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Chen C, Wang Y, Song J, Yan J. The impact of air pollution on hospitalization for COPD patients in China. Eur J Public Health 2024; 34:150-155. [PMID: 37968236 PMCID: PMC10843963 DOI: 10.1093/eurpub/ckad199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND With the rapid development of the global economy and the acceleration of urbanization, air pollution has become a major environmental problem threatening human health. There is limited evidence on the acute effects of air pollution on chronic obstructive pulmonary disease (COPD). METHODS From 2014 to 2019, we collected data on daily admissions for COPD patients from a city in China. We used the generalized additive model together with distributed lag models to fit the associations of air pollutants with hospital admissions. RESULTS We observed significant increments in the number of daily admissions (0.086-0.109%) for COPD for a unit range increase in air quality index, PM2.5 and PM10 over four lag days. The impact of air pollution on the number of daily admissions was mainly reflected in the COPD patients who were hospitalized through outpatient departments and tertiary hospitals. DISCUSSION Short-term exposure to outdoor air pollution may induce the occurrence or exacerbation of COPD patients; therefore, government departments should strengthen the management of air pollution, improve supervision and control mechanisms, pay attention to the quality of medical services, and reduce the adverse effects of air pollution on patients' health.
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Affiliation(s)
- Chen Chen
- School of Public Finance & Economics, Shanxi University of Finance and Economics, Taiyuan, China
| | - Yi Wang
- School of Public Finance & Economics, Shanxi University of Finance and Economics, Taiyuan, China
| | - Jinglin Song
- Post-Doctoral Research Center, Bank of Chongqing, Chongqing, China
| | - Juanjuan Yan
- School of Health Services and Management, Shanxi University of Chinese Medicine, Jinzhong, China
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Requia WJ, Vicedo-Cabrera AM, Amini H, Schwartz JD. Short-term air pollution exposure and mortality in Brazil: Investigating the susceptible population groups. Environ Pollut 2024; 340:122797. [PMID: 37879554 DOI: 10.1016/j.envpol.2023.122797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/05/2023] [Accepted: 10/22/2023] [Indexed: 10/27/2023]
Abstract
This is the first study to examine the association between ambient air pollution (PM2.5, O3, and NO2) and mortality (in different population groups by sex and age) based on a nationwide death record across Brazil over a 15-year period (2003-2017). We used a time-series analytic approach with a distributed lag model. Our study population includes 2,872,084 records of deaths in Brazil between 2003 and 2017. Men accounted for a higher proportion of deaths, with 58% for all-cause mortality, 54% for respiratory mortality, and 52% for circulatory mortality. Most individuals were over 65 years of age. Our results suggest an association between air pollution and mortality in Brazil. The direction, statistical significance, and effect size of these associations varied considerably by type of air pollutant, region, and population group (sex and age group). In particular, the older population group (>65 years) was most affected. The national meta-analysis for the entire data set (without stratification by sex and age) showed that for every 10 μg/m3 increase in PM2.5 concentration, the risk of death from respiratory diseases increased by 2.93% (95%CI: 1.42; 4.43). For every 10 ppb increase in O3, there is a 2.21% (95%CI: 0.59; 3.83) increase in the risk of all-cause mortality for the group of all people between 46 and 65 years old, and a 3.53% (95%CI: 0.34; 6.72) increase in the risk of circulatory mortality for the group of women, all ages. For every 10 ppb increase in NO2, the risk of respiratory mortality increases by 17.56% (95%CI: 4.44; 30.64) and the risk of all-cause mortality by 5.63% (95%CI: 1.83; 9.44). The results of our study provide epidemiological evidence that air pollution is associated with a higher risk of cardiorespiratory mortality in Brazil. Given the lack of nationwide studies on air pollution in Brazil, our research is an important contribution to the local and international literature that can provide better support to policymakers to improve air quality and public health.
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Affiliation(s)
- Weeberb J Requia
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil.
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Oeschger Center for Climate Change Research, Bern, Switzerland
| | - Heresh Amini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Joel D Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, United States
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3
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Chen C, Li T, Sun Q, Shi W, He MZ, Wang J, Liu J, Zhang M, Jiang Q, Wang M, Shi X. Short-term exposure to ozone and cause-specific mortality risks and thresholds in China: Evidence from nationally representative data, 2013-2018. Environ Int 2023; 171:107666. [PMID: 36470122 DOI: 10.1016/j.envint.2022.107666] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Ambient ozone pollution is steadily increasing and becoming a major environmental risk factor contributing to the global disease burden. Although the association between short-term ozone exposure and mortality has been widely studied, results are mostly reported on deaths from non-accidental or total cardiopulmonary disease rather than a spectrum of causes. In particular, a knowledge gap still exists for the potential thresholds in mortality risks. METHODS This nationwide time-series study in China included 323 counties totaling 230,266,168 residents. Daily maximum 8-hour average was calculated as the ozone exposure metric. A two-stage statistical approach was adopted to assess ozone effects on 21 cause-specific deaths for 2013-2018. The subset approach and threshold approach were utilized to explore potential thresholds, and stratification analysis was used to evaluate population susceptibility. RESULTS On average, the annual mean ozone concentration was 93.4 μg/m3 across 323 counties. A 10-μg/m3 increase in lag 0-1 day of ozone was associated with increases of 0.12 % in mortality risk from non-accidental disease, 0.11 % from circulatory disease, 0.09 % from respiratory disease, 0.29 % from urinary system disease, and 0.20 % from nervous system disease. There may be a "safe" threshold in the ozone-mortality association, which may be between 60 and 100 μg/m3, and vary by cause of death. Women and older adults (especially those over 75) are more affected by short-term ozone exposure. Populations in North China had a higher risk of ozone-related circulatory mortality, while populations in South China had a higher risk of ozone-related respiratory mortality. CONCLUSIONS National findings link short-term ozone exposure to premature death from circulatory, respiratory, neurological, and urinary diseases, and provide evidence for a potential "safe" threshold in the association of ozone and mortality. These findings have important implications for helping policymakers tighten the relevant air quality standards and developing early warning systems for public health protection in China.
