1
|
Bai X, Ming X, Zhao M, Zhou L. Explore the effect of apparent temperature and air pollutants on the admission rate of acute myocardial infarction in Chongqing, China: a time-series study. BMJ Open 2024; 14:e084376. [PMID: 38658006 PMCID: PMC11043748 DOI: 10.1136/bmjopen-2024-084376] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE Limited research has been conducted on the correlation between apparent temperature and acute myocardial infarction (AMI), as well as the potential impact of air pollutants in modifying this relationship. The objective of this study is to investigate the lagged effect of apparent temperature on AMI and assess the effect modification of environmental pollutants on this association. DESIGN A time-series study. SETTING AND PARTICIPANTS The data for this study were obtained from the Academy of Medical Data Science at Chongqing Medical University, covering daily hospitalisations for AMI between 1 January 2015 and 31 December 2016. Meteorological and air pollutant data were provided by China's National Meteorological Information Centre. OUTCOME MEASURES We used a combined approach of quasi-Poisson generalised linear model and distributed lag non-linear model to thoroughly analyse the relationships. Additionally, we employed a generalised additive model to investigate the interaction between air pollutants and apparent temperature on the effect of AMI. RESULT A total of 872 patients admitted to hospital with AMI were studied based on the median apparent temperature (20.43°C) in Chongqing. Low apparent temperature (10th, 7.19℃) has obvious lagged effect on acute myocardial infarction, first appearing on the 8th day (risk ratio (RR) 1.081, 95% CI 1.010 to 1.158) and the greatest risk on the 11th day (RR 1.094, 95% CI 1.037 to 1.153). No lagged effect was observed at high apparent temperature. In subgroup analysis, women and individuals aged 75 and above were at high risk. The interaction analysis indicates that there exist significant interactions between PM2.5 and high apparent temperature, as well as nitrogen dioxide (NO2) and low apparent temperature. CONCLUSION The occurrence of decreased apparent temperature levels was discovered to be linked with a heightened relative risk of hospitalisations for AMI. PM2.5 and NO2 have an effect modification on the association between apparent temperature and admission rate of AMI.
Collapse
Affiliation(s)
- Xiuyuan Bai
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xin Ming
- Chongqing Health Center for Women and Children, Chongqing, China
- Department of quality management section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Mingming Zhao
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li Zhou
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| |
Collapse
|
2
|
Shi Y, Li N, Li Z, Chen M, Chen Z, Wan X. Impact of comprehensive air pollution control policies on six criteria air pollutants and acute myocardial infarction morbidity, Weifang, China: A quasi-experimental study. Sci Total Environ 2024; 922:171206. [PMID: 38408668 DOI: 10.1016/j.scitotenv.2024.171206] [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: 10/31/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
Comprehensive air pollution control policies may reduce pollutant emissions. However, the impact on disease morbidity of the change for the concentration of air pollutants following the policies has been insufficiently studied. We aim to assess the impact of comprehensive air pollution control policies on the levels of six criteria air pollutants and acute myocardial infarction (AMI) morbidity in Weifang, China. This study performed an interrupted time series analysis. The linear model with spline terms and generalized additive quasi-Poisson model were used to estimate the immediate change from 2016 to 2019 in the daily concentration of six air pollutants (PM2.5, PM10, SO2, NO2, O3, and, CO) and AMI incident cases (Age ≥35) associated with the implementation of air pollution control policies in Weifang, respectively. After the implementation of air pollution control policies, air quality in Weifang had been improved. Specifically, the daily concentrations of PM2.5, PM10, SO2, and, CO immediately decreased by 27.9 % (95 % CI: 6.6 % to 44.3 %), 32.9 % (95 % CI: 17.5 % to 45.5 %), 14.6 % (95 % CI: 0.4 % to 26.8 %), and 33.9 % (95 % CI: 22.0 % to 44.0 %), respectively. In addition, the policies implementation was also associate with the immediate decline in the AMI morbidity (-6.5 %, 95 % CI: -10.4 % to -2.3 %). And subgroup analyses indicate that the health effects of the policy intervention were only observed in female (-9.4 %, 95 % CI: -14.4 % to -4.2 %) and those aged ≥65 years (-10.5 %, 95 % CI: -14.6 % to -6.2 %). During the final 20 months of the study period, the policy intervention was estimated to prevent 1603 (95 % CI: 574 to 2587) cases of incident AMI in Weifang. Our results provide strong rationale that the policy intervention significantly reduced ambient pollutant concentrations and AMI morbidity, which highlighted the importance for a comprehensive and rigorous air pollution control policy in regions with severe air pollution.
Collapse
Affiliation(s)
- Yulin Shi
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Ning Li
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Zhongyan Li
- Weifang People's Hospital, Weifang 261044, Shandong, China
| | - Min Chen
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Zuosen Chen
- Weifang Center for Disease Control and Prevention, Weifang 261061, Shandong, China
| | - Xia Wan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
| |
Collapse
|
3
|
Dos Santos-Silva JC, Potgieter-Vermaak S, Medeiros SHW, da Silva LV, Ferreira DV, Moreira CAB, de Souza Zorzenão PC, Pauliquevis T, Godoi AFL, de Souza RAF, Yamamoto CI, Godoi RHM. A new strategy for risk assessment of PM 2.5-bound elements by considering the influence of wind regimes. Sci Total Environ 2023; 872:162131. [PMID: 36773898 DOI: 10.1016/j.scitotenv.2023.162131] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/18/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
For regulatory purposes, air pollution has been reduced to management of air quality control regions (AQCR), by inventorying pollution sources and identifying the receptors significantly affected. However, beyond being source-dependent, particulate matter can be physically and chemically altered by factors and elements of climate during transport, as they act as local environmental constraints, indirectly modulating the adverse effects of particles on the environment and human health. This case study, at an industrial site in a Brazilian coastal city - Joinville, combines different methodologies to integrate atmospheric dynamics in a strategic risk assessment approach whereby the influence of different wind regimes on environmental and health risks of exposure to PM2.5-bound elements, are analysed. Although Joinville AQCR has been prone to stagnation/recirculation events, distinctly different horizontal wind circulation patterns indicate two airsheds within the region. The two sampling sites mirrored these two conditions and as a result we report different PM2.5 mass concentrations, chemical profiles, geo-accumulation, and ecological and human health risks. In addition, feedback mechanisms between the airsheds seem to aggravate the air quality and its effects even under good ventilation conditions. Recognizably, the risks associated with Co, Pb, Cu, Ni, Mn, and Zn loadings were extremely high for the environment as well as being the main contributors to elevated non-carcinogenic risks. Meanwhile, higher carcinogenic risks occurred during stagnation/recirculation conditions, with Cr as the major threat. These results highlight the importance of integrating local airshed characteristics into the risk assessment of PM2.5-bound elements since they can aggravate air pollution leading to different risks at a granular scale. This new approach to risk assessment can be employed in any city's longer-term development plan since it provides public authorities with a strategic perspective on incorporating environmental constraints into urban growth planning and development zoning regulations.
Collapse
Affiliation(s)
| | - Sanja Potgieter-Vermaak
- Ecology & Environment Research Centre, Department of Natural Science, Manchester Metropolitan University, Manchester M1 5GD, United Kingdom; Molecular Science Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Sandra Helena Westrupp Medeiros
- Department of Environmental and Sanitary Engineering, University of the Region of Joinville, Joinville, Santa Catarina, Brazil
| | - Luiz Vitor da Silva
- Department of Environmental and Sanitary Engineering, University of the Region of Joinville, Joinville, Santa Catarina, Brazil
| | - Danielli Ventura Ferreira
- Department of Environmental and Sanitary Engineering, University of the Region of Joinville, Joinville, Santa Catarina, Brazil
| | | | | | - Theotonio Pauliquevis
- Department of Environmental Sciences, Federal University of São Paulo, Diadema, São Paulo, Brazil
| | | | | | - Carlos Itsuo Yamamoto
- Department of Chemical Engineering, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Ricardo Henrique Moreton Godoi
- Postgraduate Program in Water Resources and Environmental Engineering, Federal University of Paraná, Curitiba, Paraná, Brazil; Department of Environmental Engineering, Federal University of Paraná, Curitiba, Paraná, Brazil.
| |
Collapse
|
4
|
Jiang Y, Chen R, Peng W, Luo Y, Chen X, Jiang Q, Han B, Su G, Duan Y, Huo J, Qu X, Fu Q, Kan H. Hourly Ultrafine Particle Exposure and Acute Myocardial Infarction Onset: An Individual-Level Case-Crossover Study in Shanghai, China, 2015-2020. Environ Sci Technol 2023; 57:1701-1711. [PMID: 36668989 DOI: 10.1021/acs.est.2c06651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Associations between ultrafine particles (UFPs) and hourly onset of acute myocardial infarction (AMI) have rarely been investigated. We aimed to evaluate the impacts of UFPs on AMI onset and the lag patterns. A time-stratified case-crossover study was performed among 20,867 AMI patients from 46 hospitals in Shanghai, China, between January 2015 and December 2020. Hourly data of AMI onset and number concentrations of nanoparticles of multiple size ranges below 0.10 μm (0.01-0.10, UFP/PNC0.01-0.10; 0.01-0.03, PNC0.01-0.03; 0.03-0.05, PNC0.03-0.05; and 0.05-0.10 μm, PNC0.05-0.10) were collected. Conditional logistic regressions were applied. Transient exposures to these nanoparticles were significantly associated with AMI onset, with almost linear exposure-response curves. These associations occurred immediately after exposure, lasted for approximately 6 h, and attenuated to be null thereafter. Each interquartile range increase in concentrations of total UFPs, PNC0.01-0.03, PNC0.03-0.05, and PNC0.05-0.10 during the preceding 0-6 h was associated with increments of 3.29, 2.08, 2.47, and 2.93% in AMI onset risk, respectively. The associations were stronger during warm season and at high temperatures and were robust after adjusting for criteria air pollutants. Our findings provide novel evidence that hourly UFP exposure is associated with immediate increase in AMI onset risk.
Collapse
Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenhui Peng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Yun Luo
- Department of Cardiology, Jiujiang No. 1 People's Hospital, Jiujiang 332000, China
| | - Xiaomin Chen
- Department of Cardiology, Ningbo First Hospital, Ningbo 315010, China
| | - Qianfeng Jiang
- Department of Cardiology, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi 563000, China
| | - Bingjiang Han
- Department of Cardiology, The Second Hospital of Jiaxing (The Second Affiliated Hospital of Jiaxing University), Jiaxing 314000, China
| | - Guohai Su
- Jinan Central Hospital, Jinan 250013, China
| | - Yusen Duan
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Juntao Huo
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China
| |
Collapse
|
5
|
Mostovenko E, Canal CG, Cho M, Sharma K, Erdely A, Campen MJ, Ottens AK. Indirect mediators of systemic health outcomes following nanoparticle inhalation exposure. Pharmacol Ther 2022; 235:108120. [PMID: 35085604 PMCID: PMC9189040 DOI: 10.1016/j.pharmthera.2022.108120] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
Abstract
The growing field of nanoscience has shed light on the wide diversity of natural and anthropogenic sources of nano-scale particulates, raising concern as to their impacts on human health. Inhalation is the most robust route of entry, with nanoparticles (NPs) evading mucociliary clearance and depositing deep into the alveolar region. Yet, impacts from inhaled NPs are evident far outside the lung, particularly on the cardiovascular system and highly vascularized organs like the brain. Peripheral effects are partly explained by the translocation of some NPs from the lung into the circulation; however, other NPs largely confined to the lung are still accompanied by systemic outcomes. Omic research has only just begun to inform on the complex myriad of molecules released from the lung to the blood as byproducts of pulmonary pathology. These indirect mediators are diverse in their molecular make-up and activity in the periphery. The present review examines systemic outcomes attributed to pulmonary NP exposure and what is known about indirect pathological mediators released from the lung into the circulation. Further focus was directed to outcomes in the brain, a highly vascularized region susceptible to acute and longer-term outcomes. Findings here support the need for big-data toxicological studies to understand what drives these health outcomes and better predict, circumvent, and treat the potential health impacts arising from NP exposure scenarios.
