Relative Risk Values Research Articles

Historical Review of the Use of Relative Risk Statistics in the Portrayal of the Purported Hazards of High LDL Cholesterol and the Benefits of Lipid-Lowering Therapy.

The manner in which clinical trial investigators present their findings to healthcare providers and the public can have a substantial influence on their impact. For example, if a heart attack occurs in 2% of those in the placebo group and in 1% of those in the drug-treated group, the benefit to the treated population is only one percentage point better than no treatment. This finding is unlikely to generate much enthusiasm from the study sponsors and in the reporting of the findings to the public. Instead, trial directors can amplify the magnitude of the appearance of the treatment benefit by using the relative risk (RR) value of a 50% reduction of the risk of a heart attack, since one is 50% of two. By using the RR type of data analysis, clinical trial directors can promote the outcome of their trial in their publication and to the media as highly successfulwhile minimizing or disregarding entirelythe absolute risk (AR) reduction of only one percentage point. The practice of expressing the RR without the AR has become routinely deployed in the reporting of findings in many different areas of clinical research. We have provided a historical perspective on how this form of data presentation has become commonplace in the reporting of findings from randomized controlled trials (RCTs) on coronary heart disease (CHD) event monitoring and prevention over the past four decades. We assert that the emphasis on RR coupled with insufficient disclosure of AR in the reporting of RCT outcomes has led healthcare providers and the public to overestimate concerns about high cholesterol and to be misled as to the magnitude of the benefits of cholesterol-lowering therapy. The goal of this review is to prompt the scientific community to address this misleading approach to data presentation.

공간자료에 대한 통계적 위험 경계선 결정 방법에 대한 연구

Relative risk maps are widely used across various industries such as healthcare, transportation, and environmental area because they allow for the identification of risk region. In this study, a Bayesian spatial hierarchical model based on a Poisson distribution was used to estimate relative risk by incorporating spatial data from within the study area. However, while risk areas were identified based on the estimated relative risk that was the final model outcome, it is important to note that the existence of spatial correlation in certain areas within the study area may result in significantly different estimated relative risk values despite their close geographic proximity. This presents a limitation in accurately defining the areas of highest risk within the study area. The aim of this study was to estimate the risk boundary within the study area, which was defined as the boundary between areas with different estimated relative risk values based on observed variables in various traffic environments. To achieve this goal, the study proposed a method for determining the risk boundary on the relative risk map. The results of the analysis indicated that the installation ratio of bus-only lanes and the number of intersections had a statistically significant impact on determining the risk boundary.

INTRINSIC AND EXTRINSIC FACTORS ASSOCIATED WITH SEXTING BEHAVIOR AMONG YOUNG PEOPLE: A SYSTEMATIC REVIEW

Sexting refers to the sharing of sexually explicit digital messages via online platform. This behavior is becoming more prevalent among young people and has been linked to a number of detrimental effects. The current systematic review has aimed to examine the significant intrinsic and extrinsic factors associated with sexting behavior among youths. The relevant studies were found via six electronic databases and the eligible studies include studies that measured intrinsic and extrinsic factors associated with sexting behavior as dependent variables among the mean age group 10 to 24 years old, and cross-sectional, cohort, or case-control studies that reported the odds ratio (OR) or relative risk (RR) value and significant p-value or 95% CI. A total of 14 articles that were produced between years 2014 to 2020 were included in the qualitative synthesis. From these 14 studies, the reported significant factors associated with sexting were age, puberty, sex, sexual orientation, personal characteristics, psychosocial factors, peers, family, relationship status, sexual activity, internet use, and online-related activities. Perception of popular peer’s sexting behavior and female sex were the reported intrinsic factors with the highest odds ratio (OR) value. Participation in risky online activities and a history of sexual activity were reported to have the highest OR value among other extrinsic factors. In contrast to prior reviews on sexting that have mostly focused on the association of sexting with sexual risk behavior and mental health, this review has closely examined both individual and extrinsic factors related with sexting behavior, particularly among youths. The findings from this review can assist in the development of more comprehensive health education and behavioral intervention on sexting behavior among youths, such as using peer-based intervention and limiting the duration of internet use.

