Promoted Relationship of Cardiovascular Morbidity with Air Pollutants in a Typical Chinese Urban Area

BackgroundA large number of studies about effects of air pollutants on cardiovascular mortality have been conducted; however, those investigating association between air pollutants and cardiovascular morbidity are limited, especially in developing countries.MethodsA time-series analysis on the short-term association between outdoor air pollutants including particulate matter (PM) with diameters of 10 µm or less (PM₁₀), sulfur dioxide (SO₂) and nitrogen dioxide (NO₂) and cardiovascular morbidity was conducted in Tianjin, China based on 4 years of daily data (2008–2011). The morbidity data were stratified by sex and age. The effects of air pollutants during the warm season and the cool season were also analyzed separately.ResultsEach increase in PM₁₀, SO₂, and NO₂ by increments of 10 µg/m³ in a 2-day average concentration was associated with increases in the cardiovascular morbidity of 0.19% with 95 percent confidence interval (95% CI) of 0.08–0.31, 0.43% with 95% CI of 0.03–0.84, and 0.52% with 95% CI of −0.09–1.13, respectively. The effects of air pollutants were more evident in the cool season than those in the warm season, females and the elderly were more vulnerable to outdoor air pollution.ConclusionsAll estimated coefficients of PM₁₀, SO₂ and NO₂ are positive but only the effect of SO₂ implied statistical significance at the 5% level. Moreover, season, sex and age might modify health effects of outdoor air pollutants. This work may bring inspirations for formulating local air pollutant standards and social policy regarding cardiovascular health of residents.     

Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing,China, in 2013

BackgroundHeavy fine particulate matter (PM_2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM_2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM_2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing.MethodsDaily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM_2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM_2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.ResultsA total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM_2.5 concentration was 102.1±73.6 μg/m³. Every 10 μg/m³ increase in PM_2.5 concentration at lag₀ was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM_2.5 concentration at lag_0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO₂, O₃, CO and NO₂. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM_2.5 exposure.ConclusionPM_2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM_2.5 pollution varied by gender and age.     

Chang impact analysis of level 3 COVID-19 alert on air pollution indicators using artificial neural network

In this study, mean monthly and diurnal variations in fine particulate matters (PM_2.5), nitrate, sulfate, and gaseous precursors were investigated during the Level 3 COVID-19 alert from May 19 to July 27 in 2021. For comparison, the historical data during the identical period in 2019 and 2020 were also provided to determine the effect of the Level 3 COVID-19 alert on aerosols and gaseous pollutants concentrations in Taichung City. A machine learning model using the artificial neural network technique coupled with a kinetic model was applied to predict NO_x, O₃, nitrate (NO₃⁻), and sulfate (SO₄²⁻) to investigate potential emission sources and chemical reaction mechanism. D during the Level 3 COVID-19 alert, a decrease in NO_x concentration due to a decrease in traffic flow under the NO_x-saturated regime was observed to enhance the secondary NO₃⁻ and O₃ formation. The present models were shown to predict 80.1, 77.0, 72.6, and 67.2% concentrations of NO_x, O₃, NO₃⁻, and SO₄²⁻, respectively, which could help decision-makers for pollutant emissions reduction policies development and air pollution control strategies. It is recommended that more long-term datasets, including water soluble inorganic salts (WIS), precursors including OH radicals, NH₃, HNO₃, and H₂SO₄, be provided by regulatory air quality monitoring stations to further improve the prediction model accuracy.     

Air Pollution in China: Mapping of Concentrations and Sources

China has recently made available hourly air pollution data from over 1500 sites, including airborne particulate matter (PM), SO₂, NO₂, and O₃. We apply Kriging interpolation to four months of data to derive pollution maps for eastern China. Consistent with prior findings, the greatest pollution occurs in the east, but significant levels are widespread across northern and central China and are not limited to major cities or geologic basins. Sources of pollution are widespread, but are particularly intense in a northeast corridor that extends from near Shanghai to north of Beijing. During our analysis period, 92% of the population of China experienced >120 hours of unhealthy air (US EPA standard), and 38% experienced average concentrations that were unhealthy. China’s population-weighted average exposure to PM_2.5 was 52 μg/m³. The observed air pollution is calculated to contribute to 1.6 million deaths/year in China [0.7–2.2 million deaths/year at 95% confidence], roughly 17% of all deaths in China.     

