Increase In PM2 Research Articles

Seasonal associations between air pollutants and influenza in 10 cities of southern China.

Few studies have explored the associations between air pollutants and influenza across seasons, especially at large scales. This study aimed to evaluate seasons' modifying effects on associations between air pollutants and influenza from 10 cities of southern China. Through scientific evidence, it provides mitigation and adaptation strategies with practical guidelines to local health authorities and environmental protection agencies. Daily influenza incidence, meteorological, and air pollutants data from 2016 to 2019 were collected. Quasi-Poisson regression with a distributed lag nonlinear model was used to evaluate city-specific air pollutants and influenza associations. Meta-analysis was used to pool site-specific estimates. Attributable fractions (AFs) of influenza incidence due to pollutants were calculated. Stratified analyses were conducted by season, sex, and age. Overall, the cumulative relative risk (CRR) of influenza incidence for a 10-unit increase in PM2.5, PM10, SO2, NO2, and CO was 1.45 (95% CI: 1.25, 1.68), 1.53 (95% CI: 1.29, 1.81), 1.87 (95% CI: 1.40, 2.48), 1.74 (95% CI: 1.49, 2.03), and 1.19 (95% CI: 1.04, 1.36), respectively. Children aged 0-17 were more sensitive to air pollutants in spring and winter. PM10 had greater effect on influenza than PM2.5 in autumn, winter, and overall, lesser in spring. The overall AF due to PM2.5, PM10, SO2, NO2, and CO was 4.46% (95% eCI: 2.43%, 6.43%), 5.03% (95% eCI: 2.33%, 7.56%), 5.36% (95% eCI: 3.12%, 7.58%), 24.88% (95% eCI: 18.02%, 31.67%), and 23.22% (95% eCI: 17.56%, 28.61%), respectively. AF due to O3 was 10.00% (95% eCI: 4.76%, 14.95%) and 3.65% (95% eCI: 0.50%, 6.59%) in spring and summer, respectively. The seasonal variations in the associations between air pollutants and influenza in southern China would provide evidence to service providers for tailored intervention, especially for vulnerable populations.

Association Between Long-Term Exposure to Fine Particulate Matter Constituents and Progression of Cerebral Blood Flow Velocity in Beijing: Modifying Effect of Greenness.

Few studies have explored the effects of fine particulate matter (PM2.5) and its constituents on the progression of cerebral blood flow velocity (BFV) and the potential modifying role of greenness. In this study, we investigated the association of PM2.5 and its constituents, including sulfate (SO4 2-), nitrate (NO3 -), ammonium (NH4 +), organic matter (OM), and black carbon (BC), with the progression of BFV in the middle cerebral artery. Participants from the Beijing Health Management Cohort who underwent at least two transcranial Doppler sonography examinations during 2015-2020 were recruited. BFV change and BFV change rate were used to define the progression of cerebral BFV. Linear mixed effects models were employed to analyze the data, and the weighted quantile sum regression assessed the contribution of PM2.5 constituents. Additionally, greenness was examined as a modifier. Among the examined constituents, OM exhibited the strongest association with BFV progression. An interquartile range increase in PM2.5 and OM exposure concentrations was associated with a decrease of -16.519cm/s (95% CI: -17.837, -15.201) and -15.403cm/s (95% CI: -16.681, -14.126) in BFV change, and -10.369cm/s/year (95% CI: -11.387, -9.352) and -9.615cm/s/year (95% CI: -10.599, -8.632) in BFV change rate, respectively. Furthermore, stronger associations between PM2.5 and BFV progression were observed in individuals working in areas with lower greenness, those aged under 45years, and females. In conclusion, reducing PM2.5 levels in the air, particularly the OM constituent, and enhancing greenness could potentially contribute to the protection of cerebrovascular health.

Effect measure modification of the association between short-term exposures to PM2.5 and hospitalizations by long-term PM2.5 exposure among a cohort of people with Chronic Obstructive Pulmonary Disease (COPD) in North Carolina, 2002–2015