THE INFLUENCE OF NUTRITIONAL STATUS ON COGNITIVE DEVELOPMENT PRE-SCHOOL AGE CHILDREN

Early childhood period is in dire need of good nutrition. Poor nutritional statuscan cause delays in children's cognitive development. Nutrition report global (2020), statedthe whole countryexperiencing nutritional problems. Globally, the most children with malnutrition problems are in Sub-Saharan Africa.Indonesia is experiencing a triple burden of disease, namely malnutrition, obesity and stunting. The aim of the study was to analyze the effect of nutritional status on the cognitive development of pre-school aged children. This research approachis a retrospective cohort analytic study with a sampling technique using purposive sampling. This study was conducted using data from 79 children aged 5-6 years from early childhood education school students. Nutritional status is determined using anthropometry by measuring body weight and height based on the child's age. Assessing children's cognitive abilities using instruments from the Mini Mental State Examination (MMSE) questionnaire. The results showed that 72.2% of children's nutritional status was normal and 72.2% of children's cognitive development was normal. Data analysis was based on the chi-square test, p-value = 0.011 (p <0.05), with a relative risk value of 2.591. Shows that nutritional status has an effect of 2.591 times on the cognitive development of pre-school age children.

Premature deaths related to urban air pollution in Poland

In the present study, we conducted a risk assessment of urban population exposure to ambient particles (PM2.5, PM10), nitrogen dioxides (NO2), and tropospheric ozone (O3) in six Polish urban areas over the period 2015–2020. The main goals were to: i) evaluate the number of premature deaths attributed to ambient air pollutants, and to ii) assess the effectiveness of emissions control policies in reducing urban population exposure to air pollution, and thus related health effects. For that, we used air quality data from 15 urban monitoring stations and city-specific health data (relative risk values and baseline incidence). For all cities, the annual PM2.5, PM10, and NO2 mean concentrations exceeded the 2021 World Health Organization Air Quality Guidelines in 2015–2020. In all cities, the annual PM2.5 (- 0.5% to - 6.1% year−1), PM10 (- 1.6 to - 8.1% year−1), and NO2 (- 1.3% to - 4.5% year−1) mean concentrations declined over time, while O3 levels rose (+1.0% to + 4.2% year−1). Exposure to ambient PM2.5, PM10, NO2, and O3 has substantially contributed to mortality in the six studied cities: a total of 6700 deaths for non-accidental causes, 2310 deaths for cardiovascular diseases, and 500 deaths for respiratory diseases were reported. Between 2015 and 2020, the number of annual PM2.5-, PM10-, and NO2-related premature deaths decreased (respectively, by - 8.4, - 6.7, and - 2.1 deaths per 106 inhabitants) in line with cleaner air. The rising O3 levels led to an increase in annual O3-related premature deaths (+1.3 deaths per 106 inhabitants) over time. A major concern is related to the overrun of exposure metrics compared to the target values for human health. To date, human health is mainly threatened by PM2.5 and O3, particularly in Southern Poland.

Urinary Amino Acid-Conjugated Acrolein and Taurine as New Biomarkers for Detection of Dementia.

Dementia, including Alzheimer's disease (AD), is one of the serious diseases at advanced age, and its early detection is important for maintaining quality of life (QOL). In this study, we sought novel biomarkers for dementia in urine. Samples of urine were collected from 57 control subjects without dementia, 62 mild cognitive impairment (MCI) patients, and 42 AD patients. Mini-Mental State Examination (MMSE) was evaluated when subjects were examined by medical doctors. Urinary amino acid (lysine)-conjugated acrolein (AC-Acro) was measured using N ɛ-(3-formyl-3, 4-dehydropiperidine) lysine (FDP-Lys) ELISA kit, and taurine content was measured using a taurine assay kit. Values were normalized by creatinine content which was measured with the colorimetric assay kit. We found that urinary amino acid (lysine)-conjugated acrolein (AC-Acro) and taurine negatively correlated with MMSE score and are significantly lower in dementia patients compared to the normal subjects. When AC-Acro and taurine were evaluated together with age using an artificial neural network model, median relative risk values for subjects with AD, subjects with mild cognitive impairment, and control subjects were 0.96, 0.53, and 0.06, respectively. Since urine is relatively easy to collect, our findings provide a novel biomarker for dementia without invasiveness.