The impact of outdoor air pollutants on outpatient visits for respiratory diseases during 2012–2016 in Jinan,China

Background

Few studies have investigated the associations between outdoor air pollution and outpatient visits for respiratory diseases (RDs) in general population.

Methods

We collected daily outpatient data of primary RDs from five hospitals in Jinan during January 2012 and December 2016, as well as daily measurements of air pollutants from the Jinan Environmental Monitoring Center and daily meteorological variables from the China Meteorological Data Sharing Service System. A generalized additive model (GAM) with quasi-Poisson regression was constructed to estimate the associations between daily average concentrations of outdoor air pollutants (PM_2.5,PM₁₀, SO₂, NO₂, CO and O₃) and daily outpatient visits of RDs after adjusting for long-time trends, seasonality, the “day of the week” effect, and weather conditions. Subgroup analysis stratified by gender, age group and the type of RDs was conducted.

Results

A total of 1,373,658 outpatient visits for RDs were identified. Increases of 10?μg/m³ in PM_2.5, PM₁₀, NO₂, CO and O₃ were associated with0.168% (95% CI, 0.072–0.265%), 0.149% (95% CI, 0.082–0.215%), 0.527% (95% CI, 0.211–0.843%), 0.013% (95% CI, 0.003–0.023%), and 0.189% (95% CI, 0.032–0.347%) increases in daily outpatient visits for RDs, respectively. PM_2.5 and PM₁₀ showed instant and continuous effects, while NO₂, CO and O₃ showed delayed effects on outpatient visits for RDs. In stratification analysis, PM_2.5 and PM₁₀ were associated with acute RDs only.

Conclusions

Exposure to outdoor air pollutants including PM_2.5, PM₁₀, NO₂, CO and O₃ associated with increased risk of outpatient visits for RDs.

     

Gender differences and effect of air pollution on asthma in children with and without allergic predisposition: northeast Chinese children health study

Background

Males and females exhibit different health responses to air pollution, but little is known about how exposure to air pollution affects juvenile respiratory health after analysis stratified by allergic predisposition. The aim of the present study was to assess the relationship between air pollutants and asthmatic symptoms in Chinese children selected from multiple sites in a heavily industrialized province of China, and investigate whether allergic predisposition modifies this relationship.

Methodology/Principal Findings

30139 Chinese children aged 3-to-12 years were selected from 25 districts of seven cities in northeast China in 2009. Information on respiratory health was obtained using a standard questionnaire from the American Thoracic Society. Routine air-pollution monitoring data was used for particles with an aerodynamic diameter ≤10 µm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxides (NO₂), ozone (O₃) and carbon monoxide (CO). A two-stage regression approach was applied in data analyses. The effect estimates were presented as odds ratios (ORs) per interquartile changes for PM₁₀, SO₂, NO₂, O₃, and CO. The results showed that children with allergic predisposition were more susceptible to air pollutants than children without allergic predisposition. Amongst children without an allergic predisposition, air pollution effects on asthma were stronger in males compared to females; Current asthma prevalence was related to PM₁₀ (ORs = 1.36 per 31 µg/m³; 95% CI, 1.08–1.72), SO₂ (ORs = 1.38 per 21 µg/m³; 95%CI, 1.12–1.69) only among males. However, among children with allergic predisposition, more positively associations between air pollutants and respiratory symptoms and diseases were detected in females; An increased prevalence of doctor-diagnosed asthma was significantly associated with SO₂ (ORs = 1.48 per 21 µg/m³; 95%CI, 1.21–1.80), NO₂ (ORs = 1.26 per 10 µg/m³; 95%CI, 1.01–1.56), and current asthma with O₃ (ORs = 1.55 per 23 µg/m³; 95%CI, 1.18–2.04) only among females.

Conclusion/Significance

Ambient air pollutions were more evident in males without an allergic predisposition and more associations were detected in females with allergic predisposition.     

