparities in concentration-response functions that were not observed when using central site data. In some cases, spatially refined pollutant metrics identified associations with health that were not observed using measurements from the central site. Complexity and challenges in incorporating modeled pollutant estimates in time-series studies are discussed.
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Affiliation(s)
- Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health-Emory University, Atlanta, Georgia, USA
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20
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Jones RR, Özkaynak H, Nayak SG, Garcia V, Hwang SA, Lin S. Associations between summertime ambient pollutants and respiratory morbidity in New York City: comparison of results using ambient concentrations versus predicted exposures. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:616-26. [PMID: 23982122 DOI: 10.1038/jes.2013.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 05/24/2013] [Accepted: 06/11/2013] [Indexed: 05/04/2023]
Abstract
Epidemiological analyses of air quality often estimate human exposure from ambient monitoring data, potentially leading to exposure misclassification and subsequent bias in estimated health risks. To investigate this, we conducted a case-crossover study of summertime ambient ozone and fine particulate matter (PM(2.5)) levels and daily respiratory hospitalizations in New York City during 2001-2005. Comparisons were made between associations estimated using two pollutant exposure metrics: observed concentrations and predicted exposures from the EPA's Stochastic Human Exposure and Dose Simulation (SHEDS) model. Small, positive associations between interquartile range mean ozone concentrations and hospitalizations were observed and were strongest for 0-day lags (hazard ratio (HR)=1.013, 95% confidence interval (CI): 0.998, 1.029) and 3-day lags (HR=1.006, 95% CI: 0.991, 1.021); applying mean predicted ozone exposures yielded similar results. PM(2.5) was also associated with admissions, strongest at 2- and 4-day lags, with few differences between exposure metrics. Subgroup analyses support recognized sociodemographic differences in concentration-related hospitalization risk, whereas few inter-stratum variations were observed in relation to SHEDS exposures. Predicted exposures for these spatially homogenous pollutants were similar across sociodemographic strata, therefore SHEDS predictions coupled with the case-crossover design may have masked observable heterogeneity in risks. However, significant effect modification was found for subjects in the top exposure-to-concentration ratio tertiles, suggesting risks may increase as a consequence of infiltration or greater exposure to outdoor air.
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Affiliation(s)
- Rena R Jones
- 1] New York State Department of Health, Center for Environmental Health, Empire State Plaza, Albany, New York, USA [2] Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, SUNY, Rensselaer, New York, USA
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Winquist A, Klein M, Tolbert P, Sarnat SE. Power estimation using simulations for air pollution time-series studies. Environ Health 2012; 11:68. [PMID: 22995599 PMCID: PMC3511883 DOI: 10.1186/1476-069x-11-68] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 09/12/2012] [Indexed: 05/19/2023]
Abstract
BACKGROUND Estimation of power to assess associations of interest can be challenging for time-series studies of the acute health effects of air pollution because there are two dimensions of sample size (time-series length and daily outcome counts), and because these studies often use generalized linear models to control for complex patterns of covariation between pollutants and time trends, meteorology and possibly other pollutants. In general, statistical software packages for power estimation rely on simplifying assumptions that may not adequately capture this complexity. Here we examine the impact of various factors affecting power using simulations, with comparison of power estimates obtained from simulations with those obtained using statistical software. METHODS Power was estimated for various analyses within a time-series study of air pollution and emergency department visits using simulations for specified scenarios. Mean daily emergency department visit counts, model parameter value estimates and daily values for air pollution and meteorological variables from actual data (8/1/98 to 7/31/99 in Atlanta) were used to generate simulated daily outcome counts with specified temporal associations with air pollutants and randomly generated error based on a Poisson distribution. Power was estimated by conducting analyses of the association between simulated daily outcome counts and air pollution in 2000 data sets for each scenario. Power estimates from simulations and statistical software (G*Power and PASS) were compared. RESULTS In the simulation results, increasing time-series length and average daily outcome counts both increased power to a similar extent. Our results also illustrate the low power that can result from using outcomes with low daily counts or short time series, and the reduction in power that can accompany use of multipollutant models. Power estimates obtained using standard statistical software were very similar to those from the simulations when properly implemented; implementation, however, was not straightforward. CONCLUSIONS These analyses demonstrate the similar impact on power of increasing time-series length versus increasing daily outcome counts, which has not previously been reported. Implementation of power software for these studies is discussed and guidance is provided.
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Affiliation(s)
- Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA
| | - Mitchel Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA
| | - Paige Tolbert
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA
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Ji M, Cohan DS, Bell ML. Meta-analysis of the Association between Short-Term Exposure to Ambient Ozone and Respiratory Hospital Admissions. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2011; 6:024006. [PMID: 21779304 PMCID: PMC3138529 DOI: 10.1088/1748-9326/6/2/024006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ozone is associated with health impacts including respiratory outcomes; however, results differ across studies. Meta-analysis is an increasingly important approach to synthesizing evidence across studies. We conducted meta-analysis of short-term ozone exposure and respiratory hospitalizations to evaluate variation across studies and explore some of the challenges in meta-analysis. We identified 136 estimates from 96 studies and investigated how estimates differed by age, ozone metric, season, lag, region, disease category, and hospitalization type. Overall results indicate associations between ozone and various types of respiratory hospitalizations; however, study characteristics affected risk estimates. Estimates were similar, but higher, for the elderly compared to all ages and for previous day exposure compared to same day exposure. Comparison across studies was hindered by variation in definitions of disease categories, as some (e.g., asthma) were identified through ≥3 different sets of ICD codes. Although not all analyses exhibited evidence of publication bias, adjustment for publication bias generally lowered overall estimates. Emergency hospitalizations for total respiratory disease increased 4.47% (95% interval 2.48, 6.50%) per 10ppb 24-hr ozone among the elderly without adjustment for publication bias and 2.97% (1.05, 4.94%) with adjustment. Comparison of multi-city study results and meta-analysis based on single-city studies further suggested publication bias.