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Affiliation(s)
- Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Wanying Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Mike Z He
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY 10029, USA
| | - Jiaonan Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jing Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Mengxue Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qizheng Jiang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Menghan Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Wen B, Wu Y, Ye T, Xu R, Yu W, Yu P, Guo Y, Li S. Short-term exposure to ozone and economic burden of premature mortality in Italy: A nationwide observation study. Ecotoxicol Environ Saf 2022; 241:113781. [PMID: 35772358 DOI: 10.1016/j.ecoenv.2022.113781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
Italy is among the countries with the highest ozone concentration in Europe. However, the mortality burden of ozone and related economic loss has not been fully characterized. This study aimed to estimate the ozone-mortality association in Italy and evaluate attributable mortality burden and related economic loss in 2015-2019. We collected daily all-cause mortality data stratified by age and sex from 2015 to 2019 in 107 provinces of Italy. A two-stage time-series framework was applied to estimate the association between daily maximum eight-hour average ozone and mortality as well as economic loss. An overall increase in the risk of mortality (RR=1.0043, 95% CI: 1.0029, 1.0057) was associated with every 10 µg/m3 increase in ozone. Generally, a total of 70,060 deaths and $65 billion economic loss were attributed to ozone exposure, corresponding to 3.11% of mortality and about 0.5% of the national GDP during the study period, respectively. The highest ozone-related mortality burden (30,910 deaths) and economic loss ($29.24 billion) were observed in the hot season. This nationwide study suggested considerable mortality burden and economic loss were associated with exposure to ozone. More actions and policies should be proposed to reduce ozone levels and help the public protect their health.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Wenhua Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Shanshan Li
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
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Michetti M, Gualtieri M, Anav A, Adani M, Benassi B, Dalmastri C, D'Elia I, Piersanti A, Sannino G, Zanini G, Uccelli R. Climate change and air pollution: Translating their interplay into present and future mortality risk for Rome and Milan municipalities. Sci Total Environ 2022; 830:154680. [PMID: 35314224 DOI: 10.1016/j.scitotenv.2022.154680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Heat and cold temperatures associated with exposure to poor air quality lead to increased mortality. Using a generalized linear model with Poisson regression for overdispersion, this study quantifies the natural-caused mortality burden attributable to heat/cold temperatures and PM10 and O3 air pollutants in Rome and Milan, the two most populated Italian cities. We calculate local-specific mortality relative risks (RRs) for the period 2004-2015 considering the overall population and the most vulnerable age category (≥85 years). Combining a regional climate model with a chemistry-transport model under future climate and air pollution scenarios (RCP2.6 and RCP8.5), we then project mortality to 2050. Results show that for historical mortality the burden is much larger for cold than for warm temperatures. RR peaks during wintertime in Milan and summertime in Rome, highlighting the relevance of accounting for the effects of air pollution besides that of climate, in particular PM10 for Milan and O3 for Rome. Overall, Milan reports higher RRs while, in both cities, the elderly appear more susceptible to heat/cold and air pollution events than the average population. Two counterbalancing effects shape mortality in the future: an increase associated with higher and more frequent warmer daily temperatures - especially in the case of climate inaction - and a decrease due to declining cold-mortality burden. The outcomes highlight the urgent need to adopt more stringent and integrated climate and air quality policies to reduce the temperature and air pollution combined effects on health.
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Affiliation(s)
- M Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy.
| | - M Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - A Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - M Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - B Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - C Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - I D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, 00196 Rome, Italy
| | - A Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - G Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - G Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - R Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
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Michetti M, Adani M, Anav A, Benassi B, Dalmastri C, D'Elia I, Gualtieri M, Piersanti A, Sannino G, Uccelli R, Zanini G. From single to multivariable exposure models to translate climatic and air pollution effects into mortality risk. A customized application to the city of Rome, Italy. MethodsX 2022; 9:101717. [PMID: 35620759 PMCID: PMC9127213 DOI: 10.1016/j.mex.2022.101717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
This study presents an approach developed to derive a Delayed-Multivariate Exposure-Response Model (D-MERF) useful to assess the short-term influence of temperature on mortality, accounting also for the effect of air pollution (O3 and PM10). By using Distributed, lag non-linear models (DLNM) we explain how city-specific exposure-response functions are derived for the municipality of Rome, which is taken as an example. The steps illustrated can be replicated to other cities while the statistical model presented here can be further extended to other exposure variables. We derive the mortality relative-risk (RR) curve averaged over the period 2004–2015, which accounts for city-specific climate and pollution conditions. Key aspects of customization are as follows: This study reports the steps followed to derive a combined, multivariate exposure-response model aimed at translating climatic and air pollution effects into mortality risk. Integration of climate and air pollution parameters to derive RR values. A specific interest is devoted to the investigation of delayed effects on mortality in the presence of different exposure factors.
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Affiliation(s)
- M. Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
- Corresponding author.
| | - M. Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - B. Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - C. Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - I. D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, Rome 00196, Italy
| | - M. Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - G. Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - R. Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - G. Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
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Qiu X, Danesh-Yazdi M, Wei Y, Di Q, Just A, Zanobetti A, Weisskopf M, Dominici F, Schwartz J. Associations of short-term exposure to air pollution and increased ambient temperature with psychiatric hospital admissions in older adults in the USA: a case-crossover study. Lancet Planet Health 2022; 6:e331-e341. [PMID: 35397221 PMCID: PMC9044858 DOI: 10.1016/s2542-5196(22)00017-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Little is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA. METHODS For this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM2·5], ozone, and nitrogen dioxide [NO2]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated. FINDINGS For each 5°C increase in short-term exposure to cold season temperature, the relative risk of acute hospital admission increased by 3·66% (95% CI 3·06-4·26) for depression, by 3·03% (2·04-4·02) for schizophrenia, and by 3·52% (2·38-4·68) for bipolar disorder in the US Medicare population. Increased short-term exposure to PM2·5 and NO2 was also associated with a significant increase in the risk of acute hospital admissions for psychiatric disorders. Each 5 μg/m3 increase in PM2·5 was associated with an increase in hospital admission rates of 0·62% (95% CI 0·23-1·02) for depression, 0·77% (0·11-1·44) for schizophrenia, and 1·19% (0·49-1·90) for bipolar disorder; each 5 parts per billion (ppb) increase in NO2, meanwhile, was linked to an increase in hospital admission rates of 0·35% (95% CI 0·03-0·66) for depression and 0·64% (0·20-1·08) for schizophrenia. No such associations were found with warm season temperature. INTERPRETATION In the US Medicare population, short-term exposure to elevated concentrations of PM2·5 and NO2 and cold season ambient temperature were significantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden. FUNDING US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Mahdieh Danesh-Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Allan Just
- Icahn School of Medicine at Mount Sinai, New York City, New York, NY, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Grigorieva E, Lukyanets A. Combined Effect of Hot Weather and Outdoor Air Pollution on Respiratory Health: Literature Review. Atmosphere 2021; 12:790. [DOI: 10.3390/atmos12060790] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Association between short-term exposure to ambient air pollution and respiratory health is well documented. At the same time, it is widely known that extreme weather events intrinsically exacerbate air pollution impact. Particularly, hot weather and extreme temperatures during heat waves (HW) significantly affect human health, increasing risks of respiratory mortality and morbidity. Concurrently, a synergistic effect of air pollution and high temperatures can be combined with weather–air pollution interaction during wildfires. The purpose of the current review is to summarize literature on interplay of hot weather, air pollution, and respiratory health consequences worldwide, with the ultimate goal of identifying the most dangerous pollution agents and vulnerable population groups. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, and Scopus, focusing only on peer-reviewed journal articles published in English from 2000 to 2021. The main findings demonstrate that the increased level of PM10 and O3 results in significantly higher rates of respiratory and cardiopulmonary mortality. Increments in PM2.5 and PM10, O3, CO, and NO2 concentrations during high temperature episodes are dramatically associated with higher admissions to hospital in patients with chronic obstructive pulmonary disease, daily hospital emergency transports for asthma, acute and chronic bronchitis, and premature mortality caused by respiratory disease. Excessive respiratory health risk is more pronounced in elderly cohorts and small children. Both heat waves and outdoor air pollution are synergistically linked and are expected to be more serious in the future due to greater climate instability, being a crucial threat to global public health that requires the responsible involvement of researchers at all levels. Sustainable urban planning and smart city design could significantly reduce both urban heat islands effect and air pollution.
