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Hoang LT, Duc VT, Ngoc VVD, Truong NX, Thanh NTN, Trang PTT, Saksena S, Nhung NTT. Health and Economic Benefits of Air Pollution Reductions in Vietnam During 2020-2021. Int J Public Health 2023; 68:1606238. [PMID: 37881770 PMCID: PMC10593963 DOI: 10.3389/ijph.2023.1606238] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023] Open
Abstract
Objectives: This paper explores the potential reduction in the number of deaths and the corresponding economic benefits in Vietnam that could have arisen from the decreased in concentrations of particulate matter with a diameter of 2.5 μm or less (PM2.5) and nitrogen dioxide (NO2). Methods: Using Global Exposure Mortality Models, we estimated the potential health and economic benefits on people aged 25 and above across Vietnam's 63 provinces. The counterfactual scenario assumed reducing PM2.5 and NO2 concentrations to levels observed during the two COVID-19 epidemic waves in 2021 with national lockdowns and activity restrictions. Results: In 2019, PM2.5 concentrations ranged from 12.8 to 40.8 μg/m3 while NO2 concentrations ranged between 2.9 and 36.98 μg/m3. The reduced levels of PM2.5 and NO2 resulted in 3,807 (95% CI: 2,845-4,730) and 2,451 (95% CI: 2,845-4,730) avoided deaths of adults aged 25 and above due to non-injury-related causes, respectively. Considering that every prevented death represents potential tangible and intangible cost savings, reduced levels of PM2.5 and NO2 concentrations during COVID-19 restrictions would have resulted in economic benefits of $793.0 million (95% CI: 592.7-985.4) and $510.6 million (95% CI: 381.3-634.9), respectively. Conclusion: The COVID-19 lockdown led to decreased PM2.5 and NO2 concentrations, benefiting health and economy in Vietnam. Our findings highlight the potential advantages of implementing air quality control policies in the country.
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Affiliation(s)
- Le Tu Hoang
- Department of Biostatistics, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vu Tri Duc
- National Children’s Hospital, Hanoi, Vietnam
| | | | - Ngo Xuan Truong
- Faculty of Information Technology, University of Engineering and Technology—Vietnam National University, Hanoi, Vietnam
| | - Nguyen Thi Nhat Thanh
- Faculty of Information Technology, University of Engineering and Technology—Vietnam National University, Hanoi, Vietnam
| | - Phan Thi Thu Trang
- Department of Environmental Health, Hanoi University of Public Health, Hanoi, Vietnam
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Nhung NTT, Hoang LT, Tuyet Hanh TT, Toan LQ, Thanh ND, Truong NX, Son NA, Nhat HV, Quyen NH, Nhu HV. Effects of Heatwaves on Hospital Admissions for Cardiovascular and Respiratory Diseases, in Southern Vietnam, 2010-2018: Time Series Analysis. Int J Environ Res Public Health 2023; 20:ijerph20053908. [PMID: 36900919 PMCID: PMC10001990 DOI: 10.3390/ijerph20053908] [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: 01/12/2023] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 06/01/2023]
Abstract
This study investigated the associations between heatwaves and daily hospital admissions for cardiovascular and respiratory diseases in two provinces in Viet Nam known to be vulnerable to droughts during 2010-2018. This study applied a time series analysis with data extracted from the electronic database of provincial hospitals and meteorological stations from the corresponding province. To eliminate over-dispersion, this time series analysis used Quasi-Poisson regression. The models were controlled for the day of the week, holiday, time trend, and relative humidity. Heatwaves were defined as the maximum temperature exceeding P90th over the period from 2010 to 2018 during at least three consecutive days. Data from 31,191 hospital admissions for respiratory diseases and 29,056 hospitalizations for cardiovascular diseases were investigated in the two provinces. Associations between hospital admissions for respiratory diseases and heatwaves in Ninh Thuan were observed at lag 2, with excess risk (ER = 8.31%, 95% confidence interval: 0.64-16.55%). However, heatwaves were negatively associated with cardiovascular diseases in Ca Mau, which was determined amongst the elderly (age above 60), ER = -7.28%, 95%CI: -13.97--0.08%. Heatwaves can be a risk factor for hospital admission due to respiratory diseases in Vietnam. Further studies need to be conducted to assert the link between heat waves and cardiovascular diseases.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Le Tu Hoang
- Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Tran Thi Tuyet Hanh
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | - Luu Quoc Toan
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi 10000, Vietnam
| | | | | | | | | | - Nguyen Huu Quyen
- Institute of Hydrology and Meteorology Science and Climate Change, Hanoi 10000, Vietnam
| | - Ha Van Nhu
- Faculty of Basic Medicine, Hanoi University of Public Health, Hanoi 10000, Vietnam
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Nhung NTT, Duc VT, Ngoc VD, Dien TM, Hoang LT, Ha TTT, Khue PM, Truong NX, Thanh NTN, Jegasothy E, Marks GB, Morgan G. Mortality benefits of reduction fine particulate matter in Vietnam, 2019. Front Public Health 2022; 10:1056370. [PMID: 36466445 PMCID: PMC9718030 DOI: 10.3389/fpubh.2022.1056370] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction and objectives Studies assessing the health benefits of air pollution reduction in Vietnam are scarce. This study quantified the annual mortality burden due to PM2.5 pollution in Vietnam above the World Health Organization recommendation for community health (AQG: 5 μg/m3) and the proposed National Technical Regulation on Ambient Air Quality (proposed QCVN: 15 μg/m3). Methodology This study applied a health impact assessment methodology with the hazard risk function for non-communicable diseases (NCDs) and lower respiratory infections (LRIs) in the Global Exposure Mortality Model (GEMM) to calculate attributable deaths, Years of Life lost, and Loss of Life expectancy at birth due to air pollution in the Vietnamese population above 25 years of age in 11 provinces. We obtained annual average PM2.5 concentrations for Vietnam in 2019 at a 3x3 km grid modeled using Mixed Linear regression and multi-data sources. Population and baseline mortality data were obtained from administrative data system in Vietnam. We reported the findings at both the provincial and smaller district levels. Results Annual PM2.5 concentrations in all studied provinces exceeded both the AQG and the proposed QCVN. The maximum annual number of attributable deaths in the studied provinces if they had complied with WHO air quality guidelines was in Ha Noi City, with 5,090 (95%CI: 4,253-5,888) attributable deaths. At the district level, the highest annual rate of attributable deaths if the WHO recommendation for community health had been met was 104.6 (95%CI: 87.0-121.5) attributable deaths per 100,000 population in Ly Nhan (Ha Nam province). Conclusion A much larger number of premature deaths in Vietnam could potentially be avoided by lowering the recommended air quality standard. These results highlight the need for effective clean air action plans by local authorities to reduce air pollution and improve community health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam,Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam,*Correspondence: Nguyen Thi Trang Nhung ;
| | - Vu Tri Duc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vo Duc Ngoc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Le Tu Hoang
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Thi Thuy Ha
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Pham Minh Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Ngo Xuan Truong
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Nguyen Thi Nhat Thanh
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Edward Jegasothy
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
| | - Guy B. Marks
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia,Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia,Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
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Nhung NTT, Duc VT, Ngoc VD, Dien TM, Hoang LT, Ha TTT, Khue PM, Truong NX, Thanh NTN, Jegasothy E, Marks GB, Morgan G. Mortality benefits of reduction fine particulate matter in Vietnam, 2019. Front Public Health 2022; 10:1056370. [PMID: 36466445 DOI: 10.3389/fpubh.2022.743348/full] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Studies assessing the health benefits of air pollution reduction in Vietnam are scarce. This study quantified the annual mortality burden due to PM2.5 pollution in Vietnam above the World Health Organization recommendation for community health (AQG: 5 μg/m3) and the proposed National Technical Regulation on Ambient Air Quality (proposed QCVN: 15 μg/m3). METHODOLOGY This study applied a health impact assessment methodology with