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Affiliation(s)
- Meng Ji
- School of Forestry and Environmental Studies, School of Public Health, Yale University, New Haven, CT, U.S.A
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Zhou J, Ito K, Lall R, Lippmann M, Thurston G. Time-series analysis of mortality effects of fine particulate matter components in Detroit and Seattle. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:461-6. [PMID: 21193387 PMCID: PMC3080926 DOI: 10.1289/ehp.1002613] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 12/29/2010] [Indexed: 05/04/2023]
Abstract
BACKGROUND Recent toxicological and epidemiological studies have shown associations between particulate matter (PM) and adverse health effects, but which PM components are most influential is less well known. OBJECTIVES In this study, we used time-series analyses to determine the associations between daily fine PM [PM ≤ 2.5 µm in aerodynamic diameter (PM2.5)] concentrations and daily mortality in two U.S. cities-Seattle, Washington, and Detroit, Michigan. METHODS We obtained daily PM2.5 filters for the years of 2002-2004 and analyzed trace elements using X-ray fluorescence and black carbon using light reflectance as a surrogate measure of elemental carbon. We used Poisson regression and distributed lag models to estimate excess deaths for all causes and for cardiovascular and respiratory diseases adjusting for time-varying covariates. We computed the excess risks for interquartile range increases of each pollutant at lags of 0 through 3 days for both warm and cold seasons. RESULTS The cardiovascular and respiratory mortality series exhibited different source and seasonal patterns in each city. The PM2.5 components and gaseous pollutants associated with mortality in Detroit were most associated with warm season secondary aerosols and traffic markers. In Seattle, the component species most closely associated with mortality included those for cold season traffic and other combustion sources, such as residual oil and wood burning. CONCLUSIONS The effects of PM2.5 on daily mortality vary with source, season, and locale, consistent with the hypothesis that PM composition has an appreciable influence on the health effects attributable to PM.
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Affiliation(s)
- Jiang Zhou
- New York University School of Medicine, Tuxedo, New York 10987, USA.
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Abstract
BACKGROUND Air pollution may increase the incidence of ventricular cardiac arrhythmias. We investigated this in patients with implantable cardioverter defibrillators attending London clinics. METHOD We explored associations between dates of activation of defibrillators and daily concentrations of various metrics of particulate matter and of pollutant gases at lags from 0 to 5 days, using a fixed-stratum case-crossover analysis controlling for confounding factors. RESULTS Over an average of 1200 days of observation, 705 patients experienced 5462 activation days. Of 11 pollutants considered, we found positive associations with particle sulfate, particulate matter with aerodynamic diameter less than 10 microm and less than 2.5 microm, ozone, and sulfur dioxide. Only the association for particle sulfate was not easily explainable by chance (for 1 microg/m, lag 0-1 day, odds ratio = 1.025 [95% confidence interval = 1.003 to 1.047]). There was little or no evidence of associations with markers of primary vehicle emissions (particle number concentration, black smoke, nitrogen oxides, and carbon monoxide). There was little evidence of interactions with clinical factors such as ischemic heart disease, frequency of activation, or cardiac drugs. CONCLUSION Overall there was little evidence of an association between air pollution and activation of implantable cardioverter defibrillators. The pollutants with positive associations tended to be those of secondary origin with a regional distribution, rather than primary pollutants emitted from transport sources.
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Tsai JH, Chen SJ, Huang KL, Lin YC, Lee WJ, Lin CC, Lin WY. PM, carbon, and PAH emissions from a diesel generator fuelled with soy-biodiesel blends. JOURNAL OF HAZARDOUS MATERIALS 2010; 179:237-43. [PMID: 20307928 DOI: 10.1016/j.jhazmat.2010.02.085] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 01/29/2010] [Accepted: 02/25/2010] [Indexed: 05/29/2023]
Abstract
Biodiesels have received increasing attention as alternative fuels for diesel engines and generators. This study investigates the emissions of particulate matter (PM), total carbon (TC), e.g., organic/elemental carbons, and polycyclic aromatic hydrocarbons (PAHs) from a diesel generator fuelled with soy-biodiesel blends. Among the tested diesel blends (B0, B10 (10 vol% soy-biodiesel), B20, and B50), B20 exhibited the lowest PM emission concentration despite the loads (except the 5 kW case), whereas B10 displayed lower PM emission factors when operating at 0 and 10 kW than the other fuel blends. The emission concentrations or factors of EC, OC, and TC were the lowest when B10 or B20 was used regardless of the loading. Under all tested loads, the average concentrations of total-PAHs emitted from the generator using the B10 and B20 were lower (by 38% and 28%, respectively) than those using pure petroleum diesel fuel (B0), while the emission factors of total-PAHs decreased with an increasing ratio of biodiesel to premium diesel. With an increasing loading, although the brake specific fuel consumption decreased, the energy efficiency increased despite the bio/petroleum diesel ratio. Therefore, soy-biodiesel is promising for use as an alternative fuel for diesel generators to increase energy efficiency and reduce the PM, carbon, and PAH emissions.