BackgroundApproximately nine million adults in the United States are living with chronic obstructive pulmonary disease (COPD), and positive associations between short-term air pollution exposure and increased risk of COPD hospitalizations in older adults are consistently reported. We examined the association between short-term PM2.5 exposure and hospitalizations and assessed if there is modification by long-term exposure in a cohort of individuals with COPD.MethodsIn a time-referent case-crossover design, we used a cohort of randomly selected individuals with electronic health records from the University of North Carolina Healthcare System, restricted to patients with a medical encounter coded with a COPD diagnosis from 2004–2016 (n = 520), and estimated ambient PM2.5 concentrations from an ensemble model. Odds ratios and 95% confidence intervals (OR (95%CI)) were estimated with conditional logistic regression for respiratory-related, cardiovascular (CVD), and all-cause hospitalizations. Exposures examined were 0–2 and 0–3 day lags of PM2.5 concentration, adjusting for daily census-tract temperature and humidity, and models were stratified by long-term (annual average) PM2.5 concentration at the median value.ResultsWe observed generally null or low-magnitude negative associations with short-term PM2.5 exposure and respiratory-related (OR per 5 µg/m3 increase in 3-day lag PM2.5: 0.971 (0.885, 1.066)), CVD (2-day lag: 0.976 (0.900, 1.058) and all-cause (3 day lag: 1.003 (0.927, 1.086)) hospitalizations. Associations between short-term PM2.5 exposure and hospitalizations were higher among patients residing in areas with higher levels of annual PM2.5 concentrations (OR per 5 µg/m3 in 3-day lag PM2.5 for all-cause hospitalizations: 1.066 (0.958, 1.185)) than those in areas with lower annual PM2.5 concentrations (OR per 5 µg/m3 in 3-day lag PM2.5 for all-cause hospitalizations: 0.914 (0.804, 1.039)).ConcluisonsDifferences in associations demonstrate that people in areas with higher annual PM2.5 exposure may be associated with higher risk of hospitalization during short-term increases in PM2.5 exposure.

Assessment Of Air Pollution And Its Association With Population Health: Geo-Statistical Evidence From Pakistan

Human health is harmed by air pollution. The objective of this research was to show that air pollution in Pakistan is getting worse and is negatively impacting people’s health. IQ Air and the Institute for Health Metrics and Evaluation provided the data for this descriptive research. Monthly data of PM2.5 μg/m³ from ten different localities across Pakistan are used to show spatial distribution through the geospatial technique of interpolation. The findings show that two third of the country has high PM2.5 concentration, with Lahore as the most polluted city. In Pakistan, solid fuel use has decreased, leading to a decline in associated mortality and morbidity. However, there have been significant increases in PM2.5 and ozone levels, resulting in a rise in the country’s overall health burden caused by air pollution. Furthermore, the number of deaths attributed to air pollution has also increased since 1990. A total of 57% of chronic obstructive pulmonary disease, 40% of lower respiratory infections, 36% of ischemic stroke, 35% of ischemic heart diseases, 32% of lung cancer, 25% of diabetes, and 20% of neonatal outcomes are directly attributed to air pollution in Pakistan. The main contributors to air pollution are population growth, growing motorization, and unsustainable energy usage. The main challenges due to air pollution control and monitoring in Pakistan include a lack of awareness, poor policy creation and implementation, the use of improper fuel, rising energy demands, and an absence of pollution monitoring stations in most cities. Therefore, there is a need for a robust air pollution monitoring system, increased public awareness, and the implementation of clean and sustainable policies to regulate this environmental health issue.

Impact analysis of meteorological variables on PM2.5 pollution in the most polluted cities in China

With the continuous promotion of urbanization in China, air pollution problems have become increasingly prominent in recent years. Various factors, such as emissions, meteorology, and physical and chemical reactions, jointly affect the severity of PM2.5 pollution to a large extent. This study selected five meteorological variables (planetary boundary layer height (PBLH), wind speed (WS), temperature(T), water vapor mixing ratio(Q), and precipitation (PCP)) for perturbation, and 21 different scenarios were set up. In this study, the effects of changes in a single meteorological variable on the pollutants produced in the area were represented by subtracting the baseline scenario (i.e., without perturbation of meteorological variables) simulated in January 2017 separately from each post-disturbance scenario. The results showed that Handan (HD) has the highest annual mean PM2.5 concentration of 85.75 μg/m3 in 2017, while all cities in study area exceeded the secondary concentration limit of urban atmospheric particulate matter. The correlation coefficient (R) between the simulation values of models and the actual monitoring values ranges from 0.41 to 0.74, indicating good model performance and acceptable simulation errors. PBLH (±10%-±20%), WS(±10%-±20%), and PCP(±10%-±20%) all showed a single adverse effect among the five meteorological variables, meaning that a reduction in these three factors led to an increase in PM2.5 concentrations. However, T (±1 K-±1.5 K) and Q (±10%-±20%) could indicate a positive impact under certain conditions. From the sensitivity calculations of single meteorological variables, it is clear that WS, PBLH, and PCP show a highly linear trend in all cities at the 0.01 level of significance. The hypothesis that T changes linearly in 10 cities in the study area is valid, while for Q, the hypothesis that Q changes linearly only occurs in Shijiazhuang and Baoding. When different meteorological variables are disturbed, there are significant spatial differences in the main affected areas of PM2.5 concentrations. By discussing the impact of meteorological variable disturbance on air quality in critically polluted cities in China, this study identified the meteorological variables that can substantially affect PM2.5 concentration. The more complex T and Q should be considered when formulating relevant emission measures.