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Kim H, Bell ML, Lee JT. Multi-dimensional community characteristics in linking particulate matter pollution and cause-specific mortality: 72 communities of South Korea. Environ Res 2021; 196:110989. [PMID: 33689820 DOI: 10.1016/j.envres.2021.110989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/04/2021] [Accepted: 03/04/2021] [Indexed: 05/18/2023]
Abstract
Concentration-response function for exposure to ambient particulate matter (PM) and mortality (i.e., relative risk, RR) may be inequal across communities by socioeconomic conditions. Investigation on specific mechanisms of this inequality regarding susceptibility to PM, beyond non-specific "socioeconomic conditions", would provide policy-relevant implications for tackling this inequality. However, such investigation via epidemiological studies is challenged by residual confounding by correlated mechanisms and different loss of life expectancy by PM exposures between communities. Here, we aimed to assess community characteristics including different aspects of socioeconomic deprivation, medical resources, health behaviors, air quality, and greenness in their relation to inequal RR for PM10 and cause-specific mortality in 72 municipalities in South Korea, 2006-2013, considering these challenges. We found that a 10 μg/m3 increase in PM10 on average across 46 days was associated with a 1.05% (95% CI: 0.24, 1.88) increase in all-cause mortality (ALL), 1.32% (95% CI: -0.29, 2.95) increase in cardiovascular mortality (CVD), and 6.47% (95% CI: 3.06, 10.00) increase in respiratory mortality (RES). The association between PM10 and mortality was higher in communities with higher ratio of SO2 to PM10 (ALL and RES), higher material deprivation (ALL, CVD, and RES), lower medical resources (CVD), higher prevalence of drinking (ALL and CVD), and lower prevalence of smoking (CVD and RES). Lag-structures showed smaller loss of life expectancy by PM exposures in communities with higher prevalence of smoking. Our findings suggest that PM-related health inequalities are shaped by a variety of mechanisms relating to susceptibility to PM exposures and different loss of life expectancy. Health policies controlling community characteristics may contribute to minimizing PM10-related health inequalities in those perspectives.
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Affiliation(s)
- Honghyok Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; School of the Environment, Yale University, CT, USA
| | | | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Department of Environmental Health, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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10
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Gao H, Wang K, W. Au W, Zhao W, Xia ZL. A Systematic Review and Meta-Analysis of Short-Term Ambient Ozone Exposure and COPD Hospitalizations. Int J Environ Res Public Health 2020; 17:ijerph17062130. [PMID: 32210080 PMCID: PMC7143242 DOI: 10.3390/ijerph17062130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 02/05/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally and ozone exposure is a main cause of its disease burden. However, studies on COPD hospitalizations from short-term ambient level ozone exposure have not generated consensus results. To address the knowledge gap, comprehensive and systematic searches in several databases were conducted using specific keywords for publications up to February 14, 2020. Random-effect models were used to derive overall excess risk estimates between short-term ambient-level ozone exposure and COPD hospitalizations. The influence analyses were used to test the robustness of the results. Both meta-regression and subgroup analyses were used to explore the sources of heterogeneity and potential modifying factors. Based on the results from 26 eligible studies, the random-effect model analyses show that a 10 µg/m3 increase in maximum 8-h ozone concentration was associated with 0.84% (95% CI: 0.09%, 1.59%) higher COPD hospitalizations. The estimates were higher for warm season and multiple-day lag but lower for old populations. Results from subgroup analyses also indicate a multiple-day lag trend and bigger significant health effects during longer day intervals. Although characteristics of individual studies added modest heterogeneity to the overall estimates, the results remained robust during further analyses and exhibited no evidence of publication bias. Our systematic review and meta-analysis indicate that short-term ambient level ozone exposure was associated with increased risk of COPD hospitalizations. The significant association with multiple-day lag trend indicates that a multiple-day exposure metric should be considered for establishing ambient ozone quality and exposure standards for improvement of population health. Future investigations and meta-analysis studies should include clinical studies as well as more careful lag selection protocol.
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Affiliation(s)
- Hui Gao
- Changning Center for Disease Control and Prevention, Shanghai 200051, China;
| | - Kan Wang
- School of Public Health, & Key Laboratory of Public Health Safety of Ministry of Education of China, Fudan University, Shanghai 200032, China;
- Department of Epidemiology, Erasmus Medical Center, 3000CA Rotterdam, The Netherlands
| | - William W. Au
- University of Medicine, Pharmacy, Science and Techonology, 540142 Tirgu Mures, Romania;
- Faculty of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou 515041, China
| | - Wensui Zhao
- Changning Center for Disease Control and Prevention, Shanghai 200051, China;
- Correspondence: (W.Z.); (Z.-l.X.); Tel./Fax: +86-21-520-641-06 (W.Z.); +86-21-542-370-90 (Z.-l.X.)
| | - Zhao-lin Xia
- School of Public Health, & Key Laboratory of Public Health Safety of Ministry of Education of China, Fudan University, Shanghai 200032, China;
- Correspondence: (W.Z.); (Z.-l.X.); Tel./Fax: +86-21-520-641-06 (W.Z.); +86-21-542-370-90 (Z.-l.X.)
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11
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Vicedo-Cabrera AM, Sera F, Liu C, Armstrong B, Milojevic A, Guo Y, Tong S, Lavigne E, Kyselý J, Urban A, Orru H, Indermitte E, Pascal M, Huber V, Schneider A, Katsouyanni K, Samoli E, Stafoggia M, Scortichini M, Hashizume M, Honda Y, Ng CFS, Hurtado-Diaz M, Cruz J, Silva S, Madureira J, Scovronick N, Garland RM, Kim H, Tobias A, Íñiguez C, Forsberg B, Åström C, Ragettli MS, Röösli M, Guo YLL, Chen BY, Zanobetti A, Schwartz J, Bell ML, Kan H, Gasparrini A. Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries. BMJ 2020; 368:m108. [PMID: 32041707 PMCID: PMC7190035 DOI: 10.1136/bmj.m108] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. DESIGN Two stage time series analysis. SETTING 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. POPULATION Deaths for all causes or for external causes only registered in each city within the study period. MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only). RESULTS A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. CONCLUSIONS Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.
