The Novel Relationship between Urban Air Pollution and Epilepsy: A Time Series Study

MethodsA hospital record-based study was carried out in Xi’an, a heavily-polluted metropolis in China. Daily baseline data were obtained. Time-series Poisson regression models were applied to analyze the association between air pollution and epilepsy.ResultsA 10 μg/m³ increase of NO₂, SO₂, and O₃ concentrations corresponded to 3.17% (95%Cl: 1.41%, 4.93%), 3.55% (95%Cl: 1.93%, 5.18%), and -0.84% (95%Cl: -1.58%, 0.09%) increase in outpatient-visits for epilepsy on the concurrent days, which were significantly influenced by sex and age. The effects of NO₂ and SO₂ would be stronger when adjusted for PM_2.5. As for O₃, a -1.14% (95%Cl: -1.90%, -0.39%) decrease was evidenced when adjusted for NO₂. The lag models showed that the most significant effects were evidenced on concurrent days.ConclusionsWe discovered previously undocumented relationships between short-term air pollution exposure and epilepsy: while NO₂ and SO₂ were positively associated with outpatient-visits of epilepsy, O₃ might be associated with reduced risk.     

Obesity and the relation between joint exposure to ambient air pollutants and incident type 2 diabetes: A cohort study in UK Biobank

BackgroundAir pollution has been related to incidence of type 2 diabetes (T2D). We assessed the joint association of various air pollutants with the risk of T2D and examined potential modification by obesity status and genetic susceptibility on the relationship.Methods and findingsA total of 449,006 participants from UK Biobank free of T2D at baseline were included. Of all the study population, 90.9% were white and 45.7% were male. The participants had a mean age of 56.6 (SD 8.1) years old and a mean body mass index (BMI) of 27.4 (SD 4.8) kg/m². Ambient air pollutants, including particulate matter (PM) with diameters ≤2.5 μm (PM_2.5), between 2.5 μm and 10 μm (PM_2.5–10), nitrogen dioxide (NO₂), and nitric oxide (NO) were measured. An air pollution score was created to assess the joint exposure to the 4 air pollutants. During a median of 11 years follow-up, we documented 18,239 incident T2D cases. The air pollution score was significantly associated with a higher risk of T2D. Compared to the lowest quintile of air pollution score, the hazard ratio (HR) (95% confidence interval [CI]) for T2D was 1.05 (0.99 to 1.10, p = 0.11), 1.06 (1.00 to 1.11, p = 0.051), 1.09 (1.03 to 1.15, p = 0.002), and 1.12 (1.06 to 1.19, p < 0.001) for the second to fifth quintile, respectively, after adjustment for sociodemographic characteristics, lifestyle factors, genetic factors, and other covariates. In addition, we found a significant interaction between the air pollution score and obesity status on the risk of T2D (p-interaction < 0.001). The observed association was more pronounced among overweight and obese participants than in the normal-weight people. Genetic risk score (GRS) for T2D or obesity did not modify the relationship between air pollution and risk of T2D. Key study limitations include unavailable data on other potential T2D-related air pollutants and single-time measurement on air pollutants.ConclusionsWe found that various air pollutants PM_2.5, PM_2.5–10, NO_2, and NO, individually or jointly, were associated with an increased risk of T2D in the population. The stratified analyses indicate that such associations were more strongly associated with T2D risk among those with higher adiposity.

Xiang Li and co-workers study the potential influence of obesity on associations between air pollutants and incidence of type 2 diabetes.     

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.     

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.     

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.     

National Patterns in Environmental Injustice and Inequality: Outdoor NO2 Air Pollution in the United States

We describe spatial patterns in environmental injustice and inequality for residential outdoor nitrogen dioxide (NO₂) concentrations in the contiguous United States. Our approach employs Census demographic data and a recently published high-resolution dataset of outdoor NO₂ concentrations. Nationally, population-weighted mean NO₂ concentrations are 4.6 ppb (38%, p<0.01) higher for nonwhites than for whites. The environmental health implications of that concentration disparity are compelling. For example, we estimate that reducing nonwhites’ NO₂ concentrations to levels experienced by whites would reduce Ischemic Heart Disease (IHD) mortality by ∼7,000 deaths per year, which is equivalent to 16 million people increasing their physical activity level from inactive (0 hours/week of physical activity) to sufficiently active (>2.5 hours/week of physical activity). Inequality for NO₂ concentration is greater than inequality for income (Atkinson Index: 0.11 versus 0.08). Low-income nonwhite young children and elderly people are disproportionately exposed to residential outdoor NO₂. Our findings establish a national context for previous work that has documented air pollution environmental injustice and inequality within individual US metropolitan areas and regions. Results given here can aid policy-makers in identifying locations with high environmental injustice and inequality. For example, states with both high injustice and high inequality (top quintile) for outdoor residential NO₂ include New York, Michigan, and Wisconsin.     