Neighbourhood Characteristics and Long-Term Air Pollution Levels Modify the Association between the Short-Term Nitrogen Dioxide Concentrations and All-Cause Mortality in Paris

BackgroundWhile a great number of papers have been published on the short-term effects of air pollution on mortality, few have tried to assess whether this association varies according to the neighbourhood socioeconomic level and long-term ambient air concentrations measured at the place of residence. We explored the effect modification of 1) socioeconomic status, 2) long-term NO₂ ambient air concentrations, and 3) both combined, on the association between short-term exposure to NO₂ and all-cause mortality in Paris (France).MethodsA time-stratified case-crossover analysis was performed to evaluate the effect of short-term NO₂ variations on mortality, based on 79,107 deaths having occurred among subjects aged over 35 years, from 2004 to 2009, in the city of Paris. Simple and double interactions were statistically tested in order to analyse effect modification by neighbourhood characteristics on the association between mortality and short-term NO₂ exposure. The data was estimated at the census block scale (n=866).ResultsThe mean of the NO₂ concentrations during the five days prior to deaths were associated with an increased risk of all-cause mortality: overall Excess Risk (ER) was 0.94% (95%CI=[0.08;1.80]. A higher risk was revealed for subjects living in the most deprived census blocks in comparison with higher socioeconomic level areas (ER=3.14% (95%CI=[1.41-4.90], p<0.001). Among these deprived census blocks, excess risk was even higher where long-term average NO₂ concentrations were above 55.8 μg/m³ (the top tercile of distribution): ER=4.84% (95%CI=[1.56;8.24], p for interaction=0.02).ConclusionOur results show that people living in census blocks characterized by low socioeconomic status are more vulnerable to air pollution episodes. There is also an indication that people living in these disadvantaged census blocks might experience even higher risk following short-term air pollution episodes, when they are also chronically exposed to higher NO₂ levels.     

Association between Air Pollution and General Outpatient Clinic Consultations for Upper Respiratory Tract Infections in Hong Kong

Background and Objectives

Many studies have shown the adverse effects of air pollution on respiratory health, but few have examined the effects of air pollution on service utilisation in the primary care setting. The aim of this study was to examine the association between air pollution and the daily number of consultations due to upper respiratory tract infections (URTIs) in general outpatient clinics (GOPCs) in Hong Kong.

Methods

Daily data on the numbers of consultations due to URTIs in GOPCs, the concentrations of major air pollutants, and the mean values of metrological variables were retrospectively collected over a 3-year period (2008–2010, inclusive). Generalised additive models were constructed to examine the association between air pollution and the daily number of consultations, and to derive the relative risks and 95% confidence intervals (95% CI) of GOPC consultations for a unit increase in the concentrations of air pollutants.

Results

The mean daily consultations due to URTIs in GOPCs ranged from 68.4 to 253.0 over the study period. The summary relative risks (and 95% CI) of daily consultations in all GOPCs for the air pollutants PM₁₀, NO₂, O₃, and SO₂ were 1.005 (1.002, 1.009), 1.010 (1.006, 1.013), 1.009 (1.006, 1.012), and 1.004 (1.000, 1.008) respectively, per 10 µg/m³ increase in the concentration of each pollutant.

Conclusion

Significant associations were found between the daily number of consultations due to URTIs in GOPCs and the concentrations of air pollutants, implying that air pollution incurs a substantial morbidity and increases the burden of primary health care services.     

Resource allocation by plants under air pollution stress: Implications for plant-pest-pathogen interactions

Plant growth depends on the coordinated acquisition and allocation of carbon, water, and nutrient resources to the major plant organs (root, stem, leaf, flower, and fruit) and to the major classes of metabolic function (vegetative growth, maintenance, defense, and reproduction). Air pollutants like SO₂, NO₂, and O₃ can directly damage plant tissues and disrupt normal patterns of resource acquisition and allocation. These disruptions in turn potentially will influence the plant’s ability to defend itself against pests and pathogens. This review summarizes the quantitative and qualitative changes that have been observed when plants are exposed to low levels of SO₂, NO₂, and O₃; the following generalizations emerge:

