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Anyanwu C, Bikomeye JC, Beyer KM. The impact of environmental conditions on non-communicable diseases in sub-Saharan Africa: A scoping review of epidemiologic evidence. J Glob Health 2024; 14:04003. [PMID: 38419464 PMCID: PMC10902803 DOI: 10.7189/jogh.14.04003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Background The burden of non-communicable diseases (NCDs) in sub-Saharan Africa (SSA) is increasing. Environmental conditions such as heavy metals and air pollution have been linked with the incidence and mortality of chronic diseases such as cancer, as well as cardiovascular and respiratory diseases. We aimed to scope the current state of evidence on the impact of environmental conditions on NCDs in SSA. Methods We conducted a scoping review to identify environmental conditions linked with NCDs in SSA by identifying studies published from January 1986 through February 2023. We searched African Index Medicus, Ovid Medline, Scopus, Web of Science, and Greenfile. Using the PICOS study selection criteria, we identified studies conducted in SSA focussed on physical environmental exposures and incidence, prevalence, and mortality of NCDs. We included only epidemiologic or quantitative studies. Results We identified 6754 articles from electronic database searches; only 36 met our inclusion criteria and were qualitatively synthesised. Two studies were conducted in multiple SSA countries, while 34 were conducted across ten countries in SSA. Air pollution (58.3%) was the most common type of environmental exposure reported, followed by exposure to dust (19.4%), meteorological variables (13.8%), heavy metals (2.7%), soil radioactivity (2.7%), and neighbourhood greenness (2.7%). The examined NCDs included respiratory diseases (69.4%), cancer (2.7%), stroke (5.5%), diabetes (2.7%), and two or more chronic diseases (19.4%). The study results suggest an association between environmental exposures and NCDs, particularly for respiratory diseases. Only seven studies found a null association between environmental conditions and chronic diseases. Conclusions There is a growing body of research on environmental conditions and chronic diseases in the SSA region. Although some cities in SSA have started implementing environmental monitoring and control measures, there remain high levels of environmental pollution. Investment can focus on improving environmental control measures and disease surveillance.
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Adebayo-Ojo TC, Wichmann J, Arowosegbe OO, Probst-Hensch N, Schindler C, Künzli N. A New Global Air Quality Health Index Based on the WHO Air Quality Guideline Values With Application in Cape Town. Int J Public Health 2023; 68:1606349. [PMID: 37936875 PMCID: PMC10625908 DOI: 10.3389/ijph.2023.1606349] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Objectives: This study developed an Air Quality Health Index (AQHI) based on global scientific evidence and applied it to data from Cape Town, South Africa. Methods: Effect estimates from two global systematic reviews and meta-analyses were used to derive the excess risk (ER) for PM2.5, PM10, NO2, SO2 and O3. Single pollutant AQHIs were developed and scaled using the ERs at the WHO 2021 long-term Air Quality Guideline (AQG) values to define the upper level of the "low risk" range. An overall daily AQHI was defined as weighted average of the single AQHIs. Results: Between 2006 and 2015, 87% of the days posed "moderate to high risk" to Cape Town's population, mainly due to PM10 and NO2 levels. The seasonal pattern of air quality shows "high risk" occurring mostly during the colder months of July-September. Conclusion: The AQHI, with its reference to the WHO 2021 long-term AQG provides a global application and can assist countries in communicating risks in relation to their daily air quality.