Association of Fine Particulate Matter and Residential Greenness With Risk of Pulmonary Tuberculosis Retreatment: Population-Based Retrospective Study.

The evidence on the association of fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) with pulmonary tuberculosis (PTB) retreatment is limited. There are no data on whether greenness exposure protects air pollution-related PTB retreatment in patients with prior PTB. In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment. A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index. Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 μg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance. Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment.

Associations Between Hourly Ambient Particulate Matter Air Pollution and Ambulance Emergency Calls: Time-Stratified Case-Crossover Study.

Associations between short-term exposure to ambient particulate matter (PM) air pollutants and mortality or hospital admissions have been well-documented in previous studies. Less is known about the associations of hourly exposure to PM air pollutants with ambulance emergency calls (AECs) for all causes and specific causes by conducting a case-crossover study. In addition, different patterns of AECs may be attributed to different seasons and daytime or nighttime periods. In this study, we quantified the risk of all-cause and cause-specific AECs associated with hourly PM air pollutants between January 1, 2013, and December 31, 2019, in Shenzhen, China. We also examined whether the observed associations of PM air pollutants with AECs for all causes differed across strata defined by sex, age, season, and the time of day. We used ambulance emergency dispatch data and environmental data between January 1, 2013, and December 31, 2019, from the Shenzhen Ambulance Emergency Centre and the National Environmental Monitor Station to conduct a time-stratified case-crossover study to estimate the associations of air pollutants (ie, PM with an aerodynamic diameter less than 2.5 µm [PM2.5] or 10 µm [PM10]) with all-cause and cause-specific AECs. We generated a well-established, distributed lag nonlinear model for nonlinear concentration response and nonlinear lag-response functions. We used conditional logistic regression to estimate odds ratios with 95% CIs, adjusted for public holidays, season, the time of day, the day of the week, hourly temperature, and hourly humidity, to examine the association of all-cause and cause-specific AECs with hourly air pollutant concentrations. A total of 3,022,164 patients were identified during the study period in Shenzhen. Each IQR increase in PM2.5 (24.0 µg/m3) and PM10 (34.0 µg/m3) concentrations over 24 hours was associated with an increased risk of AECs (PM2.5: all-cause, 1.8%, 95% CI 0.8%-2.4%; PM10: all-cause, 2.0%, 95% CI 1.1%-2.9%). We observed a stronger association of all-cause AECs with PM2.5 and PM10 in the daytime than in the nighttime (PM2.5: daytime, 1.7%, 95% CI 0.5%-3.0%; nighttime, 1.4%, 95% CI 0.3%-2.6%; PM10: daytime, 2.1%, 95% CI 0.9%-3.4%; nighttime, 1.7%, 95% CI 0.6%-2.8%) and in the older group than in the younger group (PM2.5: 18-64 years, 1.4%, 95% CI 0.6%-2.1%; ≥65 years, 1.6%, 95% CI 0.6%-2.6%; PM10: 18-64 years, 1.8%, 95% CI 0.9%-2.6%; ≥65 years, 2.0%, 95% CI 1.1%-3.0%). The risk of all-cause AECs increased consistently with increasing concentrations of PM air pollutants, showing a nearly linear relationship with no apparent thresholds. PM air pollution increase was associated with a higher risk of all-cause AECs and cardiovascular diseases-, respiratory diseases-, and reproductive illnesses-related AECs. The results of this study may be valuable to air pollution attributable to the distribution of emergency resources and consistent air pollution control.

Mist cannon trucks can exacerbate the formation of water-soluble organic aerosol and PM2.5 pollution in the road environment

Abstract. Mist cannon trucks have been widely applied in megacities in China to reduce the road dust, since they are considered to be more water saving and efficient than the traditional sprinkling trucks. However, their effect on the formation of water-soluble organic compounds and the pollution control of fine particles (PM2.5) remains unknown. We characterized the variations of chemical compositions in PM2.5 collected on the road sides during the simulated operations of mist cannon truck and traditional sprinkling truck via Fourier transform ion cyclotron resonance mass spectrometry and ion chromatography. The mass concentrations of water-soluble organic carbon in PM2.5 showed a significant increase (62 %–70 %) after air spraying. Furthermore, we found that water-soluble organic compounds, particularly organic nitrates, increased significantly via the interactions of reactive gas-phase organics, atmospheric oxidants and aerosol liquid water after air spraying, although the air spraying had a better effect on suppressing road dust than the ground aspersion. Moreover, the formation of PM2.5 on the road segment where the mist cannon truck passed by was promoted, with an increase of up to 13 % in mass concentration after 25–35 min, on average. Thus, the application of mist cannon trucks potentially worsens the road atmospheric environment through the increase in PM2.5 levels and the production of a large number of water-soluble organic compounds in PM2.5. The overall results provide not only valuable insights to the formation processes of water-soluble organic compounds associated with aerosol liquid water in the road environment but also management strategies to regulate the operation of mist cannon trucks in China.

