Effects Of Ambient Air Pollution Research Articles

Effects of sulfur dioxide, ozone, and ambient air pollution on lung histopathology, oxidative-stress biomarkers, and apoptosis-related gene expressions in rats

Purpose of the Study Ambient air pollution (AAP) has become an important health problem globally. Besides, several pieces of evidence indicate that air pollutants such as sulfur dioxide (SO2) and ozone (O3) are major contributors to a wide range of non-communicable diseases. The present study investigated the effects of AAP, sulfur dioxide, and ozone on oxidative stress, histopathology, and some apoptosis-related genes expressions of lung tissue in a rat model. Materials and Methods Thirty-two Wistar rats were randomly divided into the control, AAP, sulfur dioxide (10 ppm), and ozone (0.6 ppm) groups. After five consecutive weeks’ exposure to the selected pollutants (3 h/day), lung tissues were harvested and immediately fixed with formalin. The samples were routinely processed, sectioned, stained with hematoxylin and eosin (H&E), and finally assessed for presence of pathological changes. Expression changes of BAX, p-53, EGFR, caspase-3, caspase-8 and caspase-9 were assayed using the RT-qPCR method. One hundred milligrams of lung tissues were extracted and the supernatants were used for assaying malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase activities. Results GPx activity was increased in the ozone (P = 0.05) and AAP (P < 0.001) groups and also MDA level in sulfur dioxide group (P = 0.008). Pathological lesions were mild, moderate, and severe in the sulfur dioxide, ozone, and AAP groups, respectively, as compared to control group (P ˂ 0.05). Exposure to AAP and sulfur dioxide enhanced BAX (P = 0.002) and caspase-8 (P < 0.001) mRNA expression, respectively. Caspases-3 and −8 mRNA expressions were elevated in ozone group (P < 0.001). Conclusions The results indicated induction of oxidative stress. Our results suggest the apoptosis stimuli effect of AAP and also the extrinsic apoptotic pathway trigger effect of sulfur dioxide and ozone in the lung tissue in the concentrations used in the present study. The histopathological and the genes expression changes may be a result of the induced oxidative stress in the lung tissues.

Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses.

The available evidence on the effects of ambient air pollution on cardiovascular diseases (CVDs) has increased substantially. In this umbrella review, we summarized the current epidemiological evidence from systematic reviews and meta‐analyses linking ambient air pollution and CVDs, with a focus on geographical differences and vulnerable subpopulations. We performed a search strategy through multiple databases including articles between 2010 and 31 January 2021. We performed a quality assessment and evaluated the strength of evidence. Of the 56 included reviews, the most studied outcomes were stroke (22 reviews), all‐cause CVD mortality, and morbidity (19). The strongest evidence was found between higher short‐ and long‐term ambient air pollution exposure and all‐cause CVD mortality and morbidity, stroke, blood pressure, and ischemic heart diseases (IHD). Short‐term exposures to particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NO x ) were consistently associated with increased risks of hypertension and triggering of myocardial infarction (MI), and stroke (fatal and nonfatal). Long‐term exposures of PM2.5 were largely associated with increased risk of atherosclerosis, incident MI, hypertension, and incident stroke and stroke mortality. Few reviews evaluated other CVD outcomes including arrhythmias, atrial fibrillation, or heart failure but they generally reported positive statistical associations. Stronger associations were found in Asian countries and vulnerable subpopulations, especially among the elderly, cardiac patients, and people with higher weight status. Consistent with experimental data, this comprehensive umbrella review found strong evidence that higher levels of ambient air pollution increase the risk of CVDs, especially all‐cause CVD mortality, stroke, and IHD. These results emphasize the importance of reducing the alarming levels of air pollution across the globe, especially in Asia, and among vulnerable subpopulations.

Association of short-term exposure to air pollution with recurrent ischemic cerebrovascular events in older adults.