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Affiliation(s)
- Jen-Hsiung Tsai
- Department of Environmental Engineering and Science, National Pingtung University of Science and Technology, 1 Shieh-Fu Rd., Nei Pu 91207, Pingtung, Taiwan
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Puccio MA, Miller JH. Detection of Trace Hydrocarbons in Flames Using Direct Sampling Mass Spectrometry Coupled with Multilinear Regression Analysis. Anal Chem 2010; 82:5160-8. [DOI: 10.1021/ac1003823] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Maria A. Puccio
- Department of Chemistry, The George Washington University, Washington, DC 20052
| | - J. Houston Miller
- Department of Chemistry, The George Washington University, Washington, DC 20052
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Strickland MJ, Darrow LA, Klein M, Flanders WD, Sarnat JA, Waller LA, Sarnat SE, Mulholland JA, Tolbert PE. Short-term associations between ambient air pollutants and pediatric asthma emergency department visits. Am J Respir Crit Care Med 2010; 182:307-16. [PMID: 20378732 DOI: 10.1164/rccm.200908-1201oc] [Citation(s) in RCA: 274] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Certain outdoor air pollutants cause asthma exacerbations in children. To advance understanding of these relationships, further characterization of the dose-response and pollutant lag effects are needed, as are investigations of pollutant species beyond the commonly measured criteria pollutants. OBJECTIVES Investigate short-term associations between ambient air pollutant concentrations and emergency department visits for pediatric asthma. METHODS Daily counts of emergency department visits for asthma or wheeze among children aged 5 to 17 years were collected from 41 Metropolitan Atlanta hospitals during 1993-2004 (n = 91,386 visits). Ambient concentrations of gaseous pollutants and speciated particulate matter were available from stationary monitors during this time period. Rate ratios for the warm season (May to October) and cold season (November to April) were estimated using Poisson generalized linear models in the framework of a case-crossover analysis. MEASUREMENTS AND MAIN RESULTS Both ozone and primary pollutants from traffic sources were associated with emergency department visits for asthma or wheeze; evidence for independent effects of ozone and primary pollutants from traffic sources were observed in multipollutant models. These associations tended to be of the highest magnitude for concentrations on the day of the emergency department visit and were present at relatively low ambient concentrations. CONCLUSIONS Even at relatively low ambient concentrations, ozone and primary pollutants from traffic sources independently contributed to the burden of emergency department visits for pediatric asthma.
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Sarnat SE, Klein M, Sarnat JA, Flanders WD, Waller LA, Mulholland JA, Russell AG, Tolbert PE. An examination of exposure measurement error from air pollutant spatial variability in time-series studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2010; 20:135-46. [PMID: 19277071 PMCID: PMC3780363 DOI: 10.1038/jes.2009.10] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 12/05/2008] [Indexed: 05/20/2023]
Abstract
Relatively few studies have evaluated the effects of heterogeneous spatiotemporal pollutant distributions on health risk estimates in time-series analyses that use data from a central monitor to assign exposures. We present a method for examining the effects of exposure measurement error relating to spatiotemporal variability in ambient air pollutant concentrations on air pollution health risk estimates in a daily time-series analysis of emergency department visits in Atlanta, Georgia. We used Poisson generalized linear models to estimate associations between current-day pollutant concentrations and circulatory emergency department visits for the 1998-2004 time period. Data from monitoring sites located in different geographical regions of the study area and at different distances from several urban geographical subpopulations served as alternative measures of exposure. We observed associations for spatially heterogeneous pollutants (CO and NO(2)) using data from several different urban monitoring sites. These associations were not observed when using data from the most rural site, located 38 miles from the city center. In contrast, associations for spatially homogeneous pollutants (O(3) and PM(2.5)) were similar, regardless of the monitoring site location. We found that monitoring site location and the distance of a monitoring site to a population of interest did not meaningfully affect estimated associations for any pollutant when using data from urban sites located within 20 miles from the population center under study. However, for CO and NO(2), these factors were important when using data from rural sites located > or = 30 miles from the population center, most likely owing to exposure measurement error. Overall, our findings lend support to the use of pollutant data from urban central sites to assess population exposures within geographically dispersed study populations in Atlanta and similar cities.
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Puett RC, Hart JE, Yanosky JD, Paciorek C, Schwartz J, Suh H, Speizer FE, Laden F. Chronic fine and coarse particulate exposure, mortality, and coronary heart disease in the Nurses' Health Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1697-701. [PMID: 20049120 PMCID: PMC2801178 DOI: 10.1289/ehp.0900572] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 06/15/2009] [Indexed: 05/17/2023]
Abstract
BACKGROUND The relationship of fine particulate matter < 2.5 microm in diameter (PM(2.5)) air pollution with mortality and cardiovascular disease is well established, with more recent long-term studies reporting larger effect sizes than earlier long-term studies. Some studies have suggested the coarse fraction, particles between 2.5 and 10 microm (PM(10-2.5)), may also be important. With respect to mortality and cardiovascular events, questions remain regarding the relative strength of effect sizes for chronic exposure to fine and coarse particles. OBJECTIVES We examined the relationship of chronic PM(2.5) and PM(10-2.5) exposures with all-cause mortality and fatal and nonfatal incident coronary heart disease (CHD), adjusting for time-varying covariates. METHODS The current study included women from the Nurses' Health Study living in metropolitan areas of the northeastern and midwestern United States. Follow-up was from 1992 to 2002. We used geographic information systems-based spatial smoothing models to estimate monthly exposures at each participant's residence. RESULTS We found increased risk of all-cause mortality [hazard ratio (HR), 1.26; 95% confidence interval (CI), 1.02-1.54] and fatal CHD (HR = 2.02; 95% CI, 1.07-3.78) associated with each 10-microg/m(3) increase in annual PM(2.5) exposure. The association between fatal CHD and PM(10-2.5) was weaker. CONCLUSIONS Our findings contribute to growing evidence that chronic PM(2.5) exposure is associated with risk of all-cause and cardiovascular mortality.