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Affiliation(s)
- Ana M Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Ai Milojevic
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mathilde Pascal
- Santé Publique France, French National Public Health Agency, Saint Maurice, France
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Masahiro Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Magali Hurtado-Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Julio Cruz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Susana Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Joana Madureira
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Natural Resources and the Environment Unit, Council for Scientific and Industrial Research, Pretoria 0001, South Africa
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
- Department of Geography, Geo-informatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, University of Valencia, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taiwan
| | - Bing-Yu Chen
- Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taiwan
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Haidong Kan
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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12
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Cheng Y, Ermolieva T, Cao GY, Zheng X. Health Impacts of Exposure to Gaseous Pollutants and Particulate Matter in Beijing-A Non-Linear Analysis Based on the New Evidence. Int J Environ Res Public Health 2018; 15:E1969. [PMID: 30201896 DOI: 10.3390/ijerph15091969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 11/16/2022]
Abstract
This paper aimed to estimate health risks focusing on respiratory diseases from exposure to gaseous multi-pollutants based on new data and revealed new evidence after the most stringent air pollution control plan in Beijing which was carried out in 2013. It used daily respiratory diseases outpatient data from a hospital located in Beijing with daily meteorological data and monitor data of air pollutants from local authorities. All data were collected from 2014 to 2016. Distributed lag non-linear model was employed. Results indicated that NO2 and CO had positive association with outpatients number on the day of the exposure (1.045 (95% confidence interval (CI): 1.003, 1.089) for CO and 1.022 (95% CI: 1.008, 1.036) for NO2) (and on the day after the exposure (1.026 (95% CI: 1.005, 1.048) for CO and 1.013 (95% CI: 1.005, 1.021) for NO2). Relative risk (RR) generally declines with the number of lags; ozone produces significant effects on the first day (RR = 0.993 (95% CI: 0.989, 0.998)) as well as second day (RR = 0.995 (95% CI: 0.991, 0.999)) after the exposure, while particulate pollutants did not produce significant effects. Effects from the short-term exposure to gaseous pollutants were robust after controlling for particulate matters. Our results contribute to a comprehensive understanding of the dependencies between the change of air pollutants concentration and their health effects in Beijing after the implementation of promising air regulations in 2013. Results of the study can be used to develop relevant measures minimizing the adverse health consequences of air pollutants and supporting sustainable development of Beijing as well as other rapidly growing Asian cities.
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Raza A, Dahlquist M, Lind T, Ljungman PLS. Susceptibility to short-term ozone exposure and cardiovascular and respiratory mortality by previous hospitalizations. Environ Health 2018; 17:37. [PMID: 29653570 PMCID: PMC5899411 DOI: 10.1186/s12940-018-0384-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/05/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Ozone (O3) has been associated with cardiorespiratory mortality although few studies have explored susceptible populations based on prior disease. We aimed to investigate the role of previous hospitalization on the association between short-term exposure to O3 and cardiovascular (CV) and respiratory mortality. METHODS We performed time series analyses using generalized additive models and case-crossover on 136,624 CV and 23,281 respiratory deaths in Stockholm County (1990-2010). Deaths were linked to hospital admissions data. We constructed 2-day and 7-day averages using daily 8-h maximum for O3 and hourly values for PM2.5, PM10, NO2, and NOx from a fixed monitor. RESULTS We observed a 0.7% (95% CI: 0.1%, 1.3%) and 2.7% (95% CI: 0.8%, 4.6%) higher risk of CV and respiratory death per 10 μg/m3 higher 2-day and 7-day average O3 respectively. Individuals previously hospitalized for myocardial infarction demonstrated 1.8% (95% CI: 0.4%, 3.4%) higher risk of CV death per 10 μg/m3 higher 2-day average O3 and similar associations were observed in individuals with no previous hospitalization for any cause. Individuals with previous hospitalizations did not show susceptibility towards O3-related risk of respiratory mortality. We observed no associations for other pollutants. CONCLUSION Short-term ozone exposure is associated with CV and respiratory mortality and our results may suggest higher susceptibility to CV mortality following O3 exposure in individuals previously hospitalized for myocardial infarction. Higher risks were also observed in individuals with cardiovascular death as their first presentation of disease.
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Affiliation(s)
- Auriba Raza
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
| | - Marcus Dahlquist
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
| | - Tomas Lind
- Center for Occupational and Environmental Medicine, Stockholm County Council, Solnavägen 4, 113 65 Stockholm, Sweden
| | - Petter L. S. Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13 | Box 210 |, SE-171 77 Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
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14
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Collart P, Dramaix M, Levêque A, Mercier G, Coppieters Y. Concentration-response curve and cumulative effects between ozone and daily mortality: an analysis in Wallonia, Belgium. Int J Environ Health Res 2018; 28:147-158. [PMID: 29564909 DOI: 10.1080/09603123.2018.1453050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
Many studies have shown an association between ozone and mortality. However, little data is available on the cumulative effects of ozone on health. A time-series analysis using a Poisson regression was used to measure the impact of ozone on non-traumatic mortality in Wallonia over the period 2000-2012. Initially, a single-lag model was tested. Then a distributed-lag non-linear model was used in order to verify the cumulative effects of ozone on mortality. Our study confirms the existence of an association between ozone and mortality. The linear model without threshold shows a higher sensitivity in persons aged 75 and over (ERR = 0.7, 95 % CI: 0.4; 1.0 %) compared to younger people (ages 25-74) (ERR = 0.2, 95 % CI: - 0.2; 0.6 %). Taking cumulative effects into account, men and women aged 25-74 have an ozone sensitivity equivalent to those over 75.
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Affiliation(s)
- Philippe Collart
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Michèle Dramaix
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Alain Levêque
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Gwenaëlle Mercier
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Yves Coppieters
- a Centre de recherche Epidémiologie, biostatistiques, recherche clinique , School of Public Health, Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
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15
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Cox B, Gasparrini A, Catry B, Fierens F, Vangronsveld J, Nawrot TS. Ambient Air Pollution-related Mortality in Dairy Cattle: Does It Corroborate Human Findings? Epidemiology 2016; 27:779-86. [PMID: 27468004 DOI: 10.1097/EDE.0000000000000545] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite insights for humans, short-term associations of air pollution with mortality to our knowledge have never been studied in animals. We investigated the association between ambient air pollution and risk of mortality in dairy cows and assessed effect modification by season. METHODS We collected ozone (O3), particulate matter (PM10), and nitrogen dioxide (NO2) concentrations at the municipality level for 87,108 dairy cow deaths in Belgium from 2006 to 2009. We combined a case-crossover design with time-varying distributed lag models. RESULTS We found acute and delayed associations between air pollution and dairy cattle mortality during the warm season. The increase in mortality for a 10 μg/m increase in 2-day (lag 0-1) O3 was 1.2% (95% confidence interval [CI] = 0.3%, 2.1%), and the corresponding estimates for a 10 μg/m increase in same-day (lag 0) PM10 and NO2 were 1.6% (95% CI = 0.0%, 3.1%) and 9.2% (95% CI = 6.3%, 12%), respectively. Compared with the acute increases, the cumulative 26-day (lag 0-25) estimates were considerably larger for O3 (3.0%; 95% CI = 0.2%, 6.0%) and PM10 (3.2%; 95% CI = -0.6%, 7.2%), but not for NO2 (1.4%; 95% CI = -4.9%, 8.2%). In the cold season, we only observed increased mortality risks associated with same-day (lag 0) exposure to NO2 (1.4%; 95% CI = -0.1%, 3.1%) and with 26-day (lag 0-25) exposure to O3 (4.6%; 95% CI = 2.2%, 7.0%). CONCLUSIONS Our study adds to the epidemiologic findings in humans and reinforces the evidence on the plausibility of causal effects. Furthermore, our results indicate that air pollution associations go beyond short-term mortality displacement. (See video abstract at http://links.lww.com/EDE/B105.).