The acute effects of ambient air pollution on recurrence of ischemic cerebrovascular events (ICEs) remains largely unknown. We therefore conducted a time-stratified case-crossover study of 43,896 patients who were 60 years or older and were admitted to hospital for recurrent ICEs including ischemic stroke and transient ischemic attack in Guangzhou, China during 2016-2019. Based on each patient's home address and pollutant data from its neighboring air quality monitoring stations, we used an inverse distance weighting method to assess exposures to particulate matter with an aerodynamic diameter ≤2.5μm (PM2.5), particulate matter with an aerodynamic diameter ≤10μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). Conditional logistic regression models were used to quantify exposure-response associations. During the study period, there were 43,896 case days and 149,131 control days. In single-pollutant models, each 10μg/m3 increase in exposure to PM10, NO2 and CO (mean exposure on date of admission and 1 day prior) was significantly associated with a 0.74% (95% confidence interval [CI]: 0.13-1.36%), 2.15% (1.38-2.93%) and 0.14% (0.07-0.21%) increase in odds of hospital admissions for recurrent ICEs, respectively, and no significant departures from linearity were detected. The association for NO2 exposure remained consistent in 2-pollutant models, while the associations for PM10 and CO disappeared or changed materially with adjustment for other pollutants. Stronger association for NO2 exposure was observed in cool season than that in warm season. We found that short-term exposure to ambient air pollutants, especially NO2, was associated with increased risk of hospital admissions for recurrent ICEs in older adults.

Ambient Particulate Air Pollution and Daily Hospital Admissions in 31 Cities in Poland

A strong and consistent association has been observed between morbidity or mortality rates and PM concentration, and is well documented in many countries. In Poland, despite poor air quality, studies concerning the evaluation of acute health effects of ambient air pollution on morbidity from respiratory or cardiovascular diseases are rare. We examined the short-term impact of PMx concentration on hospital admission in 31 Polish cities based on the daily PM10, PM2.5 concentration, meteorological variables, and hospital data. The generalized additive model (GAM) and a random-effects meta-analysis were used to assess the impact of air pollution on morbidity within the exposed population. Almost 1.6 million cardiovascular admissions and 600 thousand respiratory disorders were analyzed. The RR values for PM10-related cardiovascular and respiratory hospital admissions in Poland are equal to 1.0077 (95% confidence interval, 1.0062 to 1.0092) and 1.0218 (95% confidence interval, 1.0182 to 1.0253), respectively, while for PM2.5 1.0088 (95% confidence interval, 1.0072 to 1.0103) and 1.0289 (95% confidence interval, 1.0244 to 1.0335), respectively. Moreover, a moderate heterogeneity of RR estimates was observed between the analyzed cities (I2 values from 27% to 45%). The presented analysis confirms the significant association between hospital admission and PMx concentration, especially during heating seasons.

Short-term effects of ambient air pollution on daily emergency room visits for abdominal pain: a time-series study in Wuhan, China.

Short-term exposure to ambient air pollution has been proven to result in respiratory, cardiovascular, and digestive diseases, leading to increased emergency room visits (ERVs). Abdominal pain complaints provide a large proportion of the ERVs, as yet few studies have focused on the correlations between ambient air pollution and abdominal pain, especially in emergency departments within China. Daily data for daily ERVs were collected in Wuhan, China (from January 1, 2016 to December 31, 2018), including air pollution concentration (SO2, NO2, PM2.5, PM10, CO, and O3), and meteorological variables. We conducted a time-series study to investigate the potential correlation between six ambient air pollutants and ERVs for abdominal pain and their effects, in different genders, ages, and seasons. A total of 16,318 abdominal pain ERVs were identified during the study period. A 10-μg/m3 increase in concentration of SO2, NO2, PM2.5, PM10, CO, and O3 corresponded respectively to incremental increases in abdominal pain of 4.89% (95% confidence interval [CI]: - 1.50-11.70), 1.85% (95% CI: - 0.29-4.03), 0.83% (95% CI: - 0.05-1.72), - 0.22% (95% CI: - 0.73-0.30), 0.24% (95% CI: 0.08-0.40), and 0.86% (95% CI: 0.04 - 1.69). We observed significant correlations between CO and O3 and increases in daily abdominal pain ERVs and positive but insignificant correlations between the other pollutants and ERVs (except PM10). The effects were stronger for females (especially SO2 and O3: 13.53% vs. - 2.46%; 1.20% vs. 0.47%, respectively) and younger people (especially CO and O3: 0.25% vs. 0.01%; 1.36% vs. 0.15%, respectively). Males (1.38% vs. 0.87%) and elders (1.27% vs. 0.99%) were more likely to be affected by PM2.5. The correlations with PM2.5 were stronger in cool seasons (1.25% vs. - 0.07%) while the correlation with CO was stronger in warm seasons (0.47% vs. 0.14%). Our time-series study suggests that short-term exposure to air pollution (especially CO and O3) was positively correlated with ERVs for abdominal pain in Wuhan, China, and that the effects varied by season, gender and age. These data can add evidence on how air pollutants affect the human body and may prompt hospitals to take specific precautions on polluted days and maintain order in emergency departments made busier due to the pollution.