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.     

Air Pollution and the microvasculature: a cross-sectional assessment of in vivo retinal images in the population-based multi-ethnic study of atherosclerosis (MESA)

Background

Long- and short-term exposures to air pollution, especially fine particulate matter (PM_2.5), have been linked to cardiovascular morbidity and mortality. One hypothesized mechanism for these associations involves microvascular effects. Retinal photography provides a novel, in vivo approach to examine the association of air pollution with changes in the human microvasculature.

Methods and Findings

Chronic and acute associations between residential air pollution concentrations and retinal vessel diameters, expressed as central retinal arteriolar equivalents (CRAE) and central retinal venular equivalents (CRVE), were examined using digital retinal images taken in Multi-Ethnic Study of Atherosclerosis (MESA) participants between 2002 and 2003. Study participants (46 to 87 years of age) were without clinical cardiovascular disease at the baseline examination (2000–2002). Long-term outdoor concentrations of PM_2.5 were estimated at each participant''s home for the 2 years preceding the clinical exam using a spatio-temporal model. Short-term concentrations were assigned using outdoor measurements on the day preceding the clinical exam. Residential proximity to roadways was also used as an indicator of long-term traffic exposures. All associations were examined using linear regression models adjusted for subject-specific age, sex, race/ethnicity, education, income, smoking status, alcohol use, physical activity, body mass index, family history of cardiovascular disease, diabetes status, serum cholesterol, glucose, blood pressure, emphysema, C-reactive protein, medication use, and fellow vessel diameter. Short-term associations were further controlled for weather and seasonality. Among the 4,607 participants with complete data, CRAE were found to be narrower among persons residing in regions with increased long- and short-term levels of PM_2.5. These relationships were observed in a joint exposure model with −0.8 µm (95% confidence interval [CI] −1.1 to −0.5) and −0.4 µm (95% CI −0.8 to 0.1) decreases in CRAE per interquartile increases in long- (3 µg/m³) and short-term (9 µg/m³) PM_2.5 levels, respectively. These reductions in CRAE are equivalent to 7- and 3-year increases in age in the same cohort. Similarly, living near a major road was also associated with a −0.7 µm decrease (95% CI −1.4 to 0.1) in CRAE. Although the chronic association with CRAE was largely influenced by differences in exposure between cities, this relationship was generally robust to control for city-level covariates and no significant differences were observed between cities. Wider CRVE were associated with living in areas of higher PM_2.5 concentrations, but these findings were less robust and not supported by the presence of consistent acute associations with PM_2.5.

Conclusions

Residing in regions with higher air pollution concentrations and experiencing daily increases in air pollution were each associated with narrower retinal arteriolar diameters in older individuals. These findings support the hypothesis that important vascular phenomena are associated with small increases in short-term or long-term air pollution exposures, even at current exposure levels, and further corroborate reported associations between air pollution and the development and exacerbation of clinical cardiovascular disease. Please see later in the article for the Editors'' Summary     

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。     

Environmental Factors Related to Pulmonary Tuberculosis in HIV-Infected Patients in the Combined Antiretroviral Therapy (cART) Era

The aim of our study was to evaluate the seasonal variations and whether short-term exposure to environmental risk factors, such as climate and air pollution, is associated with PTB-related hospital admissions in human immunodeficiency virus (HIV)-infected patients in Spain during the era of combined antiretroviral therapy (cART). A retrospective study was carried out using data from the Minimum Basic Data Set (MBDS) and the State Meteorological Agency (AEMET) of Spain. The primary outcome variable was hospital admissions with PTB diagnosis. The environmental risk factors evaluated were season, temperature, humidity, NO₂, SO₂, O₃, PM₁₀, and CO. Overall, HIV-infected patients had a lower frequency of PTB-related hospital admissions in summer (22.8%) and autumn (22.4%), but higher values in winter (26.6%) and spring (28.2%). Using a Bayesian temporal model, PTB-related hospital admissions were less frequent in summer-autumn and more abundant in winter-spring during the first years of follow-up. During the later years of follow-up, the seasonal trends continued resulting in the lowest values in autumn and the highest in spring. When considering short-term exposure to environmental risk factors, lower temperatures at 1 week (odds ratio (OR) = 1.03; p = 0.008), 1.5 weeks (OR = 1.03; p<0.001), 2 weeks (OR = 1.04; p<0.001), and 3 weeks (OR = 1.03; p<0.001) prior to PTB admission. In addition, higher concentration of NO₂ at the time of admission were significantly associated with higher likelihoods of PTB-related hospital admission in HIV-infected patients when 1.5 weeks (OR = 1.1; p = 0.044) and 2 weeks (OR = 1.21; p<0.001) were used as controls. Finally, higher concentration of SO₂ at 1.5 weeks prior to PTB admission was significantly associated with a higher likelihood of PTB-related hospital admissions (OR = 0.92; p = 0.029). In conclusion, our data suggest an apparent seasonal variation in hospital admissions of HIV-infected patients with a PTB diagnosis (summer/autumn vs. winter/spring), as well as a link to short-term exposure to environmental risk factors, such as temperature and ambient NO₂ and SO₂.     