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Affiliation(s)
- Robin C Puett
- South Carolina Cancer Prevention and Control Program and Department of Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29201, USA.
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Peng RD, Bell ML, Geyh AS, McDermott A, Zeger SL, Samet JM, Dominici F. Emergency admissions for cardiovascular and respiratory diseases and the chemical composition of fine particle air pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:957-63. [PMID: 19590690 PMCID: PMC2702413 DOI: 10.1289/ehp.0800185] [Citation(s) in RCA: 324] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Accepted: 02/10/2009] [Indexed: 05/17/2023]
Abstract
BACKGROUND Population-based studies have estimated health risks of short-term exposure to fine particles using mass of PM(2.5) (particulate matter <or= 2.5 microm in aerodynamic diameter) as the indicator. Evidence regarding the toxicity of the chemical components of the PM(2.5) mixture is limited. OBJECTIVE In this study we investigated the association between hospital admission for cardiovascular disease (CVD) and respiratory disease and the chemical components of PM(2.5) in the United States. METHODS We used a national database comprising daily data for 2000-2006 on emergency hospital admissions for cardiovascular and respiratory outcomes, ambient levels of major PM(2.5) chemical components [sulfate, nitrate, silicon, elemental carbon (EC), organic carbon matter (OCM), and sodium and ammonium ions], and weather. Using Bayesian hierarchical statistical models, we estimated the associations between daily levels of PM(2.5) components and risk of hospital admissions in 119 U.S. urban communities for 12 million Medicare enrollees (>or= 65 years of age). RESULTS In multiple-pollutant models that adjust for the levels of other pollutants, an interquartile range (IQR) increase in EC was associated with a 0.80% [95% posterior interval (PI), 0.34-1.27%] increase in risk of same-day cardiovascular admissions, and an IQR increase in OCM was associated with a 1.01% (95% PI, 0.04-1.98%) increase in risk of respiratory admissions on the same day. Other components were not associated with cardiovascular or respiratory hospital admissions in multiple-pollutant models. CONCLUSIONS Ambient levels of EC and OCM, which are generated primarily from vehicle emissions, diesel, and wood burning, were associated with the largest risks of emergency hospitalization across the major chemical constituents of PM(2.5).
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Affiliation(s)
- Roger D Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Alley DF, Gordon NR, Langley-Turnbaugh S, Wise JP, Van Epps G, Jalbert A. The effect of PM10 on human lung fibroblasts. Toxicol Ind Health 2009; 25:111-20. [PMID: 19458133 PMCID: PMC4138961 DOI: 10.1177/0748233709103185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Asthma diagnoses are increasing nationally with the highest rates in the New England states. Epidemiological studies have suggested a relationship between airborne particulate matter (PM) and severity of an asthma attack. However, because particulate matter, PM, is such a complex mixture, it is difficult to isolate the exacerbating factors. In this paper we investigate the effect of NIST (National Institute of Standards and Technology) and Maine PM and the soluble metals released from the PM on the growth of human lung fibroblasts. While the NIST PM itself had the most pronounced effect on cell survival rates, solutions of metals extracted from the PM also affected cell survival. Treatment of cells with 10, 50, 100 and 200 ug/cm(2) resulted in 84 +/- 13%, 69 +/- 15%, 58 +/- 14% and 58 +/- 16% survival, respectively. Appropriate concentrations of eight acid soluble metals from NIST PM were determined and tested on cells giving 91 +/- 11%, 87 +/- 10%, 72 +/- 18% and 66 +/- 20% survival, respectively. Soluble metals from Maine PM were extracted and mixtures of appropriate concentrations of these metals were used to treat cells, resulting in 88 +/- 5%, 81 +/- 5%, 79 +/- 3% and 57 +/- 9% survival rate. To determine which, if any, of the metals individually affected the cells, Mn, Cu, V and As were used to treat the cells. At the metal concentrations tested, only As and V affected cell survival.
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Affiliation(s)
- D. F. Alley
- Chemistry Dept., University of Southern Maine, Gorham, ME 04038
| | - N. R. Gordon
- Chemistry Dept., University of Southern Maine, Gorham, ME 04038
| | | | - J. P. Wise
- Dept. of Applied Medical Sciences and Maine Center for Toxicology and Environmental Health, University of Southern Maine, Gorham, ME 04038
| | - G. Van Epps
- Dept. of Environmental Science, University of Southern Maine, Gorham, ME 04038
| | - A. Jalbert
- Dept. of Environmental Science, University of Southern Maine, Gorham, ME 04038
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Joseph PM. Can fine particulate matter explain the paradoxical ozone associations? ENVIRONMENT INTERNATIONAL 2008; 34:1185-91. [PMID: 18430471 DOI: 10.1016/j.envint.2008.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 02/27/2008] [Accepted: 03/05/2008] [Indexed: 05/03/2023]
Abstract
Our previous paper entitled "Paradoxical ozone associations could be due to methyl nitrite from combustion of methyl ethers or esters in engine fuels" (Env. Int.. 2007;33;1090) reviewed 11 studies of the impact of ozone on human health that, paradoxically, found a negative coefficient for ozone-morbidity associations. We argued that the most likely explanation for this effect would be methyl nitrite (MN) as an unsuspected exhaust component of engines with methyl ether in the fuel. The basis of the argument was the fact that MN is rapidly destroyed by sunlight, so that MN would be negatively correlated with ozone. All (but one) of the reviewed studies concluded that criterion pollutants could not explain the negative slope. The argument was strengthened by the observation that such paradoxical ozone associations have not been found in regions without significant methyl ether in gasoline. Left unaddressed in the previous paper was the possibility that fine particulate matter (FPM) might explain the POA. If this were true, then it would be necessary that the FPM be negatively correlated with ozone in those regions that found a POA. The current paper reviews data on FPM-ozone correlations in those regions where a POA was identified. The results show that FPM was, in most cases, positively correlated with ozone and so could not explain the POA.