The short-term effects and burden of particle air pollution on hospitalization for coronary heart disease: a time-stratified case-crossover study in Sichuan, China

BackgroundCoronary heart disease (CHD), the leading cause of death globally, might be developed or exacerbated by air pollution, resulting high burden to patients. To date, limited studies have estimated the relations between short-term exposure to air pollution and CHD disease burden in China, with inconsistent results. Hence, we aimed to estimate the short-term impact and burden of ambient PM pollutants on hospitalizations of CHD and specific CHD.MethodsPM10 and PM2.5 were measured at 82 monitoring stations in 9 cities in Sichuan Province, China during 2017-2018. Based on the time-stratified case-crossover design, the effects of short-term exposure to particle matter (PM) pollution on coronary heart disease (CHD) hospital admissions were estimated. Meanwhile, the linked burden of CHD owing to ambient PM pollution were estimated.ResultsA total of 104,779 CHD records were derived from 153 hospitals from these 9 cities. There were significant effects of PM pollution on hospital admissions (HAs) for CHD and specific CHD in Sichuan Province. A 10 μg/m3 increase of PM10 and PM2.5 was linked with a 0.46% (95% CI: 0.08, 0.84%), and 0.57% (95% CI: 0.05, 1.09%) increments in HAs for CHD at lag7, respectively. The health effects of air pollutants were comparable modified by age, season and gender, showing old (≥ 65 years) and in cold season being more vulnerable to the effects of ambient air pollution, while gender-specific effects is positive but not conclusive. Involving the WHO’s air quality guidelines as the reference, 1784 and 2847 total cases of HAs for CHD could be attributable to PM10 and PM2.5, separately. The total medical cost that could be attributable to exceeding PM10 and PM2.5 were 42.04 and 67.25 million CNY from 2017 to 2018, respectively.ConclusionsThis study suggested that the short-term exposure to air pollutants were associated with increased HAs for CHD in Sichuan Province, which could be implications for local environment improvement and policy reference.

Effect of ambient air pollutants on in vitro fertilization-embryo transfer pregnancy outcome in Zhengzhou, China

With the acceleration of China's urbanization and industrialization, air pollution has become a major environmental problem. Retrospective data analysis of 6564 patients who underwent IVF-ET in the center for reproductive medicine of the First Affiliated Hospital of Zhengzhou University from 2015 to 2020. Different stages were selected from 90 days before oocyte retrieval to 35 days after transfer and divided into five exposure periods. Multivariate logistic regression was used to analyze the relationship between six ambient air pollutants (PM2.5, PM10, NO2, SO2, CO and O3) and the IVF-ET pregnancy outcome. The results showed that air pollutants can significantly affect the IVF pregnancy outcome. The harmful effects of ambient air pollutants are more obvious in the patients aged < 35 years, single embryo transfer and cleavage stage embryo transfer.