the hazard risk function for non-communicable diseases (NCDs) and lower respiratory infections (LRIs) in the Global Exposure Mortality Model (GEMM) to calculate attributable deaths, Years of Life lost, and Loss of Life expectancy at birth due to air pollution in the Vietnamese population above 25 years of age in 11 provinces. We obtained annual average PM2.5 concentrations for Vietnam in 2019 at a 3x3 km grid modeled using Mixed Linear regression and multi-data sources. Population and baseline mortality data were obtained from administrative data system in Vietnam. We reported the findings at both the provincial and smaller district levels. RESULTS Annual PM2.5 concentrations in all studied provinces exceeded both the AQG and the proposed QCVN. The maximum annual number of attributable deaths in the studied provinces if they had complied with WHO air quality guidelines was in Ha Noi City, with 5,090 (95%CI: 4,253-5,888) attributable deaths. At the district level, the highest annual rate of attributable deaths if the WHO recommendation for community health had been met was 104.6 (95%CI: 87.0-121.5) attributable deaths per 100,000 population in Ly Nhan (Ha Nam province). CONCLUSION A much larger number of premature deaths in Vietnam could potentially be avoided by lowering the recommended air quality standard. These results highlight the need for effective clean air action plans by local authorities to reduce air pollution and improve community health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vu Tri Duc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Vo Duc Ngoc
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Tran Minh Dien
- Vietnam National Children's Hospital, The Training and Research Institute for Child Health, Hanoi, Vietnam
| | - Le Tu Hoang
- Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Thi Thuy Ha
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Pham Minh Khue
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Ngo Xuan Truong
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Nguyen Thi Nhat Thanh
- University of Engineering and Technology, Vietnam National University, Hanoi, Vietnam
| | - Edward Jegasothy
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
| | - Guy B Marks
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
- Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Faculty of Medicine and Health, Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
- Centre for Air Pollution, Energy and Health Research, University of New South Wales, Sydney, NSW, Australia
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Thu LT, Tuyet TT, Nguyet Tu TT, Trang Nhung NT. Impact of tobacco tax increase in 2016 and 2019 in retail prices in Vietnam. Tob Induc Dis 2021. [DOI: 10.18332/tid/140868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Dang NV, Son LX, Hong NTT, Nhung NTT, Tung NT, Quang LV. Recurrence of carcinoma showing thymus-like differentiation (CASTLE) involving the thyroid gland. Thyroid Res 2021; 14:20. [PMID: 34399813 PMCID: PMC8365953 DOI: 10.1186/s13044-021-00111-3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Carcinoma showing thymus-like differentiation (CASTLE) in the thyroid gland is a rare disease with generally a favorable prognosis. Treatment with surgery and adjuvant radiotherapy has been shown to improve local control and long-term survival rates. In this report, we present a case of a recurrent thyroid gland CASTLE and review the literature on the diagnosis and treatment of this disease. CASE PRESENTATION A 60-year-old woman, who was diagnosed with a CASTLE thyroid tumor in 2015, had a total thyroidectomy and was maintained on thyroid hormone replacement (levothyroxine). After 5 years, the patient had a recurrence, in an advanced stage unsuitable for surgery. As the patient declined to undergo radiotherapy, she was followed up without intervention and is currently stable after 15 months. CONCLUSIONS CASTLE is a rare disease, diagnosed based on postoperative pathology and immunohistochemistry analysis, especially upon CD5 marker. In case of relapse, treatment options include surgery and radiotherapy; however conservative management without intervention is an acceptable alternative in some cases.
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Affiliation(s)
- N V Dang
- Department of Oncology, Hanoi Medical University, 01 Ton That Tung Street, Dong Da District, Hanoi, Vietnam. .,Department of Head and Neck Radiation Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam.