Collapse
|
6
|
Wine O, Osornio Vargas A, Campbell SM, Hosseini V, Koch CR, Shahbakhti M. Cold Climate Impact on Air-Pollution-Related Health Outcomes: A Scoping Review. Int J Environ Res Public Health 2022; 19:1473. [PMID: 35162495 PMCID: PMC8835073 DOI: 10.3390/ijerph19031473] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 01/05/2023]
Abstract
In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below -7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.
Collapse
Affiliation(s)
- Osnat Wine
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Alvaro Osornio Vargas
- Department of Paediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Sandra M. Campbell
- Health Sciences Library, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Vahid Hosseini
- School of Sustainable Energy Engineering, Simon Fraser University, Surrey, BC V3T 0N1, Canada;
| | - Charles Robert Koch
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Mahdi Shahbakhti
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| |
Collapse
|
7
|
Huang X, Ma W, Law C, Luo J, Zhao N. Importance of applying Mixed Generalized Additive Model (MGAM) as a method for assessing the environmental health impacts: Ambient temperature and Acute Myocardial Infarction (AMI), among elderly in Shanghai, China. PLoS One 2021; 16:e0255767. [PMID: 34383808 PMCID: PMC8360529 DOI: 10.1371/journal.pone.0255767] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/23/2021] [Indexed: 11/18/2022] Open
Abstract
Association between acute myocardial infarction (AMI) morbidity and ambient temperature has been examined with generalized linear model (GLM) or generalized additive model (GAM). However, the effect size by these two methods might be biased due to the autocorrelation of time series data and arbitrary selection of degree of freedom of natural cubic splines. The present study analyzed how the climatic factors affected AMI morbidity for older adults in Shanghai with Mixed generalized additive model (MGAM) that addressed these shortcomings mentioned. Autoregressive random effect was used to model the relationship between AMI and temperature, PM10, week days and time. The degree of freedom of time was chosen based on the seasonal pattern of temperature. The performance of MGAM was compared with GAM on autocorrelation function (ACF), partial autocorrelation function (PACF) and goodness of fit. One-year predictions of AMI counts in 2011 were conducted using MGAM with the moving average. Between 2007 and 2011, MGAM adjusted the autocorrelation of AMI time series and captured the seasonal pattern after choosing the degree of freedom of time at 5. Using MGAM, results were well fitted with data in terms of both internal (R2 = 0.86) and external validity (correlation coefficient = 0.85). The risk of AMI was relatively high in low temperature (Risk ratio = 0.988 (95% CI 0.984, 0.993) for under 12°C) and decreased as temperature increased and speeded up within the temperature zone from 12°C to 26°C (Risk ratio = 0.975 (95% CI 0.971, 0.979), but it become increasing again when it is 26°C although not significantly (Risk ratio = 0.999 (95% CI 0.986, 1.012). MGAM is more appropriate than GAM in the scenario of response variable with autocorrelation and predictors with seasonal variation. The risk of AMI was comparatively higher when temperature was lower than 12°C in Shanghai as a typical representative location of subtropical climate.
Collapse
Affiliation(s)
- Xiaoqian Huang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Weiping Ma
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Chikin Law
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- * E-mail:
| | - Naiqing Zhao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| |
Collapse
|
8
|
Liu X, Bertazzon S, Villeneuve PJ, Johnson M, Stieb D, Coward S, Tanyingoh D, Windsor JW, Underwood F, Hill MD, Rabi D, Ghali WA, Wilton SB, James MT, Graham M, McMurtry MS, Kaplan GG. Temporal and spatial effect of air pollution on hospital admissions for myocardial infarction: a case-crossover study. CMAJ Open 2020; 8:E619-E626. [PMID: 33037069 PMCID: PMC7567508 DOI: 10.9778/cmajo.20190160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In studies showing associations between ambient air pollution and myocardial infarction (MI), data have been lacking on the inherent spatial variability of air pollution. The aim of this study was to determine whether the long-term spatial distribution of air pollution influences short-term temporal associations between air pollution and admission to hospital for MI. METHODS We identified adults living in Calgary who were admitted to hospital for an MI between 2004 and 2012. We evaluated associations between short-term exposure to air pollution (ozone [O3], nitrogen dioxide [NO2], sulfur dioxide [SO2], carbon monoxide [CO], particulate matter < 10 μm in diameter [PM10] and particulate matter < 2.5 μm in diameter [PM2.5]), and hospital admissions for MI using a time-stratified, case-crossover study design. Air Quality Health Index (AQHI) scores were calculated from a composition of O3, NO2 and PM2.5. Conditional logistic regression models were stratified by low, medium and high levels of neighbourhood NO2 concentrations derived from land use regression models; results of these analyses are presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS From 2004 to 2012, 6142 MIs were recorded in Calgary. Individuals living in neighbourhoods with higher long-term air pollution concentrations were more likely to be admitted to hospital for MI after short-term elevations in air pollution (e.g., 5-day average NO2: OR 1.20, 95% CI 1.03-1.40, per interquartile range [IQR]) as compared with regions with lower air pollution (e.g., 5-day average NO2: OR 0.90, 95% CI 0.78-1.04, per IQR). In high NO2 tertiles, the AQHI score was associated with MI (e.g., 5-day average OR 1.13, 95% CI 1.02-1.24, per IQR; 3-day average OR 1.13, 95% CI 1.04-1.23, per IQR). INTERPRETATION Our results show that the effect of air pollution on hospital admissions for MI was stronger in areas with higher NO2 concentrations than that in areas with lower NO2 concentrations. Individuals living in neighbourhoods with higher traffic-related pollution should be advised of the health risks and be attentive to special air quality warnings.
Collapse
Affiliation(s)
- Xiaoxiao Liu
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Stefania Bertazzon
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Paul J Villeneuve
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Markey Johnson
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Dave Stieb
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Stephanie Coward
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Divine Tanyingoh
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Joseph W Windsor
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Fox Underwood
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Michael D Hill
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Doreen Rabi
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - William A Ghali
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Stephen B Wilton
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Matthew T James
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Michelle Graham
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - M Sean McMurtry
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta
| | - Gilaad G Kaplan
- Departments of Community Health Sciences (Liu, Coward, Tanyingoh, Windsor, Underwood, Rabi, Ghali, James, Kaplan) and of Geography (Liu, Bertazzon), University of Calgary, Calgary, Alta.; Department of History, Archaeology, Geography, Fine & Performing Arts (Bertazzon), University of Florence, Florence, Italy; School of Mathematics and Statistics and Department of Neuroscience, and CHAIM Research Centre (Villeneuve), Carleton University, Ottawa, Ont.; Air Health Science Division (Johnson), Health Canada, Ottawa, Ont.; Environmental Health Science and Research Bureau (Stieb), Health Canada, Vancouver, BC; Departments of Medicine (Coward, Tanyingoh, Windsor, Underwood, Hill, Rabi, Wilton, James, Kaplan); of Clinical Neurosciences (Hill, Ghali); and of Cardiac Sciences (Wilton), University of Calgary, Calgary, Alta.; Department of Medicine (Graham, McMurtry), University of Alberta; Mazankowski Alberta Heart Institute (McMurtry), Edmonton, Alta.
| |
Collapse
|
9
|
Lee KK, Spath N, Miller MR, Mills NL, Shah ASV. Short-term exposure to carbon monoxide and myocardial infarction: A systematic review and meta-analysis. Environ Int 2020; 143:105901. [PMID: 32634667 DOI: 10.1016/j.envint.2020.105901] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Previous studies suggest an association between short-term exposure to carbon monoxide and myocardial infarction. We performed a systematic review and meta-analysis to assess current evidence on this association to support the update of the World Health Organization (WHO) Global Air Quality Guidelines. METHODS We searched Medline, Embase and Cochrane Central Register of Controlled Trials to update the evidence published in a previous systematic review up to 30th September 2018 for studies investigating the association between short-term exposure to ambient carbon monoxide (up to lag of seven days) and emergency department visits or hospital admissions and mortality due to myocardial infarction. Two reviewers assessed potentially eligible studies and performed data extraction independently. Random-effects meta-analysis was used to derive the pooled risk estimate per 1 mg/m3 increase in ambient carbon monoxide concentration. Risk of bias in individual studies was assessed using a domain-based assessment tool. The overall certainty of the body of evidence was evaluated using an adapted certainty of evidence assessment framework. RESULTS We evaluated 1,038 articles from the previous review and our updated literature search, of which, 26 satisfied our inclusion criteria. Overall, myocardial infarction was associated with exposure to ambient carbon monoxide concentration (risk ratio of 1.052, 95% confidence interval 1.017-1.089 per 1 mg/m3 increase). A third of studies were assessed to be at high risk of bias (RoB) due to inadequate adjustment for confounding. Using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, the overall evidence was assessed to be of moderate certainty. CONCLUSIONS This review demonstrated that the pooled risk ratio for myocardial infarction was 1.052 (95% CI 1.017-1.089) per 1 mg/m3 increase in ambient carbon monoxide concentration. However, very few studies originated from low- and middle-income countries.
Collapse
Affiliation(s)
- Kuan Ken Lee
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Nicholas Spath
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Mark R Miller
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
| | - Anoop S V Shah
- BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom.
| |
Collapse
|
10
|
Héritier H, Vienneau D, Foraster M, Eze IC, Schaffner E, de Hoogh K, Thiesse L, Rudzik F, Habermacher M, Köpfli M, Pieren R, Brink M, Cajochen C, Wunderli JM, Probst-Hensch N, Röösli M. A systematic analysis of mutual effects of transportation noise and air pollution exposure on myocardial infarction mortality: a nationwide cohort study in Switzerland. Eur Heart J 2020; 40:598-603. [PMID: 30357335 DOI: 10.1093/eurheartj/ehy650] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/04/2018] [Accepted: 09/24/2018] [Indexed: 01/17/2023] Open
Abstract
AIMS The present study aimed to disentangle the risk of the three major transportation noise sources-road, railway, and aircraft traffic-and the air pollutants NO2 and PM2.5 on myocardial infarction (MI) mortality in Switzerland based on high quality/fine resolution exposure modelling. METHODS AND RESULTS We modelled long-term exposure to outdoor road traffic, railway, and aircraft noise levels, as well as NO2 and PM2.5 concentration for each address of the 4.40 million adults (>30 years) in the Swiss National Cohort (SNC). We investigated the association between transportation noise/air pollution exposure and death due to MI during the follow-up period 2000-08, by adjusting noise [Lden(Road), Lden(Railway), and Lden(Air)] estimates for NO2 and/or PM2.5 and vice versa by multipollutant Cox regression models considering potential confounders. Adjusting noise risk estimates of MI for NO2 and/or PM2.5 did not change the hazard ratios (HRs) per 10 dB increase in road traffic (without air pollution: 1.032, 95% CI: 1.014-1.051, adjusted for NO2 and PM2.5: 1.034, 95% CI: 1.014-1.055), railway traffic (1.020, 95% CI: 1.007-1.033 vs. 1.020, 95% CI: 1.007-1.033), and aircraft traffic noise (1.025, 95% CI: 1.006-1.045 vs. 1.025, 95% CI: 1.005-1.046). Conversely, noise adjusted HRs for air pollutants were lower than corresponding estimates without noise adjustment. Hazard ratio per 10 μg/m³ increase with and without noise adjustment were 1.024 (1.005-1.043) vs. 0.990 (0.965-1.016) for NO2 and 1.054 (1.013-1.093) vs. 1.019 (0.971-1.071) for PM2.5. CONCLUSION Our study suggests that transportation noise is associated with MI mortality, independent from air pollution. Air pollution studies not adequately adjusting for transportation noise exposure may overestimate the cardiovascular disease burden of air pollution.