Short term exposure to ambient air pollutants and cardiovascular emergency department visits in Mexico city

Available data on the acute cardiovascular effect of ambient air pollution (AAP) in Latin America is limited considering that over 80% of its 1 billion inhabitants live in urban settlements with poor air quality. The study aim was to evaluate the association between Cardiovascular Emergency Department Visits (CEDVs) and AAP in Mexico City from 2016 to 2019 using generalized additive models with distributed lags to examine the percentage change of CEDVs and a backward approach of time-series model to calculate attributable fractions. A total of 48,891 CEDVs were recorded in a period of 1019 days. We estimated a significant percentage increase for each 10 μg/m3 of PM10 at Lag0-5 (2.8%, 95%CI 0.6–5.0), PM2.5 at Lag0-6 (3.7%, 95%CI 0.1–7.6), O3 at Lag0-5 (1.1%, 95%CI 0.2–2.0), NO2 at Lag0-4 (2.5%, 95%CI 0.3–4.7) and for each 1 mg/m3 of CO at Lag0 (6.6%, 95%CI 0.3–13.2). Overall, 10.3% of CEDVs in Mexico City may be related to PM10 exposure, 9.5% to PM2.5, 10.3% to O3, 11% to NO2 and 5.7% to CO. AAP significantly increase cardiovascular morbidity impacting on emergency medical services.

Sulfur Dioxide May Predominate in the Adverse Effects of Ambient Air Pollutants on Semen Quality Among General Population in Hefei, China

Sulfur Dioxide May Predominate in the Adverse Effects of Ambient Air Pollutants on Semen Quality Among General Population in Hefei, China

A Comprehensive Study on Environmental Pollution and Pregnancy Outcomes

Vehicular traffic contributes significantly to the pollution of air and neighborhood noise. Since there is increasing affirmation that ambient air pollution hurts reproductive health, which is less known regarding the relationship between traffic noise and pregnancy outcomes. Many researchers have investigated all the possible adverse effects of ambient air pollution on birth outcomes during the last decade or so. We examined these studies, which were discovered by thoroughly searching the major scientific databases. Overall, research suggests that air pollution and noise pollution significantly impact birth outcomes, while the quality of the deposition varies. Researchers utilized connected administrative health data sources to discover pregnancy outcomes with detailed covariate data (gender, contemporary lifestyle, total no of pregnancies, birth month and year, and so on), earnings and education, and mother housing history. Using the deterministic model (CadnaA) and air pollutants exposure, they assessed noise exposure during pregnancy by assessing temporally adjusted land-use regression. Noise exposure is related to reduced birth weight. We also looked into various processes to prevent air pollution and noise. As a result of the policy change and technical innovation, the government, authorities, and industry have been at the forefront of combating pollution. Pollution levels in and around people's homes and workplaces are typically beyond their control. However, few things may be done to mitigate the impacts of contaminated air.

ANALYSIS OF ASSOCIATIONS BETWEEN AIR POLLUTION AND MORTALITY FROM NONCOMMUNICABLE DISEASES ACROSS GENDERS AND AGE-GROUPS

Introduction: Identification of the groups of patients that are the most vulnerable to the effects of ambient air pollution is required for the development of public health measures to promote health and prevent diseases in cities with a high level of atmospheric air pollution with the further going aim to reduce mortality and increase life expectancy of the population Aim: To analyze associations between air pollution and mortality from the most common non-communicable diseases stratified across genders and age-groups. Methods: To assess the isolated effect of ambient air pollution on the mortality rate, we selected 4 pairs of cities with similar climatic and socio-economic condition, but with high vs. low levels of air pollution. There pairs were: Bratsk - Kirov; Chita - Tomsk; Nizhny Tagil - Kirov; Magnitogorsk - Orenburg. Differences in mortality rates from major non-communicable diseases between the cities were analyzed using stratification by gender and age. Results: Cardiovascular mortality in cities with high levels of air pollution significantly exceeded mortality in cities with low pollution in all age groups. The differences in mortality from respiratory causes and neoplasms was less pronounced. Conclusion: The results suggest that high levels of air pollution may be associated with greater cardiovascular mortality in all age- groups. Closer monitoring of cardiovascular health of residents of polluted cities is warranted.