| | - L X Son
- Department of Oncology, Hanoi Medical University, 01 Ton That Tung Street, Dong Da District, Hanoi, Vietnam
| | - N T T Hong
- Department of Radiation Physics, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - N T T Nhung
- Department of Head and Neck Radiation Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - N T Tung
- Department of Head and Neck Radiation Oncology, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - L V Quang
- Department of Oncology, Hanoi Medical University, 01 Ton That Tung Street, Dong Da District, Hanoi, Vietnam
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Nhung NTT, Schindler C, Chau NQ, Hanh PT, Hoang LT, Dien TM, Thanh NTN, Künzli N. Exposure to air pollution and risk of hospitalization for cardiovascular diseases amongst Vietnamese adults: Case-crossover study. Sci Total Environ 2020; 703:134637. [PMID: 31731158 DOI: 10.1016/j.scitotenv.2019.134637] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 06/27/2019] [Revised: 09/18/2019] [Accepted: 09/23/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Associations between hospital admissions and ambient air pollutants in the Vietnamese population have been reported in previous studies. However, most studies were conducted in Hanoi or Hochiminh city. We used hospital records of seven hospitals in Northern Vietnam to investigate short-term associations between ambient air pollutants and hospital admissions due to cardiovascular conditions. METHODS We used 135'101 hospital records of residents (age ≥15) living in three provinces (Hanoi, Quang Ninh, and Phu Tho) and daily ambient air pollutant concentrations to estimate percentage changes and 95% confidence intervals for hospital admissions due to seven cardiovascular conditions per interquartile range (IQR) increases in daily ambient air pollutants. We used a time-stratified case-crossover analysis adjusting for meteorological factors, indicators of holidays and influenza epidemics. We also investigated modification of effects by age groups (<65 and ≥65), seasons (cold and hot) and hospital levels (national and province level). RESULTS Particulate matter concentrations were positively associated with daily hospital admissions due to most cardiovascular conditions. For example, an increment in the two-day average (lag1-2) level of PM2.5 by one IQR (34.4 µg/m3) was associated with a 6.3% (95%CI: 3.0%-9.8%) increase in the daily count of admissions for ischemic heart disease in Hanoi and with 23.2% (95%CI: 11.1%-36.5%) for cardiac failure in Quang Ninh. Moreover, hospitalisations for stroke in Hanoi and cardiac failure in Phu Tho showed strong positive associations with SO2. The findings also show that estimates varied by age groups, seasons and hospital levels. CONCLUSION Ambient air pollutants were associated with daily cardiovascular admissions in Northern Vietnam. The findings underline the important role of ambient air pollutants as a trigger of cardiovascular conditions.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Hanoi University of Public Health, Hanoi, Viet Nam; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | | | - Le Tu Hoang
- Hanoi University of Public Health, Hanoi, Viet Nam
| | | | - Nguyen Thi Nhat Thanh
- University of Engineering and Technology, Vietnam National University, Hanoi, Viet Nam
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Tuyet Hanh TT, Huong LTT, Huong NTL, Linh TNQ, Quyen NH, Nhung NTT, Ebi K, Cuong ND, Van Nhu H, Kien TM, Hales S, Cuong DM, Tho NTT, Toan LQ, Bich NN, Van Minh H. Vietnam Climate Change and Health Vulnerability and Adaptation Assessment, 2018. Environ Health Insights 2020; 14:1178630220924658. [PMID: 32612364 PMCID: PMC7309337 DOI: 10.1177/1178630220924658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND The Global Climate Risk Index 2020 ranked Vietnam as the sixth country in the world most affected by climate variability and extreme weather events over the period 1999-2018. Sea level rise and extreme weather events are projected to be more severe in coming decades, which, without additional action, will increase the number of people at risk of climate-sensitive diseases, challenging the health system. This article summaries the results of a health vulnerability and adaptation (V&A) assessment conducted in Vietnam as evidences for development of the National Climate Change Health Adaptation Plan to 2030. METHODS The assessment followed the first 4 steps outlined in the World Health Organization's Guidelines in conducting "Vulnerability and Adaptation Assessments." A framework and list of indicators were developed for semi-quantitative assessment for the period 2013 to 2017. Three sets of indicators were selected to assess the level of (1) exposure to climate change and extreme weather events, (2) health sensitivity, and (3) adaptation capacity. The indicators were rated and analyzed using a scoring system from 1 to 5. RESULTS The results showed that climate-sensitive diseases were common, including dengue fever, diarrheal, influenza, etc, with large burdens of disease that are projected to increase. From 2013 to 2017, the level of "exposure" to climate change-related hazards of the health sector was "high" to "very high," with an average score from 3.5 to 4.4 (out of 5.0). For "health sensitivity," the scores decreased from 3.8 in 2013 to 3.5 in 2017, making the overall rating as "high." For "adaptive capacity," the scores were from 4.0 to 4.1, which meant adaptive capacity was "very low." The overall V&A rating in 2013 was "very high risk" (score 4.1) and "high risk" with scores of 3.8 in 2014 and 3.7 in 2015 to 2017. CONCLUSIONS Adaptation actions of the health sector are urgently needed to reduce the vulnerability to climate change in coming decades. Eight adaptation solutions, among recommendations of V&A assessment, were adopted in the National Health Climate Change Adaptation Plan.