Association between short-term exposure to PM2.5 and nasal microbiota dysbiosis, inflammation and oxidative stress: A panel study of healthy young adults

Fine particulate matter (PM2.5) is the primary environmental stressor and a significant threat to public health. However, the effect of PM2.5 exposure on human nasal microbiota and its pathophysiological implication remain less understood. This study aimed to explore the associations of PM2.5 exposure with indices of nasal microbiota and biomarkers of nasal inflammation and oxidative stress. We conducted a panel study with 75 students in Xinxiang, Henan Province, China, from September to December 2017. Biomarkers of nasal inflammation and oxidative stress including interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α), 8-epi-prostaglandin F2 alpha (8-epi-PGF2α) and indices of nasal microbiota diversity and phenotypes were measured. Linear mixed-effect models and bioinformatic analyses were performed to assess the association of PM2.5 concentrations with the abovementioned biomarkers and indices. It was found that per 1 μg/m3 increase in PM2.5 was associated with increments of 13.15% (95 % CI: 5.53–20.76 %) and 78.98 % (95 % CI: 21.61–136.36 %) in TNF-α on lag2 and lag02. Indices of microbial diversity and phenotypes including equitability, Shannon index, biofilm forming, and oxidative stress tolerant decreased to different extent with the increment in PM2.5. Notably, thirteen differential microbes in Clostridia, Bacilli, and Gammaproteobacteria classes were recognized as keystone taxa and eight of them were associated with TNF-α, IL-6, or 8-epi-PGF2α. Moreover, environmental adaptation was the most critical functional pathway of nasal microbiota associated with PM2.5 exposure. In summary, short-term exposure to PM2.5 is associated with nasal inflammation, microbiota diversity reduction, and the microbiota phenotype alterations.

COVID-19 and Beyond: COVID-19 Interventions and Power Plant Emissions in the United States

Short- and long-term changes in electricity generating unit (EGU) emissions were observed during COVID-19 public health interventions in the United States. In a generalized synthetic control framework, we employ weekly EGU SO2, NOx, and CO2 emissions data from EPA’s Clean Air Markets Database and location-specific meteorology from 2010 to 2019 to estimate each EGU’s hypothetical business as usual (BAU) emissions throughout 2020. We find that over 60% (covering >50% of total electricity generation) of EGUs saw SO2, NOx, and CO2 emissions increases relative to BAU, with most of the increases occurring in the eastern U.S. We find increases relative to BAU in the March–April stringent lockdown period for SO2, NOx, and CO2 of 44% (4500 tons/week), 23% (2200 tons/week), and 14% (2.3 million tons/week), respectively, with similar results from March to December 2020. We find that EGUs using coal as primary fuels are the main driver of increased emissions due to increased operations, and SO2 emissions increases at coal EGUs led to a 28% increase in PM2.5 related to coal SO2 emissions relative to BAU across March–December. We find increases in SO2 and NOx emissions factors at coal EGUs in 2020 relative to 2019 that likely played a role in these increases, and we identify changes in coal fuel consumption and price that may have played a role.

Independent and interactive associations between greenness and ambient pollutants on novel glycolipid metabolism biomarkers: A national repeated measurement study

This study aims to investigate the independent and interactive effects of greenness and ambient pollutants on novel glycolipid metabolism biomarkers. A repeated national cohort study was conducted among 5085 adults from 150 counties/districts across China, with levels of novel glycolipid metabolism biomarkers of TyG index, TG/HDL-c, TC/HDL-c, and non-HDL-c measured. Exposure levels of greenness and ambient pollutants (including PM1, PM2.5, PM10, and NO2) for each participant were determined based on their residential location. Linear mixed-effect and interactive models were used to evaluate the independent and interactive effects between greenness and ambient pollutants on the four novel glycolipid metabolism biomarkers. In the main models, the changes [β (95% CIs)] of TyG index, TG/HDL-c, TC/HDL-c, and non-HDL-c were −0.021 (−0.036, −0.007), −0.120 (−0.175, −0.066), −0.092 (−0.122, −0.062), and −0.445 (−1.370, 0.480) for every 0.1 increase in NDVI, and were 0.004 (0.003, 0.005), 0.014 (0.009, 0.019), 0.009 (0.006, 0.011), and 0.067 (−0.019, 0.154) for every 1 μg/m3 increase in PM1. Results of interactive analyses demonstrated that individuals living in low-polluted areas could get greater benefits from greenness than those living in highly-polluted areas. Additionally, the results of mediation analyses revealed that PM2.5 mediated 14.40% of the association between greenness and the TyG index. Further research is needed to validate our findings.