Collapse
Affiliation(s)
- Harris Héritier
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Maria Foraster
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland.,ISGlobal, Universitat Pompeu Fabra (UFP), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP); Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, Madrid, Spain
| | - Ikenna C Eze
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Emmanuel Schaffner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Laurie Thiesse
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Birmannsgasse 8, Basel, Switzerland
| | - Franziska Rudzik
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Birmannsgasse 8, Basel, Switzerland
| | | | - Micha Köpfli
- n-sphere AG, Räffelstrasse 29, Zürich, Switzerland
| | - Reto Pieren
- Empa, Laboratory for Acoustics/Noise control, Swiss Federal Laboratories for Materials Science and Technology, Überlandstrase 129, Dübendorf, Switzerland
| | - Mark Brink
- Federal Office for the Environment, Division of Noise and Non-Ionizing Radiation, Bern, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Birmannsgasse 8, Basel, Switzerland
| | - Jean Marc Wunderli
- Empa, Laboratory for Acoustics/Noise control, Swiss Federal Laboratories for Materials Science and Technology, Überlandstrase 129, Dübendorf, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.,University of Basel, Petersplatz 1, Basel, Switzerland
| |
Collapse
|
11
|
Stieb DM, Zheng C, Salama D, BerjawI R, Emode M, Hocking R, Lyrette N, Matz C, Lavigne E, Shin HH. Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity. Environ Health 2020; 19:47. [PMID: 32357902 PMCID: PMC7195719 DOI: 10.1186/s12940-020-00601-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/20/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Nitrogen dioxide (NO2) is a pervasive urban pollutant originating primarily from vehicle emissions. Ischemic heart disease (IHD) is associated with a considerable public health burden worldwide, but whether NO2 exposure is causally related to IHD morbidity remains in question. Our objective was to determine whether short term exposure to outdoor NO2 is causally associated with IHD-related morbidity based on a synthesis of findings from case-crossover and time-series studies. METHODS MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined using Leave One Out analysis and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill. RESULTS Thirty-eight case-crossover studies and 48 time-series studies were included in our analysis. NO2 was significantly associated with IHD morbidity (pooled odds ratio from case-crossover studies: 1.074 95% CI 1.052-1.097; pooled relative risk from time-series studies: 1.022 95% CI 1.016-1.029 per 10 ppb). Pooled estimates for case-crossover studies from Europe and North America were significantly lower than for studies conducted elsewhere. The high degree of heterogeneity among studies was only partially accounted for in meta-regression. There was evidence of publication bias, particularly for case-crossover studies. For both case-crossover and time-series studies, pooled estimates based on multi-pollutant models were smaller than those from single pollutant models, and those based on older populations were larger than those based on younger populations, but these differences were not statistically significant. CONCLUSIONS We concluded that there is a likely causal relationship between short term NO2 exposure and IHD-related morbidity, but important uncertainties remain, particularly related to the contribution of co-pollutants or other concomitant exposures, and the lack of supporting evidence from toxicological and controlled human studies.
Collapse
Affiliation(s)
- David M. Stieb
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Carine Zheng
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Dina Salama
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rania BerjawI
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Robyn Hocking
- Learning, Knowledge and Library Services, Health Canada, Ottawa, Canada
| | - Ninon Lyrette
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Carlyn Matz
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Hwashin H. Shin
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- Department of Mathematics and Statistics, Queen’s University, Kingston, Canada
| |
Collapse
|
12
|
Chen K, Schneider A, Cyrys J, Wolf K, Meisinger C, Heier M, von Scheidt W, Kuch B, Pitz M, Peters A, Breitner S. Hourly Exposure to Ultrafine Particle Metrics and the Onset of Myocardial Infarction in Augsburg, Germany. Environ Health Perspect 2020; 128:17003. [PMID: 31939685 PMCID: PMC7015564 DOI: 10.1289/ehp5478] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Epidemiological evidence on the health effects of ultrafine particles (UFP) remains insufficient to infer a causal relationship that is largely due to different size ranges and exposure metrics examined across studies. Moreover, evidence regarding the association between UFP and cardiovascular disease at a sub-daily timescale is lacking. OBJECTIVE We investigated the relationship between different particle metrics, including particle number (PNC), length (PLC), and surface area (PSC) concentrations, and myocardial infarction (MI) at an hourly timescale. METHODS We collected hourly air pollution and meteorological data from fixed urban background monitoring sites and hourly nonfatal MI cases from a MI registry in Augsburg, Germany, during 2005-2015. We conducted a time-stratified case-crossover analysis with conditional logistic regression to estimate the association between hourly particle metrics and MI cases, adjusted for air temperature and relative humidity. We also examined the independent effects of a certain particle metric in two-pollutant models by adjusting for copollutants, including particulate matter (PM) with an aerodynamic diameter of ≤10μm or 2.5μm (PM10 and PM2.5, respectively), nitrogen dioxide, ozone, and black carbon. RESULTS Overall, a total of 5,898 cases of nonfatal MI cases were recorded. Exploratory analyses showed similar associations across particle metrics in the first 6-12 h. For example, interquartile range increases in PNC within the size range of 10-100 nm, PLC, and PSC were associated with an increase of MI 6 h later by 3.27% [95% confidence interval (CI): 0.27, 6.37], 5.71% (95% CI: 1.79, 9.77), and 5.84% (95% CI: 1.04, 10.87), respectively. Positive, albeit imprecise, associations were observed for PNC within the size range of 10-30 nm and 100-500 nm. Effect estimates for PLC and PSC remained similar after adjustment for PM and gaseous pollutants. CONCLUSIONS Transient exposure to particle number, length, and surface area concentrations or other potentially related exposures may trigger the onset of nonfatal myocardial infraction. https://doi.org/10.1289/EHP5478.
Collapse
Affiliation(s)
- Kai Chen
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
| | - Josef Cyrys
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Wolfgang von Scheidt
- Department of Internal Medicine I–Cardiology, University Hospital of Augsburg, Augsburg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine I–Cardiology, University Hospital of Augsburg, Augsburg, Germany
- Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, Germany
| | - Mike Pitz
- Bavarian State Office for the Environment, Augsburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- German Research Center for Cardiovascular Research (DZHK), Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | | |
Collapse
|
13
|
Mannucci PM, Harari S, Franchini M. Novel evidence for a greater burden of ambient air pollution on cardiovascular disease. Haematologica 2019; 104:2349-2357. [PMID: 31672903 PMCID: PMC6959193 DOI: 10.3324/haematol.2019.225086] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [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: 04/18/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
Ambient and household air pollution is a major health problem worldwide, contributing annually to approximately seven million of all-cause avoidable deaths, shorter life expectancy, and significant direct and indirect costs for the community. Air pollution is a complex mixture of gaseous and particulate materials that vary depending on their source and physicochemical features. Each material has detrimental effects on human health, but a number of experimental and clinical studies have shown a strong impact for fine particulate matter (PM2.5). In particular, there is more and more evidence that PM2.5 exerts adverse effects particularly on the cardiovascular system, contributing substantially (mainly through mechanisms of atherosclerosis, thrombosis and inflammation) to coronary artery and cerebrovascular disease, but also to heart failure, hypertension, diabetes and cardiac arrhythmias. In this review, we summarize knowledge on the mechanisms and magnitude of the cardiovascular adverse effects of short-and long-term exposure to ambient air pollution, particularly for the PM2.5 size fraction. We also emphasize that very recent data indicate that the global mortality and morbidity burden of cardiovascular disease associated with this air pollutant is dramatically greater than what has been thought up to now.
Collapse
Affiliation(s)
| | - Sergio Harari
- Department of Pneumology and Semi-Intensive Care Unit, Department of Respiratory Physiopathology and Pulmonary Hemodynamics, Ospedale San Giuseppe MultiMedica, Milan and
| | - Massimo Franchini
- Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy
| |
Collapse
|
14
|
Piscitelli P, Valenzano B, Rizzo E, Maggiotto G, Rivezzi M, Esposito Corcione F, Miani A. Air Pollution and Estimated Health Costs Related to Road Transportations of Goods in Italy: A First Healthcare Burden Assessment. Int J Environ Res Public Health 2019; 16:E2876. [PMID: 31408946 DOI: 10.3390/ijerph16162876] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/02/2019] [Accepted: 08/07/2019] [Indexed: 11/28/2022]
Abstract
Background: The Italian Society of Environmental Medicine has performed a preliminary assessment of the health impact attributable to road freight traffic in Italy. Methods: We estimated fine particulate matter (PM10, PM2.5) and nitrogen oxides (NOx) generated by road transportation of goods in Italy considering the number of trucks, the emission factors and the average annual distance covered in the year 2016. Simulations on data concerning Years of Life Lost (YLL) attributable to PM2.5 (593,700) and nitrogen oxides NO2 (200,700) provided by the European Environmental Agency (EEA) were used as a proxy of healthcare burden. We set three different healthcare burden scenarios, varying from 1/5 to 1/10 of the proportion of the overall particulate matter attributable to road freight traffic in Italy (about 7% on a total of 2262 tons/year). Results: Road freight traffic in Italy produced about 189 tons of PM10, 147 tons of PM2.5 and 4125 tons of NOx in year 2016, resulting in annual healthcare costs varying from 400 million up to 1.2 billion EUR per year. Conclusion: Road freight traffic has a relevant impact on air pollution and healthcare costs, especially if considered over a 10-year period. Any solution able to significantly reduce the road transportation of goods could decrease avoidable mortality due to air pollution and related costs.
Collapse
|
15
|
Zhang S, Ren Q, Qi H, Liu S, Liu Y. Adverse Effects of Fine-Particle Exposure on Joints and Their Surrounding Cells and Microenvironment. ACS Nano 2019; 13:2729-2748. [PMID: 30773006 DOI: 10.1021/acsnano.8b08517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Current understanding of the health risks and adverse effects upon exposure to fine particles is premised on the direct association of particles with target organs, particularly the lung; however, fine-particle exposure has also been found to have detrimental effects on sealed cavities distant to the portal-of-entry, such as joints. Moreover, the fundamental toxicological issues have been ascribed to the direct toxic mechanisms, in particular, oxidative stress and proinflammatory responses, without exploring the indirect mechanisms, such as compensated, adaptive, and secondary effects. In this Review, we recapitulate the current findings regarding the detrimental effects of fine-particle exposure on joints, the surrounding cells, and microenvironment, as well as their deteriorating impact on the progression of arthritis. We also elaborate the likely molecular mechanisms underlying the particle-induced detrimental influence on joints, not limited to direct toxicity, but also considering the other indirect mechanisms. Because of the similarities between fine air particles and engineered nanomaterials, we compare the toxicities of engineered nanomaterials to those of fine air particles. Arthritis and joint injuries are prevalent, particularly in the elderly population. Considering the severity of global exposure to fine particles and limited studies assessing the detrimental effects of fine-particle exposure on joints and arthritis, this Review aims to appeal to a broad interest and to promote more research efforts in this field.