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Affiliation(s)
- Tran Thi Tuyet Hanh
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Le Thi Thanh Huong
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
- Le Thi Thanh Huong, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi 100000, Vietnam.
| | | | - Tran Nu Quy Linh
- Center for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Nguyen Huu Quyen
- Climate research and Climate Forecasting Division, Institute of Hydrology and Meteorology Science and Climate Change, Hanoi, Vietnam
| | | | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | | | - Ha Van Nhu
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Mai Kien
- Climate Change Research Center, Institute of Hydrology and Meteorology Science and Climate Change, Hanoi, Vietnam
| | - Simon Hales
- Public Health Department, University of Otago, Otago, New Zealand
| | - Do Manh Cuong
- Vietnam Health Environment Management Agency, Hanoi, Vietnam
| | - Nguyen Thi Thi Tho
- Department of Non-Communicable Diseases Prevention and Control, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Luu Quoc Toan
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Ngoc Bich
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Hoang Van Minh
- Vice-Rector, Hanoi University of Public Health, Hanoi, Vietnam
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Amini H, Trang Nhung NT, Schindler C, Yunesian M, Hosseini V, Shamsipour M, Hassanvand MS, Mohammadi Y, Farzadfar F, Vicedo-Cabrera AM, Schwartz J, Henderson SB, Künzli N. Short-term associations between daily mortality and ambient particulate matter, nitrogen dioxide, and the air quality index in a Middle Eastern megacity. Environ Pollut 2019; 254:113121. [PMID: 31493628 DOI: 10.1016/j.envpol.2019.113121] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 05/22/2023]
Abstract
There is limited evidence for short-term association between mortality and ambient air pollution in the Middle East and no study has evaluated exposure windows of about a month prior to death. We investigated all-cause non-accidental daily mortality and its association with fine particulate matter (PM2.5), nitrogen dioxide (NO2), and the Air Quality Index (AQI) from March 2011 through March 2014 in the megacity of Tehran, Iran. Generalized additive quasi-Poisson models were used within a distributed lag linear modeling framework to estimate the cumulative effects of PM2.5, NO2, and the AQI up to a lag of 45 days. We further conducted multi-pollutant models and also stratified the analyses by sex, age group, and season. The relative risk (95% confidence interval (CI)) for all seasons, both sexes and all ages at lag 0 for PM2.5, NO2, and AQI were 1.004 (1.001, 1.007), 1.003 (0.999, 1.007), and 1.004 (1.001, 1.007), respectively, per inter-quartile range (IQR) increment (18.8 μg/m3 for PM2.5, 12.6 ppb for NO2, and 31.5 for AQI). In multi-pollutant models, the PM2.5 associations were almost independent from NO2. However, the RRs for NO2 were slightly attenuated after adjustment for PM2.5 but they were still largely independent from PM2.5. The cumulative relative risks (95% CI) per IQR increment reached maximum during the cooler months, including: 1.13 (1.06, 1.20) for PM2.5 at lag 0-31 (for females, all ages); 1.17 (1.10, 1.25) for NO2 at lag 0-45 (for males, all ages); and 1.13 (1.07, 1.20) for the AQI at lag 0-30 (for females, all ages). Generally, the RRs were slightly larger for NO2 than PM2.5 and AQI. We found somewhat larger RRs in females, age group >65 years of age, and in cooler months. In summary, positive associations were found in most models. This is the first study to report short-term associations between all-cause non-accidental mortality and ambient PM2.5 and NO2 in Iran.