Short-term effects of individual exposure to PM2.5 on hospital admissions for myocardial infarction and stroke: a population-based case-crossover study in Guangzhou, China.

Some studies have investigated the effects of PM2.5 on cardiovascular diseases based on the population-average exposure data from several monitoring stations. No one has explored the short-term effect of PM2.5 on cardiovascular hospitalizations using individual-level exposure data. We assessed the short-term effects of individual exposure to PM2.5 on hospitalizations for myocardial infarction (MI) and stroke in Guangzhou, China, during 2014-2019. The population-based data on cardio-cerebrovascular events were provided by Guangzhou Center for Disease Control and Prevention. Average annual percent changes (AAPCs) were used to describe trends in the hospitalization rates of MI and stroke. The conditional logistic regression model with a time-stratified case-crossover design was applied to estimate the effects of satellite-retrieved PM2.5 with 1-km resolution as individual-level exposure. Furthermore, we performed stratified analyses by demographic characteristics and season. There were 28,346 cases of MI, 188,611, and 36,850 cases of ischemic stroke (IS) and hemorrhagic stroke (HS), respectively, with an annual average hospitalization rate of 37.2, 247, and 48.4 per 100,000 people. Over the six-year study period, significant increasing trends in the hospitalization rates were observed with AAPCs of 12.3% (95% confidence interval [CI]: 7.24%, 17.6%), 13.1% (95% CI: 9.54%, 16.7%), and 9.57% (95% CI: 6.27%, 13.0%) for MI, IS, and HS, respectively. A 10μg/m3 increase in PM2.5 was associated with an increase of 1.15% (95% CI: 0.308%, 1.99%) in MI hospitalization and 1.29% (95% CI: 0.882%, 1.70%) in IS hospitalization. A PM2.5-associated reduction of 1.17% (95% CI: 0.298%, 2.03%) was found for HS hospitalization. The impact of PM2.5 was greater in males than in females for MI hospitalization, and greater effects were observed in the elderly (≥ 65years) and in cold seasons for IS hospitalization. Our study added important evidence on the adverse effect of PM2.5 based on satellite-retrieved individual-level exposure data.

Cardiovascular effects of wearing respirators against particulate matter: A randomized crossover trial

Fine particles (PM2.5) are implicated as an important risk to cardiovascular health. N95 respirators had been widely used to provide protection by filtering particles. Yet the practical effects of wearing respirators have not been fully understood. This study aimed to evaluate the cardiovascular effects of respirator wearing against PM2.5 and underpin the understanding of the mechanisms of cardiovascular responses triggered by PM2.5. We conducted a randomized, double-blind crossover trial among 52 healthy adults in Beijing, China. Participants were exposed to outdoor PM2.5 for 2 h in alterations wearing true respirators (with membranes) or sham ones (without membranes). We measured ambient PM2.5 and tested the filtration efficiency of the respirators. We compared the heart rate variability (HRV), blood pressure and arterial stiffness indicators between the true respirator group and the sham respirator group. Concentrations of ambient PM2.5 during the 2-h exposure ranged from 4.9 to 255.0 μg/m3. The filtration efficiency of true respirators was 90.1 % and that of sham ones was 18.7 %. Between-group differences varied by pollution levels. On less polluted days (PM2.5< 75 μg/m3), participants wearing true respirators showed lower levels of HRV and higher levels of heart rate compared with those wearing sham respirators. These between-group differences were inconspicuous on heavily polluted days (PM2.5≥ 75 μg/m3). We found that a 10 μg/m3 increase in PM2.5 was associated with a 2.2 % to 6.4 % decrease in HRV, prominent at 1 h after the start of exposure. N95 respirators have good performance in reducing PM2.5 exposure. Short-term exposure to PM2.5 can induce very acute responses in autonomic nervous function. However, the overall effects of wearing respirators might be not always favorable to human health in terms of their inherent adverse effects, which seem dependent on the levels of air pollution. Precise individual protection recommendations warrant to be developed.