Epiphytic macrolichen community correlates with modeled air pollutants and forest conditions

Novel systems combining bioindicators, models, and remote sensing are possible cost-effective methods to monitor regional-scale pollution. Epiphytic macrolichen communities have been widely used as air pollution bioindicators, however these communities are also affected by microclimate conditions as influenced by forest structure. We used the Finnish epiphytic macrolichen survey method SFS5670 to collect data in 27 spruce and birch dominated forests in southern Finland and northwestern Russia. The method measures the abundance and physiological damage of Hypogymnia physodes and Bryoria spp., and the frequency of 13 epiphytic macrolichen species of known sensitivity which can be used to calculate the widely used Index of Atmospheric Purity (IAP). The location of the sites represents an east–west gradient of air pollution conditions of SO₂, SO₄^2?, NO₂, NH₃ + NH₄⁺, and HNO₃ + NO₃^?. We also recorded living and dead forest structure characteristics at these sites, which we initially chose to be as similar as possible on either side of the border. Abundance and damage of H. physodes were correlated with forest structure but not with air pollution, indicating that these macrolichen variables may not be reliable bioindicators at low air pollution concentrations. However, the Index of Atmospheric Purity, calculated from observed presence/absence data of multiple epiphytic macrolichen species, was strongly correlated with sulfur and nitrogen pollutant concentrations. These results suggest that the IAP as calculated using data from the Finnish epiphytic macrolichen survey method may be a useful air pollution indicator in combination with modeled data, even in relatively clean regions.     

Relationship between Air Pollutants and Economic Development of the Provincial Capital Cities in China during the Past Decade

With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictorssuch as Gross Regional Product per capita (GRP per capita), the concentration of air pollutants (PM₁₀, SO₂, NO₂₎ and the air pollution index (API) from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO₂, but a negative relationship with PM₁₀ and SO₂. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provinical cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC), that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China.     

Spatial patterns and effects of air pollution and meteorological factors on hospitalization for chronic lung diseases in Beijing,China

Chronic obstructive pulmonary disease(COPD), lung cancer(LC) and tuberculosis(TB) are common chronic lung diseases that generate a large disease burden and significant health care resource use in China. The aim of this study was to quantify spatial patterns and effects of air pollution and meteorological factors on hospitalization of COPD, LC and TB in Beijing. Daily counts of hospitalization for 2010 were obtained from the Beijing Urban Employees Basic Medical Insurance(UEBMI) system.Bayesian hierarchical Poisson regression models were applied to identify spatial patterns of hospitalization for COPD, LC and TB at the district level and explore associations with inhalable particulate matter(aerodynamic diameter 10 μm, PM_(10)), sulfur dioxide(SO_2), nitrogen dioxide(NO_2), mean temperature and relative humidity. There were 18,882, 14,295 and 2,940 counts of hospitalizations for COPD, LC and TB respectively, in Beijing in 2010. Clusters of high relative risk were in different locations for the three diseases. The effect of relative humidity on COPD hospitalization was most significant with a relative risk(RR) of 1.070(95%CI: 1.054, 1.086) per one percent increase. For lung cancer hospitalization, exposure to ambient SO_2 was associated with a RR of 1.034(95%CI: 1.011, 1.058) per μg m~(–3) increase. For tuberculosis, the effect of mean temperature was significant with a RR of 1.107(95%CI: 1.038, 1.180) per °C increase. Risk factors and spatial patterns were different for hospitalization of non-infectious and infectious chronic lung disease in Beijing. Even over a short time period(one year), associations were apparent with air pollution and meteorological factors.     