Collapse
Affiliation(s)
- Shuping Zhang
- Institute for Medical Engineering and Science , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Quanzhong Ren
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , P. R. China
| | - Hui Qi
- Beijing Jishuitan Hospital , Peking University Health Science Center , Beijing 100035 , P. R. China
- Beijing Research Institute of Traumatology and Orthopaedics , Beijing 100035 , P. R. China
| | - Sijin Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology , Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences , Beijing 100085 , P. R. China
| | - Yajun Liu
- Beijing Jishuitan Hospital , Peking University Health Science Center , Beijing 100035 , P. R. China
| |
Collapse
|
16
|
Young SS, Acharjee MK, Das K. The reliability of an environmental epidemiology meta-analysis, a case study. Regul Toxicol Pharmacol 2018; 102:47-52. [PMID: 30590082 DOI: 10.1016/j.yrtph.2018.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
Abstract
Claims made in science papers are coming under increased scrutiny with many claims failing to replicate. Meta-analyses are questionable when based on data from observational studies which are often unreliable. We examine the reliability of the base studies used in an air quality/heart attack meta-analysis and the resulting meta-analysis. A meta-analysis study that includes 14 observational air quality/heart attack studies is examined for its statistical reliability. We use simple counting to evaluate the reliability of the base papers and a p-value plot of the p-values from the base studies to examine study heterogeneity. We find that the base papers have the potential for massive multiple testing and multiple modeling with no statistical adjustments. Statistics coming from the base papers are not guaranteed to be unbiased, a requirement for a valid meta-analysis. There is study heterogeneity for the base papers with strong evidence for so called p-hacking in some, possibly many, of the studies. We make two observations: there are many claims at issue in each of the 14 base studies so uncorrected multiple testing is a serious issue. We find that some of the base papers exhibit the characteristics of p-hacking and are therefore not reliable; the resulting meta-analysis is not reliable.
Collapse
|
17
|
Alfano R, Herceg Z, Nawrot TS, Chadeau-Hyam M, Ghantous A, Plusquin M. The Impact of Air Pollution on Our Epigenome: How Far Is the Evidence? (A Systematic Review). Curr Environ Health Rep 2018; 5:544-578. [PMID: 30361985 DOI: 10.1007/s40572-018-0218-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW This systematic review evaluated existing evidence linking air pollution exposure in humans to major epigenetic mechanisms: DNA methylation, microRNAs, long noncoding RNAs, and chromatin regulation. RECENT FINDINGS Eighty-two manuscripts were eligible, most of which were observational (85%), conducted in adults (66%) and based on DNA methylation (79%). Most observational studies, except panel, demonstrated modest effects of air pollution on the methylome. Panel and experimental studies revealed a relatively large number of significant methylome alterations, though based on smaller sample sizes. Particulate matter levels were positively associated in several studies with global or LINE-1 hypomethylation, a hallmark of several diseases, and with decondensed chromatin structure. Several air pollution species altered the DNA methylation clock, inducing accelerated biological aging. The causal nature of identified associations is not clear, however, especially that most originate from countries with low air pollution levels. Existing evidence, gaps, and perspectives are highlighted herein.
Collapse
Affiliation(s)
- Rossella Alfano
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Zdenko Herceg
- Epigenetics Group, International Agency for Research on Cancer (IARC), 150 Cours Albert-Thomas, 69008, Lyon, France
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Environment & Health Unit, Leuven University, Leuven, Belgium
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
| | - Akram Ghantous
- Epigenetics Group, International Agency for Research on Cancer (IARC), 150 Cours Albert-Thomas, 69008, Lyon, France.
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.
| |
Collapse
|
18
|
Liu Y, Sun J, Gou Y, Sun X, Li X, Yuan Z, Kong L, Xue F. A Multicity Analysis of the Short-Term Effects of Air Pollution on the Chronic Obstructive Pulmonary Disease Hospital Admissions in Shandong, China. Int J Environ Res Public Health 2018; 15:E774. [PMID: 29673181 DOI: 10.3390/ijerph15040774] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/08/2018] [Accepted: 04/12/2018] [Indexed: 11/17/2022]
Abstract
Although there is growing evidence linking chronic obstructive pulmonary disease (COPD) hospital admissions to the exposure to ambient air pollution, the effect can vary depending on the local geography, pollution type, and pollution level. The number of large-scale multicity studies remains limited in China. This study aims to assess the short-term effects of ambient air pollution (PM2.5, PM10, SO2, NO2) on chronic obstructive pulmonary disease hospital admissions from 2015 to 2016, with a total of 216,159 records collected from 207 hospitals in 17 cities all over the Shandong province, east China. Generalized additive models and penalized splines were applied to study the data whilst controlling for confounding meteorological factors and long-term trends. The air pollution was analyzed with 0–6 day lag effects and the percentage change of hospital admissions was assessed for a 10-μg/m3 increase in the air pollution levels. We also examined the percentage changes for different age groups and gender, respectively. The results showed that air pollution was significantly associated with adverse health outcomes and stronger effects were observed for females. The air pollution health effects were also impacted by geographical factors such that the air pollution had weaker health effects in coastal cities.
Collapse
|
19
|
Liang H, Qiu H, Tian L. Short-term effects of fine particulate matter on acute myocardial infraction mortality and years of life lost: A time series study in Hong Kong. Sci Total Environ 2018; 615:558-563. [PMID: 28988091 DOI: 10.1016/j.scitotenv.2017.09.266] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 07/31/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Previous studies have applied years of life lost (YLL) as a complementary indicator to assess the short-term effect of the air pollution on the health burden from all-cause mortality, but sparsely focused on individual diseases such as acute myocardial infraction (AMI). In this study, we aimed to conduct a time-series analysis to evaluate short-term effects of fine particulate matter (PM2.5) on mortality and YLL from AMI in Hong Kong from 2011 to 2015, and explore the potential effect modifiers including sex and age by subgroup analysis. We applied generalized additive Poisson and Gaussian regression model for daily death count and YLL, respectively. We found that 10μg/m3 increment in concentration of PM2.5 lasting for two days (lag01) was associated with a 2.35% (95% CI 0.38% to 4.36%) increase in daily mortality count and a 1.69 (95% CI 0.01 to 3.37) years increase in YLL from AMI. The association between PM2.5 and AMI mortality count was stronger among women and older people than men and young people, respectively. We concluded that acute exposure to PM2.5 may increase the risk of mortality and YLL from AMI in Hong Kong and this effect can be modified by age and gender. These findings add to the evidence base for public health policy formulation and resource allocation.
Collapse
Affiliation(s)
- Haiqing Liang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
| |
Collapse
|
20
|
Akbarzadeh MA, Khaheshi I, Sharifi A, Yousefi N, Naderian M, Namazi MH, Safi M, Vakili H, Saadat H, Alipour Parsa S, Nickdoost N. The association between exposure to air pollutants including PM 10, PM 2.5, ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide concentration and the relative risk of developing STEMI: A case-crossover design. Environ Res 2018; 161:299-303. [PMID: 29178978 DOI: 10.1016/j.envres.2017.11.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 06/03/2017] [Revised: 10/18/2017] [Accepted: 11/15/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Unfavorable associations between air pollution and myocardial infarction are broadly investigated in recent studies and some of them revealed considerable associations; however, controversies exists between these investigations with regard to culprit components of air pollution and significance of correlation between myocardial infarction risk and air pollution. METHODS The association between exposure to PM10, PM2.5, ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide concentration of background air that residents of Tehran, the capital city of Iran, which is ranked as the most air polluted city of Iran and the relative risk of developing ST-elevation myocardial infarction (STEMI) were investigated by a case-crossover design. Our study included 208 patients admitted with a diagnosis of STEMI and undergone primary percutaneous intervention. Air pollutant concentration was averaged in 24-h windows preceding the time of onset of myocardial infarction for the case period. Besides, the mean level of each element of air pollution of the corresponding time in one week, two weeks and three weeks before onset of myocardial infarction, was averaged separately for each day as one control periods. Thus, 624 control periods were included in our investigation such that. Each patient is matched and compared with him/herself. RESULTS The mean level of PM10 in case periods (61.47µg/m3) was significantly higher than its level in control periods (57.86µg/m3) (P-value = 0.019, 95% CI: 1.002-1.018, RR = 1.010). Also, the mean level of PM2.5 in case periods (95.40µg/m3) was significantly higher than that in control days (90.88µg/m3) (P-value = 0.044, 95% CI: 1.001-1.011, RR = 1.006). The level of other components including NO2, SO2, CO and O3 showed no significant differences between case and control periods. A 10µg/m3 increase in PM10 and PM2.5 would result in 10.10% and 10.06% increase in STEMI event, respectively. Furthermore, the results of sub-group analysis showed that older patients (equal or more than 60 year-old), diabetic patients, non-hypertensive ones and patients with more than one diseased vessel may be more vulnerable to the harmful effect of particular matters including PM10 and PM2.5 on development of STEMI. CONCLUSION Air pollution is a worldwide pandemic with great potential to cause terrible events especially cardiovascular ones. PM2.5 and PM10 are amongst ambient air pollutant with a high risk of developing STEMI. Thus, more restrictive legislations should be applied to define a safe level of indoor and outdoor air pollutant production.
Collapse
Affiliation(s)
- Mohammad Ali Akbarzadeh
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran.
| | - Amirsina Sharifi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Yousefi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Outcome Research and Education (CORE), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Hasan Namazi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Morteza Safi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Hossein Vakili
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Habibollah Saadat
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Saeed Alipour Parsa
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| | - Negin Nickdoost
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran
| |
Collapse
|
21
|
Liu X, Bertazzon S. Exploratory Temporal and Spatial Analysis of Myocardial Infarction Hospitalizations in Calgary, Canada. Int J Environ Res Public Health 2017; 14:E1555. [PMID: 29232910 DOI: 10.3390/ijerph14121555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 11/25/2017] [Accepted: 12/06/2017] [Indexed: 11/16/2022]
Abstract
Spatial and temporal analyses are critical to understand the pattern of myocardial infarction (MI) hospitalizations over space and time, and to identify their underlying determinants. In this paper, we analyze MI hospitalizations in Calgary from 2004 to 2013, stratified by age and gender. First, a seasonal trend decomposition analyzes the seasonality; then a linear regression models the trend component. Moran's I and hot spot analyses explore the spatial pattern. Though exploratory, results show that most age and gender groups feature a statistically significant decline over the 10 years, consistent with previous studies in Canada. Decline rates vary across ages and genders, with the slowest decline observed for younger males. Each gender exhibits a seasonal pattern with peaks in both winter and summer. Spatially, MI hot spots are identified in older communities, and in socioeconomically and environmentally disadvantaged communities. In the older communities, higher MI rates appear to be more highly associated with demographics. Conversely, worse air quality appears to be locally associated with higher MI incidence in younger age groups. The study helps identify areas of concern, where MI hot spots are identified for younger age groups, suggesting the need for localized public health policies to target local risk factors.
Collapse
|
22
|
Ghiasmand M, Moghadamnia MT, Pourshaikhian M, Kazemnejad Lili E. Acute triggers of myocardial infarction: A case-crossover study. Egypt Heart J 2017; 69:223-228. [PMID: 29622981 PMCID: PMC5883494 DOI: 10.1016/j.ehj.2017.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/16/2017] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is one of the most preventable non-communicable diseases in human. Identifying triggers of myocardial infarction (MI) and prevention ways of exposure-induced complications can reduce morbidity and mortality in people at risk. AIM The aim of this study was to identify the emotional, environmental, physical and chemical dimensions of acute triggers in patients with AMI. METHODS This case-crossover study was conducted on 269 patients with AMI, hospitalized at two remedial centers in Rasht in 2015. The study samples were selected by convenient sampling method. Data were collected using researcher-made questionnaire through interviews. Hazard and control periods for each trigger and its effects on the development of MI were studied. The collected data were analyzed using descriptive and analytical statistical methods, Cochran test, and generalized estimating equation (GEE) model with logistics function default in SPSS version 21, and p < 0.05 was considered statistically significant. RESULTS The results showed that quarrel (P = 0.008, OR = 2.01) and hearing the sudden news (P = 0.001, OR = 2.19) were the most common emotional triggers. Respiratory infections (P = 0.0001, OR = 6.78) and exposure to hot or cold weather (P = 0.005, OR = 2.19) were the most frequent environmental triggers. Doing heavy activities (P = 0.005, OR = 1.66) and sexual activities (P = 0.003, OR = 2.36) were among the most common physical triggers. High-fat foods consumption and overeating (P = 0.0001, OR = 3.79) were the most frequent chemical triggers of AMI. CONCLUSION It seems that given the importance of the triggers in the incidence of AMI, planning is necessary to train vulnerable individuals to reduce exposure to triggers.