Short-term residential exposure to air pollution and risk of acute myocardial infarction deaths at home in China

Air pollution remains a major threat to cardiovascular health and most acute myocardial infarction (AMI) deaths occur at home. However, currently established knowledge on the deleterious effect of air pollution on AMI has been limited to routinely monitored air pollutants and overlooked the place of death. In this study, we examined the association between short-term residential exposure to China’s routinely monitored and unmonitored air pollutants and the risk of AMI deaths at home. A time-stratified case-crossover analysis was undertaken to associate short-term residential exposure to air pollution with 0.1 million AMI deaths at home in Jiangsu Province (China) during 2016–2019. Individual-level residential exposure to five unmonitored and monitored air pollutants including PM1 (particulate matter with an aerodynamic diameter ≤ 1 μm) and PM2.5 (particulate matter with an aerodynamic diameter ≤ 2.5 μm), SO2 (sulfur dioxide), NO2 (nitrogen dioxide), and O3 (ozone) was estimated from satellite remote sensing and machine learning technique. We found that exposure to five air pollutants, even below the recently released stricter air quality standards of the World Health Organization (WHO), was all associated with increased odds of AMI deaths at home. The odds of AMI deaths increased by 20% (95% confidence interval: 8 to 33%), 22% (12 to 33%), 14% (2 to 27%), 13% (3 to 25%), and 7% (3 to 12%) for an interquartile range increase in PM1, PM2.5, SO2, NO2, and O3, respectively. A greater magnitude of association between NO2 or O3 and AMI deaths was observed in females and in the warm season. The greatest association between PM1 and AMI deaths was found in individuals aged ≤ 64 years. This study for the first time suggests that residential exposure to routinely monitored and unmonitored air pollutants, even below the newest WHO air quality standards, is still associated with higher odds of AMI deaths at home. Future studies are warranted to understand the biological mechanisms behind the triggering of AMI deaths by air pollution exposure, to develop intervention strategies to reduce AMI deaths triggered by air pollution exposure, and to evaluate the cost-effectiveness, accessibility, and sustainability of these intervention strategies.Graphical abstract

Ambient fine particulate matter and allergic symptoms in the middle-aged and elderly population: results from the PIFCOPD study

BackgroundThe associations between short- and long-term exposure to ambient fine particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM2.5) and allergic symptoms in middle-aged and elderly populations remain unclear, particularly in China, where most cities have severe air pollution.MethodsParticipants (n = 10,142; age = 40–75 years) were recruited from ten regions in China from 2018 to 2021 for the Predictive Value of Inflammatory Biomarkers and Forced Expiratory Volume in 1 s (FEV1) for Chronic Obstructive Pulmonary Disease (PIFCOPD) study. Short-term (lag0 and lag0–7 day) and long-term (1-, 3- and 5-year) PM2.5 concentrations at residences were extracted from the air pollutant database known as Tracking Air Pollution (TAP) in China. Multivariate logistic regression models were used to estimate associations for short- and long-term PM2.5 exposure concentrations and long-term exposure models were additionally adjusted for short-term deviations.ResultsA 10 µg/m3 increase in PM2.5 on the day the allergic symptoms questionnaire was administered (lag0 day) was associated with higher odds of allergic nasal (1.09, 95% CI 1.05, 1.12) and eye symptoms (1.08, 95% CI 1.05, 1.11), worsening dyspnea caused by allergens (1.06, 95% CI 1.02, 1.10), and ≥ 2 allergic symptoms (1.07, 95% CI 1.03, 1.11), which was similar in the lag0–7 day concentrations. A 10 µg/m3 increase in the 1-year average PM2.5 concentration was associated with an increase of 23% for allergic nasal symptoms, 22% for eye symptoms, 20% for worsening dyspnea caused by allergens, and 21% for ≥ 2 allergic symptoms, similar to the 3- and 5-year average PM2.5 concentrations. These associations between long-term PM2.5 concentration and allergic symptoms were generally unchanged after adjustment for short-term deviations.ConclusionsShort- and long-term exposure to ambient PM2.5 was associated with an increased risk of allergic nasal and eye symptoms, worsening dyspnea caused by allergens, and ≥ 2 allergic symptoms.Trial registrationClinical trial ID: NCT03532893 (29 Mar 2018).

Mortality burden based on the associations of ambient PM2.5 with cause-specific mortality in China: Evidence from a death-spectrum wide association study (DWAS)

Although studies have estimated the associations of PM2.5 with total mortality or cardiopulmonary mortality, few have comprehensively examined cause-specific mortality risk and burden caused by ambient PM2.5. Thus, this study investigated the association of short-term exposure to PM2.5 with cause-specific mortality using a death-spectrum wide association study (DWAS). Individual information of 5,450,764 deaths during 2013–2018 were collected from six provinces in China. Daily PM2.5 concentration in the case and control days were estimated by a random forest model. A time-stratified case-crossover study design was applied to estimate the associations (access risk, ER) of PM2.5 with cause-specific mortality, which was then used to calculate the population-attributable fraction (PAF) of mortality and the corresponding mortality burden caused by PM2.5. Each 10 μg/m3 increase in PM2.5 concentration (lag03) was associated with a 0.80 % [95 % confidence interval (CI): 0.73 %, 0.86 %] rise in total mortality. We found greater mortality effect at PM2.5 concentrations < 50 μg/m3. Stratified analyses showed greater ERs in females (1.01 %, 95 %CI: 0.91 %, 1.11 %), children ≤ 5 years (2.17 %, 95 %CI: 0.85 %, 3.51 %), and old people ≥ 70 years. We identified 33 specific causes (level 2) of death which had significant associations with PM2.5, including 16 circulatory diseases, 9 respiratory diseases, and 8 other causes. The PAF estimated based on the overall association between PM2.5 and total mortality was 3.16 % (95 %CI: 2.89 %, 3.40 %). However, the PAF was reduced to 2.88 % (95 %CI: 1.88 %, 3.81 %) using the associations of PM2.5 with 33 level 2 causes of death, based on which 250.15 (95 %CI: 163.29, 330.93) thousand deaths were attributable to short-term PM2.5 exposure across China in 2019. Overall, this study provided a comprehensive picture on the death-spectrum wide association between PM2.5 and morality in China. We observed robust positive cause-specific associations of PM2.5 with mortality risk, which may provide more precise basis in assessing the mortality burden of air pollution.