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Affiliation(s)
- Peter M Joseph
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-4283, USA.
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Grahame T, Schlesinger R. Evaluating the Health Risk from Secondary Sulfates in Eastern North American Regional Ambient Air Particulate Matter. Inhal Toxicol 2008; 17:15-27. [PMID: 15764480 DOI: 10.1080/08958370590885672] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Epidemiological studies of particulate matter (PM) using central area monitors have associated total PM mass, as well as certain individual components of PM, including sulfate, with adverse human health effects. However, some recent studies that used concentrated ambient particles (CAPs) or analyzed the effects of air pollution from different sources or geographic areas suggest that while some particles may be harmful, other particulate species including secondary sulfates may have negligible health effects. Toxicology studies to date also suggest that secondary sulfates pose little health risk. While studies using central-area monitors implicitly assume that all residents of the area are exposed to the same levels of pollution, newer studies find substantial health effects for those in close proximity to major roads. These latter studies recognize that although population exposure to widespread pollutants, such as total PM mass and sulfates, may be relatively uniform over a wide area, exposure to pollutants from local sources is not. While there is an emerging literature associating several adverse health effects with proximity to local pollution sources, the current database provides limited information that allows identification of specific particulate species that may cause little to no harm. In this article, we suggest that ambient secondary sulfates, and eastern North American regional air masses generally, appear to have little adverse impact on public health. This suggestion is based on evidence gleaned from eight avenues of investigation: (1) recent non-central-area monitor studies, including exposure gradient or proximity studies; (2) CAPs studies; (3) studies that examine effects related to different geographic areas or sources; (4) toxicology studies; (5) the limited number of studies that analyze existing central-area monitor data to explicitly examine the health impacts of sulfate and acidity versus PM mass; (6) "modern" area monitor studies with additional capabilities to distinguish among sources of pollution; (7) partial reinterpretation of two pivotal cohort studies; and (8) studies separating effects of secondary sulfates from those of primary metal sulfates. However, uncertainties remain regarding the role that secondary sulfates may play in ambient PM chemistry pathways leading to potentially harmful products, such as the possible effects of secondary organic aerosols that may be the product of acid catalysis of sulfur dioxide. Thus, more targeted study is needed, and some research suggestions are made in this regard.
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Chuang KJ, Chan CC, Su TC, Lin LY, Lee CT. Associations between particulate sulfate and organic carbon exposures and heart rate variability in patients with or at risk for cardiovascular diseases. J Occup Environ Med 2007; 49:610-7. [PMID: 17563603 DOI: 10.1097/jom.0b013e318058205b] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE It is still unknown whether specific components in fine particles are associated with heart rate variability (HRV) reduction. METHODS We recruited 46 patients with or at risk for cardiovascular diseases to measure 24-hour HRV by ambulatory electrocardiographic monitoring. Fixed-site air-monitoring stations were used to represent participants' exposures to particles with aerodynamic diameters less than 10 microm (PM 10) and 2.5 microm (PM2.5), and particulate components of sulfate, nitrate, organic carbon (OC) and elemental carbon, and gaseous pollutants. RESULTS We found that HRV reduction was associated with sulfate, OC, and PM2.5 but not with the other five pollutants in single-pollutant models. Sulfate was found to remain in significant association with HRV reduction adjusting for OC and PM2.5 in three-pollutant models. CONCLUSIONS Exposures to sulfate and OC in PM2.5 were associated with HRV reduction in patients with or at risk for cardiovascular diseases.
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Affiliation(s)
- Kai-Jen Chuang
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
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Berger A, Zareba W, Schneider A, Rückerl R, Ibald-Mulli A, Cyrys J, Wichmann HE, Peters A. Runs of ventricular and supraventricular tachycardia triggered by air pollution in patients with coronary heart disease. J Occup Environ Med 2007; 48:1149-58. [PMID: 17099451 DOI: 10.1097/01.jom.0000245921.15916.03] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The authors conducted an investigation of the association between air pollution and arrhythmia. METHODS A prospective panel study (October 2000-April 2001) was conducted in Erfurt, Germany. Fifty-seven men with coronary heart disease were subjected to six 24-hour electrocardiogram recordings. Runs of supraventricular and ventricular tachycardia were associated with continuous ultrafine particle counts (UFP), accumulation mode particle counts (ACP), PM2.5, and gaseous pollutants. Poisson and linear regression models were applied adjusting for trend, weekday, and meteorologic data. RESULTS Elevated concentrations of UFP, ACP, PM2.5, and nitrogen dioxide increased the risk for supraventricular runs and the number of ventricular runs at almost all lags. Statistically significant associations were found predominantly in the previous 24 to 71 hours and with the 5-day moving average. CONCLUSION Elevated concentrations of fine and ultrafine particle increased the risk of arrhythmia in men with coronary heart disease.