Anti-epithelial-derived cytokines for severe asthma: Systematic review and meta-analysis

Therapies directed against epithelial-derived cytokines, often referred to as alarmins, have been studied in large randomized trials, and reports suggest possible benefit for non-type 2 as well as type 2 severe asthma. We performed a systematic review of Medline, Embase, Cochrane Central Register of Controlled Trials, Medline In-Process, and Web of Science databases from inception to March 2022. We performed a random-effects pairwise meta-analysis of randomized controlled trials addressing antialarmin therapy in severe asthma. Results use relative risk (RR) values and 95% confidence intervals (CIs). For continuous outcomes, we report mean difference (MD) values and 95% CIs. We define high eosinophils as ≥300 cells/μL and low eosinophils as <300 cells/μL. We used Cochrane-endorsed RoB 2.0 software to assess the risk of bias of trials, and we used the Grades of Recommendation Assessment, Development, and Evaluation (aka GRADE) framework to assess the certainty of the evidence. We identified 12 randomized trials including 2391 patients. Antialarmins probably reduce annualized exacerbation rates in patients with high eosinophils (RR 0.33 [95% CI 0.28 to 0.38]; moderate certainty). Antialarmins may reduce this rate in patients with low eosinophils (RR 0.59 [95% CI 0.38 to 0.90]; low certainty). Antialarmins improve FEV1 in patients with high eosinophils (MD 218.5 mL [95% CI 160.2 to 276.7]; high certainty). Antialarmin therapy probably does not improve FEV1 in patients with low eosinophils (MD 68.8 mL [95% CI 22.4 to 115.2]; moderate certainty). Antialarmins reduce blood eosinophils, total IgE, and fractional excretion of nitric oxide across studied subjects. Antialarmins are effective at improving lung function and probably reduce exacerbations in patients with severe asthma and blood eosinophils ≥300 cells/μL. The effect on patients with lower eosinophils is less certain.

Обоснование оптимальных параметров яркости экрана интерактивной панели для снижения риска общего и зрительного утомления школьников

The digital transformation of modern education contributes to the active introduction of interactive panels (IP) into the educational process, replacing traditional chalkboards. Minimizing possible risk factors when using an IP also requires considering the visual characteristics of its screen. At present, there are no results of such studies in the scientific literature. The purpose of this work was to substantiate the optimal range of IP screen brightness when it is used in the classroom to prevent general and visual fatigue of schoolchildren. We analysed research articles describing studies in visual hygiene, lighting engineering, display technologies, etc. Our study involved measuring brightness and pulsation coefficient of a working IP screen. Ranges of IP screen brightness that could produce harmful effects on children's health have been empirically established. With the help of a specially designed questionnaire, complaints of students attending the 4th grade of secondary schools were studied to identify general and visual fatigue, as well as factors caused by the IP and negatively affecting the respondents’ well-being. The relative risk values are calculated, namely a probability that these complaints would occur in schoolchildren, depending on parameters of IP screen brightness. The optimal range of IP screen brightness is justified for a working mode that significantly reduces the probability of students complaining about general and visual fatigue. Monitoring and correction of IP screen brightness mode during classes will reduce the risks of students' health disorders. It is necessary to continue research to substantiate the optimal visual characteristics of the IP screen based on investigating indicators describing the functional state of the child's body.

Substantiation of the optimum screen brightness parameters of the interactive panel to reduce the risk of general and visual fatigue of schoolchildren