Exposure to air pollution is associated with an increased risk of metabolic dysfunction-associated fatty liver disease

Accumulating animal studies have demonstrated the harmful contribution of ambient air pollution (AP) to metabolic dysfunction-associated fatty liver disease (MAFLD), but corresponding epidemiological evidence is limited. We examined the associations between long-term AP exposure and MAFLD prevalence in a Chinese population. We conducted a cross-sectional study of 90,086 participants recruited in China from 2018 to 2019. MAFLD was assessed based on radiologically diagnosed hepatic steatosis and the presence of overweight/obese status, diabetes mellitus, or metabolic dysregulation. Residence-specific levels of air pollutants, including particulate matter with aerodynamic diameters of ≤1 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10), and nitrogen dioxide (NO2), were estimated by validated spatiotemporal models. We used logistic regression models to examine the AP-MAFLD associations and further evaluated potential effect modifications by demographics, lifestyle, central obesity, and diabetes status. Increased exposure levels to all 4 air pollutants were significantly associated with increased odds of MAFLD, with odds ratios (ORs) of 1.13 (95% CI 1.10-1.17), 1.29 (1.25-1.34), 1.11 (1.09-1.14), and 1.15 (1.12-1.17) for each 10 μg/m3 increase in PM1, PM2.5, PM10, and NO2, respectively. Further stratified analyses revealed that individuals who are male, alcohol drinkers, and current and previous smokers, those who consume a high-fat diet, and those with central obesity experience more significant adverse effects from AP exposure than other individuals. This study provides evidence that long-term exposure to ambient PM1, PM2.5, PM10, and NO2 may increase the odds of MAFLD in the real world. These effects may be exacerbated by unhealthy lifestyle habits and central obesity. We conducted an epidemiological study on the potential effect of ambient air pollution on the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in approximately 90 thousand adults in China. We found that long-term exposure to ambient air pollution may increase the odds of MAFLD, especially in individuals who are male, smokers, and alcohol drinkers, those who consume a high-fat diet, and those with central obesity.

Ambient Air Pollution and Mortality Rate in Nigeria: An ARDL Approach

The study on ambient air pollution and mortality rate in Nigeria is an attempt to evaluate the effect of ambient air pollution proxied by carbon dioxide on non-accidental, cardiovascular and respiratory disease related mortality in Nigeria from 1970-2019. Time series data adopted from World Development Indicators were analyzed using Auto Regressive Distributed Lag Model. Results suggest a positive relationship between CO2 and crude death rate in Nigeria. Thus, the result of ARDL for lnCruder as the dependent variable showed that carbon dioxide emission was positively related to the crude death rate. Consequently, one unit increase in the quantity of carbon dioxide emission increased the death rate by 19% at lag 1, all things being equal. A similar result was obtained for CO2 and life expectancy where carbon dioxide emission was found to have a negative effect on life expectancy. The study concludes that carbon dioxide emission has a negative effect on human health and causes death in human beings. Therefore, further study is recommended on ways of abating carbon dioxide emissions through the use of technologies that generate less carbon dioxide and the adoption of domestic practices that reduce the quantity of CO2 produced in the environment.

Effects of ambient air pollutants on hospital admissions and deaths for cardiovascular diseases: a time series analysis in Tehran.

Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1mg/m3 increase at lags of 6 and 7days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO2 at a lag of 4days. PM2.5 and PM10 were associated with cerebrovascular disease admissions in females aged 16-65years and 16years and younger for each 10µg/m3 increase, respectively. Short-term exposure to SO2, NO2, and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution.