Effects of PM2.5 and NO2 on the 8-isoprostane and lung function indices of FVC and FEV1 in students of Ahvaz city,Iran

The aim of this study was to determine the correlation between PM_2.5 and NO₂ pollutants and oxidative stress marker (8-isoprostane) and lung function tests (FVC and FEV₁) in healthy children who were living and studying in three different areas of Ahvaz city including A₁: Naderi site with high traffic, A₂: Alavi Alley site with average traffic, and A₃: Ein 2 site with low traffic (a rural area on the suburb of Ahvaz). 30 students in the 12–13 year-old range were selected from each studied zone (1, 2 and 3 sites) during three months of year. Of each student, one sample was taken every two weeks to measure 8-isoprostane of exhaled breath condensate (EBC). Air pollution data were collected from three air quality monitoring stations. Also, the relationship between air pollution and 8-isoprostane as well as lung function tests were determined using generalized estimating equations (GEE). The mean concentration of PM_2.5 and NO₂ in A₁, A₂ and A₃ areas were 116, 92 and 45 (μg/m³) also 77, 53 and 14 (ppb) respectively. Among all studied students, there was a significant correlation between the increase of mean concentration of PM_2.5 and NO₂ in 1–4 before sampling day, increased 8-isoprostane concentration and decreased FEV₁, while there was no significant correlation between them and decreased FVC. In A₁ site, an increase in IQR (13 μg/m³) PM_2.5 and IQR (6.5 ppb) NO₂ on 1–4 days before sampling was associated with 0.38 unit (95% CI: 0.11, 0.65) and 1.1 unit (95% CI: 0.85, 1.35) increase in 8-isoprostane concentration, also decreased 121 ml and 190 ml FEV₁, respectively. Results showed that the short-term exposure to traffic-related air pollution can decrease the values of lung function indices and increase the oxidative stress. It may adversely affect children’s lungs.     

Trends in undernutrition mortality among children under five years of age and adults over 60

Introduction: Children under five years of age living in poor areas and with low availability of healthy food have a higher risk of undernutrition-related mortality. However, this relationship has not been well established among older adults.Objective: To analyse socioeconomic inequality trends related to undernutrition mortality in children under five years of age and adults over 60 in Colombian municipalities during 2003-2009 and 2010-2016.Materials and methods: We conducted an ecological study of trends between 2003 and 2016. The study population consisted of children under five years of age and adults over 60 residing in the Colombian municipalities during the study period. We estimated smoothed and standardized mortality rates by fitting a hierarchical Bayesian model and explored their relationship with five socioeconomic area-level variables.Results: In most of the municipalities, undernutrition-related mortality was three times higher in older adults compared to children. Moreover, the difference in the risk of undernutrition-related mortality between municipalities showed a marked reduction. Finally, the poor and less developed municipalities had higher rates of undernutrition-related mortality in children; conversely, wealthier territories had higher rates in older adults.Conclusions: Although in most of the municipalities the mortality rates due to undernutrition in children under five and older adults have decreased, their socioeconomic conditions influence in different ways the risk of mortality for these two populations so there is the need to develop age-specific strategies to close social gaps considering the structural conditions of the areas.     

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 air pollution exposure and living close to busy roads are associated with COPD in women

Background

Lung function and exacerbations of chronic obstructive pulmonary disease (COPD) have been associated with short-term exposure to air pollution. However, the effect of long-term exposure to particulate matter from industry and traffic on COPD as defined by lung function has not been evaluated so far. Our study was designed to investigate the influence of long-term exposure to air pollution on respiratory symptoms and pulmonary function in 55-year-old women. We especially focused on COPD as defined by GOLD criteria and additionally compared the effects of air pollution on respiratory symptoms by questionnaire data and by lung function measurements.

Methods

In consecutive cross sectional studies conducted between 1985–1994, we investigated 4757 women living in the Rhine-Ruhr Basin of Germany. NO₂ and PM₁₀ exposure was assessed by measurements done in an 8 km grid, and traffic exposure by distance from the residential address to the nearest major road using Geographic Information System data. Lung function was determined and COPD was defined by using the GOLD criteria. Chronic respiratory symptoms and possible confounders were defined by questionnaire data. Linear and logistic regressions, including random effects were used to account for confounding and clustering on city level.

Results

The prevalence of COPD (GOLD stages 1–4) was 4.5%. COPD and pulmonary function were strongest affected by PM₁₀ and traffic related exposure. A 7 μg/m₃ increase in five year means of PM₁₀ (interquartile range) was associated with a 5.1% (95% CI 2.5%–7.7%) decrease in FEV₁, a 3.7% (95% CI 1.8%–5.5%) decrease in FVC and an odds ratio (OR) of 1.33 (95% CI 1.03–1.72) for COPD. Women living less than 100 m from a busy road also had a significantly decreased lung function and COPD was 1.79 times more likely (95% CI 1.06–3.02) than for those living farther away. Chronic symptoms as based on questionnaire information showed effects in the same direction, but less pronounced.

Conclusion

Chronic exposure to PM₁₀, NO₂ and living near a major road might increase the risk of developing COPD and can have a detrimental effect on lung function.     

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.