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Affiliation(s)
- Annette Berger
- Institute of Epidemiology, GSF-National Research Center for Environment and Health, Ingolstaedter Landstrasse 1, D-85764 Neuherberg, Germany
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Lipsett MJ, Tsai FC, Roger L, Woo M, Ostro BD. Coarse particles and heart rate variability among older adults with coronary artery disease in the Coachella Valley, California. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1215-20. [PMID: 16882528 PMCID: PMC1552018 DOI: 10.1289/ehp.8856] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Alterations in cardiac autonomic control, assessed by changes in heart rate variability (HRV), provide one plausible mechanistic explanation for consistent associations between exposure to airborne particulate matter (PM) and increased risks of cardiovascular mortality. Decreased HRV has been linked with exposures to PM10 (PM with aerodynamic diameter<or=10 microm) and with fine particles (PM with aerodynamic diameter<or=2.5 microm) originating primarily from combustion sources. However, little is known about the relationship between HRV and coarse particles [PM with aerodynamic diameter 10-2.5 microm (PM10-2.5)], which typically result from entrainment of dust and soil or from mechanical abrasive processes in industry and transportation. We measured several HRV variables in 19 nonsmoking older adults with coronary artery disease residing in the Coachella Valley, California, a desert resort and retirement area in which ambient PM10 consists predominantly of PM10-2.5. Study subjects wore Holter monitors for 24 hr once per week for up to 12 weeks during spring 2000. Pollutant concentrations were assessed at nearby fixed-site monitors. We used mixed models that controlled for individual-specific effects to examine relationships between air pollutants and several HRV metrics. Decrements in several measures of HRV were consistently associated with both PM10 and PM10-2.5; however, there was little relationship of HRV variables with PM2.5 concentrations. The magnitude of the associations (approximately 1-4% decrease in HRV per 10-microg/m3 increase in PM10 or PM10-2.5) was comparable with those observed in several other studies of PM. Elevated levels of ambient PM10-2.5 may adversely affect HRV in older subjects with coronary artery disease.
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Affiliation(s)
- Michael J Lipsett
- California Department of Health Services, Environmental Health Investigations Branch, Richmond, California 94804-6403, USA.
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Bennett CM, McKendry IG, Kelly S, Denike K, Koch T. Impact of the 1998 Gobi dust event on hospital admissions in the Lower Fraser Valley, British Columbia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2006; 366:918-25. [PMID: 16483637 DOI: 10.1016/j.scitotenv.2005.12.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2005] [Revised: 12/09/2005] [Accepted: 12/18/2005] [Indexed: 04/14/2023]
Abstract
The adverse public health impacts of anthropogenically derived particulate matter have been well documented, with measurable increases in both morbidity and mortality rates associated with high particulate matter pollution events. Most current research has focussed on the health impacts of anthropogenically derived particulate matter, and there is a distinct scarcity of literature that examines the role of naturally derived particulate matter and adverse health impacts in the urban context. This study of a Gobi desert dust event in the Greater Vancouver region of British Columbia, Canada, in spring of 1998 provided a unique opportunity to identify the adverse health effects related to naturally derived particulate matter in a large urban setting. Respiratory and cardiac hospitalizations were examined for a three-year period (January 1997 to December 1999), with the Gobi dust event occurring in late April 1998. A meteorological analogue was identified for spring 1997 in order to identify the public health impacts associated with anthropogenically derived particulate matter and those impacts associated with the presence of the Gobi desert dust. Results indicate that this Gobi dust event was not associated with an excess of hospitalizations in the Greater Vancouver region. Peak particulate matter concentrations of Gobi desert dust in the airshed were only associated with an additional one or two hospitalizations per 100,000 population for respiratory and cardiac illnesses, and these increases were not distinguishable from the 'normal' variability in hospitalization rates. Despite high particulate matter concentrations, fine particle size, presence of heavy metals in the dust and extended exposure periods, it appears that the Gobi desert dust event was not associated with significant risk to public health in Greater Vancouver, British Columbia. Therefore it is concluded that naturally derived particulate matter is more benign than particulate matter of anthropogenic origin, and thus poses a low risk to health for the general public.
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Affiliation(s)
- C M Bennett
- Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia.
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Langley-Turnbaugh SJ, Gordon NR, Lambert T. Airborne particulates and asthma: a Maine case study. Toxicol Ind Health 2005; 21:75-92. [PMID: 15986579 DOI: 10.1191/0748233705th218oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Maine currently has the second fastest growing asthma rate in the nation 9.4% of the adult population has asthma and one out of eight children is affected. The factors behind this increase are poorly understood, but previous reports suggest that biologically soluble metal ions from particulate matter (PM10) may play a role in asthma episodes. In an effort to study this issue, we first identified geographic and temporal trends in Maine asthma hospitalizations. Clinical data show a strong fall peak in asthma admissions with weaker peaks in January and May, and a summer low in asthma admissions. Asthma admissions are also higher in the cities than in the rural areas in Maine. We then analysed PM10 collected by the Maine Department of Environmental Protection in three different Maine locations in the years 2000 and 2001, at times when clinical asthma data showed peaks and during the summer low period. We also collected soil samples in the same locations. The PM10 and soils were analysed for 10 metals by acid extraction to determine total metal content and then with cell culture medium, DMEM/F12+CCS growth medium, to determine metal biosolubility. Our results showed that Mn, Cu, Pb, As, V, Ni and Al were present in the Maine PM samples. V, Ni and Pb showed seasonal variation, while the others were relatively constant throughout the year. Pb and Al did not appear to be soluble in the biological medium. There was also variation from location to location with the urban area showing the highest concentrations for most metals. Aluminium was present in the highest concentration in soil samples, followed by Mn and V. Only Cu was biologically available in soils. We determined from M/Al ratios that most of the PM10 did not originate from local crustal material.