Collapse
Affiliation(s)
- Maryam Ghiasmand
- Guilan Social Security Organization, Rasool-e-Akram Hospital, Rasht, Iran
| | - Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nursing (Medical-Surgical), Instructor, Social Determinants of Health Research Center (SDHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Majid Pourshaikhian
- Department of Operating Room & Anesthesia, Paramedical School, Guilan University of Medical Sciences, Rasht, Iran
| | | |
Collapse
|
23
|
Wu XM, Basu R, Malig B, Broadwin R, Ebisu K, Gold EB, Qi L, Derby C, Green RS. Association between gaseous air pollutants and inflammatory, hemostatic and lipid markers in a cohort of midlife women. Environ Int 2017; 107:131-139. [PMID: 28732305 PMCID: PMC5584622 DOI: 10.1016/j.envint.2017.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Exposures to ambient gaseous pollutants have been linked to cardiovascular diseases (CVDs), but the biological mechanisms remain uncertain. OBJECTIVES This study examined the changes in CVD marker levels resulting from elevated exposure to ambient gaseous pollutants in midlife women. METHODS Annual repeated measurements of several inflammatory, hemostatic and lipid makers were obtained from 2306 midlife women enrolled in the longitudinal Study of Women's Health Across the Nation (SWAN) between 1999 and 2004. Ambient carbon monoxide (CO), nitrogen dioxide (NO2), and sulfur dioxide (SO2) data were assigned to each woman based on proximity of the monitoring station to her residential address. Short- and long-term exposures were calculated, and their associations with markers were examined using linear mixed-effects regression models, adjusted for demographic, health and other factors. RESULTS Short-term CO exposure was associated with increased fibrinogen, i.e., every interquartile increase of average prior one-week exposure to CO was associated with 1.3% (95% CI: 0.6%, 2.0%) increase in fibrinogen. Long-term exposures to NO2 and SO2 were associated with reduced high-density lipoproteins and apolipoprotein A1, e.g., 4.0% (1.7%, 6.3%) and 4.7% (2.8%, 6.6%) decrease per interquartile increment in prior one-year average NO2 concentration, respectively. Fine particle (PM2.5) exposure confounded associations between CO/NO2 and inflammatory/hemostatic markers, while associations with lipoproteins were generally robust to PM2.5 adjustment. CONCLUSIONS Exposures to these gas pollutants at current ambient levels may increase thrombotic potential and disrupt cholesterol metabolism, contributing to greater risk of CVDs in midlife women. Caution should be exercised in evaluating the confounding by PM2.5 exposure.
Collapse
Affiliation(s)
- Xiangmei May Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Brian Malig
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Rachel Broadwin
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California Davis, School of Medicine, Davis, CA, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, School of Medicine, Davis, CA, USA
| | - Carol Derby
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rochelle S Green
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Xu A, Mu Z, Jiang B, Wang W, Yu H, Zhang L, Li J. Acute Effects of Particulate Air Pollution on Ischemic Heart Disease Hospitalizations in Shanghai, China. Int J Environ Res Public Health 2017; 14:ijerph14020168. [PMID: 28208759 PMCID: PMC5334722 DOI: 10.3390/ijerph14020168] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 12/03/2016] [Revised: 01/25/2017] [Accepted: 02/04/2017] [Indexed: 12/30/2022]
Abstract
Background: Air pollution has been demonstrated to be a major risk factor for the development of cardiovascular and respiratory diseases worldwide. This study examines the relationship between the exposure to fine particulate matter (PM) and patient hospitalizations as a result of ischemic heart disease (IHD) during 2013-2014 in Shanghai, China. Methods: Daily IHD hospitalization data were acquired from the Shanghai Health Insurance Bureau (SHIB) from 1 January 2013 to 21 December 2014. Daily average concentrations of air pollution as well as meteorological data were obtained from the database of Shanghai Environmental Monitoring Center (SEMC) during the same time period, and all data were analyzed using standard epidemiological methodology. Generalized linear model (GLM) adjusted for time trends, weather conditions, and medical insurance policy was used to estimate the immediate and delayed effects of PMs on IHD hospitalizations, and the effects of PMs were also examined based on gender, age group and seasonal variation. Results: A total of 188,198 IHD hospitalizations were recorded during 2013-2014 in Shanghai, China. During this period, the average concentrations of the fine particulate matter with aerodynamic diameter of <10 μm (PM10) and ≤2.5 (PM2.5) were 76 µg/m³ and 56.3 µg/m³, respectively. The effect of PMs was strongest on days when a 10 μg/m³ increment increase of PM2.5 and PM10, which coincided with an increase in IHD hospitalizations by 0.25% (95% CI: 0.10%, 0.39%) and 0.57% (95% CI: 0.46%, 0.68%), respectively. Furthermore, the effect of PMs was significantly greater in males and people between 41 and 65 years old. Conclusions: Hospitalizations of IHD was strongly associated with short-term exposure to high levels of PM10 and PM2.5 during 2013-2014 in Shanghai, China.
Collapse
Affiliation(s)
- Anyang Xu
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| | - Zhe Mu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200000, China.
| | - Bo Jiang
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| | - Wei Wang
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| | - Han Yu
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| | - Lijuan Zhang
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| | - Jue Li
- Department of Prevention, School of Medicine, Tongji University, Shanghai 200092, China.
- Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai 200092, China.
| |
Collapse
|
26
|
Chanel O, Perez L, Künzli N, Medina S. The hidden economic burden of air pollution-related morbidity: evidence from the Aphekom project. Eur J Health Econ 2016; 17:1101-1115. [PMID: 26649740 DOI: 10.1007/s10198-015-0748-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 12/19/2014] [Accepted: 11/11/2015] [Indexed: 05/20/2023]
Abstract
Public decision-makers commonly use health impact assessments (HIA) to quantify the impacts of various regulation policies. However, standard HIAs do not consider that chronic diseases (CDs) can be both caused and exacerbated by a common factor, and generally focus on exacerbations. As an illustration, exposure to near road traffic-related pollution (NRTP) may affect the onset of CDs, and general ambient or urban background air pollution (BP) may exacerbate these CDs. We propose a comprehensive HIA that explicitly accounts for both the acute effects and the long-term effects, making it possible to compute the overall burden of disease attributable to air pollution. A case study applies the two HIA methods to two CDs-asthma in children and coronary heart disease (CHD) in adults over 65-for ten European cities, totaling 1.89 million 0-17-year-old children and 1.85 million adults aged 65 and over. We compare the current health effects with those that might, hypothetically, be obtained if exposure to NRTP was equally low for those living close to busy roads as it is for those living farther away, and if annual mean concentrations of both PM10 and NO2-taken as markers of general urban air pollution-were no higher than 20 μg/m3. Returning an assessment of € 0.55 million (95 % CI 0-0.95), the HIA based on acute effects alone accounts for only about 6.2 % of the annual hospitalization burden computed with the comprehensive method [€ 8.81 million (95 % CI 3-14.4)], and for about 0.15 % of the overall economic burden of air pollution-related CDs [€ 370 million (95 % CI 106-592)]. Morbidity effects thus impact the health system more directly and strongly than previously believed. These findings may clarify the full extent of benefits from any public health or environmental policy involving CDs due to and exacerbated by a common factor.
Collapse
Affiliation(s)
- Olivier Chanel
- Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS, Greqam, 2 rue de la Charité, 13236, Marseille Cedex 02, France.
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sylvia Medina
- Département Santé Environnement, Institut de Veille Sanitaire, 12 rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| |
Collapse
|
27
|
Sohn J, You SC, Cho J, Choi YJ, Joung B, Kim C. Susceptibility to ambient particulate matter on emergency care utilization for ischemic heart disease in Seoul, Korea. Environ Sci Pollut Res Int 2016; 23:19432-19439. [PMID: 27380182 DOI: 10.1007/s11356-016-7144-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/23/2015] [Accepted: 06/23/2016] [Indexed: 06/06/2023]
Abstract
Many epidemiological studies have reported associations between ambient particulate matter (PM) and cardiovascular diseases. However, the effects associated with PM that promote cardiovascular events among susceptible populations who may respond differently than the general population to the same ambient air pollutants remain unclear. We conducted a time-series study with generalized additive models to assess the association between ambient PM10 and emergency department (ED) visits for ischemic heart disease (IHD) in Seoul, Republic of Korea from 2005 to 2009. The ED data and previous medical records within the 5 years of each IHD event to examine the effect of PM10 in a susceptible population were obtained from Health Insurance Review and Assessment Service. Overall, the adjusted relative risks (RRs) of ED visits for IHD were not statistically significant for PM10, but significant positive RRs were found for groups with hypertension (1.018; 95 % confidence interval [CI] 1.002-1.035) and those who are ≥80 years of age (1.019; 1.002-1.037) for same-day exposure and with diabetes (1.019; 1.002-1.037) for single-lag models. Subgroup analyses revealed gender differences in ED visits for IHD in hypertensive patients and those who are ≥80 years of age; positive correlations were found only in males with the lag models. Our study suggests that ambient PM10 is significantly associated with ED visits for IHD, especially in males with hypertension, diabetes mellitus, or who are aged ≥80 years. Identification of populations susceptible to air pollution is of paramount importance to establishing recommendations or guidelines for high-risk individuals.
Collapse
Affiliation(s)
- Jungwoo Sohn
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Seng Chan You
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Jaelim Cho
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Yoon Jung Choi
- Health Insurance Review & Assessment Service, 267 Hyoyeong-ro, Seocho-gu, Seoul, 137-706, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| |
Collapse
|
28
|
Blangiardo M, Finazzi F, Cameletti M. Two-stage Bayesian model to evaluate the effect of air pollution on chronic respiratory diseases using drug prescriptions. Spat Spatiotemporal Epidemiol 2016; 18:1-12. [PMID: 27494955 DOI: 10.1016/j.sste.2016.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 11/22/2022]
Abstract
Exposure to high levels of air pollutant concentration is known to be associated with respiratory problems which can translate into higher morbidity and mortality rates. The link between air pollution and population health has mainly been assessed considering air quality and hospitalisation or mortality data. However, this approach limits the analysis to individuals characterised by severe conditions. In this paper we evaluate the link between air pollution and respiratory diseases using general practice drug prescriptions for chronic respiratory diseases, which allow to draw conclusions based on the general population. We propose a two-stage statistical approach: in the first stage we specify a space-time model to estimate the monthly NO2 concentration integrating several data sources characterised by different spatio-temporal resolution; in the second stage we link the concentration to the β2-agonists prescribed monthly by general practices in England and we model the prescription rates through a small area approach.