1. Root biomass is reduced more than shoot biomass in plants exposed to SO₂ or O₃, but NO₂ does not appear to induce the differential suppression of above-versus below-ground organs.
2. Quantitative allocation to leaves increases and to stem decreases under SO₂ pollution regimes; too few data are available to generalize about O₃ or NO₂ effects on leaf: stem ratio.
3. Root carbohydrate concentrations sometimes increase and sometimes decrease after SO₂ or O₃ fumigations. Leaf nitrogen concentrations tend to decrease after exposure to air pollutants, and leaf carbohydrate concentrations can increase or decrease. Too few data on leaf concentrations of lipids and secondary chemicals are available to justify any generalizations on pollutant responses.
4. Reproduction is suppressed by O₃, SO₂, and NO₂, with O₃ appearing to have the most marked effects. Seed lipid and protein composition can be altered by exposure to pollutants. While both quantitative and qualitative changes in plant resource allocation after exposure to pollutants are common, the importance of these diverse changes for plant-pest and plant-pathogen interaction requires more comprehensive study. Ideally, the time course of plant growth and of metabolite pools critical to particular pests or pathogens should be followed in plants exposed to realistic pollutant regimes and related to pest or pathogen performance on the treated plants.

     

Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis

Background

Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined.

Objective

We sought to quantify the associations between short-term exposure to air pollutants [ozone (O₃), carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and particulate matter ≤10μm (PM₁₀) and PM_2.5] and the asthma-related emergency room visits (ERV) and hospitalizations.

Methods

Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.

Results

After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O₃: RR(95%CI), 1.009 (1.006, 1.011); I² = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I² = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO₂: RR(95%CI), 1.018 (1.014, 1.022); I² = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO₂: RR(95%CI), 1.011 (1.007, 1.015); I² = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM₁₀: RR(95%CI), 1.010 (1.008, 1.013); I² = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM_2.5: RR(95%CI), 1.023 (1.015, 1.031); I² = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.

Conclusion

Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.     

Influence of air pollution on the mountain forests along the Tateyama–Kurobe Alpine route

The effects of air pollution on the growth of mountain trees were investigated at Buna-daira (1,180 m a.s.l.), about half the way up Mt. Tateyama, located in Japan. Every year, about 1 million tourists are transported by highland buses through the Tateyama–Kurobe Alpine route. Since the route opened in 1971, some tree species along the road have declined and have been blighted, suggesting that bus exhaust was the cause. However, the level of regional and long-range transboundary air pollution has also increased significantly over the last few decades. The atmospheric NO₂ concentration at the roadside in the forest was highly correlated with the traffic density of buses and penetration of the exhaust into the forest was detected. However, the maximum average NO₂ concentration was lower than 3.5 ppbv during the peak traffic period in the year. At Buna-daira, the total stem cross-sectional area at breast height (BA) of the forest was nearly unchanged from 1999 to 2006, but the BA of Fagus crenata decreased 10% and that of Cryptomeria japonica increased 6%. Neither tree growth nor tree death was significantly correlated with distance from the road. The cause of the decline of F. crenata could not be attributed to the effects of road, i.e., air pollution emitted from the buses or edge effects of the road. This area was more affected by regional, long-range transport of air pollution (O₃, SO₂, etc.). The average atmospheric O₃ concentration in autumn was higher than 40 ppbv and the recent increase in the O₃ concentration may be an important factor of F. crenata decline through the changes in the interspecific relationships between F. crenata and C. japonica, O₃ sensitive and tolerant species, respectively.     

基于环境库兹涅茨曲线的我国大气污染防治重点区域环境空气质量与经济增长关系研究

改革开放以来,中国经济迅猛发展,但大气污染等环境问题日益突出。进入21世纪,我国通过颁布实施多项大气污染防治政策,将京津冀及周边地区、长三角地区、珠三角地区等大气污染较严重的区域划定为重点区域,针对性制定治污措施和实施减排工程,努力推动区域环境空气质量改善。基于2000-2019年我国31个省（自治区、直辖市）（以下简称31个省份）GDP,以及SO₂、PM₁₀、NO₂三项大气污染物浓度数据,利用环境库兹涅茨曲线（EKC,Environmental Kuznets Curve）模型,对31个省份和京津冀及周边地区、长三角地区、珠三角地区的经济增长情况、大气污染物浓度演变以及二者之间的关系进行了系统全面的分析评估。研究结果显示：（1）近年来实施的各项大气污染防治政策,特别是2013年以来颁布实施的《大气污染防治行动计划》《打赢蓝天保卫战三年行动计划》,推动环境空气质量改善的同时,促进了经济发展与环境保护长期关系协调性逐步增强,除NO₂浓度呈U型外,31个省份SO₂浓度、PM₁₀浓度与人均GDP的EKC曲线呈倒U型和倒N型,并处于快速下降阶段。（2）京津冀及周边地区SO₂浓度与人均GDP呈倒U型,且处于快速下降阶段;PM₁₀和NO₂浓度均呈现U型关系,且均处于上升期。（3）长三角地区SO₂、PM₁₀浓度与人均GDP呈现倒U型和U型,但均处于下降阶段;NO₂浓度与人均GDP无相关关系。（4）珠三角地区SO₂、PM₁₀和NO₂浓度与人均GDP均呈现倒U型关系,且均处于下降阶段。为此,建议"十四五"期间我国政府要继续实施新一轮的大气污染防治行动计划,聚焦机动车NO_x污染管控,大力推动NO₂浓度稳步下降,以实现我国环境空气质量持续改善,为统筹经济高质量发展和生态环境高水平保护奠定坚实基础。     

Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

Background

The air pollution caused by vehicular emissions is associated with cognitive decline. However, the associations between the levels of nitrogen dioxide (NO₂) and carbon monoxide (CO) exposure and dementia remain poorly defined and have been addressed in only a few previous studies.

Materials and Methods

In this study, we obtained data on 29547 people from the National Health Insurance Research Database (NHIRD) of Taiwan, including data on 1720 patients diagnosed with dementia between 2000 and 2010, and we evaluated the risk of dementia among four levels of air pollutant. Detailed data on daily air pollution were available from January 1, 1998 to December 31, 2010. Yearly average concentrations of pollutants were calculated from the baseline to the date of dementia occurrence, withdrawal of patients, or the end of the study, and these data were categorized into quartiles, with Q1 being the lowest level and Q4 being the highest.

Results

In the case of NO₂, the adjusted hazard ratios (HRs) of dementia for all participants in Q2, Q3, and Q4 compared to Q1 were 1.10 (95% confidence interval (CI), 0.96–1.26), 1.01 (95% CI, 0.87–1.17), and 1.54 (95% CI, 1.34–1.77), and in the case of CO, the adjusted HRs were 1.07 (95% CI, 0.92–1.25), 1.37 (95% CI, 1.19–1.58), and 1.61 (95% CI, 1.39–1.85).

Conclusion

The results of this large retrospective, population-based study indicate that exposure to NO₂ and CO is associated with an increased risk of dementia in the Taiwanese population.     

The Association between Ambient Air Pollution and Daily Mortality in Beijing after the 2008 Olympics: A Time Series Study

In recent decades, ambient air pollution has been an important public health issue in Beijing, but little is known about air pollution and health effects after the 2008 Beijing Olympics. We conduct a time-series analysis to evaluate associations between daily mortality (nonaccidental, cardiovascular and respiratory mortality) and the major air pollutants (carbon monoxide, nitrogen dioxide and particulate matter less than 10 µm in aerodynamic diameter) in Beijing during the two years (2009∼2010) after the 2008 Beijing Olympics. We used generalized additive model to analyze relationship between daily mortality and air pollution. In single air pollutant model with two-day moving average concentrations of the air pollutants, increase in their interquartile range (IQR) associated with percent increase in nonaccidental mortality, 2.55 percent [95% confidence interval (CI): 1.99, 3.11] for CO, 2.54 percent (95% CI: 2.00, 3.08) for NO₂ and 1.80 percent (95% CI: 1.21, 2.40) for PM₁₀, respectively; increases in the IQR of air pollutant concentrations associated with percent increase in cardiovascular mortality, 2.88 percent (95% CI: 2.10,3.65) for CO, 2.63 percent (95% CI: 1.87, 3.39) for NO₂ and 1.72 percent (95% CI: 0.88, 2.55) for PM₁₀, respectively; and increase in IQR of air pollutant concentrations associated with respiratory mortality, 2.39 percent (95% CI: 0.68, 4.09) for CO, 1.79 percent (95% CI: 0.11, 3.47) for NO₂ and 2.07 percent (95% CI: 0.21, 3.92) for PM₁₀, respectively. We used the principal component analysis to avoid collinearity of varied air pollutants. In addition, the association stratified by sex and age was also examined. Ambient air pollution remained a significant contributor to nonaccidental and cardiopulmonary mortalities in Beijing during 2009∼2010.     