A study of health profile and effects of ambient air pollution among auto drivers of Bangalore city

Background: Auto drivers battle several occupational health hazards due to increasing pollution and unhealthy lifestyle. Improper diet and sleeping habits coupled with smoking, tobacco and alcohol use make them prone to respiratory and cardiovascular health hazards. Objectives: To assess the health status and quality of life (QoL) among auto drivers in Bangalore city and to study the association of selected parameters with respiratory and cardiac morbidities. Methods: In this cross-sectional study, 450 auto drivers were given a questionnaire and they were distributed according to age, education, body mass index, smoking, tobacco and/or alcohol consumption. The QoL was assessed by World Health Organization Quality of Life Instrument (WHOQOL-BREF) and peak expiratory flow, blood pressure, and blood sugar levels for each participant were recorded. The association between two categorical variables was determined by Chi-square test and p?0.05 was considered statistically significant. Results: The association of number of years of driving with prevalence of chronic morbidity (p=0.005), hypertension (p=0.008), diabetes (p&lt;0.001), and heart disease (p=0.04) were significant. QoL for physical and environmental domain were 16.11±0.28 and 12.48±0.06, respectively. Conclusion: A proportional increase in the risk of respiratory and cardiac morbidities with increasing number of driving years was observed among auto drivers.

Sex-difference in air pollution-related acute circulatory and respiratory mortality and hospitalization

BackgroundNumerous studies have estimated adverse effects of short-term exposure to ambient air pollution on public health. Few have focused on sex-differences, and results have been inconsistent. The purpose of this study was three-fold: to identify sex-differences in air pollution-related health outcomes; to examine sex-differences by cause and season; and to examine time trends in sex-differences. MethodsDaily data were collected on circulatory- and respiratory-related mortality (for 29 years) and cause-specific hospitalization (for 17 years) with hourly concentrations of ozone (O3), nitrogen dioxide (NO2), and fine particulate matter (PM2.5). For hospitalization, more specific causes were examined: ischemic heart disease (IHD), other heart disease (OHD), cerebrovascular disease (CEV), chronic lower respiratory diseases (CLRD), and Influenza/Pneumonia (InfPn). Generalized Poisson models were applied to 24 Canadian cities, and the city-specific estimates were combined for nationwide estimates for each sex using Bayesian hierarchical models. Finally, sex-differences were tested statistically based on their interval estimates, considering the correlation between sex-specific national estimates. ResultsSex-differences were more frequently observed for hospitalization than mortality, respiratory than circulatory health outcomes, and warm than cold season. For hospitalization, males were at higher risk (M > F) for warm season (OHD and InfPn from O3; IHD from NO2; and InfPn from PM2.5), but F > M for cold season (CEV from O3 and OHD from NO2). For mortality, we found F > M only for circulatory diseases from ozone during the warm season. Among the above-mentioned sex-differences, three cases showed consistent time trends over the years: while M > F for OHD from O3 and IHD from NO2, F > M for OHD from NO2. ConclusionsWe found that sex-differences in effect of ambient air pollution varied over health outcome, cause, season and time. In particular, the consistent trends (either F > M or M > F) across 17 years provide stronger evidence of sex-differences in hospitalizations, and warrant investigation in other populations.

Ambient air pollution and COVID-19 in Delhi, India: a time-series evidence

ABSTRACT This study aimed to explore the short-term health effects of ambient air pollutants , , , , , and on COVID-19 daily new cases and COVID-19 daily new deaths. A time-series design used in this study. Data were obtained from 1 April 2020 to 31 December 2020 in the National Capital Territory (NCT) of Delhi, India. The generalized additive models (GAMs) were applied to explore the associations of six air pollutants with COVID-19 daily new cases and COVID-19 daily new deaths. The GAMs revealed statistically significant associations of ambient air pollutants with COVID-19 daily new cases and COVID-19 daily new deaths. These findings suggest that governments need to give greater considerations to regions with higher concentrations of , , , , , and , since these areas may experience a more serious COVID-19 pandemic or, in general, any respiratory disease.