The digital transformation of modern education contributes to the active introduction of interactive panels (IP) into the educational process, replacing traditional chalkboards. Minimizing possible risk factors when using an IP also requires considering the visual characteristics of its screen. At present, there are no results of such studies in the scientific literature. The purpose of this work was to substantiate the optimal range of IP screen brightness when it is used in the classroom to prevent general and visual fatigue of schoolchildren. We analysed research articles describing studies in visual hygiene, lighting engineering, display technologies, etc. Our study involved measuring brightness and pulsation coefficient of a working IP screen. Ranges of IP screen brightness that could produce harmful effects on children's health have been empirically established. With the help of a specially designed questionnaire, complaints of students attending the 4th grade of secondary schools were studied to identify general and visual fatigue, as well as factors caused by the IP and negatively affecting the respondents’ well-being. The relative risk values are calculated, namely a probability that these complaints would occur in schoolchildren, depending on parameters of IP screen brightness. The optimal range of IP screen brightness is justified for a working mode that significantly reduces the probability of students complaining about general and visual fatigue. Monitoring and correction of IP screen brightness mode during classes will reduce the risks of students' health disorders. It is necessary to continue research to substantiate the optimal visual characteristics of the IP screen based on investigating indicators describing the functional state of the child's body.

Evaluation of the Significance of the Psychosocial Risk Factors in Patients with Cerebrovascular Disease

The report presents a randomized study to assess the significance of psychosocial (PS) factors for the dominant brain form of atherosclerosis – cerebrovascular disease (CVD), using a battery of original tests to assess and quantify the psychosocial status of the subjects and a validated test for conventional risk factors, compiled in an integrated questionnaire. The study enrolled a total of 201 subjects: normal control group (NC, N=100); group of patients with CVD (CVD; N=101). The test for conventional risk factors (I) found significantly higher negative values in patients with CVD, in comparison to the clinically healthy control group. In the case of the specific PS tests II (Psychosocial Personality Assessment), III (Spiritual Dysfunction), and IV (Stress and Adaptation), we found significantly lower parameter values in the CVD group vs. the NC group. The study using the cognitive test V, found again significantly lower test values in patients with CVD, compared to the NC subjects. On the basis of the settled standards, it was found that PS test II, III and IV parameters were normal in 76% of cases in the clinically healthy subjects and were risky or pathological in almost 60% of cases in patients with atherosclerosis. The deteriorated quality of life and lack of happiness comprise a major risk factor for the onset and development of atherosclerosis. The relative risk (RR) for developing atherosclerosis in conventional risk factors according to Test I is 1.5. In the case of the PS risk factors, the RR values are 1.5. These findings firmly demonstrate that the psychosocial factors are just as significant risk factors for atherosclerosis as the conventional ones.

Identifikasi Bahaya Perencanaan Proyek Renovasi Gedung Hotel Horison Express Fatmawati Jakarta

The implementation of construction development is an activity that causes many elements of danger, so it has a risk of work accidents. Factors that cause work accidents, ranging from a lack of employee discipline in maintaining occupational health and safety. This identification aims to assess the risks in the Planning of the Horison Express Hotel Building Renovation Fatmawati Jakarta, using a questionnaire with a frequency value (F) and a severity value (A), the results of the identification of the IBPRP method there are work items with a moderate level of risk in the Lt. 1-4 the relative risk value is obtained with a value of 9 (medium), and the work with a high level of risk is in the Lt. Structural Work. 5-6 relative risk values obtained Value of 20 (High), the results of the identification there are 58 basic events that cause the basic risk of 26 items of work, obtained a presentation of the value of low risk level of: 50%, moderate risk level of: 46.5%, and high risk level of: 3.5%. For hazard identification methods other than using the IBPRP method, can use other hazard identification methods for research on the same theme.

RELATIVE RISK ANALYSIS OF THE SPREAD OF COVID-19 VIRUS IN MEDAN CITY BY SPATIAL AND NON-SPATIAL APPROACHES

&lt;span lang="EN"&gt;The city of Medan is the city with the highest cases of COVID-19 virus among cities in North Sumatra. This study was conducted to analyze the relative risk level for the spread of the COVID-19 virus. Estimation of relative risk is a statistic in disease mapping that is used to determine the distribution of disease. Relative risk estimation can be estimated using a direct estimator model or Standardized Morbility ratio and a small area estimation model using Bayesian Conditional Autoregressive (CAR) with the Poisson-Gamma model. The Poisson-Gamma model is one of the models in estimating small areas in the form of count data which is suitable for use in disease mapping cases. This study aims to find the relative risk value as the basis for mapping the spread of the COVID-19 virus in the city of Medan using the Standardized Morbility Ratio and Bayesian Condition Autoregressive models. And look for the value of the Central Error Squared (KTG) / Mean Squared Error (MSE) as a comparison which model is more efficient in estimating this research. Condition Autoregressive models. And look for the value of the Central Error Squared (KTG) / Mean Squared Error (MSE) as a comparison which model is more efficient in estimating this research.&lt;/span&gt;

The Epidemiological Pattern, Resistance Characteristics and Clinical Outcome of Enterobacter cloacae: Recent Updates and Impact of COVID-19 Pandemic.