Inhibition of photosynthesis ofPopulus euramericana andHelianthus annuus by SO2, NO2 and O3

Populus euramericana cv. I-214 andHelianthus annuus L. cv. Russian Mammoth were exposed to various concentrations of O₃ SO₂ or NO₂ for 2 h in a cylindrical assimilation chamber. The threshold concentrations of air pollutants for inhibition of net photosynthesis differed between the two species and also between the pollutants tested. Furthermore, the lethal concentrations where the net photosynthetic rates were completely inhibited, also differed between species and between pollutants. For SO₂ and NO₂,P. euramericana was more tolerant photosynthetically thanH. annuus when related to the concentration of pollutants used during the experiment. However, when related to the cumulative uptake rate of each pollutant, the photosynthetic tolerance of the two species was similar. In contrast to the effects of SO₂ or NO₂, the influence of O₃ on net photosynthesis was quite different. The relative rates of net photosynthesis in both species showed the same linear relationship with O₃ concentration. However, the relationship between the relative rate of net photosynthesis and the cumulative uptake rate of O₃ differed between the two species, although it was linear in both cases.     

我国典型城市空气质量演变及其调控——以深圳市2000—2017年为例

目前国内外许多城市面临严重的空气污染问题,严重制约城市发展、影响人体健康。同时,部分城市(如深圳)空气质量已经达到并保持在良好的水平。探究这些城市空气质量演变过程及其调控,可为我国大量仍面临严重空气污染问题的城市提供参考和借鉴。以深圳市为案例,利用环境质量公报数据和统计年鉴数据,通过分析多个社会经济因子与典型污染物的相关关系,探究其空气质量演变特征与调控经验。结果表明,深圳市各类型空气污染物与城市社会经济发展均符合EKC模型假说,但不同污染物所处阶段不同。颗粒物、SO2和NO2均处于下降阶段,而O3目前处于高水平平稳阶段。总结深圳市空气质量改善历程及调控措施,发现主要有两大方面:宏观上严格把控;微观上精准治理。宏观上,重点放在产业结构和能源结构的快速调整上,对于空气质量的改善起到了非常明显的作用。而在微观精细化的管理上,对于空气污染的治理政策要具有持续性、精准性和及时性。当下,针对首要的O3污染问题,深圳市应重点关注城市人为排放VOCs和植物释放VOCs对O3生成的影响,以及城市热环境对O3浓度的影响。     

Association between long-term exposure to ambient air pollution and COVID-19 severity: a prospective cohort study

Background:The tremendous global health burden related to COVID-19 means that identifying determinants of COVID-19 severity is important for prevention and intervention. We aimed to explore long-term exposure to ambient air pollution as a potential contributor to COVID-19 severity, given its known impact on the respiratory system.Methods:We used a cohort of all people with confirmed SARS-CoV-2 infection, aged 20 years and older and not residing in a long-term care facility in Ontario, Canada, during 2020. We evaluated the association between long-term exposure to fine particulate matter (PM_2.5), nitrogen dioxide (NO₂) and ground-level ozone (O₃), and risk of COVID-19-related hospital admission, intensive care unit (ICU) admission and death. We ascertained individuals’ long-term exposures to each air pollutant based on their residence from 2015 to 2019. We used logistic regression and adjusted for confounders and selection bias using various individual and contextual covariates obtained through data linkage.Results:Among the 151 105 people with confirmed SARS-CoV-2 infection in Ontario in 2020, we observed 8630 hospital admissions, 1912 ICU admissions and 2137 deaths related to COVID-19. For each interquartile range increase in exposure to PM_2.5 (1.70 μg/m³), we estimated odds ratios of 1.06 (95% confidence interval [CI] 1.01–1.12), 1.09 (95% CI 0.98–1.21) and 1.00 (95% CI 0.90–1.11) for hospital admission, ICU admission and death, respectively. Estimates were smaller for NO₂. We also estimated odds ratios of 1.15 (95% CI 1.06–1.23), 1.30 (95% CI 1.12–1.50) and 1.18 (95% CI 1.02–1.36) per interquartile range increase of 5.14 ppb in O₃ for hospital admission, ICU admission and death, respectively.Interpretation:Chronic exposure to air pollution may contribute to severe outcomes after SARS-CoV-2 infection, particularly exposure to O₃.