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Affiliation(s)
- Temitope Christina Adebayo-Ojo
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Janine Wichmann
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Oluwaseyi Olalekan Arowosegbe
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
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Li Z, Lv S, Lu F, Guo M, Wu Z, Liu Y, Li W, Liu M, Yu S, Jiang Y, Gao B, Wang X, Li X, Wang W, Liu X, Guo X. Causal Associations of Air Pollution With Cardiovascular Disease and Respiratory Diseases Among Elder Diabetic Patients. Geohealth 2023; 7:e2022GH000730. [PMID: 37351309 PMCID: PMC10282596 DOI: 10.1029/2022gh000730] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/24/2023]
Abstract
Extensive researches have linked air pollutants with cardiovascular disease (CVD) and respiratory diseases (RD), however, there is limited evidence on causal effects of air pollutants on morbidity of CVD or RD with comorbidities, particularly diabetes mellitus in elder patients. We included hospital admissions for CVD or RD among elder (≥65 years) diabetic patients between 2014 and 2019 in Beijing. A time-stratified case-crossover design based on negative-control exposure was used to assess causal associations of short-term exposure to air pollutants with CVD and RD among diabetic patients with the maximum lag of 7 days. A random forest regression model was used to calculate the contribution magnitude of air pollutants. A total of 493,046 hospital admissions were recorded. Per 10 μg/m3 uptick in PM1, PM2.5, PM10, SO2, NO2, O3, and 1 mg/m3 in CO was associated with 0.29 (0.05, 0.53), 0.14 (0.02, 0.26), 0.06 (0.00, 0.12), 0.36 (0.01, 0.70), 0.21 (0.02, 0.40), -0.08 (-0.25, 0.09), and 4.59 (0.56, 8.61) causal effect estimator for admission of CVD among diabetic patients, corresponding to 0.12 (0.05, 0.18), 0.09 (0.05, 0.13), 0.05, 0.23 (0.06, 0.41), 0.10 (0.02, 0.19), -0.04 (-0.06, -0.01), and 3.91(1.81, 6.01) causal effect estimator for RD among diabetic patients. The effect of gaseous pollutants was higher than particulate pollutants in random forest model. Short-term exposure to air pollution was causally associated with increased admission of CVD and RD among elder diabetic patients. Gaseous pollutants had a greater contribution to CVD and RD among elder diabetic patients.
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Affiliation(s)
- Zhiwei Li
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Shiyun Lv
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Feng Lu
- Beijing Municipal Health Commission Information CenterBeijingChina
| | - Moning Guo
- Beijing Municipal Health Commission Information CenterBeijingChina
| | - Zhiyuan Wu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Yue Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Weiming Li
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Mengmeng Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Siqi Yu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Yanshuang Jiang
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Bo Gao
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xiaonan Wang
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xia Li
- Department of Mathematics and StatisticsLa Trobe UniversityMelbourneAustralia
| | - Wei Wang
- School of Medical Sciences and HealthEdith Cowan UniversityPerthAustralia
| | - Xiangtong Liu
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
| | - Xiuhua Guo
- Department of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Beijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijingChina
- School of Medical Sciences and HealthEdith Cowan UniversityPerthAustralia
- National Institute for Data Science in Health and MedicineCapital Medical UniversityBeijingChina
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Dong TF, Zha ZQ, Sun L, Liu LL, Li XY, Wang Y, Meng XL, Li HB, Wang HL, Nie HH, Yang LS. Ambient nitrogen dioxide and cardiovascular diseases in rural regions: a time-series analyses using data from the new rural cooperative medical scheme in Fuyang, East China. Environ Sci Pollut Res Int 2023; 30:51412-51421. [PMID: 36809617 DOI: 10.1007/s11356-023-25922-9] [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] [Received: 10/07/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Most of studies relating ambient nitrogen dioxide (NO2) exposure to hospital admissions for cardiovascular diseases (CVDs) were conducted among urban population. Whether and to what extent these results could be generalizable to rural population remains unknown. We addressed this question using data from the New Rural Cooperative Medical Scheme (NRCMS) in Fuyang, Anhui, China. Daily hospital admissions for total CVDs, ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and haemorrhagic stroke in rural regions of Fuyang, China, were extracted from NRCMS between January 2015 and June 2017. A two-stage time-series analysis method was used to assess the associations between NO2 and CVD hospital admissions and the disease burden fractions attributable to NO2. In our study period, the average number (standard deviation) of hospital admissions per day were 488.2 (117.1) for total CVDs, 179.8 (45.6) for ischaemic heart disease, 7.0 (3.3) for heart rhythm disturbances, 13.2 (7.2) for heart failure, 267.9 (67.7) for ischaemic stroke, and 20.2 (6.4) for haemorrhagic stroke. The 10-μg/m3 increase of NO2 was related to an elevated risk of 1.9% (RR: 1.019, 95% CI: 1.005 to 1.032) for hospital admissions of total CVDs at lag0-2 days, 2.1% (1.021, 1.006 to 1.036) for ischaemic heart disease, and 2.1% (1.021, 1.006 to 1.035) for ischaemic stroke, respectively, while no significant association was observed between NO2 and hospital admissions for heart rhythm disturbances, heart failure, and haemorrhagic stroke. The attributable fractions of total CVDs, ischaemic heart disease, and ischaemic stroke to NO2 were 6.52% (1.87 to 10.94%), 7.31% (2.19 to 12.17%), and 7.12% (2.14 to 11.85%), respectively. Our findings suggest that CVD burdens in rural population are also partly attributed to short-term exposure to NO2. More studies across rural regions are required to replicate our findings.