Collapse
|
29
|
Cai X, Li Z, Scott EM, Li X, Tang M. Short-term effects of atmospheric particulate matter on myocardial infarction: a cumulative meta-analysis. Environ Sci Pollut Res Int 2016; 23:6139-6148. [PMID: 26846245 DOI: 10.1007/s11356-016-6186-3] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/27/2016] [Indexed: 06/05/2023]
Abstract
Atmospheric particulate matter (PM) is hypothesized to increase the risk of myocardial infarction (MI). However, the epidemiological evidence is inconsistent. We identified 33 studies with more than 4 million MI patients and applied meta-analysis and meta-regression to assess the available evidence. Twenty-five studies presented the effects of the PM level on hospitalization for MI patients, while eight studies showed the effects on mortality. An increase in PM10 was associated with hospitalization and mortality in myocardial infarction patients (RR per 10 μg/m(3) = 1.011, 95% CI 1.006-1.016; RR per 10 μg/m(3) = 1.008, 95 % CI 1.004-1.012, respectively); PM2.5 also increased the risk of hospitalization and mortality in MI patients (RR per 10 μg/m(3) = 1.024, 95% CI 1.007-1.041 for hospitalization and RR per 10 μg/m(3) = 1.012, 95% CI 1.010-1.015 for mortality). The results of the cumulative meta-analysis indicated that PM10 and PM2.5 were associated with myocardial infarction with the addition of new studies each year. In conclusion, short-term exposure to high PM10 and PM2.5 levels revealed to increase risk of hospitalization and mortality for myocardial infarction. Policy support of pollution control and individual protection was strongly recommended.
Collapse
Affiliation(s)
- Xianlei Cai
- Institute of Environment Medicine, Zhejiang University, Hangzhou, People's Republic of China
- Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, People's Republic of China
| | - Zhenhong Li
- School of Civil Engineering and Geosciences, Newcastle University, Newcastle, UK
| | - E Marian Scott
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Xiuyang Li
- Institute of Environment Medicine, Zhejiang University, Hangzhou, People's Republic of China.
- Department of Epidemiology and Biostatistics, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, People's Republic of China.
| | - Mengyao Tang
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| |
Collapse
|
30
|
Luo C, Zhu X, Yao C, Hou L, Zhang J, Cao J, Wang A. Short-term exposure to particulate air pollution and risk of myocardial infarction: a systematic review and meta-analysis. Environ Sci Pollut Res Int 2015; 22:14651-62. [PMID: 26298338 DOI: 10.1007/s11356-015-5188-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [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: 02/27/2015] [Accepted: 08/10/2015] [Indexed: 05/20/2023]
Abstract
A growing number of studies have associated short-term exposure to ambient particulate matter air pollution (PM) and risk of specific cardiovascular events, just as myocardial infarction (MI). However, the results of the recent studies were inconsistent; therefore, a systematic review and meta-analysis was performed. To synthetically quantify the association between short-term exposure to PM and risk of MI, a meta-analysis was conducted to combine the estimates of effect for a relationship between short-term exposure to PM10, PM2.5 (particulate matter ≤ 10 μm, 2.5 μm in diameter) and risk of MI. Electronic database searches for all relevant published studies were updated in January 2015. And, a random-effects model was performed to estimate pooled relative risk (RR) and 95 % confidence intervals (95 % CI). Thirty-one published observational epidemiological studies were identified. Risk of MI was significantly associated with per 10 μg/m(3) increment in PM10 (OR = 1.005; 95 % CI 1.001-1.008) and PM2.5 (OR = 1.022; 95 % CI 1.015-1.030). The risk of PM2.5 exposure was relatively greater than PM10. In the subgroup analysis by study design, location, quality score, and lag exposure, the results were basically consistent with the former overall results in PM2.5 but slightly changed in PM10. Short-term exposure to particulate matter (PM2.5, PM10) was a risk factor for MI, and the results further confirmed the discovery in the previous meta-analysis.
Collapse
Affiliation(s)
- Chunmiao Luo
- Department of Cardiology Medical, The Second People's Hospital of Hefei, Heping Road, Hefei, Anhui, China
| | - Xiaoxia Zhu
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Cijiang Yao
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Lijuan Hou
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Jian Zhang
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Jiyu Cao
- The Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Ailing Wang
- Department of Cardiology Medical, the First Affiliated Hospital of Anhui Medical University, Jixi Road, Hefei, Anhui, China.
| |
Collapse
|
31
|
Huang M, Kang Y, Wang W, Chan CY, Wang X, Wong MH. Potential cytotoxicity of water-soluble fraction of dust and particulate matters and relation to metal(loid)s based on three human cell lines. Chemosphere 2015; 135:61-66. [PMID: 25911218 DOI: 10.1016/j.chemosphere.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 03/21/2014] [Revised: 04/02/2015] [Accepted: 04/05/2015] [Indexed: 06/04/2023]
Abstract
Hepatocellular liver carcinoma (HepG2), human skin derived keratinocyte (KERTr,) and lung epithelial carcinoma (A549) were employed in MTT assay to evaluate the cytotoxicity of water-soluble fraction of road dust, air-conditioning (AC) filter dust and PM2.5 via ingestion, dermal contact and inhalation. Their effects on cell growth were dependent on exposure time and concentration. The LC20s of PM2.5 for A549 cell were approximately one order of magnitude lower than those of road dust and AC filter dust for KERTr cell and HepG2 cell. The LC20s of aqueous extracts were negatively correlated to the water-soluble metal(loid)s contained in dust coarse particles (KERTr: p=0.004; HepG2: p<0.001). However, no significant correlation between soluble metal(loid)s and LC20s of PM2.5 was observed for A549 cell (p>0.05). Other water-soluble components in dust and PM might cause the cell hazards synergistically or additively with metal(loid)s.
Collapse
Affiliation(s)
- Minjuan Huang
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou 510275, PR China; Croucher Institute for Environmental Sciences, Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China; Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou 510275, PR China.
| | - Yuan Kang
- Croucher Institute for Environmental Sciences, Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China; School of Chemistry & Environment, South China Normal University, Key Laboratory of Theoretical Chemistry of Environment, Ministry of Education, Higher Education Mega Center, Guangzhou 510006, PR China
| | - Wei Wang
- Croucher Institute for Environmental Sciences, Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Chuen Yu Chan
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou 510275, PR China; Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou 510275, PR China
| | - Xuemei Wang
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou 510275, PR China; Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou 510275, PR China
| | - Ming Hung Wong
- Croucher Institute for Environmental Sciences, Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
| |
Collapse
|
32
|
Abstract
Air pollution is a complex and ubiquitous mixture of pollutants including particulate matter, chemical substances and biological materials. There is growing awareness of the adverse effects on health of air pollution following both acute and chronic exposure, with a rapidly expanding body of evidence linking air pollution with an increased risk of respiratory (e.g., asthma, chronic obstructive pulmonary disease, lung cancer) and cardiovascular disease (e.g., myocardial infarction, heart failure, cerebrovascular accidents). Elderly subjects, pregnant women, infants and people with prior diseases appear especially susceptible to the deleterious effects of ambient air pollution. The main diseases associated with exposure to air pollutants will be summarized in this narrative review.
Collapse
Affiliation(s)
- Pier Mannuccio Mannucci
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy,
| | | | | | | |
Collapse
|
33
|
Jalava PI, Happo MS, Huttunen K, Sillanpää M, Hillamo R, Salonen RO, Hirvonen MR. Chemical and microbial components of urban air PM cause seasonal variation of toxicological activity. Environ Toxicol Pharmacol 2015; 40:375-87. [PMID: 26245811 DOI: 10.1016/j.etap.2015.06.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 06/17/2015] [Accepted: 06/22/2015] [Indexed: 05/06/2023]
Abstract
The chemical and microbial composition of urban air particulate matter (PM) displays seasonal variation that may affect its harmfulness on human health. We studied the in vitro inflammatory and cellular metabolic activity/cytotoxicity of urban air particulate samples collected in four size-ranges (PM10-2.5, PM2.5-1, PM1-0.2, PM0.2) during four seasons in relatively clean urban environment in Helsinki, Finland. The composition of the same samples were analyzed, including ions, elements, PAH compounds and endotoxins. In addition, microbial contribution on the detected responses was studied by inhibiting the endotoxin-induced responses with Polymyxin B both in the PM samples and by two different bacterial strains representing Gram-positive and -negative bacteria. Macrophage cell line (RAW 264.7) was exposed to the size segregated particulate samples as well as to microbe samples for 24h and markers of inflammation and cytotoxicity were analyzed. The toxicological responses were dependent on the dose as well as size range of the particles, PM10-2.5 being the most potent and smaller size ranges having significantly smaller responses. Samples collected during spring and autumn had in most cases the highest inflammatory activity. Soil components and other non-exhaust particulate emissions from road traffic correlated with inflammatory responses in coarse particles. Instead, PAH-compounds and K(+) had negative associations with the particle-induced inflammatory responses in fine particles, suggesting the role of incomplete biomass combustion. Endotoxin content was the highest in PM10-2.5 samples and correspondingly, the largest decrease in the responses by Polymyxin B was seen with the very same samples. We found also that inhibitory effect of Polymyxin B was not completely specific for Gram-negative bacteria. Thus, in addition to endotoxin, also other microbial components may have a significant effect on the toxicological responses by ambient particulate matter.
Collapse
Affiliation(s)
- Pasi I Jalava
- University of Eastern Finland, Department of Environmental Science, PO Box 1627, FI-70211 Kuopio, Finland.
| | - Mikko S Happo
- University of Eastern Finland, Department of Environmental Science, PO Box 1627, FI-70211 Kuopio, Finland
| | - Kati Huttunen
- University of Eastern Finland, Department of Environmental Science, PO Box 1627, FI-70211 Kuopio, Finland
| | - Markus Sillanpää
- Finnish Meteorological Institute, Air Quality Research, PO Box 503, FI-00101 Helsinki, Finland
| | - Risto Hillamo
- Finnish Meteorological Institute, Air Quality Research, PO Box 503, FI-00101 Helsinki, Finland
| | - Raimo O Salonen
- National Institute for Health and Welfare, Department of Environmental Health, PO Box 95, FI-70701 Kuopio, Finland
| | - Maija-Riitta Hirvonen
- University of Eastern Finland, Department of Environmental Science, PO Box 1627, FI-70211 Kuopio, Finland; National Institute for Health and Welfare, Department of Environmental Health, PO Box 95, FI-70701 Kuopio, Finland
| |
Collapse
|
34
|
Abstract
OBJECTIVE This study was the first to explore the relationship between Asian dust storm events (ADS) and acute myocardial infarction (AMI) hospital admissions by applying time series models. DESIGN AND SAMPLE Nationwide population-based hospitalization claims data in Taiwan were used. There were 143,063 AMI admissions during 2000-2009. MEASURES An autoregressive with exogenous variables (ARX) time series model was used to investigate the dynamic connection between AMI hospital admissions and ADS events. RESULTS AMI hospitalizations significantly spiked on post-ADS day three. Among the total population, 3.2 more cases of AMI admissions occurred on post-ADS day three. When the data were stratified by age and gender, the same delayed effect was present in the male population, especially those aged 45-64 and over 74. CONCLUSIONS Our study shows that although an ADS event does not cause an immediate incidence of AMI, storms may increase AMI incidence through a delayed effect. Hence, AMI prevention is not only important during a dust storm, but particularly so in subsequent days. During the days after an ADS, exposure to dust should be minimized by staying indoors as much as possible and by wearing a mask when exposure to dust is unavoidable. This is especially true for working and older adults. Nurses at local public health centers can increase awareness and promote public safety by providing health information to local communities regarding the link between dust storms and AMI.