E. cloacae is an opportunistic organism that causes serious infections, particularly in immuno-compromised and hospitalized patients, along with the emergence of resistance traits. The COVID-19 pandemic has impacted the epidemiological pattern and resistance traits of E. cloacae infections as well as those of other bacteria. The study aims to assess the epidemiological patterns, resistance characteristics and clinical outcomes of E. cloacae in Saudi Arabia and the impact of the COVID-19 pandemic. King Fahad Medical City in Riyadh provided the data between January 2019 and December 2021 for the retrospective study of 638 isolates of E. cloacae. The clinical outcome of an E. cloacae infection was also determined by collecting and statistically analyzing the clinical records of 153 ICU patients. The total percentage of resistant E. cloacae isolates decreased from 48.36% in 2019 to 38% in 2020 and 37.6% in 2021. The overall mortality rate among ICU patients was 40.5%, with an adult age group having a substantial relative risk value of 1.37. E. cloacae is a prevalent nosocomial infection in which adult age is a significant risk factor for mortality. Moreover, this study emphasizes the importance of comparing E. cloacae resistance trends before and throughout the pandemic period in order to better understand the bacteria's behaviour.

Is the Tradeoff between Folic Acid or/and Multivitamin Supplementation against Birth Defects in Early Pregnancy Reconsidered? Evidence Based on a Chinese Birth Cohort Study.

Several studies have reported conflicting results on the association between maternal exposure to folic acid (FA) and/or multivitamin (MV) supplements and the risk of birth defects (BDs), especially for different subtypes of BDs. The present study aimed to identify the association between maternal exposure to FA or/and MV and BDs in offspring. In the Chinese Birth Cohort Study initiated from 20 November 2017, 120,652 pregnant women completed follow-up until 20 August 2021. The participants were classified into four groups: without exposure to FA and MV, exposure to only FA, exposure to only MV, and exposure to FA and MV. Birth defects were coded by the International Classification of Diseases (ICD)-10. In order to explore the structural relationship between maternal FA or MV supplements and BDs, directed acyclic graphs were drawn. Then, an inverse probability treatment weighting was utilized to reduce the systematic differences in the baseline characteristics among the different groups. Lastly, a two-level mixed-effect log binomial regression analysis was used to estimate the relative risk (RR) value of the different subtypes of BDs under different exposures to FA and/or MV. Compared with the maternal group without exposure to FA and MV, the RR values of nervous system defects, face, ear, and neck defects, limb defects, and CHDs in the maternal group with only FA supplementation were less than 1.0, but they were not statistically significant. The RR values of genitourinary defects, abnormal chromosomes, and oral clefts were more than 1.0, and they were also not statistically significant. However, the risk of genitourinary defects (RR: 3.22, 95% CI: 1.42-7.29) and chromosomal abnormalities (RR: 2.57, 95% CI: 1.16-5.73) in the maternal group with only MV supplementation increased more than those in the maternal group without exposure to FA and MV. In addition, the RR values of all subtypes of BDs in the maternal group with exposure to FA and MV were closer to 1.0 than those in maternal group with exposure to only MV, but they were not statistically significant. It was indicated that the simultaneous supplementation of FA and MV in early pregnancy may have an interaction for the prevention of BDs and may have inconsistent effects for different subtypes of BDs. At the same time, excessive FA supplementation in pregnant women may increase the risk of BDs in their offspring. Although the mechanism is not clear, this evidence reminded us that more trade-offs are necessary for formulating strategies for the prevention of BDs with FA and/or MV supplementation in early pregnancy.

Molecular detection of Spirochetes and Borrelia burgdorferi in stray dogs of Nineveh province, Iraq.