What influences the regional variation of heart failure in Poland?

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Science Center, Poland. In Poland, more than 1.5 million people suffer from chronic heart failure (HF), and the rate of hospitalization for HF is one of the highest in Europe The risk of hospitalization of patients with HF is related not only to lifestyle, but also to environmental, economic, social factors and the organization of the health care system. The main purpose of the research is an assessment the impact of environmental and socioeconomic factors on hospitalized heart failure prevalence. We analyzed age- and gender-standardized data on the frequency of hospitalizations due to CHF in Poland in 2012-2019. In addition, using data from the National Institute of Public Health, the Central Statistical Office and Provincial Environmental Inspectorates, as well as panel data regression techniques, the impact of environmental and socioeconomic factors on HF in Poland in 2012-2019 was estimated. During the period analyzed, there were 1,618,734 hospitalizations due to CHF (51.3% male; 82.6% over 65 years of age). An increase in the number of physicians by 10/10000 population resulted in a 3% decrease in hospitalizations due to CHF (β=-0.029; 95%Cl -0.004 - -0.013; P=0.001). In addition, the development of a network of outpatient health care facilities resulted in a 0.3% decrease in hospitalizations for each newly established unit per 1,000 residents (β=-0.031; 95%Cl -0.048 - -0.014; P=0.000). The main environmental factors reducing hospitalized prevalence due to CHF were the proportion of green areas in the analyzed environment (2.7% decrease for a percentage point increase in the proportion of green areas; β=-0.027; 95%Cl -0.053 - -0.001; P=0.047) and pollution levels (a 10 µg/m3 increase in PM2.5 and PM10 concentrations in the province resulted in a county-wide increase in hospitalizations of 7.5% [β=0.075, 95%CI 0.013-0.137, P=0.017] and 6% [β=0.060; 95%CI 0.012 -0.108, P=0.015]). The opposite relationship was observed for the number of cars; an increase of 100 cars per 1,000 residents was associated with a 6% increase in hospitalizations due to CHF (β=0.064; 95%Cl (0.008 - 0.121; P=0.026). An injection of PLN 100 per capita per year into the health sector by local governments results in a 3.5% decrease in hospitalizations (β=-0.003; 95%Cl (-0.006 - -0.001; P=0.002). Also, the situation in local labor markets translates into hospitalizations due to CHF - a 1 pp increase in the unemployment rate results in an average one percent increase in HF. The number of hospitalizations for heart failure has been increasing in the last decade and this trend is most noticeable in regions with low levels of socioeconomic development and poor medical facilities. Health policy measures using environmental and socioeconomic instruments can result in no less positive health effects than the use of health care tools alone.

The association between chemical constituents of ambient fine particulate matter and obesity in adults: A large population-based cohort study

ObjectivesCurrent evidence demonstrated that ambient fine particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) and its constituents may be obesogenic in children, but evidence from adults is lacking. Our aim was to characterize the association between PM2.5 and its constituents and obesity in adults. MethodsWe included 68,914 participants from the China Multi-Ethnic Cohort (CMEC) baseline survey. Three-year average concentrations of PM2.5 and its constituents were evaluated by linking pollutant estimates to the geocoded residential addresses. Obesity was defined as body mass index (BMI) ≥ 28 kg/m2. Logistic regression was used to examine the relationship between PM2.5 and its constituents and obesity. We performed weighed quantile sum (WQS) regression to get the overall effect of PM2.5 and its constituents and the relative contribution of each constituent. ResultsPer-SD increase in PM2.5 (odds ratio [OR] = 1.43, 95% confidence interval [CI]: 1.37–1.49), black carbon (BC) (1.42, 1.36–1.48), ammonium (1.43, 1.37–1.49), nitrate (1.44, 1.38–1.50), organic matter (OM) (1.45, 1.39–1.51), sulfate (1.42, 1.35–1.48), and soil particles (SOIL) (1.31, 1.27–1.36) were positively associated with obesity, and SS (0.60, 0.55–0.65) was negatively associated with obesity. The overall effect (OR = 1.34, 95% CI: 1.29–1.41) of the PM2.5 and its constituents was positively associated with obesity, and ammonium made the most contribution to this relationship. Participants who were older, female, never smoked, lived in urban areas, had lower income or higher levels of physical activity were more significantly adversely affected by PM2.5, BC, ammonium, nitrate, OM, sulfate and SOIL compared to other individuals. ConclusionOur study revealed that PM2.5 constituents except SS were positively associated with obesity, and ammonium played the most important role. These findings provided new evidence for public health interventions, especially the precise prevention and control of obesity.