Collapse
Affiliation(s)
| | - Yun-Shan Chan
- Department of Public Finance, National Taipei University, New Taipei City, Taiwan
| | - Yu-I Peng
- Department of Public Finance, National Taipei University, New Taipei City, Taiwan
| | - Tsai-Ching Liu
- Department of Public Finance, National Taipei University, New Taipei City, Taiwan
| |
Collapse
|
35
|
Wolf K, Schneider A, Breitner S, Meisinger C, Heier M, Cyrys J, Kuch B, von Scheidt W, Peters A. Associations between short-term exposure to particulate matter and ultrafine particles and myocardial infarction in Augsburg, Germany. Int J Hyg Environ Health 2015; 218:535-42. [PMID: 26013401 DOI: 10.1016/j.ijheh.2015.05.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/04/2015] [Accepted: 05/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Short-term exposure to increased particulate matter (PM) concentration has been reported to trigger myocardial infarction (MI). However, the association with ultrafine particles remains unclear. OBJECTIVES We aimed to assess the effects of short-term air pollution and especially ultrafine particles on registry-based MI events and coronary deaths in the area of Augsburg, Germany. METHODS Between 1995 and 2009, the MONICA/KORA myocardial infarction registry recorded 15,417 cases of MI and coronary deaths. Concentrations of PM<10μm (PM10), PM<2.5μm (PM2.5), particle number concentration (PNC) as indicator for ultrafine particles, and meteorological parameters were measured in the study region. Quasi-Poisson regression adjusting for time trend, temperature, season, and weekday was used to estimate immediate, delayed and cumulative effects of air pollutants on the occurrence of MI. The daily numbers of total MI, nonfatal and fatal events as well as incident and recurrent events were analysed. RESULTS We observed a 1.3% risk increase (95%-confidence interval: [-0.9%; 3.6%]) for all events and a 4.4% [-0.4%; 9.4%] risk increase for recurrent events per 24.3μg/m(3) increase in same day PM10 concentrations. Nonfatal events indicated a risk increase of 3.1% [-0.1%; 6.5%] with previous day PM10. No association was seen for PM2.5 which was only available from 1999 on. PNC showed a risk increase of 6.0% [0.6%; 11.7%] for recurrent events per 5529 particles/cm(3) increase in 5-day average PNC. CONCLUSIONS Our results suggested an association between short-term PM10 concentration and numbers of MI, especially for nonfatal and recurrent events. For ultrafine particles, risk increases were notably high for recurrent events. Thus, persons who already suffered a MI seemed to be more susceptible to air pollution.
Collapse
Affiliation(s)
- Kathrin Wolf
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
| | - Alexandra Schneider
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Susanne Breitner
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Christa Meisinger
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany; Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
| | - Margit Heier
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany; Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
| | - Josef Cyrys
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany; Environmental Science Center, University of Augsburg, Augsburg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine I, Central Hospital of Augsburg, Augsburg, Germany; Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, Germany
| | - Wolfgang von Scheidt
- Department of Internal Medicine I, Central Hospital of Augsburg, Augsburg, Germany
| | - Annette Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany; German Research Center for Cardiovascular Disease (DZHK), Partner Site Munich, Germany
| | | |
Collapse
|
36
|
Hayter AKM, Jeffery R, Sharma C, Prost A, Kinra S. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study. Glob Health Action 2015; 8:25946. [PMID: 25669238 PMCID: PMC4323408 DOI: 10.3402/gha.v8.25946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 12/16/2014] [Accepted: 01/16/2015] [Indexed: 11/14/2022] Open
Abstract
Background Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. Design We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Results Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. Conclusions In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.
Collapse
Affiliation(s)
- Arabella K M Hayter
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Audrey Prost
- Institute for Global Health, University College London, London, UK
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;
| |
Collapse
|
37
|
Greenwald R, Bergin MH, Yip F, Boehmer T, Kewada P, Shafer MM, Schauer JJ, Sarnat JA. On-Roadway In-Cabin Exposure to Particulate Matter: Measurement Results Using Both Continuous and Time-Integrated Sampling Approaches. Aerosol Sci Technol 2014; 48:664-675. [PMID: 35923760 PMCID: PMC9345602 DOI: 10.1080/02786826.2014.912745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The Atlanta Commuters Exposure (ACE) Study was designed to measure in-cabin exposure to roadway particulate pollution and acute health response in a panel of adults with and without asthma following a 2-h scripted route along major highways in Atlanta. This article focuses on methods and results of both continuous and integrated approaches used to measure the concentration of PM2.5 mass, particle number concentration (PNC), black carbon (BC) mass, and particle-bound PAHs, in-cabin noise, PM elemental composition, elemental carbon, organic carbon, water-soluble organic carbon (WSOC) content, and speciation of a broad range of organic compounds including alkanes, hopanes, and PAHs. Speciated PM data indicates that in-cabin particles derive from three non-co-varying processes: the resuspension of road dust containing crustal elements and previously-deposited brake pad residue with a contribution of normal fuel combustion, incomplete combustion processes producing PAHs and carbon particles, and particles ablated from brake pads that have not previously deposited to the roadside environment. Most in-cabin pollutants were elevated during the warm season with the notable exception of PNC. PNC was not found to be correlated with most other pollutants. In-cabin concentrations were marginally higher when windows were open.
Collapse
Affiliation(s)
- Roby Greenwald
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Michael H. Bergin
- Department of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Fuyuen Yip
- Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tegan Boehmer
- Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Priya Kewada
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Martin M. Shafer
- Environmental Chemistry and Technology Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - James J. Schauer
- Environmental Chemistry and Technology Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Jeremy A. Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
38
|
Pun VC, Yu ITS, Ho KF, Qiu H, Sun Z, Tian L. Differential effects of source-specific particulate matter on emergency hospitalizations for ischemic heart disease in Hong Kong. Environ Health Perspect 2014; 122:391-6. [PMID: 24509062 PMCID: PMC3984224 DOI: 10.1289/ehp.1307213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 02/04/2014] [Indexed: 05/05/2023]
Abstract
BACKGROUND Ischemic heart disease (IHD) is a major public health concern. Although many epidemiologic studies have reported evidence of adverse effects of particulate matter (PM) mass on IHD, significant knowledge gaps remain regarding the potential impacts of different PM sources. Much the same as PM size, PM sources may influence toxicological characteristics. OBJECTIVES We identified contributing sources to PM10 mass and estimated the acute effects of PM10 sources on daily emergency IHD hospitalizations in Hong Kong. METHODS We analyzed the concentration data of 19 PM10 chemical components measured between 2001 and 2007 by positive matrix factorization to apportion PM10 mass, and used generalized additive models to estimate associations of interquartile range (IQR) increases in PM10 exposures with IHD hospitalization for different lag periods (up to 5 days), adjusted for potential confounders. RESULTS We identified 8 PM10 sources: vehicle exhaust, soil/road dust, regional combustion, residual oil, fresh sea salt, aged sea salt, secondary nitrate, and secondary sulfate. Vehicle exhaust, secondary nitrate, and secondary sulfate contributed more than half of the PM10 mass. Although associations with IQR increases in 2-day moving averages (lag01) were statistically significant for most sources based on single-source models, only PM10 from vehicle exhaust [1.87% (95% CI: 0.66, 3.10); IQR = 4.9 μg/m3], secondary nitrate [2.28% (95% CI: 1.15, 3.42); IQR = 8.6 μg/m3], and aged sea salt [1.19% (95% CI: 0.04, 2.36); IQR = 5.9 μg/m3] were significantly associated with IHD hospitalizations in the multisource model. Analysis using chemical components provided similar findings. CONCLUSION Emergency IHD hospitalization was significantly linked with PM10 from vehicle exhaust, nitrate-rich secondary PM, and sea salt-related PM. Findings may help prioritize toxicological research and guide future monitoring and emission-control polices.
Collapse
Affiliation(s)
- Vivian Chit Pun
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China
| | | | | | | | | | | |
Collapse
|
39
|
Franck U, Leitte AM, Suppan P. Multiple exposures to airborne pollutants and hospital admissions due to diseases of the circulatory system in Santiago de Chile. Sci Total Environ 2014; 468-469:746-56. [PMID: 24064344 DOI: 10.1016/j.scitotenv.2013.08.088] [Citation(s) in RCA: 13] [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: 05/08/2013] [Revised: 07/23/2013] [Accepted: 08/27/2013] [Indexed: 05/27/2023]
Abstract
BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of cardiovascular diseases. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to different cardiovascular disease groups in Santiago de Chile. METHODS The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5--particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for cardiovascular illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to cardiovascular admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were NO2 and particulate matter (PM10 and PM2.5) followed by CO, while in 2-pollutant models effects of PM10 persisted in most cases whereas other effects weakened. In addition the strongest effects seemed to be immediate or with a delay of up to 2 days. Adverse effects of ozone could not be detected. CONCLUSIONS Our results provided evidence for adverse health effects of combined exposure to airborne pollutants. Different pollutants accounted for varying adverse effects within different cardiovascular disease groups. Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants but especially NO2, PM10, and CO.
Collapse
Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
| | | | | |
Collapse
|
40
|
Koton S, Molshatzki N, Yuval, Myers V, Broday DM, Drory Y, Steinberg DM, Gerber Y. Cumulative exposure to particulate matter air pollution and long-term post-myocardial infarction outcomes. Prev Med 2013; 57:339-44. [PMID: 23777671 DOI: 10.1016/j.ypmed.2013.06.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/03/2013] [Accepted: 06/06/2013] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Chronic environmental exposure to particulate matter <2.5μm in diameter (PM2.5) has been associated with cardiovascular disease; however, the effect of air pollution on myocardial infarction (MI) survivors is not clear. We studied the association of chronic exposure to PM2.5 with death and recurrent cardiovascular events in MI survivors. METHODS Consecutive patients aged ≤65years admitted to all medical centers in central Israel after first-MI in 1992-1993 were followed through 2005 for cardiovascular events and 2011 for survival. Data on sociodemographic and prognostic factors were collected at baseline and during follow-up. Residential exposure to PM2.5 was estimated for each patient based on data recorded at air quality monitoring stations. Cox and Andersen-Gill proportional hazards models were used to study the pollution-outcome association. RESULTS Among the 1120 patients, 469 (41.9%) died and 541 (48.3%) experienced one or more recurrent cardiovascular event. The adjusted hazard ratios associated with a 10μg/m(3) increase in PM2.5 exposure were 1.3 (95% CI 0.8-2.1) for death and 1.5 (95% CI 1.1-1.9) for multiple recurrences of cardiovascular events (MI, heart failure and stroke). CONCLUSION When adjustment for socio-demographic factors is performed, cumulative chronic exposure to PM2.5 is positively associated with recurrence of cardiovascular events in patients after a first MI.
Collapse
Affiliation(s)
- Silvia Koton
- School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
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.
Collapse
Affiliation(s)
- Daniela Nuvolone
- Epidemiology Unit, Regional Agency for Public Health of Tuscany, Via Pietro Dazzi 1, 51100 Florence, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Bell ML, Zanobetti A, Dominici F. Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis. Am J Epidemiol 2013; 178:865-76. [PMID: 23887042 DOI: 10.1093/aje/kwt090] [Citation(s) in RCA: 213] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Although there is strong evidence that short-term exposure to particulate matter is associated with health risks, less is known about whether some subpopulations face higher risks. We identified 108 papers published after 1995 and summarized the scientific evidence regarding effect modification of associations between short-term exposure to particulate matter and the risk of death or hospitalization. We performed a meta-analysis of estimated mortality associations by age and sex. We found strong, consistent evidence that the elderly experience higher risk of particular matter--associated hospitalization and death, weak evidence that women have higher risks of hospitalization and death, and suggestive evidence that those with lower education, income, or employment status have higher risk of death. Meta-analysis showed a statistically higher risk of death of 0.64% (95% confidence interval (CI): 0.50, 0.78) for older populations compared with 0.34% (95% CI: 0.25, 0.42) for younger populations per 10 μg/m3 increase of particulate matter with aerodynamic diameter ≤10 μm. Women had a slightly higher risk of death of 0.55% (95% CI: 0.41, 0.70) compared with 0.50% (95% CI: 0.34, 0.54) for men, but these 2 risks were not statistically different. Our synthesis on modifiers for risks associated with particulate matter can aid the design of air quality policies and suggest directions for future research. Studies of biological mechanisms could be informed by evidence of differential risks by population, such as by sex and preexisting conditions.