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Affiliation(s)
- Heresh Amini
- Harvard T.H. Chan School of Public Health, Boston, MA, United States; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Masud Yunesian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Hosseini
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran; Modelling of Noncommunicable Diseases Research Center, Hamadan University of Medical Science, Hamadan, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana M Vicedo-Cabrera
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Nhung NTT, Schindler C, Dien TM, Probst-Hensch N, Künzli N. Association of ambient air pollution with lengths of hospital stay for hanoi children with acute lower-respiratory infection, 2007-2016. Environ Pollut 2019; 247:752-762. [PMID: 30721866 DOI: 10.1016/j.envpol.2019.01.115] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 09/26/2018] [Revised: 01/26/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The association between ambient air pollution and length of hospital stay (LOS) for children with lower-respiratory infection is unclear. MATERIALS AND METHODS The association was examined using admission data for 75,432 children in Hanoi, aged 0-5 years, hospitalized with acute lower-respiratory infection (ALRI) and daily air pollutant levels in Hanoi between 2007 and 2016. We estimated the odds ratio of being discharged for an interquartile range (IQR) increment (IQR) of ambient pollutants during one to four days prior to admission date. We used pooled logistic regression models including a B-spline function of calendar time and terms describing the baseline odds, adjusting for meteorological factors, age, gender, residential location, week-day of admission, discharge on weekends or holidays, and number of respiratory hospitalizations one day prior to the discharge date. RESULTS An IQR increase in O3 concentrations (85.8 μg/m3) was associated with a 5% (95%CI: 2%-8%) decrease in the odds of discharge from hospital among children with ALRI. Results were similar for PM10, but only for children aged 2-5 years. For the other pollutants, corresponding associations were close to null or in the opposite direction. For example, increase in CO was associated with shorter LOS. CONCLUSIONS Our study provides the first investigation of the associations between lengths of hospital stays and air pollutant levels prior to hospitalization in Asian children. Increased levels of O3 prior to admission predicted prolonged hospitalizations. The inconsistencies in the findings for other pollutants call for further investigations.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Nhung NTT, Schindler C, Dien TM, Probst-Hensch N, Perez L, Künzli N. Corrigendum to "Acute effects of ambient air pollution on lower respiratory infections in Hanoi children: An eight-year time series study" [Environ. Int. 110 (2018) 139-148]. Environ Int 2018; 119:240. [PMID: 29980048 DOI: 10.1016/j.envint.2018.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Nhung NTT, Schindler C, Dien TM, Probst-Hensch N, Perez L, Künzli N. Acute effects of ambient air pollution on lower respiratory infections in Hanoi children: An eight-year time series study. Environ Int 2018; 110:139-148. [PMID: 29128032 DOI: 10.1016/j.envint.2017.10.024] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [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: 10/26/2017] [Accepted: 10/28/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND Lower respiratory diseases are the most frequent causes of hospital admission in children worldwide, particularly in developing countries. Daily levels of air pollution are associated with lower respiratory diseases, as documented in many time-series studies. However, investigations in low-and-middle-income countries, such as Vietnam, remain sparse. OBJECTIVE This study investigated the short-term association of ambient air pollution with daily counts of hospital admissions due to pneumonia, bronchitis and asthma among children aged 0-17 in Hanoi, Vietnam. We explored the impact of age, gender and season on these associations. METHODS Daily ambient air pollution concentrations and hospital admission counts were extracted from electronic databases received from authorities in Hanoi for the years 2007-2014. The associations between outdoor air pollution levels and hospital admissions were estimated for time lags of zero up to seven days using Quasi-Poisson regression models, adjusted for seasonal variations, meteorological variables, holidays, influenza epidemics and day of week. RESULTS All ambient air pollutants were positively associated with pneumonia hospitalizations. Significant associations were found for most pollutants except for ozone and sulfur dioxide in children aged 0-17. Increments of an interquartile range (21.9μg/m3) in the 7-day-average level of NO2 were associated with a 6.1% (95%CI 2.5% to 9.8%) increase in pneumonia hospitalizations. These associations remained stable in two-pollutant models. All pollutants other than CO were positively associated with hospitalizations for bronchitis and asthma. Associations were weaker in infants than in children aged 1-5. CONCLUSION Strong associations between hospital admissions for lower respiratory infections and daily levels of air pollution confirm the need to adopt sustainable clean air policies in Vietnam to protect children's health.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Nhung NTT, Amini H, Schindler C, Kutlar Joss M, Dien TM, Probst-Hensch N, Perez L, Künzli N. Short-term association between ambient air pollution and pneumonia in children: A systematic review and meta-analysis of time-series and case-crossover studies. Environ Pollut 2017; 230:1000-1008. [PMID: 28763933 DOI: 10.1016/j.envpol.2017.07.063] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 05/22/2023]