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Yin P, Chen R, Wang L, Meng X, Liu C, Niu Y, Lin Z, Liu Y, Liu J, Qi J, You J, Zhou M, Kan H. Ambient Ozone Pollution and Daily Mortality: A Nationwide Study in 272 Chinese Cities. Environ Health Perspect 2017; 125:117006. [PMID: 29212061 PMCID: PMC5947936 DOI: 10.1289/ehp1849] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 10/03/2017] [Accepted: 10/20/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Few large multicity studies have been conducted in developing countries to address the acute health effects of atmospheric ozone pollution. OBJECTIVE We explored the associations between ozone and daily cause-specific mortality in China. METHODS We performed a nationwide time-series analysis in 272 representative Chinese cities between 2013 and 2015. We used distributed lag models and over-dispersed generalized linear models to estimate the cumulative effects of ozone (lagged over 0-3 d) on mortality in each city, and we used hierarchical Bayesian models to combine the city-specific estimates. Regional, seasonal, and demographic heterogeneity were evaluated by meta-regression. RESULTS At the national-average level, a 10-μg/m3 increase in 8-h maximum ozone concentration was associated with 0.24% [95% posterior interval (PI): 0.13%, 0.35%], 0.27% (95% PI: 0.10%, 0.44%), 0.60% (95% PI: 0.08%, 1.11%), 0.24% (95% PI: 0.02%, 0.46%), and 0.29% (95% PI: 0.07%, 0.50%) higher daily mortality from all nonaccidental causes, cardiovascular diseases, hypertension, coronary diseases, and stroke, respectively. Associations between ozone and daily mortality due to respiratory and chronic obstructive pulmonary disease specifically were positive but imprecise and nonsignificant. There were no statistically significant differences in associations between ozone and nonaccidental mortality according to region, season, age, sex, or educational attainment. CONCLUSIONS Our findings provide robust evidence of higher nonaccidental and cardiovascular mortality in association with short-term exposure to ambient ozone in China. https://doi.org/10.1289/EHP1849.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- Key Laboratory of Public Health Security, School of Public Health, Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technique Assessment, School of Public Health, Ministry of Health, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Cong Liu
- Key Laboratory of Public Health Security, School of Public Health, Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technique Assessment, School of Public Health, Ministry of Health, Fudan University, Shanghai, China
| | - Yue Niu
- Key Laboratory of Public Health Security, School of Public Health, Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technique Assessment, School of Public Health, Ministry of Health, Fudan University, Shanghai, China
| | - Zhijing Lin
- Key Laboratory of Public Health Security, School of Public Health, Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technique Assessment, School of Public Health, Ministry of Health, Fudan University, Shanghai, China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinling You
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- Key Laboratory of Public Health Security, School of Public Health, Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technique Assessment, School of Public Health, Ministry of Health, Fudan University, Shanghai, China
- Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University , Shanghai, China
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Abstract
This study assesses two alternative approaches for investigating linear and nonlinear lagged associations in environmental time series data, comparing through simulations simple methods based on moving average summaries with more flexible distributed lag linear and nonlinear models. Results indicate that the latter provide estimates with no or low bias and close-to-nominal confidence intervals, even for long-lagged associations and in the presence of strong seasonal trends. Moving average models represent a viable alternative only in the presence of relatively short lag periods, and when the lag interval is correctly specified. In contrast, the use of moving averages to roughly approximate long and complex lag patterns, or the specification of an interval different than the actual lag period, can result in substantial biases. More flexible approaches based on distributed lag linear or nonlinear models provide noteworthy advantages, in particular when complex lagged associations are assumed.
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Chiu HF, Weng YH, Chiu YW, Yang CY. Short-term effects of ozone air pollution on hospital admissions for myocardial infarction: A time-stratified case-crossover study in Taipei. J Toxicol Environ Health A 2017; 80:251-257. [PMID: 28598271 DOI: 10.1080/15287394.2017.1321092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study was undertaken to determine whether there was a correlation between ambient ozone (O3) levels and number of hospital admissions for myocardial infarction (MI) in Taipei, Taiwan. Hospital admissions for MI and ambient air pollution data for Taipei were obtained for the period from 2006 to 2010. The relative risk (RR) of hospital admissions for MI was estimated using a time-stratified 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 RR for a number of MI admissions was significantly associated with higher O3 levels both on warm days (>23°C) and on cool days (<23°C). This observation was accompanied by an interquartile range elevation correlated with a 7% (95% CI = 2%-12%) and 17% (95% CI = 11%-25%) rise in number of MI admissions, respectively. In the two-pollutant models, no significant associations between ambient O3 concentrations and number of MI admissions were observed on warm days. However, on cool days, correlation between ambient O3 after inclusion of each of the other five pollutants, particulate matter (PM10 or PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2) or carbon monoxide (CO), and number of MI admissions remained significant. This study provides evidence that higher levels of ambient O3 increase the RR of number of hospital admissions for MI.
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Affiliation(s)
- Hui-Fen Chiu
- a Department of Pharmacology , College of Medicine, 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
- e Division of Environmental Health and Occupational Medicine , National Health Research Institute , Miaoli , Taiwan
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Samoli E, Dimakopoulou K, Evangelopoulos D, Rodopoulou S, Karakatsani A, Veneti L, Sionidou M, Tsolakoglou I, Krasanaki I, Grivas G, Papakosta D, Katsouyanni K. Is daily exposure to ozone associated with respiratory morbidity and lung function in a representative sample of schoolchildren? Results from a panel study in Greece. J Expo Sci Environ Epidemiol 2017; 27:346-351. [PMID: 27189255 DOI: 10.1038/jes.2016.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 04/02/2016] [Indexed: 06/05/2023]
Abstract
Previous time series or panel studies of asthmatics have reported respiratory health effects following short-term exposure to ozone (O3). We followed 186 children aged 10 years old in Athens and Thessaloniki, Greece for 5 weeks during the academic year 2013-2014 and recorded daily their respiratory symptoms, absenteeism and peak expiratory flow (PEF). We applied mixed models controlling for various possible confounders to investigate the daily associations between O3 exposure - derived from weekly personal and fixed school site measurements calibrated using daily values of the fixed monitoring site nearest to the child's school location - and PEF, presence of any symptom, cough and stuffy nose, as well as absenteeism. We tested the robustness of our findings to varying modeling assumptions and confounders and investigated effect modification patterns by medication use, time spent outdoors and prevalence of asthma. A 10 μg/m3 increase in O3 personal exposure was associated with increased odds of any symptom (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.98, 1.44), largely attributed to the increase in the odds of stuffy nose (OR: 1.23, 95% CI: 1.00, 1.51). PEF and absenteeism were not related to O3 exposure. Our results were robust to several sensitivity analyses. Effects were modified by medication use as presence of symptoms but also decreases in PEF were mainly reported among non-users, while our effect estimates were not driven by the asthmatic subgroup of children. Our findings indicate that short-term O3 exposure may be associated with respiratory symptoms extending previously reported results for asthmatics to the general population.