Collapse
|
43
|
Pascal L, Pascal M, Stempfelet M, Goria S, Declercq C. Ecological study on hospitalizations for cancer, cardiovascular, and respiratory diseases in the industrial area of Etang-de-Berre in the South of France. J Environ Public Health 2013; 2013:328737. [PMID: 23864868 DOI: 10.1155/2013/328737] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/15/2013] [Accepted: 05/07/2013] [Indexed: 01/31/2023]
Abstract
The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2) for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.
Collapse
|
44
|
Li Y, Nie J, Beyea J, Rudra CB, Browne RW, Bonner MR, Mu L, Trevisan M, Freudenheim JL. Exposure to traffic emissions: associations with biomarkers of antioxidant status and oxidative damage. Environ Res 2013; 121:31-8. [PMID: 23140610 PMCID: PMC3578064 DOI: 10.1016/j.envres.2012.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 07/17/2012] [Accepted: 10/04/2012] [Indexed: 05/12/2023]
Abstract
BACKGROUND Oxidative stress has been implicated as a possible mechanism for adverse health effects associated with traffic emissions. We examined the association of an estimate of traffic emissions with blood biomarkers of antioxidant capacity (glutathione, glutathione peroxidase, trolox-equivalent antioxidant capacity) and oxidative damage (thiobarbituric acid-reactive substances (TBARS)) among 1810 healthy women, randomly selected from Erie and Niagara Counties in Western New York. METHODS A geographic traffic emission and meteorological dispersion model was used to estimate annual polycyclic aromatic hydrocarbon (PAH) exposure from traffic emissions for each woman based on her residence at the time of study. Associations of traffic-related PAH exposure with measures of oxidative stress and antioxidant capacity were examined in multiple regression analyses with adjustment for potential confounders. RESULTS Higher traffic-related PAH exposure was associated with decreased glutathione and increased glutathione peroxidase. Stronger associations between traffic-related PAH exposure and levels of glutathione and glutathione peroxidase were suggested among nonsmoking women without secondhand smoke exposure, especially among premenopausal nonsmoking women. Associations were also stronger for measurements made in warmer months. CONCLUSIONS These findings suggest that PAHs or other components of traffic emissions may impact anti-oxidative capacity among healthy women, particularly premenopausal non-smokers without secondhand smoke exposure.
Collapse
Affiliation(s)
- Yanli Li
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Jing Nie
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Jan Beyea
- Consulting in the Public Interest, Lambertville, NJ
| | | | - Richard W. Browne
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, Buffalo, NY
| | - Matthew R. Bonner
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Lina Mu
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Maurizio Trevisan
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY
| | - Jo L. Freudenheim
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| |
Collapse
|
45
|
Chang CC, Kuo CC, Liou SH, Yang CY. Fine particulate air pollution and hospital admissions for myocardial infarction in a subtropical city: Taipei, Taiwan. J Toxicol Environ Health A 2013; 76:440-448. [PMID: 23611182 DOI: 10.1080/15287394.2013.771559] [Citation(s) in RCA: 24] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study was undertaken to determine whether there was a correlation between fine particles (PM2.5) levels and 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 2006-2010. The relative risk of hospital admissions for MI was estimated using a casecrossover approach, controlling for weather variables, day of the week, seasonality, and longterm time trends. For the single-pollutant model (without adjustment for other pollutants), increased numbers of MI admissions were significantly associated with higher PM2.5 levels both on warm days (>23°C) and on cool days (<23°C). This was accompanied by an interquartile range elevation correlated with a 10% (95% CI = 6-15%) and 5% (95% CI = 1-9%) rise in number of MI admissions, respectively. In the two-pollutant models, PM2.5 remained significant after inclusion of SO2 or O3 on both warm and cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for MI.
Collapse
Affiliation(s)
- Chih-Ching Chang
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | | | | | | |
Collapse
|
46
|
Franchini M, Guida A, Tufano A, Coppola A. Air pollution, vascular disease and thrombosis: linking clinical data and pathogenic mechanisms. J Thromb Haemost 2012; 10:2438-51. [PMID: 23006215 DOI: 10.1111/jth.12006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The public health burden of air pollution has been increasingly recognized over the last decades. Following the first assessed adverse effects on respiratory diseases and lung cancer, a large body of epidemiologic and clinical studies definitely documented an even stronger association of air pollution exposure with cardiovascular mortality and morbidity, particularly related to atherothrombotic (coronary and cerebrovascular) disease. Particulate matter (PM), mainly that with lower aerodynamic diameter (fine and ultrafine PM), is responsible for the most severe effects, due to its capacity to transport toxic substances deep into the lower airways. These effects have been shown to occur not only after short-term exposure to elevated concentrations of pollutants, but even after long-term relatively low levels of exposure. Vulnerable subjects (elderly persons and those with preexisting cardiopulmonary diseases) show the highest impact. Fewer and conflicting data also suggest an association with venous thromboembolism. Although not completely elucidated, a series of mechanisms have been hypothesized and tested in experimental settings. These phenomena, including vasomotor and cardiac autonomic dysfunction, hemostatic unbalance, oxidative stress and inflammatory response, have been shown to change over time and differently contribute to the short-term and long-term adverse effects of pollution exposure. Beyond environmental health policies, crucial for improving air quality and reducing the impact of such an elusive threat to public health, the recognition and assessment of the individual risk, together with specific advice, should be routinely implemented in the strategies of primary and secondary cardiovascular prevention.
Collapse
Affiliation(s)
- M Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | | | | | | |
Collapse
|
47
|
Goggins WB, Chan EYY, Yang CY. Weather, pollution, and acute myocardial infarction in Hong Kong and Taiwan. Int J Cardiol 2012; 168:243-9. [PMID: 23041014 DOI: 10.1016/j.ijcard.2012.09.087] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 06/28/2012] [Accepted: 09/15/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several previous studies examined the association between acute myocardial infarction (AMI) incidence and temperature and/or air pollution. Results of these studies have been inconsistent and few studies have been done in cities with sub-tropical or tropical climates. METHODS Daily data on AMI hospitalizations, mean temperature and humidity, and pollutants, were collected for 2000-2009 for three warm-climate Asian cities. Poisson Generalized Additive Models were used to regress daily AMI counts on temperature, humidity, and pollutants while controlling for day of the week, long-term trends and seasonal effects. Smoothing splines allowing non-linear associations were used for temperature and humidity while pollutants were modeled as linear terms. RESULTS A 1°C drop below a threshold temperature of 24°C was significantly (p<.0001) associated with AMI hospitalization increases of 3.7% (average lag 0-13 temperature) in Hong Kong, 2.6% (average lag 0-15) in Taipei, and 4.0% (average lag 0-11) in Kaohsiung. No significant heat effects were observed. Among pollutants same day nitrogen dioxide (NO2) levels were the strongest predictors in all three cities, with a 10mg/m(3) increase in NO2 being associated with a 1.1% rise in AMI hospitalization in Hong Kong, and a 10 ppb rise being associated with 4.4% and 2.6% rises in Taipei and Kaohsiung, respectively. CONCLUSIONS Cool temperatures and higher NO2 levels substantially raised AMI risk in these warm-climate cities and the effect sizes we observed were stronger than those found in previous studies. More attention should be paid to the health dangers of cold weather in warm-climate cities.
Collapse
Affiliation(s)
- William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong.
| | | | | |
Collapse
|
48
|
Corea F, Silvestrelli G, Baccarelli A, Giua A, Previdi P, Siliprandi G, Murgia N. Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions. Neurol Int 2012; 4:e11. [PMID: 23139849 PMCID: PMC3490470 DOI: 10.4081/ni.2012.e11] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 05/15/2012] [Accepted: 06/26/2012] [Indexed: 12/31/2022] Open
Abstract
Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006-08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 µm (PM(10)), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM(10) [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00-1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM(10) level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00-1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01-1.07; P<0.05).In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.
Collapse
|
49
|
Shannahan JH, Kodavanti UP, Brown JM. Manufactured and airborne nanoparticle cardiopulmonary interactions: a review of mechanisms and the possible contribution of mast cells. Inhal Toxicol 2012; 24:320-39. [PMID: 22486349 DOI: 10.3109/08958378.2012.668229] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Human inhalation exposures to manufactured nanoparticles (NP) and airborne ultrafine particles (UFP) continues to increase in both occupational and environmental settings. UFP exposures have been associated with increased cardiovascular mortality and morbidity, while ongoing research supports adverse systemic and cardiovascular health effects after NP exposures. Adverse cardiovascular health effects include alterations in heart rate variability, hypertension, thrombosis, arrhythmias, increased myocardial infarction, and atherosclerosis. Exactly how UFP and NP cause these negative cardiovascular effects is poorly understood, however a variety of mediators and mechanisms have been proposed. UFP and NP, as well as their soluble components, are known to systemically translocate from the lung. Translocated particles could mediate cardiovascular toxicity through direct interactions with the vasculature, blood, and heart. Recent study suggests that sensory nerve stimulation within the lung may also contribute to UFP- and NP-induced acute cardiovascular alterations. Activation of sensory nerves, such as C-fibers, within the lung may result in altered cardiac rhythm and function. Lastly, release of pulmonary-derived mediators into systemic circulation has been proposed to facilitate cardiovascular effects. In general, these proposed pulmonary-derived mediators include proinflammatory cytokines, oxidatively modified macromolecules, vasoactive proteins, and prothrombotic factors. These pulmonary-derived mediators have been postulated to contribute to the subsequent prothrombotic, atherogenic, and inflammatory effects after exposure. This review will evaluate the potential contribution of individual mediators and mechanisms in facilitating cardiopulmonary toxicity following inhalation of UFP and NP. Lastly, we will appraise the literature and propose a hypothesis regarding the possible role of mast cells in contributing to these systemic effects.
Collapse
Affiliation(s)
- Jonathan H Shannahan
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | | | | |
Collapse
|
50
|
Fang SC, Mehta AJ, Alexeeff SE, Gryparis A, Coull B, Vokonas P, Christiani DC, Schwartz J. Residential black carbon exposure and circulating markers of systemic inflammation in elderly males: the normative aging study. Environ Health Perspect 2012; 120:674-80. [PMID: 22336131 PMCID: PMC3346771 DOI: 10.1289/ehp.1103982] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 02/15/2012] [Indexed: 05/19/2023]
Abstract
BACKGROUND Traffic-related particles (TRPs) are associated with adverse cardiovascular events. The exact mechanisms are unclear, but systemic inflammatory responses likely play a role. OBJECTIVES We conducted a repeated measures study among male participants of the Normative Aging Study in the greater Boston, Massachusetts, area to determine whether individual-level residential black carbon (BC), a marker of TRPs, is associated with systemic inflammation and whether coronary heart disease (CHD), diabetes, and obesity modify associations. METHODS We quantified markers of inflammation in 1,163 serum samples from 580 men. Exposure to BC up to 4 weeks prior was predicted from a validated spatiotemporal land-use regression model. Linear mixed effects models estimated the effects of BC on each marker while adjusting for potential confounders. RESULTS Associations between BC and blood markers were not observed in main effects models or when stratified by obesity status. However, BC was positively associated with markers of inflammation in men with CHD (particularly vascular endothelial growth factor) and in men with diabetes (particularly interleukin-1β and tumor necrosis factor-α). Significant exposure time windows varied by marker, although in general the strongest associations were observed with moving averages of 2-7 days after a lag of several days. CONCLUSIONS In an elderly male population, estimated BC exposures were positively associated with markers of systemic inflammation but only in men with CHD or diabetes.
Collapse
Affiliation(s)
- Shona C Fang
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
| | | | | | | | | | | | | | | |
Collapse
|