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Gong H, Linn WS, Terrell SL, Clark KW, Geller MD, Anderson KR, Cascio WE, Sioutas C. Altered heart-rate variability in asthmatic and healthy volunteers exposed to concentrated ambient coarse particles. Inhal Toxicol 2004; 16:335-43. [PMID: 15204749 DOI: 10.1080/08958370490439470] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Twelve mildly asthmatic and four healthy adults were exposed to filtered air (FA) and concentrated ambient coarse particles (CCP) supplied to a whole-body exposure chamber via a coarse particle concentrator with 15 parallel virtual impactors. Exposures were conducted in a Los Angeles suburb with high levels of motor-vehicle pollution and lasted 2 h with intermittent exercise. Mean CCP concentration was 157 microg/m(3) (range: 56-218 microg/m(3)) measured by continuous monitoring with a tapered-element oscillating microbalance (TEOM). On average, 80% of mass was coarse (2.5-10 microm aerodynamic diameter) and the rest <2.5 microm. Relative to FA, CCP exposure did not significantly alter respiratory symptoms, spirometry, arterial oxygen saturation, or airway inflammation according to exhaled nitric oxide and total and differential cell counts of induced sputum. After CCP exposure, Holter electrocardiograms showed small (p <.05) increases in heart rate and decreases in heart-rate variability, which were larger in healthy than in asthmatic subjects. Cardiac ectopy did not increase. In conclusion, acute exposure to elevated concentrations of ambient coarse particles elicited no obvious pulmonary effects but appeared to alter the autonomic nervous system of the heart in adult volunteers.
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Affiliation(s)
- Henry Gong
- University of Southern California Keck School of Medicine, Los Angeles, USA.
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Welthagen W, Schnelle-Kreis J, Zimmermann R. Search criteria and rules for comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry analysis of airborne particulate matter. J Chromatogr A 2004; 1019:233-49. [PMID: 14650618 DOI: 10.1016/j.chroma.2003.08.053] [Citation(s) in RCA: 128] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Direct thermal desorption-gas chromatography-time-of-flight mass spectrometry (DTD-GC-TOFMS) and comprehensive two-dimensional (2D) gas chromatography-time-of-flight mass spectrometry (GC x GC-TOFMS) was applied for characterisation of semi-volatile organic compounds (SVOC) in fine particulate matter (PM), with a diameter of up to 2.5 microm (PM2.5), from ambient air in Augsburg, Germany. DTD-GC-TOFMS measurements on the SVOC in PM2.5 are done on a daily basis (time series over several years). The data will be used in an epidemiological study questioning the influence of SVOC in PM2.5 on ambient aerosol related health effects. The outcome of the first measurements periods is that the organic inventory in the ambient aerosol can undergo drastic fluctuations, e.g. due to meteorological influences or specific emission sources. This includes also the large fraction of chromatographically not resolved peaks (unresolved carbonaceous matter (UCM)). The UCM fraction contains about 70% of the SVOC mass in PM2.5. GC x GC-TOFMS is a suited technique to study the nature of the yet unidentified compounds forming the UCM. The considerably increased chromatographic resolution in GC x GC allows separation of many UCM compounds while the TOFMS supplies mass spectral data of all separated compounds. However, the data sets are getting enormously complex. In a typical PM2.5 sample from Augsburg more than 15,000 peaks can be detected. Thus, it is important to classify the observed GC x GC peaks by rational means. A classification procedure based on GC x GC retention times and the fragmentation patterns is suggested. With a preliminary classification procedure it is already possible to group compounds with some certainty into substance classes. After some further development, this approach can be used for classifying GC x GC data, e.g. for environmental and epidemiological studies.
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Affiliation(s)
- W Welthagen
- Institute of Ecological Chemistry, GSF-Research Centre, Ingolstädter Landstrasse 1, D-85764 Oberschleissheim, Germany
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Levy JI, Bennett DH, Melly SJ, Spengler JD. Influence of traffic patterns on particulate matter and polycyclic aromatic hydrocarbon concentrations in Roxbury, Massachusetts. JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY 2003; 13:364-71. [PMID: 12973364 DOI: 10.1038/sj.jea.7500289] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Vehicle emissions have been associated with adverse health effects in multiple epidemiological studies, but the sources or constituents responsible have not been established. Characterization of vehicle-related exposures requires detailed information on spatial and temporal trends of various pollutants and the ability to predict exposures in unmonitored settings. To address these issues, in the summer of 2001 we measured continuously particle-bound polycyclic aromatic hydrocarbons (PAHs), ultrafine particles, and PM(2.5) at a number of sites in Roxbury, a neighborhood of Boston, Massachusetts with significant diesel and gasoline-fueled traffic. We took measurements at the side of the road and at varying distances from the road, with simultaneous collection of traffic counts and meteorological conditions. Across all nine sites, median roadside concentrations were 8 ng/m(3) of particle-bound PAHs (range: 4-57), 16,000 ultrafine particles/cm(3) (range: 11,000-53,000), and 54 microg/m(3) of PM(2.5) as measured with a DustTrak (range: 12-86). Concentrations of all pollutants were lower at greater distances from the road, upwind, and at higher wind speeds, with greater concentration gradients for PAHs and ultrafine particles. In linear mixed effects regression models accounting for temporal autocorrelation, large diesel vehicle counts were significantly associated with roadside concentrations of PAHs (P=0.02), with a moderate association with ultrafine particles and little relation with PM(2.5). Although more comprehensive information would be needed for epidemiological applications, these data demonstrate significant spatial and temporal heterogeneity for traffic-related pollutants during the summer in an urban center, with our monitoring and analytical methodology helping to inform source attribution.