Borrelia burgdorferi is a Gram-negative bacterium that causes Lyme disease or borreliosis in domestic and wild animals, including dogs, with the possible transmission to humans. This study was conducted to investigate the infection rate of Spirochetes and B. burgdorferi in stray dogs in Nineveh province, Iraq. During the period from May to October (2022), a total of 55 stray dogs were selected randomly from different areas in Nineveh province, Iraq. Blood samples were collected from cephalic venous and tested molecularly using the conventional polymerase chain reaction technique. The present study revealed that the total infection rates of Spirochetes and B. burgdorferi were 41.82% and 27.27%, respectively. Concerning age, values of infection rate, odds ratio, and relative risk of B. burgdorferi were increased significantly in dogs aged ? 4 months (42.86%, 3.505%, and 2.438%, respectively), while decreased in dogs of ? 1-3 (12.5%, 0.337% and 0.42%, respectively) and ? 3 (13.33%, 0.32% and 0.409%) years old when compared to dogs aged 5-12 months (27.27%, 1% and 1%, respectively). While concerning dogs sex, a significantly higher infection rate, odds ratio, and relative risk of B. burgdorferi were shown in females (32.56%, 5.495% and 6.792%, respectively) compared to males (8.33%, 0.182% and 0.147%, respectively). To the best of our knowledge, this represents the first Iraqi study on the prevalence of spirochetes, in particular B. burgdorferi, in stray dogs in Nineveh province (Iraq). However, additional studies of B. burgdorferi infection in other animals as well as vectors such as ticks in different geographic areas, appear necessary to detect variation in the distribution patterns of infection. In addition, owners and veterinarians should be aware of zoonotic diseases transmitted from wild and domestic animals, in particular those with tick-bite histories.

Relationship between common air pollutants with risk of cardio-respiratory hospitalization in urbanized areas in Kelantan

A high concentration of air pollution can lead to health problems which are the cardiovascular and respiratory systems (WHO, 2014). A study has been conducted to know the relationship between five criteria air pollutants with hospitalization related to cardiovascular and respiratory diseases in two cities in Kelantan. The secondary data from 2000 until 2015 analyzed in the study were obtained from DOE and MOH for the air pollutants concentration and hospitalization, respectively. This study shows that the mean concentration of all pollutants in the study area is below the RMAAQS. Significant Relative Risk (RR) values were found for cardiovascular hospitalization associated with SO2 (RR = 1.537, 95% CI = 2.970, 7.956), NO2 (RR = 1.212, 95% CI = 1.156, 1.272), and O3 (RR = 4.873, 95% CI = 2.768, 8.578). In contrast, significant RR for respiratory hospitalization was found to be associated with SO2 (RR = 1.952, 95% CI = 1.013, 3.762), NO2 (RR = 2.021, 95% CI = 6.170, 6.620), O3 (RR = 1.128, 95% CI = 4.427, 2.874), and PM10 (RR = 1.008, 95% CI = 1.007, 1.008). The highest value of Relative Risk is O3 and NO2 for hospitalization related to cardiovascular and respiratory diseases, respectively. In conclusion, the value of RR associated with air pollutants proves that air pollutants are associated with cardiovascular and respiratory-related hospitalization risk.

Association of Statin Use with the Risk of Incident Prostate Cancer: A Meta-Analysis and Systematic Review.

With the growth and aging of population, the incidence of prostate cancer will increase year by year, which is bound to bring greater economic burden to the society. There has been greater interest in the anticancer effects of statin in recent years. It is controversial whether statin use is associated with the risk of prostate cancer (PCa). Thus, we conducted a meta-analysis and systematic review to explore the effects of statin use and their duration and cumulative dose on the overall incidence of PCa. The study was conducted according to the latest guidelines for PRISMA 2020. We searched PubMed and other databases for studies about the association of statin use with the risk of incident prostate cancer between January 1, 1990, and April 11, 2022. Two independent researchers extracted data and evaluated the quality of the studies. R x64 4.1.2 and random-effects model were used for data statistics. Relative risk (RR) and odds ratio (OR) effective values with a 95% confidence interval (95% CI) were used to assess the main results. The results of 6 RCT and 26 cohort studies showed that statins did not significantly associate with the incidence of PCa (RR = 0.94, 95% CI: 0.82-1.08). The similar results were obtained from 9 case-control studies (OR = 1.03, 95% CI: 0.99-1.07). However, statins were associated with a lower risk of Pca (RR = 0.44, 95% CI: 0.28-0.70) when the cumulative defined daily dose (cDDD) was high. Using statins for more than five years could be associated with a reduced incidence of Pca (RR = 0.47, 95% CI: 0.23-0.97). There was a significant heterogeneity in these studies (RCT and cohort study: I 2 = 98%, P < 0.01; case-control study: I 2 = 72%, P < 0.01). We concluded that statins had a neutral association with the overall risk of PCa. High cDDD and long duration were associated with a lower risk of PCa.