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Affiliation(s)
- Teng-Fei Dong
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Zhen-Qiu Zha
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, 230601, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, 236069, Anhui, China
| | - Ling-Li Liu
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Xing-Yang Li
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Yuan Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Xiang-Long Meng
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Huai-Biao Li
- Fuyang Center for Disease Control and Prevention, Fuyang, 236069, Anhui, China
| | - Hong-Li Wang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Huan-Huan Nie
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Lin-Sheng Yang
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China.
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5
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Psistaki K, Achilleos S, Middleton N, Paschalidou AK. Exploring the impact of particulate matter on mortality in coastal Mediterranean environments. Sci Total Environ 2023; 865:161147. [PMID: 36587685 DOI: 10.1016/j.scitotenv.2022.161147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Air pollution is one of the most important problems the world is facing nowadays, adversely affecting public health and causing millions of deaths every year. Particulate matter is a criteria pollutant that has been linked to increased morbidity, as well as all-cause and cause-specific mortality. However, this association remains under-investigated in smaller-size cities in the Eastern Mediterranean, which are also frequently affected by heat waves and dust storms. This study explores the impact of particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5) on mortality (all-cause, cardiovascular, respiratory) in two coastal cities in the Eastern Mediterranean; Thessaloniki, Greece and Limassol, Cyprus. Generalized additive Poisson models were used to explore overall and gender-specific associations, controlling for long- and short-term patterns, day of week and the effect of weather variables. Moreover, the effect of different lags, season, co-pollutants and dust storms on primary associations was investigated. A 10 μg/m3 increase in PM2.5 resulted in 1.10 % (95 % CI: -0.13, 2.34) increase in cardiovascular mortality in Thessaloniki, and in 3.07 % (95 % CI: -0.90, 7.20) increase in all-cause mortality in Limassol on the same day. Additionally, significant positive associations were observed between PM2.5 as well as PM10 and mortality at different lags up to seven days. Interestingly, an association with dust storms was observed only in Thessaloniki, having a protective effect, while the gender-specific analysis revealed significant associations only for the males in both cities. The outcome of this study highlights the need of city- or county-specific public health interventions to address the impact of climate, population lifestyle behaviour and other socioeconomic factors that affect the exposure to air pollution and other synergistic effects that alter the effect of PM on population health.
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Affiliation(s)
- K Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada 68200, Greece
| | - S Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - N Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - A K Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada 68200, Greece.