By November 2021, COVID-19 had caused more than 5 million deaths globally¹ and more than 29 400 in Canada.² The clinical manifestations of SARS-CoV-2 infection range from being asymptomatic to multiple organ failure and death. Identifying risk factors for COVID-19 severity is important to better understand etiological mechanisms and identify populations to prioritize for screening, vaccination and medical treatment. Risk factors for severity of COVID-19 include male sex, older age, pre-existing medical conditions and being from racialized communities.^3–5 More recently, ambient air pollution has been implicated as a potential driver of COVID-19 severity.^6–10Long-term exposure to ambient air pollution, a major contributor to global disease burden,¹¹ could increase the risk of severe COVID-19 outcomes by several mechanisms. Air pollutants can reduce individuals’ pulmonary immune responses and antimicrobial activities, boosting viral loads.⁸ Air pollution can also induce chronic inflammation and overexpression of the alveolar angiotensin-converting enzyme 2 (ACE) receptor,⁷ the key receptor that facilitates SARS-CoV-2 entry into cells.^12,13 Exposure to air pollution contributes to chronic conditions, such as cardiovascular disease, that are associated with unfavourable COVID-19 prognosis, possibly owing to persistent immune activation and excessive amplification of cytokine development.¹⁰ Thus, greater exposure to long-term air pollution may lead to severe COVID-19 outcomes.Reports exist of positive associations between long-term exposure to particulate matter with diameters equal to or smaller than 2.5 or 10 μm (PM_2.5 and PM₁₀), ground-level ozone (O₃) and nitrogen dioxide (NO₂), and metrics of COVID-19 severity (e.g., mortality and case fatality rate).^8–10 However, most studies to date have used ecological and cross-sectional designs, owing to limited access to individual data, which leads to ambiguity in interpreting the results, thus hindering their influence on policy. ^6,14 Ecological designs do not allow for disentangling the relative impacts of air pollution on individual susceptibility to infection and disease severity.¹⁴ Residual confounding by factors such as population mobility and social interactions is also problematic. Therefore, a cohort study with data on individuals with SARS-CoV-2 is a more appropriate design.^6,14 Studies that have used individual data were conducted in specific subpopulations^15,16 or populations with few severe cases,¹⁷ or had limited data on individual exposure to air pollutants.¹⁸ In Canada, 1 ecological study found a positive association between long-term exposure to PM_2.5 and COVID-19 incidence,¹⁹ but no published study has explored the association between air pollution and COVID-19 severity.We aimed to examine the associations between long-term exposure to 3 common air pollutants (PM_2.5, NO₂ and O₃) and key indicators of COVID-19 severity, including hospital admission, intensive care unit (ICU) admission and death, using a large prospective cohort of people with confirmed SARS-CoV-2 infection in Ontario, Canada, in 2020. The air contaminants PM_2.5, NO₂ and O₃ are regularly monitored by the Canadian government, and are key pollutants that are considered when setting air-quality policies. They originate from varying sources (NO₂ is primarily emitted during combustion of fuel, O₃ is primarily formed in air by chemical reactions of nitrogen oxides and volatile organic compounds, and PM_2.5 can be emitted during combustion or formed by reactions of chemicals like sulphur dioxide and nitrogen oxides in air) and they may affect human health differently.^20,21,22     

Long-Term Exposure to Primary Traffic Pollutants and Lung Function in Children: Cross-Sectional Study and Meta-Analysis

Background

There is widespread concern about the possible health effects of traffic-related air pollution. Nitrogen dioxide (NO₂) is a convenient marker of primary pollution. We investigated the associations between lung function and current residential exposure to a range of air pollutants (particularly NO₂, NO, NOx and particulate matter) in London children. Moreover, we placed the results for NO₂ in context with a meta-analysis of published estimates of the association.