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Affiliation(s)
- Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitris Evangelopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Anna Karakatsani
- 2nd Pulmonary Department, "ATTIKON" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lambrini Veneti
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Maria Sionidou
- Pulmonary Department, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tsolakoglou
- Pulmonary Department, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Krasanaki
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgios Grivas
- School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - Despoina Papakosta
- Pulmonary Department, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
- Department of Primary Care & Public Health Sciences and Environmental Research Group, King's College, London
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Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. Air Pollution and Deaths among Elderly Residents of São Paulo, Brazil: An Analysis of Mortality Displacement. Environ Health Perspect 2017; 125:349-354. [PMID: 27713111 PMCID: PMC5332200 DOI: 10.1289/ehp98] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. OBJECTIVES We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. METHODS We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 μm (PM10), nitrogen dioxide (NO2) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0-10, 0-20 and 0-30 days were used to assess mortality displacement and potential cumulative exposure effects. RESULTS PM10, NO2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0-10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0-30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. CONCLUSIONS We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. Citation: Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. 2017. Air pollution and deaths among elderly residents of São Paulo, Brazil: an analysis of mortality displacement. Environ Health Perspect 125:349-354; http://dx.doi.org/10.1289/EHP98.
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Affiliation(s)
- Amine Farias Costa
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Brazilian National Cancer Institute, Rio de Janeiro, Brazil
- Address correspondence to A.F. Costa, Rua Equador 831, Rio de Janeiro, RJ, Brazil, 20220-410. Telephone: 552132072846. E-mail:
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Abstract
The genetic cardiovascular disease (CVD) and associated metabolic impairments can influence the lung injury from inhaled pollutants. We hypothesized that comparative assessment of global pulmonary expression profile of healthy and CVD-prone rat models will provide mechanistic insights into susceptibility differences to ozone. The lung expression profiles of healthy Wistar Kyoto (WKY) and CVD-compromised spontaneously hypertensive (SH), stroke-prone SH (SHSP), obese SH heart failure (SHHF) and obese, atherosclerosis-prone JCR rats were analyzed using Affymetrix platform immediately after 4-h air or 1 ppm ozone exposure. At baseline, the JCR exhibited the largest difference in the number of genes among all strains when compared with WKY. Interestingly, the number of genes affected by ozone was inversely correlated with genes different at baseline relative to WKY. A cluster of NFkB target genes involved in cell-adhesion, antioxidant response, inflammation and apoptosis was induced in all strains, albeit at different levels (JCR < WKY < SHHF < SH < SHSP). The lung metabolic syndrome gene cluster indicated expressions in opposite directions for SHHF and JCR suggesting different mechanisms for common disease phenotype and perhaps obesity-independent contribution to exacerbated lung disease. The differences in expression of adrenergic receptors and ion-channel genes suggested distinct mechanisms by which ozone might induce protein leakage in CVD models, especially SHHF and JCR. Thus, the pulmonary response to ozone in CVD strains was likely linked to the defining gene expression profiles. Differential transcriptional patterns between healthy and CVD rat strains at baseline, and after ozone suggests that lung inflammation and injury might be influenced by multiple biological pathways affecting inflammation gene signatures.
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Affiliation(s)
- William O Ward
- a Research Cores Unit, National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency , Research Triangle Park , NC , USA and
| | - Urmila P Kodavanti
- b Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency , Research Triangle Park , NC , USA
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Ward WO, Ledbetter AD, Schladweiler MC, Kodavanti UP. Lung transcriptional profiling: insights into the mechanisms of ozone-induced pulmonary injury in Wistar Kyoto rats. Inhal Toxicol 2016; 27 Suppl 1:80-92. [PMID: 26667333 DOI: 10.3109/08958378.2014.954172] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Acute ozone-induced pulmonary injury and inflammation are well characterized in rats; however, mechanistic understanding of the pathways involved is limited. We hypothesized that acute exposure of healthy rats to ozone will cause transcriptional alterations, and comprehensive analysis of these changes will allow us to better understand the mechanism of pulmonary injury and inflammation. Male Wistar Kyoto rats (10-12 week) were exposed to air, or ozone (0.25, 0.5 or 1.0 ppm) for 4 h and pulmonary injury and inflammation were assessed at 0-h or 20-h (n = 8/group). Lung gene expression profiling was assessed at 0-h (air and 1.0 ppm ozone, n = 3-4/group). At 20-h bronchoalveolar lavage, fluid protein and neutrophils increased at 1 ppm ozone. Numerous genes involved in acute inflammatory response were up-regulated along with changes in genes involved in cell adhesion and migration, steroid metabolism, apoptosis, cell cycle control and cell growth. A number of NRF2 target genes were also induced after ozone exposure. Based on expression changes, Rela, SP1 and TP3-mediated signaling were identified to be mediating downstream changes. Remarkable changes in the processes of endocytosis provide the insight that ozone-induced lung injury and inflammation are likely initiated by changes in cell membrane components and receptors likely from oxidatively modified lung lining lipids and proteins. In conclusion, ozone-induced injury and inflammation are preceded by changes in gene targets for cell adhesion/migration, apoptosis, cell cycle control and growth regulated by Rela, SP1 and TP53, likely mediated by the process of endocytosis and altered steroid receptor signaling.
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Affiliation(s)
| | - Allen D Ledbetter
- b Environmental Public Health Division , National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency , Research Triangle Park , NC , USA
| | - Mette C Schladweiler
- b Environmental Public Health Division , National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency , Research Triangle Park , NC , USA
| | - Urmila P Kodavanti
- b Environmental Public Health Division , National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency , Research Triangle Park , NC , USA
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Goudarzi G, Geravandi S, Foruozandeh H, Babaei AA, Alavi N, Niri MV, Khodayar MJ, Salmanzadeh S, Mohammadi MJ. Cardiovascular and respiratory mortality attributed to ground-level ozone in Ahvaz, Iran. Environ Monit Assess 2015; 187:487. [PMID: 26141926 DOI: 10.1007/s10661-015-4674-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 06/09/2015] [Indexed: 06/04/2023]
Abstract
Ahvaz, the capital city of Khuzestan Province, which produces Iran's most oil, is on the rolls of fame in view of air pollution. It has also suffered from dust storm during the recent two decades. So, emissions from transportation systems, steel, oil, black carbon, and other industries as anthropogenic sources and dust storm as a new phenomenon are two major concerns of air pollution in Ahvaz. Without any doubt, they can cause many serious problems for the environment and humans in this megacity. The main objective of the present study was to estimate the impact of ground-level ozone (GLO) as a secondary pollutant on human heath. Data of GLO in four monitoring stations were collected at the first step and they were processed and at the final step they were inserted to a health effect model. Findings showed that cumulative cases of cardiovascular and respiratory deaths which attributed to GLO were 43 and 173 persons, respectively. Corresponding RR for these two events were 1.008 (95% CI) and 1.004 (95% CI), respectively. Although we did not provide a distinction between winter and summer in case of mentioned mortalities attributed to GLO, ozone concentrations in winter due to more fuel consumption and sub adiabatic condition in tropospheric atmospherewere higher than those GLO in summer.