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Kumar R, Mrigpuri P, Sarin R, Saini JK, Yadav R, Nagori A, Kabra SK, Mukherjee A, Yadav G. Air pollution and its effects on emergency room visits in tertiary respiratory care centers in Delhi, India. Monaldi Arch Chest Dis 2023; 94. [PMID: 36843510 DOI: 10.4081/monaldi.2023.2511] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 02/28/2023] Open
Abstract
Environmental pollution has harmful effects on human health, particularly the respiratory system. We aimed to study the impact of daily ambient air pollution on daily emergency room visits for acute respiratory symptoms. This study was conducted in two tertiary respiratory care centres in Delhi, India. Daily counts of emergency room visits were collected. All patients attending the emergency room were screened for acute onset (less than 2 weeks) of respiratory symptoms and were recruited if they were staying in Delhi continuously for at least 4 weeks and having onset (≤2 weeks) of respiratory symptoms. Daily average air pollution data for the study period was obtained from four continuous ambient air quality monitoring stations. A total of 61,285 patients were screened and 11,424 were enrolled from June 2017 to February 2019. Cough and difficulty in breathing were most common respiratory symptoms. Poor air quality was observed during the months of October to December. Emergency room visits with acute respiratory symptoms significantly increased per standard deviation increase in PM10 from lag days 2-7. Increase in wheezing was primarily seen with increase in NO2. Pollutant levels have effect on acute respiratory symptoms and thus influence emergency room visits. *************************************************************** *Appendix Authors list Kamal Singhal,1 Kana Ram Jat,2 Karan Madan,3 Mohan P. George,4 Kalaivani Mani,5 Randeep Guleria,3 Ravindra Mohan Pandey,5 Rupinder Singh Dhaliwal,6 Rakesh Lodha,2 Varinder Singh1 1Department of Paediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India 2Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India 3Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India 4Department of Environment, Delhi Pollution Control Committee, Kashmere Gate, New Delhi, India 5Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India 6Department of Non-communicable Diseases, Indian Council of Medical Research, New Delhi, India.
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Affiliation(s)
- Raj Kumar
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
| | - Parul Mrigpuri
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
| | - Rohit Sarin
- Department of Pulmonary Medicine, National Institute of Tuberculosis and Respiratory Diseases, New Delhi.
| | - Jitendra Kumar Saini
- Department of Pulmonary Medicine, National Institute of Tuberculosis and Respiratory Diseases, New Delhi.
| | - Rashmi Yadav
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | | | - Sushil Kumar Kabra
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | - Arpana Mukherjee
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
| | - Geetika Yadav
- Department of Non-communicable Diseases, Indian Council of Medical Research, New Delhi.
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Makunyane MS, Rautenbach H, Sweijd N, Botai J, Wichmann J. Health Risks of Temperature Variability on Hospital Admissions in Cape Town, 2011-2016. Int J Environ Res Public Health 2023; 20:1159. [PMID: 36673914 PMCID: PMC9859170 DOI: 10.3390/ijerph20021159] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Epidemiological studies have provided compelling evidence of associations between temperature variability (TV) and health outcomes. However, such studies are limited in developing countries. This study aimed to investigate the relationship between TV and hospital admissions for cause-specific diseases in South Africa. Hospital admission data for cardiovascular diseases (CVD) and respiratory diseases (RD) were obtained from seven private hospitals in Cape Town from 1 January 2011 to 31 October 2016. Meteorological data were obtained from the South African Weather Service (SAWS). A quasi-Poisson regression model was used to investigate the association between TV and health outcomes after controlling for potential effect modifiers. A positive and statistically significant association between TV and hospital admissions for both diseases was observed, even after controlling for the non-linear and delayed effects of daily mean temperature and relative humidity. TV showed the greatest effect on the entire study group when using short lags, 0-2 days for CVD and 0-1 days for RD hospitalisations. However, the elderly were more sensitive to RD hospitalisation and the 15-64 year age group was more sensitive to CVD hospitalisations. Men were more susceptible to hospitalisation than females. The results indicate that more attention should be paid to the effects of temperature variability and change on human health. Furthermore, different weather and climate metrics, such as TV, should be considered in understanding the climate component of the epidemiology of these (and other diseases), especially in light of climate change, where a wider range and extreme climate events are expected to occur in future.