Abstract
Ambient air pollution has been associated with respiratory diseases in children. However, its effects on pediatric pneumonia have not been meta-analyzed. We conducted a systematic review and meta-analysis of the short-term association between ambient air pollution and hospitalization of children due to pneumonia. We searched the Web of Science and PubMed for indexed publications up to January 2017. Pollutant-specific excess risk percentage (ER%) and confidence intervals (CI) were estimated using random effect models for particulate matter (PM) with diameter ≤ 10 (PM10) and ≤2.5 μm (PM2.5), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). Results were further stratified by subgroups (children under five, emergency visits versus hospital admissions, income level of study location, and exposure period). Seventeen studies were included in the meta-analysis. The ER% per 10 μg/m3 increase of pollutants was 1.5% (95% CI: 0.6%-2.4%) for PM10 and 1.8% (95% CI: 0.5%-3.1%) for PM2.5. The corresponding values per 10 ppb increment of gaseous pollutants were 2.9% (95% CI: 0.4%-5.3%) for SO2, 1.7% (95% CI: 0.5%-2.8%) for O3, and 1.4% (95% CI: 0.4%-2.4%) for NO2. ER% per 1000 ppb increment of CO was 0.9% (95% CI: 0.0%-1.9%). Associations were not substantially different between subgroups. This meta-analysis shows a positive association between daily levels of ambient air pollution markers and hospitalization of children due to pneumonia. However, lack of studies from low-and middle-income countries limits the quantitative generalizability given that susceptibilities to the adverse effects of air pollution may be different in those populations. The meta-regression in our analysis further demonstrated a strong effect of country income level on heterogeneity.
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Affiliation(s)
- Nguyen Thi Trang Nhung
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Heresh Amini
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Meltem Kutlar Joss
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tran Minh Dien
- Vietnam National Children's Hospital, Dong Da, Hanoi, Viet Nam
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Laura Perez
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Abstract
Burden of disease has been used to assess population health status. This article presents the first estimations of burden of disease in Vietnam in 2008 using disability-adjusted life years (DALYs). DALYs were calculated using the Global Burden of Disease (GBD) methods. Incidence, prevalence of diseases, and causes of death was extracted from Vietnam data. Disability weights were borrowed from GBD and Dutch research. In 2008, the total burden of disease in Vietnam was 12.3 million DALYs. Noncommunicable diseases dominated the total burden of diseases in Vietnam, accounting for 71% of the total burden, and cardiovascular disease was the leading cause group of premature death. While pneumonia was an important cause of burden in Vietnamese children, stroke and depression were the main causes of disease burden among adults. The study provides a snapshot of Vietnamese health status and offers guidance for health policymaking in Vietnam.
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Affiliation(s)
| | | | | | - Theo Vos
- University of Washington, Seattle, WA, USA
| | | | - Ngo Duc Anh
- University of South Australia, Adelaide, South Australia, Australia
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Abstract
INTRODUCTION Chronic diseases account for most of the disease burden in low- and middle-income countries, particularly those in Asia. We reviewed literature on chronic disease risk factors in Viet Nam to identify patterns and data gaps. METHODS All population-based studies published from 2000 to 2012 that reported chronic disease risk factors were considered. We used standard chronic disease terminology to search PubMed and assessed titles, abstracts, and articles for eligibility for inclusion. We summarized relevant study information in tables listing available studies, risk factors measured, and the prevalence of these risk factors. RESULTS We identified 23 studies conducted before 2010. The most common age range studied was 25 to 64 years. Sample sizes varied, and sample frames were national in 5 studies. A combination of behavioral, physical, and biological risk factors was studied. Being overweight or obese was the most common risk factor studied (n = 14), followed by high blood pressure (n = 11) and tobacco use (n = 10). Tobacco and alcohol use were high among men, and tobacco use may be increasing among Vietnamese women. High blood pressure is common; however, people's knowledge that they have high blood pressure may be low. A high proportion of diets do not meet international criteria for fruit and vegetable consumption. Prevalence of overweight and obesity is increasing. None of the studies evaluated measured dietary patterns or total caloric intake, and only 1 study measured dietary salt intake. CONCLUSION Risk factors for chronic diseases are common in Viet Nam; however, more recent and context-specific information is required for planning and monitoring interventions to reduce risk factors and chronic disease in this country.
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Affiliation(s)
- Damian Hoy
- School of Population Health, University of Queensland, Herston Rd, Herston, QLD, 4006, Australia.
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