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Affiliation(s)
- Gholamreza Goudarzi
- Department of Environmental Health Engineering, School of Public Health, Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
Although the air quality in Western countries has continued to improve over the past decades, rapid economic growth in developing countries has left air quality in many cities notoriously poor. The World Health Organization estimates that urban outdoor air pollution is estimated to cause 1.3 million deaths worldwide per year. The primary health concerns of outdoor air pollution come from particulate matter less than 2.5 μm (PM2.5) and ozone (O3). Short-term exposure to PM2.5 increases cardiopulmonary morbidity and mortality. Long-term exposure to PM2.5 has been linked to adverse perinatal outcomes and lung cancer. Excessive O3 exposure is known to increase respiratory morbidity. Patients with chronic cardiopulmonary diseases are more susceptible to the adverse effects of air pollution. Counseling these patients about air pollution and the associated risks should be part of the regular management plans in clinical practice.
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Goodman JE, Prueitt RL, Sax SN, Lynch HN, Zu K, Lemay JC, King JM, Venditti FJ. Weight-of-evidence evaluation of short-term ozone exposure and cardiovascular effects. Crit Rev Toxicol 2015; 44:725-90. [PMID: 25257961 DOI: 10.3109/10408444.2014.937854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is a relatively large body of research on the potential cardiovascular (CV) effects associated with short-term ozone exposure (defined by EPA as less than 30 days in duration). We conducted a weight-of-evidence (WoE) analysis to assess whether it supports a causal relationship using a novel WoE framework adapted from the US EPA's National Ambient Air Quality Standards causality framework. Specifically, we synthesized and critically evaluated the relevant epidemiology, controlled human exposure, and experimental animal data and made a causal determination using the same categories proposed by the Institute of Medicine report Improving the Presumptive Disability Decision-making Process for Veterans ( IOM 2008). We found that the totality of the data indicates that the results for CV effects are largely null across human and experimental animal studies. The few statistically significant associations reported in epidemiology studies of CV morbidity and mortality are very small in magnitude and likely attributable to confounding, bias, or chance. In experimental animal studies, the reported statistically significant effects at high exposures are not observed at lower exposures and thus not likely relevant to current ambient ozone exposures in humans. The available data also do not support a biologically plausible mechanism for CV effects of ozone. Overall, the current WoE provides no convincing case for a causal relationship between short-term exposure to ambient ozone and adverse effects on the CV system in humans, but the limitations of the available studies preclude definitive conclusions regarding a lack of causation. Thus, we categorize the strength of evidence for a causal relationship between short-term exposure to ozone and CV effects as "below equipoise."
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Bekö G, Allen JG, Weschler CJ, Vallarino J, Spengler JD. Impact of cabin ozone concentrations on passenger reported symptoms in commercial aircraft. PLoS One 2015; 10:e0128454. [PMID: 26011001 PMCID: PMC4444275 DOI: 10.1371/journal.pone.0128454] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 04/27/2015] [Indexed: 11/20/2022] Open
Abstract
Due to elevated ozone concentrations at high altitudes, the adverse effect of ozone on air quality, human perception and health may be more pronounced in aircraft cabins. The association between ozone and passenger-reported symptoms has not been investigated under real conditions since smoking was banned on aircraft and ozone converters became more common. Indoor environmental parameters were measured at cruising altitude on 83 US domestic and international flights. Passengers completed a questionnaire about symptoms and satisfaction with the indoor air quality. Average ozone concentrations were relatively low (median: 9.5 ppb). On thirteen flights (16%) ozone levels exceeded 60 ppb, while the highest peak level reached 256 ppb for a single flight. The most commonly reported symptoms were dry mouth or lips (26%), dry eyes (22.1%) and nasal stuffiness (18.9%). 46% of passengers reported at least one symptom related to the eyes or mouth. A third of the passengers reported at least one upper respiratory symptom. Using multivariate logistic (individual symptoms) and linear (aggregated continuous symptom variables) regression, ozone was consistently associated with symptoms related to the eyes and certain upper respiratory endpoints. A concentration-response relationship was observed for nasal stuffiness and eye and upper respiratory symptom indicators. Average ozone levels, as opposed to peak concentrations, exhibited slightly weaker associations. Medium and long duration flights were significantly associated with more symptoms compared to short flights. The relationship between ultrafine particles and ozone on flights without meal service was indicative of ozone-initiated chemistry.
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Affiliation(s)
- Gabriel Bekö
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Joseph G. Allen
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Charles J. Weschler
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Lyngby, Denmark
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey, United States of America
| | - Jose Vallarino
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - John D. Spengler
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
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Nuvolone D, Balzi D, Pepe P, Chini M, Scala D, Giovannini F, Cipriani F, Barchielli A. Ozone short-term exposure and acute coronary events: a multicities study in Tuscany (Italy). Environ Res 2013; 126:17-23. [PMID: 24011457 DOI: 10.1016/j.envres.2013.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 07/02/2013] [Accepted: 08/06/2013] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Many studies have investigated the potential role of ozone exposure in cardiovascular mortality and morbidity. The effects on specific cardiovascular outcome and the role of individual susceptibility are less studied. This paper focuses on the short-term effects of ozone on acute coronary events and it investigates comorbidities as indicators of personal susceptibility. SETTING AND PATIENTS This study was conducted in five urban areas of the Tuscany region (Italy) covering the period January 2002-December 2005. Air quality and meteorological data from urban background monitoring sites were collected. Hospital admissions for acute myocardial infarction and out-of-hospital coronary deaths were extracted from administrative database. DESIGN Both time series and case-crossover designs were applied. The confounding effects of some time-dependent variables, such as temperature, were taken into account. Some potential susceptibility factors were investigated. Pooled estimates were derived from random-effect meta-analysis. RESULTS During the warm season 4555 hospitalized acute myocardial infarctions and 1931 out-of-hospital coronary deaths occurred. Authors estimated a 6.3% (95% confidence interval, 1.2%, 11.7%) increase in out-of-hospital coronary deaths for a 10 μg/m3 increase in ozone (lag 0-5). Results also suggested higher risks for females, elderly, and patients previously hospitalized for cerebrovascular and artery diseases. CONCLUSIONS This study adds further evidence to the relation between cardiovascular diseases and ozone exposure, showing an adverse effect on out-of-hospital coronary deaths, but not on hospitalized acute myocardial infarctions. Some susceptible subgroups, such as females, elderly, and patients affected by some chronic diseases, are likely to be at major risk.
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Affiliation(s)
- Daniela Nuvolone
- Epidemiology Unit, Regional Agency for Public Health of Tuscany, Via Pietro Dazzi 1, 51100 Florence, Italy.