Excess deaths associated with long-term exposure to ambient NO2 in China

World Health Organization updated the target of annual mean NO2 from 40 μg m−3 to 10 μg m−3 in 2021 based on new evidences that showed statistically independent effects of long-term exposure to ambient NO2 and mortality. We estimate the excess deaths associated with long-term exposure to ambient NO2 (DAAN) from non-accidental disease (NAD), cardiovascular disease (CVD) and respiratory disease (RD) in China in 2013–2020 using a counterfactual analytic framework adopted by Global Burden Disease. We use relative risk (RR) values based on a meta-analysis, and assume a linear concentration-response (C-R) function and a threshold value of 10 μg m−3. DAAN from NAD vary in 279 (95% Cl: 189–366) to 339 (95% Cl: 231–442) thousand in 2013–2020, comparable to excess deaths attributed to long-term exposure to ambient O3 in China. DAAN from NAD changes by −43%–+220% using different RR values, C-R function shapes, and threshold values. DAAN from RD reduces while those from CVD increases significantly in 2013–2020. DAAN from RD account for ∼10% of total DAAN. We found that the reduction of NO2 concentration and baseline mortality of NAD offsets the adverse effects of population growth and aging in 2013–2017. In 2017–2020, the contribution from air pollution reduction surpasses the adverse effects of population growth and aging in most regions. We suggest that continuing the reduction rate of NO2 emissions in 2013–2020 would offset the effects of population growth and aging in 2020–2030. Faster reduction of NO2 sources is required to reduce DAAN in Liaoning, Shanxi, Shanghai, and Anhui, where DAAN from NAD, CVD and RD increased in 2013–2020. Our results should be interpreted with caution because the causality support of long-term exposure to ambient NO2 on mortality from toxicological studies is not firm yet, and NO2 is possibly just a marker of traffic-related pollutants.

Associations and mitigations: an analysis of the changing risk factor landscape for chronic kidney disease in primary care using national general practice level data

ObjectivesEarly recognition of chronic kidney disease (CKD) should be achieved by every modern healthcare system. The objective of this study was to investigate CKD risk factor trends in England using...

Increased tropospheric ozone levels as a public health issue during COVID-19 lockdown and estimation the related pulmonary diseases

The aims of this study were to i) investigate the variation of tropospheric ozone (O3) levels during the COVID-19 lockdown; ii) determine the relationships between O3 concentrations with the number of COVID-19 cases; and iii) estimate the O3-related health effects in Southwestern Iran (Khorramabad) over the time period 2019–2021. The hourly O3 data were collected from ground monitoring stations, as well as retrieved from Sentinel-5 satellite data for showing the changes in O3 levels pre, during, and after lockdown period. The concentration-response function model was applied using relative risk (RR) values and baseline incidence (BI) to assess the O3-related health effects. Compared to 2019, the annual O3 mean concentrations increased by 12.2% in 2020 and declined by 3.9% in 2021. The spatiotemporal changes showed a significant O3 increase during COVID-19 lockdown, and a negative correlation between O3 levels and the number of COVID-19 cases was found (r = − 0.59, p < 0.05). In 2020, the number of hospital admissions for cardiovascular diseases increased by 4.0 per 105 cases, the mortality for respiratory diseases increased by 0.7 per 105 cases, and the long-term mortality for respiratory diseases increased by 0.9 per 105 cases. Policy decisions are now required to reduce the surface O3 concentrations and O3-related health effects in Iran.