477Long-term exposure to low PM2.5 and NO2 and all-cause mortality in Australia: a difference-in-differences analyses

Abstract Background Although many cohort studies have documented the long-term effects of ambient air pollution on mortality, but they suffer from residual confounding, being unable to control unmeasured confounders, and are often not population representative. A recently developed variant of difference-in-difference (DID) approach is promising to address these limitations. Methods We collected annual all-cause death data from 2,193 statistical areas level-2 (SA2) in Australia during 2001-2015. Area-level annual mean concentrations of PM2.5 and NO2 were derived from widely used grid (0.01°×0.01° and 0.1°×0.1°, respectively) datasets. The variant of DID method was used to evaluate the causal relationship between annual PM2.5 and NO2 and all-cause mortality. We further developed this method by considering non-linear associations and lag impacts using distributed lag non-linear model. Results The impacts of low PM2.5 (1.94-12.00 µg/m3) and NO2 (0-7.41 µg/m3) on all-cause mortality were non-linear and lasted for 0-3 year and 0-6 year, respectively. The moving average PM2.5 (0-3 year) and NO2 (0-6 year) showed non-significant impacts below the thresholds (4.44 µg/m3 and 1.10 µg/m3) observed, while every 1 µg/m3 increase above the thresholds were associated with 2.4% (95%CI: 1.6-3.3%) and 9.4% (95%CI: 7.9-10.8%) increase in all-cause mortality, respectively. We estimated that 3.0% (95%CI: 2.0-3.9%) and 9.9% (8.3-11.3%) deaths were attributable to PM2.5 and NO2, respectively. Conclusions We further developed the causal DID model and documented the deadly impacts of long-term exposure to low PM2.5 and NO2 with thresholds and lag periods. Key messages Long-term exposure to low PM2.5 and NO2 are still deadly but have thresholds.

Interactive webbased figure to communicate health effects of ambient air pollution

BACKGROUND AND AIM: With an ever increasing number of publications on ambient air pollution and its effects on human health it has become difficult to distinguish between causal and accepted effects of air pollutants and suggested effects. We aimed at finding an appealing way to better communicate the accepted short-term and long-term health effects of ambient air pollution. METHODS: The US EPA’s integrated science assessments analyze the level of evidence for health effects of the “criteria pollutants” including particulate matter (PM), oxides of nitrogen (e.g. NO2), ozone, sulfur dioxide (SO2) and carbon monoxide (CO). The EPA assesses the relationship between pollutants and potential health effects using a five-point scale. The levels

Ambient air pollution and cardiovascular diseases: an Umbrella review of systematic reviews and meta-analyses

BACKGROUND AND AIM: The available evidence on the effects of ambient air pollution on cardiovascular diseases (CVDs) has increased substantially, including emerging evidence from low-and-middle income countries (LMICs). In this umbrella review we aimed to summarize the current epidemiological evidence from systematic reviews and meta-analyses linking ambient air pollution and cardiovascular diseases highlighting regional differences in evidence and vulnerable subpopulations. METHODS: We performed a comprehensive search strategy through the electronic databases PubMed, Embase and Web of Science for articles published between 2010 and 2020. We included systematic reviews and meta-analyses that evaluated the association between ambient air pollution (particulate matter and nitrogen oxides) and multiple CVDs. The search was limited to articles in English and studies on humans. Data screening, quality evaluation using AMSTAR-2 critical domains and extraction were done in duplicate. RESULTS:In preliminary results, our research strategy obtained 1112 hits and finally 70 articles were eligible for the review. The most common outcomes were: CVD-mortality/morbidity/hospitalizations (30 studies), stroke (13), atherosclerosis (10), blood pressure and hypertension (6), myocardial infarction (5), arrhythmias (4), cardiac arrest (2), and heart failure, ischemic heart diseases (1 each). Of the included reviews and meta-analyses, 33 examined only particulate matter, 4 studies examined only nitrogen oxides and 28 studies examined both pollutants. Overall, all studies found that increased levels of ambient air pollution were associated with increased CVDs. CONCLUSIONS:This comprehensive umbrella review summarizes the current evidence concerning both long-term and short-term exposure to ambient air pollution and effects on multiple clinical CVDs. We will describe for which clinical conditions there is most evidence, evaluate the state of the science in/from LMICs and which groups are most vulnerable to the effects of air pollution. KEYWORDS: Air pollution, Particulate matter, Oxides of nitrogen, Cardiovascular diseases, Umbrella review