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Lin YK, Chang SC, Lin C, Chen YC, Wang YC. Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei Metropolitan area. Environ Pollut 2013; 177:177-84. [PMID: 23333210 PMCID: PMC7127381 DOI: 10.1016/j.envpol.2012.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 12/09/2012] [Accepted: 12/14/2012] [Indexed: 05/05/2023]
Abstract
This study reported cumulative 6-day (lag 0-5 days) relative risks (RR) and confidence intervals (CI) of daily outpatient visits for total respiratory disease (RD), asthma, and chronic airway obstruction not otherwise classified (CAO) associated with three ozone metrics (daily 1-h maximum (O3, 1 h max), 8-h average maximum (O3, 8 h max), 24-h average (O3, 24 h avg)), and an alternative oxidant indicator (Ox) in Taipei Metropolitan, using distributed lag non-linear models after controlling for potential confounders. The Ox showed the strongest association with outpatient visits for total RD (RR = 1.10, 95% CI: 1.10, 1.11) and asthma (RR = 1.18, 95% CI: 1.00, 1.39) in the cold season. The O3, 24 h avg appeared to be the optimal ozone metric associating with total RD than O3, 1 h max and O3, 8 h max based on model selection. In conclusion, outpatient visits for total RD associated with ozone vary with ozone metrics, disease and season.
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Affiliation(s)
- Yu-Kai Lin
- Institute of Environmental Health, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
- Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, 677 Huntington Ave, Boston, MA 02115, USA
| | - Shuenn-Chin Chang
- Taiwan Environmental Protection Administration, 83, Sec. 1, Jhonghua Road, Taipei City 10042, Taiwan
- School of Public Health, National Defense Medical Center, 161, Sec. 6, Min-Chuan East Road, Taipei 114, Taiwan
| | - ChitSan Lin
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, 142 Haijhuan Road, Nanzih District, Kaohsiung City 811, Taiwan
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung 824, Taiwan
| | - Yu-Chun Wang
- Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan
- Corresponding author.
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Gasparrini A, Armstrong B. Reducing and meta-analysing estimates from distributed lag non-linear models. BMC Med Res Methodol 2013; 13:1. [PMID: 23297754 PMCID: PMC3599933 DOI: 10.1186/1471-2288-13-1] [Citation(s) in RCA: 362] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 12/17/2012] [Indexed: 01/08/2023] Open
Abstract
Background The two-stage time series design represents a powerful analytical tool in environmental epidemiology. Recently, models for both stages have been extended with the development of distributed lag non-linear models (DLNMs), a methodology for investigating simultaneously non-linear and lagged relationships, and multivariate meta-analysis, a methodology to pool estimates of multi-parameter associations. However, the application of both methods in two-stage analyses is prevented by the high-dimensional definition of DLNMs. Methods In this contribution we propose a method to synthesize DLNMs to simpler summaries, expressed by a reduced set of parameters of one-dimensional functions, which are compatible with current multivariate meta-analytical techniques. The methodology and modelling framework are implemented in R through the packages dlnm and mvmeta. Results As an illustrative application, the method is adopted for the two-stage time series analysis of temperature-mortality associations using data from 10 regions in England and Wales. R code and data are available as supplementary online material. Discussion and Conclusions The methodology proposed here extends the use of DLNMs in two-stage analyses, obtaining meta-analytical estimates of easily interpretable summaries from complex non-linear and delayed associations. The approach relaxes the assumptions and avoids simplifications required by simpler modelling approaches.
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Affiliation(s)
- Antonio Gasparrini
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
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Gasparrini A, Armstrong B, Kenward MG. Multivariate meta-analysis for non-linear and other multi-parameter associations. Stat Med 2012; 31:3821-39. [PMID: 22807043 PMCID: PMC3546395 DOI: 10.1002/sim.5471] [Citation(s) in RCA: 448] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 05/11/2012] [Indexed: 12/13/2022]
Abstract
In this paper, we formalize the application of multivariate meta-analysis and meta-regression to synthesize estimates of multi-parameter associations obtained from different studies. This modelling approach extends the standard two-stage analysis used to combine results across different sub-groups or populations. The most straightforward application is for the meta-analysis of non-linear relationships, described for example by regression coefficients of splines or other functions, but the methodology easily generalizes to any setting where complex associations are described by multiple correlated parameters. The modelling framework of multivariate meta-analysis is implemented in the package mvmeta within the statistical environment R. As an illustrative example, we propose a two-stage analysis for investigating the non-linear exposure–response relationship between temperature and non-accidental mortality using time-series data from multiple cities. Multivariate meta-analysis represents a useful analytical tool for studying complex associations through a two-stage procedure. Copyright © 2012 John Wiley & Sons, Ltd.
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Affiliation(s)
- A Gasparrini
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
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Fraga J, Botelho A, Sá A, Costa M, Quaresma M. The lag structure and the general effect of ozone exposure on pediatric respiratory morbidity. Int J Environ Res Public Health 2011; 8:4013-24. [PMID: 22073025 PMCID: PMC3210594 DOI: 10.3390/ijerph8104013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 11/16/2022]
Abstract
Up to now no study has investigated the lag structure of children's respiratory morbidity due to surface ozone. In the present study, we investigate the lag structure and the general effect of surface ozone exposure on children and adolescents' respiratory morbidity using data from a particularly well suited area in southern Europe to assess the health effects of surface ozone. The effects of surface ozone are estimated using the recently developed distributed lag non-linear models, allowing for a relatively long timescale, while controlling for weather effects, a range of other air pollutants, and long and short term patterns. The public health significance of the estimated effects is higher than has been previously reported in the literature, providing evidence contrary to the conjecture that the surface ozone-morbidity association is mainly due to short-term harvesting. In fact, our data analysis reveals that the effects of surface ozone at medium and long timescales (harvesting-resistant) are substantially larger than the effects at shorter timescales (harvesting-prone), a finding that is consistent with all children and adolescents being affected by high surface ozone concentrations, and not just the very frail.
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Affiliation(s)
- José Fraga
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Anabela Botelho
- University of Minho and NIMA, Campus de Gualtar, Braga 4710-057, Portugal
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +351-253-604-538; Fax: +351-253-601-380
| | - Aida Sá
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Margarida Costa
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
| | - Márcia Quaresma
- Department of Pediatrics at Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega-Lordelo, Vila Real 5000-508, Portugal; E-Mails: (J.F.); (A.S.); (M.C.); (M.Q.)
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Stafoggia M, Forastiere F, Faustini A, Biggeri A, Bisanti L, Cadum E, Cernigliaro A, Mallone S, Pandolfi P, Serinelli M, Tessari R, Vigotti MA, Perucci CA. Susceptibility Factors to Ozone-related Mortality. Am J Respir Crit Care Med 2010; 182:376-84. [DOI: 10.1164/rccm.200908-1269oc] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gasparrini A, Armstrong B. Time series analysis on the health effects of temperature: advancements and limitations. Environ Res 2010; 110:633-8. [PMID: 20576259 DOI: 10.1016/j.envres.2010.06.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 06/09/2010] [Indexed: 05/02/2023]
Abstract
The association between extreme temperatures and health outcomes has been frequently investigated during the last few years. This assessment is usually based on a time series design, a framework which has gained a substantial development in the last two decades. In this contribution we offer an overview of the recent methodological advancements which provide new statistical tools to examine the health effects of temperature in a time series setting, highlighting at the same time the main limitations that still affect this research area.
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Affiliation(s)
- Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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