Outdoor air pollution and histologic composition of normal breast tissue

BackgroundBiologic pathways underlying the association between outdoor air pollution and breast cancer risk are poorly understood. Breast tissue composition may reflect cumulative exposure to breast cancer risk factors and has been associated with breast cancer risk among patients with benign breast disease. Herein, we evaluated whether fine particulate matter (PM2.5) was associated with the histologic composition of normal breast tissue. MethodsMachine-learning algorithms were applied to digitized hematoxylin and eosin-stained biopsies of normal breast tissue to quantify the epithelium, stroma, adipose and total tissue area from 3,977 individuals aged 18–75 years from a primarily Midwestern United States population who donated breast tissue samples to the Susan G. Komen Tissue Bank (2009–2019). Annual levels of PM2.5 were assigned to each woman’s residential address based on year of tissue donation. We applied predictive k-means to assign participants to clusters with similar PM2.5 chemical composition and used linear regression to examine the cross-sectional associations between a 5-μg/m3 increase in PM2.5 and square root-transformed proportions of epithelium, stroma, adipose, and epithelium-to-stroma proportion [ESP], overall and by PM2.5 cluster. ResultsHigher residential PM2.5 was associated with lower proportion of breast stromal tissue [β = -0.93, 95% confidence interval: (-1.52, −0.33)], but was not related to the proportion of epithelium [β = -0.11 (-0.34, 0.11)]. Although PM2.5 was not associated with ESP overall [β = 0.24 (-0.16, 0.64)], the association significantly differed by PM2.5 chemical composition (p-interaction = 0.04), with a positive association evident only among an urban, Midwestern cluster with higher concentrations of nitrate (NO3–) and ammonium (NH4+) [β = 0.49 (0.03, 0.95)]. ConclusionsOur findings are consistent with a possible role of PM2.5 in breast cancer etiology and suggest that changes in breast tissue composition may be a potential pathway by which outdoor air pollution impacts breast cancer risk. This study further underscores the importance of considering heterogeneity in PM2.5 composition and its impact on breast carcinogenesis.

Long-term ambient air pollution and venous thromboembolism in a population-based Swedish cohort

Air pollution is a major contributor to the global burden of disease and has been linked to several diseases and conditions, including cardiovascular disease. The biological mechanisms are related to inflammation and increased coagulability, factors that play an important role in the pathogenesis of venous thromboembolism (VTE, i.e., deep vein thrombosis or pulmonary embolism). This study investigates if long-term exposure to air pollution is associated with increased VTE incidence. The study followed 29 408 participants from the Malmö Diet and Cancer (MDC) cohort, which consists of adults aged 44–74 recruited in Malmö, Sweden between 1991 and 1996. For each participant, annual mean residential exposures to particulate matter <2.5 μg (PM2.5) and <10 μg (PM10), nitrogen oxides (NOx) and black carbon (BC) from 1990 up to 2016 were calculated. Associations with VTE were analysed using Cox proportional hazard models for air pollution in the year of the VTE event (lag0) and the mean of the prior 1–10 years (lag1-10). Annual air pollution exposures for the full follow-up period had the following means: 10.8 μg/m3 for PM2.5, 15.8 μg/m3 for PM10, 27.7 μg/m3 for NOx, and 0.96 μg/m3 for BC. The mean follow-up period was 19.5 years, with 1418 incident VTE events recorded during this period. Exposure to lag1-10 PM2.5 was associated with an increased risk of VTE (HR 1.17 (95%CI 1.01–1.37)) per interquartile range (IQR) of 1.2 μg/m3 increase in PM2.5 exposure. No significant associations were found between other pollutants or lag0 PM2.5 and incident VTE. When VTE was divided into specific diagnoses, associations with lag1-10 PM2.5 exposure were similarly positive for deep vein thrombosis but not for pulmonary embolism. Results persisted in sensitivity analyses and in multi-pollutant models. Long-term exposure to moderate concentrations of ambient PM2.5 was associated with increased risks of VTE in the general population in Sweden.