Methods and Findings

Associations between primary traffic pollutants and lung function were investigated in 4884 children aged 9–10 years who participated in the Child Heart and Health Study in England (CHASE). A systematic literature search identified 13 studies eligible for inclusion in a meta-analysis. We combined results from the meta-analysis with the distribution of the values of FEV₁ in CHASE to estimate the prevalence of children with abnormal lung function (FEV₁<80% of predicted value) expected under different scenarios of NO₂ exposure. In CHASE, there were non-significant inverse associations between all pollutants except ozone and both FEV1 and FVC. In the meta-analysis, a 10 μg/m³ increase in NO₂ was associated with an 8 ml lower FEV₁ (95% CI: -14 to -1 ml; p: 0.016). The observed effect was not modified by a reported asthma diagnosis. On the basis of these results, a 10 μg/m³ increase in NO₂ level would translate into a 7% (95% CI: 4% to 12%) increase of the prevalence of children with abnormal lung function.

Conclusions

Exposure to traffic pollution may cause a small overall reduction in lung function and increase the prevalence of children with clinically relevant declines in lung function.     

Association between Traffic-Related Air Pollution,Subclinical Inflammation and Impaired Glucose Metabolism: Results from the SALIA Study

Background

Environmental and lifestyle factors regulate the expression and release of immune mediators. It has been hypothesised that ambient air pollution may be such an external factor and that the association between air pollution and impaired glucose metabolism may be attributable to inflammatory processes. Therefore, we assessed the associations between air pollution, circulating immune mediators and impaired glucose metabolism.

Methods

We analysed concentrations of 14 pro- and anti-inflammatory immune mediators as well as fasting glucose and insulin levels in plasma of 363 women from the Study on the influence of Air pollution on Lung function, Inflammation and Aging (SALIA, Germany). Exposure data for a group of pollutants such as nitrogen oxides (NO₂, NO_x) and different fractions of particulate matter were available for the participants'' residences. We calculated the association between the pollutants and impaired glucose metabolism by multiple regression models.

Results

The study participants had a mean age of 74.1 (SD 2.6) years and 48% showed impaired glucose metabolism based on impaired fasting glucose or previously diagnosed type 2 diabetes. Only long-term exposure NO₂ and NO_x concentrations showed positive associations (NO₂: OR 1.465, 95% CI 1.049-2.046, NO_x: OR 1.409, 95% CI 1.010-1.967) per increased interquartile range of NO₂ (14.65 µg/m³) or NO_x (43.16 µg/m³), respectively, but statistical significance was lost after correction for multiple comparisons. Additional adjustment for circulating immune mediators or the use of anti-inflammatory medication had hardly any impact on the observed ORs.

Conclusions

Our results suggest that exposure to nitrogen oxides may contribute to impaired glucose metabolism, but the associations did not reach statistical significance so that further studies with larger sample sizes are required to substantiate our findings. Our data do not preclude a role of inflammatory mechanisms in adipose or other tissues which may not be reflected by immune mediators in plasma.     

Long-term exposure to ambient air pollution and mortality due to cardiovascular disease and cerebrovascular disease in Shenyang, China

Background

The relationship between ambient air pollution exposure and mortality of cardiovascular and cerebrovascular diseases in human is controversial, and there is little information about how exposures to ambient air pollution contribution to the mortality of cardiovascular and cerebrovascular diseases among Chinese. The aim of the present study was to examine whether exposure to ambient-air pollution increases the risk for cardiovascular and cerebrovascular disease.

Methodology/Principal Findings

We conducted a retrospective cohort study among humans to examine the association between compound-air pollutants [particulate matter <10 µm in aerodynamic diameter (PM₁₀), sulfur dioxide (SO₂) and nitrogen dioxide (NO₂)] and mortality in Shenyang, China, using 12 years of data (1998–2009). Also, stratified analysis by sex, age, education, and income was conducted for cardiovascular and cerebrovascular mortality. The results showed that an increase of 10 µg/m³ in a year average concentration of PM₁₀ corresponds to 55% increase in the risk of a death cardiovascular disease (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51 to 1.60) and 49% increase in cerebrovascular disease (HR, 1.49; 95% CI, 1.45 to 1.53), respectively. The corresponding figures of adjusted HR (95%CI) for a 10 µg/m³ increase in NO₂ was 2.46 (2.31 to 2.63) for cardiovascular mortality and 2.44 (2.27 to 2.62) for cerebrovascular mortality, respectively. The effects of air pollution were more evident in female that in male, and nonsmokers and residents with BMI<18.5 were more vulnerable to outdoor air pollution.

Conclusion/Significance

Long-term exposure to ambient air pollution is associated with the death of cardiovascular and cerebrovascular diseases among Chinese populations.