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Affiliation(s)
- Malebo Sephule Makunyane
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
- South African Weather Service, Pretoria 0001, South Africa
| | - Hannes Rautenbach
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
- Faculty of Natural Sciences, Akademia, Pretoria 0002, South Africa
| | - Neville Sweijd
- Applied Centre for Climate and Earth Systems Science, Council for Scientific and Industrial Research, Cape Town 7700, South Africa
| | - Joel Botai
- South African Weather Service, Pretoria 0001, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
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Mainka A, Żak M. Synergistic or Antagonistic Health Effects of Long- and Short-Term Exposure to Ambient NO 2 and PM 2.5: A Review. Int J Environ Res Public Health 2022; 19:ijerph192114079. [PMID: 36360958 PMCID: PMC9657687 DOI: 10.3390/ijerph192114079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 05/31/2023]
Abstract
Studies on adverse health effects associated with air pollution mostly focus on individual pollutants. However, the air is a complex medium, and thus epidemiological studies face many challenges and limitations in the multipollutant approach. NO2 and PM2.5 have been selected as both originating from combustion processes and are considered to be the main pollutants associated with traffic; moreover, both elicit oxidative stress responses. An answer to the question of whether synergistic or antagonistic health effects of combined pollutants are demonstrated by pollutants monitored in ambient air is not explicit. Among the analyzed studies, only a few revealed statistical significance. Exposure to a single pollutant (PM2.5 or NO2) was mostly associated with a small increase in non-accidental mortality (HR:1.01-1.03). PM2.5 increase of <10 µg/m3 adjusted for NO2 as well as NO2 adjusted for PM2.5 resulted in a slightly lower health risk than a single pollutant. In the case of cardiovascular heart disease, mortality evoked by exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed an antagonistic effect on health risk compared to the single pollutant. Both short- and long-term exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed a synergistic effect appearing as higher mortality from respiratory diseases.
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Arowosegbe OO, Röösli M, Künzli N, Saucy A, Adebayo-Ojo TC, Schwartz J, Kebalepile M, Jeebhay MF, Dalvie MA, de Hoogh K. Ensemble averaging using remote sensing data to model spatiotemporal PM 10 concentrations in sparsely monitored South Africa. Environ Pollut 2022; 310:119883. [PMID: 35932898 DOI: 10.1016/j.envpol.2022.119883] [Citation(s) in RCA: 4] [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] [Received: 04/14/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
There is a paucity of air quality data in sub-Saharan African countries to inform science driven air quality management and epidemiological studies. We investigated the use of available remote-sensing aerosol optical depth (AOD) data to develop spatially and temporally resolved models to predict daily particulate matter (PM10) concentrations across four provinces of South Africa (Gauteng, Mpumalanga, KwaZulu-Natal and Western Cape) for the year 2016 in a two-staged approach. In stage 1, a Random Forest (RF) model was used to impute Multiangle Implementation of Atmospheric Correction AOD data for days where it was missing. In stage 2, the machine learner algorithms RF, Gradient Boosting and Support Vector Regression were used to model the relationship between ground-monitored PM10 data, AOD and other spatial and temporal predictors. These were subsequently combined in an ensemble model to predict daily PM10 concentrations at 1 km × 1 km spatial resolution across the four provinces. An out-of-bag R2 of 0.96 was achieved for the first stage model. The stage 2 cross-validated (CV) ensemble model captured 0.84 variability in ground-monitored PM10 with a spatial CV R2 of 0.48 and temporal CV R2 of 0.80. The stage 2 model indicated an optimal performance of the daily predictions when aggregated to monthly and annual means. Our results suggest that a combination of remote sensing data, chemical transport model estimates and other spatiotemporal predictors has the potential to improve air quality exposure data in South Africa's major industrial provinces. In particular, the use of a combined ensemble approach was found to be useful for this area with limited availability of air pollution ground monitoring data.