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Affiliation(s)
- Jonathan I Levy
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
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Holguín F, Téllez-Rojo MM, Hernández M, Cortez M, Chow JC, Watson JG, Mannino D, Romieu I. Air Pollution and Heart Rate Variability Among the Elderly in Mexico City. Epidemiology 2003; 14:521-7. [PMID: 14501266 DOI: 10.1097/01.ede.0000081999.15060.ae] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Suspended particles and ozone have been associated with varying degrees of cardiac autonomic dysfunction. METHODS In Mexico City, residents from a nursing home underwent heart rate variability analysis every other day for 3 months. Indoor and outdoor PM2.5 (particulate matter less than 2.5 mm in diameter) were measured daily at the nursing home. Levels of ozone and other atmospheric pollutants were obtained from a nearby automated monitoring station. RESULTS Of the initial 42 screened participants, 34 (81%) were followed during the study period. The 24-hour average levels of indoor PM2.5 ranged from 15 to 67 micro g/m3, and outdoor PM2.5 ranged from 9 to 87 micro g/m3. Daily 1-hour maximum ozone levels ranged from 47 to 228 ppb. After adjusting for age and heart rate, we observed a strong decrease in the high frequency component of heart rate variability and the average 24-hour concentrations of PM2.5. Participants with hypertension had considerably larger reductions in their HF-HRV (high frequency-heart rate variability) component in relation to both ozone and PM2.5 exposure. CONCLUSIONS Our results suggest that ambient levels of PM2.5 and ozone can reduce the high-frequency component of heart rate variability in elderly subjects living in Mexico City and that subjects with underlying hypertension are particularly susceptible to this effect.
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Luttinger D, Wilson L. A study of air pollutants and acute asthma exacerbations in urban areas: status report. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2003; 123:399-402. [PMID: 12667768 DOI: 10.1016/s0269-7491(03)00025-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A study to try to better understand the interactions between various air contaminants and acute asthma exacerbations is described. The study evaluates temporal associations between a panel of air contaminants and acute asthmatic exacerbations as measured by emergency room visits for asthma in communities in the Bronx and Manhattan in New York City (NYC). In addition, ambient levels of various air pollutants in two NYC communities are being compared. Almost 2 years of daily data have been collected for most of the air contaminants to be investigated. The air contaminants measured include gaseous compounds (ozone, sulfur dioxide, nitrogen oxides, aldehydes, nitrous acid, nitric acid, hydrochloric acid and ammonia), particulate matter components (metals, elemental and organic carbon, sulfate, hydrogen ion, pollen, mold spores and particle mass and number).
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Affiliation(s)
- Daniel Luttinger
- New York State Department of Health, Bureau of Toxic Substance Assessment, 547 River Street, Troy, NY 12180-2216, USA.
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Gilmour PS, Rahman I, Hayashi S, Hogg JC, Donaldson K, MacNee W. Adenoviral E1A primes alveolar epithelial cells to PM(10)-induced transcription of interleukin-8. Am J Physiol Lung Cell Mol Physiol 2001; 281:L598-606. [PMID: 11504686 DOI: 10.1152/ajplung.2001.281.3.l598] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The presence of the adenoviral early region 1A (E1A) protein in human lungs has been associated with an increased risk of chronic obstructive pulmonary disease (COPD), possibly by a mechanism involving amplification of proinflammatory responses. We hypothesize that enhanced inflammation results from increased transcription factor activation in E1A-carrying cells, which may afford susceptibility to environmental particulate matter < 10 microm (PM(10))-mediated oxidative stress. We measured interleukin (IL)-8 mRNA expression and protein release in human alveolar epithelial cells (A549) transfected with the E1A gene (E1A+ve). Both E1A+ve and -ve cells released IL-8 after incubation with TNF-alpha, but only E1A+ve cells were sensitive to LPS stimulation in IL-8 mRNA expression and protein release. E1A+ve cells showed an enhanced IL-8 mRNA and protein response after treatment with H(2)O(2) and PM(10). E1A-enhanced induction of IL-8 was accompanied by increases in activator protein-1 and nuclear factor-kappa B nuclear binding in E1A+ve cells, which also showed higher basal nuclear binding of these transcription factors. These data suggest that the presence of E1A primes the cell transcriptional machinery for oxidative stress signaling and therefore facilitates amplification of proinflammatory responses. By this mechanism, susceptibility to exacerbation of COPD in response to particulate air pollution may occur in individuals harboring E1A.
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Affiliation(s)
- P S Gilmour
- Respiratory Section, Edinburgh Lung and The Environment Group Initiative/Colt Laboratories, Department of Medical and Radiological Sciences, The University of Edinburgh Medical School, Edinburgh EH8 9AG, United Kingdom
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