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Affiliation(s)
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Apolline Saucy
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Temitope C Adebayo-Ojo
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Moses Kebalepile
- Department for Education Innovation, University of Pretoria, Pretoria, South Africa
| | - Mohamed Fareed Jeebhay
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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Kim JH, Woo HD, Choi S, Song DS, Lee JH, Lee K. Long-Term Effects of Ambient Particulate and Gaseous Pollutants on Serum High-Sensitivity C-Reactive Protein Levels: A Cross-Sectional Study Using KoGES-HEXA Data. Int J Environ Res Public Health 2022; 19:ijerph191811585. [PMID: 36141854 PMCID: PMC9517608 DOI: 10.3390/ijerph191811585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/23/2023]
Abstract
Ambient air pollutants reportedly increase inflammatory responses associated with multiple chronic diseases. We investigated the effects of long-term exposure to ambient air pollution on high-sensitivity C-reactive protein (hs-CRP) using data from 60,581 participants enrolled in the Korean Genome and Epidemiology Study-Health Examinees Study between 2012 and 2017. Community Multiscale Air Quality System with surface data assimilation was used to estimate the participants' exposure to criteria air pollutants based on geocoded residential addresses. Long-term exposure was defined as the 2-year moving average concentrations of PM10, PM2.5, SO2, NO2, and O3. Multivariable linear and logistic regression models were utilized to estimate the percent changes in hs-CRP and odds ratios of systemic low-grade inflammation (hs-CRP > 3 mg/L) per interquartile range increment in air pollutants. We identified positive associations between hs-CRP and PM10 (% changes: 3.75 [95% CI 2.68, 4.82]), PM2.5 (3.68, [2.57, 4.81]), SO2 (1.79, [1.10, 2.48]), and NO2 (3.31, [2.12, 4.52]), while negative association was demonstrated for O3 (-3.81, [-4.96, -2.65]). Elevated risks of low-grade inflammation were associated with PM10 (odds ratio: 1.07 [95% CI 1.01, 1.13]), PM2.5 (1.08 [1.02, 1.14]), and SO2 (1.05 [1.01, 1.08]). The odds ratios reported indicated that the exposures might be risk factors for inflammatory conditions; however, they did not reflect strong associations. Our findings suggest that exposure to air pollutants may play a role in the inflammation process.
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Adebayo-Ojo TC, Wichmann J, Arowosegbe OO, Probst-Hensch N, Schindler C, Künzli N. Short-Term Effects of PM10, NO2, SO2 and O3 on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006–2015. IJERPH 2022; 19:ijerph19138078. [PMID: 35805737 PMCID: PMC9265394 DOI: 10.3390/ijerph19138078] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023]
Abstract
Background: The health effect of air pollution is rarely quantified in Africa, and this is evident in global systematic reviews and multi-city studies which only includes South Africa. Methods: A time-series analysis was conducted on daily mortality (cardiovascular (CVD) and respiratory diseases (RD)) and air pollution from 2006–2015 for the city of Cape Town. We fitted single- and multi-pollutant models to test the independent effects of particulate matter (PM10), nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3) from co-pollutants. Results: daily average concentrations per interquartile range (IQR) increase of 16.4 µg/m3 PM10, 10.7 µg/m3 NO2, 6 µg/m3 SO2 and 15.6 µg/m3 O3 lag 0–1 were positively associated with CVD, with an increased risk of 2.4% (95% CI: 0.9–3.9%), 2.2 (95% CI: 0.4–4.1%), 1.4% (95% CI: 0–2.8%) and 2.5% (95% CI: 0.2–4.8%), respectively. For RD, only NO2 showed a significant positive association with a 4.5% (95% CI: 1.4–7.6%) increase per IQR. In multi-pollutant models, associations of NO2 with RD remained unchanged when adjusted for PM10 and SO2 but was weakened for O3. In CVD, O3 estimates were insensitive to other pollutants showing an increased risk. Interestingly, CVD and RD lag structures of PM10, showed significant acute effect with evidence of mortality displacement. Conclusion: The findings suggest that air pollution is associated with mortality, and exposure to PM10 advances the death of frail population.
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Affiliation(s)
- Temitope Christina Adebayo-Ojo
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
- Correspondence:
| | - Janine Wichmann
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa;
| | - Oluwaseyi Olalekan Arowosegbe
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123 Basel, Switzerland; (O.O.A.); (N.P.-H.); (C.S.); (N.K.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
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